Assessment of Musculoskeletal Flashcards
1
Q
serve as storage sites for minerals such as calcium
A
bones
2
Q
produces red blood cells
A
bone marrow
3
Q
The junction of two or more bones is called a
A
joint
4
Q
stabilize the bones and allow a specific type of movement
A
Joints
5
Q
a smooth, fibrous tissue—cushions the end of each bone, and synovial fluid fills the joint space
A
Cartilage
6
Q
This fluid lubricates the joint and eases movement, much as the brake fluid functions in a car
A
synovial fluid
7
Q
the bones are connected by fibrous tissue, or cartilage.
the bones may be immovable
A
nonsynovial joints
8
Q
- move freely
- the bones are separate from each other and meet in a
cavity filled with synovial fluid (lubricant)
A
Synovial joints
9
Q
Moving backward and forward
A
Retraction and protraction
10
Q
Bending, decreasing the joint angle
A
Flexion
11
Q
Straightening, increasing the joint angle
A
Extension
12
Q
Moving away from midline
A
Abduction
13
Q
Moving toward midline
A
Adduction
14
Q
Turning toward midline
A
Internal rotation
15
Q
Moving in a circular manner
A
Circumduction
16
Q
Turning away from midline
A
External rotation
17
Q
Turning downward
A
Pronation
18
Q
Turning upward
A
Supination
19
Q
Turning outward
A
Eversion
20
Q
Turning inward
A
Inversion
21
Q
are tough fibrous portions of muscle that attach the muscles to bone.
A
Tendons
22
Q
Skeletal muscles contract and produce _________________when they receive a stimulus from the central nervous system (CNS) → both involuntary and voluntary muscle function.
A
skeletal movement
23
Q
sacs filled with friction-reducing synovial fluid; they’re located in areas of high friction such as the knee.
A
Bursae
24
Q
allow adjacent muscles or muscles and tendons to glide smoothly over each other during movement.
A
Bursae
25
location of Bursae
located in areas of high friction such as the knee
26
The mandible should be in the ______________, not shifted to the right or left.
midline
27
- an abnormal grating sound.
- This sound is different from the occasional crack that can be heard from joints.
crepitus
28
Ask the patient to try touching his right ear to his right shoulder and his left ear to his left shoulder. The usual range of motion is _________________ on each side
40 degrees
29
Ask him to touch his chin to his chest and then to point his chin toward the ceiling. The neck should flex forward _____________________and extend backward _________________.
45 degrees; 55 degrees
30
Finally, ask him to move his head in a circle—normal rotation is_________________
70 degrees.
31
To assess abduction, ask the patient to move his arm from the neutral position laterally as far as possible. Normal range of motion (ROM) is __________________
180 degrees
32
To assess adduction, have the patient move his arm from the neutral position across the front of his body as far as possible. Normal ROM is __________________
50 degrees
33
To assess flexion, ask the patient to move his arm anteriorly from his side over his head, as if reaching for the sky. Full flexion is
180 degrees
34
To assess extension, have him move his arm from the neutral position posteriorly as far as possible. Normal extension ranges from
30 to 50 degrees
35
Normal external and internal rotation is
90 degrees
36
Normal ROM is _________________ for both flexion and extension of the elbow
90 degrees
37
Elbow pronation and supination
■ Have the patient place the side of his hand on a flat surface with the thumb on top.
■ Ask him to rotate his palm down for pronation and
upward for supination. The normal angle of elbow rotation is _______________ in each direction.
90 degrees
38
Radial and ulnar deviation
■ Ask the patient to rotate each wrist by moving his entire hand—first laterally then medially—as if he’s waxing a car.
■ Normal range of motion is ________________________ (ulnar deviation) and __________________ (radial deviation).
55 degrees laterally; 20 degrees medially
39
Extension and flexion
■ Observe the wrist while the patient extends his fingers up toward the ceiling and down toward the floor, as if he’s flapping his hand. He should be able to extend his wrist ____________________ and flex it ________________
70 degrees; 90 degrees
40
- Lightly percuss the transverse carpal ligament over the median nerve where the patient’s palm and wrist meet.
- If this action produces numbness and tingling shooting into the palm and finger, the patient has _____________ and may have
Tinel’s sign; carpal tunnel syndrome
41
■ Have the patient put the backs of his hands together and flex his wrists downward at a 90-degree angle.
■ Pain or numbness in his hand or fingers during this maneuver indicates a positive _____________________. The more severe the carpal tunnel syndrome, the more rapidly the
symptoms develop
Phalen’s sign
42
Assessing finger range of motion
Normal hyperextension is ___________________; normal flexion, _______________________
30 degrees; 90 degrees
43
To test abduction,
have the patient spread his fingers apart
44
To test adduction,
have the patient draw the fingers back together.
45
knees that point out
bowlegged (genu varum)
46
knees that turn in
knock knees (genu valgum)
47
Normal ROM for internal rotation is _________________; for external rotation, _____________________.
40 degrees; 45 degrees
48
indicates excess fluid in the joint
bulge sign
49
What should you look for in the ankles and feet?
Swelling, redness, nodules, or other deformities.
50
Normal range of motion (ROM) for plantar flexion is
about ______________________; for dorsiflexion, _________________
45 degrees; 20 degrees
51
Ask the patient to demonstrate inversion by turning
his feet inward, and eversion by turning his feet
outward. Normal ROM for inversion is __________________; for
eversion, __________________.
30 degrees; 20 degrees
52
describes muscular resistance to passive stretching
Muscle tone
53
No evidence of muscle contraction
0/5
54
Trace: Patient’s attempt at muscle contraction is palpable but without joint movement.
1/5
55
Poor: Patient completes full ROM with gravity eliminated (passive motion)
2/5
56
Fair: Patient completes ROM against gravity only
3/5
57
Good: Patient completes ROM against gravity with moderate resistance
4/5
58
Normal: Patient moves joint through full range of motion (ROM) and against gravity with full resistance.
5/5
59
plantar flexion of the foot with the toes bent toward the instep
Footdrop
60
It results from weakness or paralysis of the dorsiflexor muscles of the foot and ankle.
Footdrop
61
is an abnormal crunching or grating you can hear and feel when a joint with roughened articular surfaces moves
Crepitus
62
are strong, painful contractions. They can occur in virtually any muscle but are most common in the calf and foot
Muscle spasms
63
muscle spasms commonly occur in
calf and foot
64
typically result from simple muscle fatigue, exercise, electrolyte imbalances, neuromuscular disorders,
and pregnancy
Muscle spasms
65
muscle atrophy or
muscle wasting
66
results from denervation or prolonged muscle disuse
Muscle atrophy
67
Some muscle atrophy also occurs with
aging
68
It occurs in patients with rheumatoid arthritis or
osteoarthritis or when broken pieces of bone rub
together.
Crepitus
69
can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots, peripheral nerves, or
myoneural junctions and within the muscle itself.
Muscle weakness
70
Traumatic injuries include
fractures, dislocations, amputations, crush injuries, and serious lacerations.
71
To swiftly assess a musculoskeletal injury, remember the 5 P’s:
pain, paresthesia, paralysis, pallor, and pulse.
72
Does the patient feel pain? If he does, assess its location, severity, and quality
Pain
73
Assess for loss of sensation by touching the injured area with the tip of an open safety pin. Abnormal sensation or loss of sensation indicates neuro vascular involvement.
Paresthesia
74
Can the patient move the affected area? If he can’t, he might have nerve or tendon damage.
Paralysis
75
Paleness, discoloration, and coolness on the injured side may indicate neurovascular compromise.
Pallor
76
Check all pulses distal to the injury site. If a pulse is decreased or absent, blood supply to the area is reduced.
Pulse
77
pain anywhere from the hand to the shoulder
Arm Pain
78
Arm pain (pain anywhere from the hand to the shoulder) and leg pain usually result from musculoskeletal
disorders, but they can also stem from neurovascular, cardiovascular, or neurologic disorders
Pain
79
lateral deviation of the spine is present and the patient leans to the side. Other findings include:
■ uneven shoulder blade height and shoulder blade
prominence
■ unequal distance between the arms and the body
■ asymmetrical waistline
■ uneven hip height.
Scoliosis
80
the thoracic curve is abnormally rounded
Kyphosis
81
the lumbar spine is abnormally concave
Lordosis
82
Lordosis (as well as a waddling gait) is normal in
pregnant women and young children
83
Spine is S or C shaped
Scoliosis
84
thoracic spine curves outward
kyphosis
85
lumbar spine curves inward
lordosis
86
a chronic deterioration of the joint cartilage that commonly
occurs in the hips, knees, and joints of the fingers
osteoarthritis
87
are typically seen in patients with osteoarthritis, a chronic deterioration of the joint cartilage that commonly
occurs in the hips, knees, and joints of the fingers.
Heberden’s and Bouchard’s nodes
88
are hard, bony, and cartilaginous enlargements that appear
on the distal interphalangeal joints.
Heberden’s nodes
89
Heberden's nodes appear on the
distal interphalangeal joints
90
Usually hard and pain-less, these bony and cartilaginous enlargements typically occur in middle-aged and elderly patients with osteoarthritis.
Heberden's nodes
91
are similar but less common and appear on the proximal
interphalangeal joints.
Bouchard’s nodes
92
Bouchard’s nodes appear on the
proximal interphalangeal joints.
93
A chronic, systemic inflammatory immune disorder
rheumatoid arthritis
94
Spontaneous remissions and unpredictable exacerbations mark the course of this potentially crippling disease. Swollen, painful, and stiff joints, especially of the
hands, are typical in
acute rheumatoid arthritis
95
rheumatoid arthritis commonly affects
bilateral joints of the fingers, wrists, elbows, knees, or ankles
as well as surrounding muscles, tendons, ligaments, and blood vessels.
96
hyperextension of the proximal interphalangeal joints with flexion of the distal interphalangeal joints
Swan-neck deformity
97
flexion of the proximal interphalangeal joint with hyperextension of the distal interphalangeal joint
boutonnière deformity
98
is a metabolic disorder in which uric acid deposits in the joints cause the joints to become painful, arthritic, red, and swollen. Skin temperature may be elevated due to the irritation and inflammation.
Gout
99
a round, enlarged, fluid-filled cyst commonly found on the dorsal side of the wrist
Ganglion
100
is a group of congenital disorders characterized by progressive symmetrical wasting of skeletal muscles without neural or sensory defects
Muscular dystrophy
101
The most common form of Muscular Dystrophy is
Duchenne’s (pseudohypertrophic) muscular dystrophy
102
occurs during early childhood; onset is insidious and occurs between ages 3 and 5. The disorder initially affects
the legs, pelvis, and shoulders. Findings include:
■ enlarged, firm calf muscles
■ waddling gait, toe-walking, lumbar lordosis, and positive Gower’s sign
■ difficulty climbing stairs
■ history of frequent falls.
Duchenne’s (pseudohypertrophic) muscular dystrophy
103
an inability to lift the trunk without using the hands and arms to brace and push
Gower’s sign
104
indicates pelvic muscle weakness, as occurs in muscular
dystrophy and spinal muscle atrophy
positive Gower’s sign
105
Assessing Neck ROM
lateral (on each side): 40 degrees
flexion: 45 degrees
extension: 55 degrees
rotation: 70 degrees
106
Assessing the Range of Spinal Movement
length of the spine from neck to waist usually increases by at least _______________ when patient bends forward
2 inches (5 cm)
107
Shoulders
Abduction:
Adduction:
Flexion:
Extension:
Internal and External Rotation:
Abduction: 180 degrees
Adduction: 50 degrees
Flexion: 180 degrees
Extension: 30-50 degrees
Internal and External Rotation: 90 degrees
108
Elbow
Flexion and Extension:
Pronation and Supination:
Flexion and Extension: 90 degrees
Pronation and Supination: 90 degrees
109
Assessing Wrist ROM
Ulnar Deviation =
Radial Deviation =
Extension =
Flexion =
Ulnar Deviation = 55 degrees laterally
Radial Deviation = 20 degrees medially
Extension = 70 degrees
Flexion = 90 degrees
110
- where the palm and wrist meet
Transverse Carpal Ligament
111
if there is numbness and tingling then it indicates
Tinel’s Sign —> Carpal Tunnel Syndrome
112
put backs of hands together and flex wrists downward at 90 degrees angle
Phalen’ s Maneuver
113
Assessing Finger ROM
Hyperextension:
Normal Flexion:
Hyperextension: 30 degrees
Normal Flexion: 90 degrees
114
Assessing Hip ROM
Flexion:
Extension:
Internal Rotation:
External Rotation:
Abduction:
Adduction:
Flexion: 120 degrees
Extension: 30 degrees
Internal Rotation: 40 degress
External Rotation: 45 degrees
Abduction: 45 degrees
Adduction: 30 degrees
115
Assessing Ankle and Foot ROM
Plantar Flexion:
Dorsiflexion:
Inversion:
Eversion:
Plantar Flexion: 45 degrees
Dorsiflexion: 20 degrees
Inversion: 30 degrees
Eversion: 20 degrees
116
Earliest sign and is often out of proportion to what might be expected from the extent of injury
Pain
117
Refers to the skin tone of the affected limb. Any deviation from the individual's typical skin tone, especially blue or purple in color, can be indicative of compromised blood flow.
Pallor
118
Refers to the sensation of numbness and tingling. which can be indicative of neurological trauma.
Paresthesias
119
Refers to the inability to move the affected limb
Paralysis
120
Specifically the radial, dorsalis pedis, and posterior tibial pulses. are checked to ensure proper blood flow.
Pulselessness
