Ch 22 Musculoskeletal Flashcards
Supination
Turning the forearm so that the palm is up
Pronation
Turning the forearm so that the palm is down
Inversion
Eversion
Moving the sole of the foot inward at the ankle
Moving the sole of the foot outward at the ankle
Lordosis
Anterior convexity of the lumbar spine [bending backwards]
This occurs during pregnancy to compensate the extra weight by shifting the weight father back on he lower extremities
Epiphyses
Is the growth plate
Lengthening occurs at the epiphyses
Joint pain
And loss of function are most common musculoskeletal concerns that prompt people to seek care
Joint pain 10 to 14 days after an untreated strep throat suggest Rheumatic fever
Rheumatoid arthritis
Involves symmetric joints; other musculoskeletal illnesses involve isolated or unilateral joints
RA Pain is worse in the morning when arising; movement decreases the pain
RA Stiffness occurs in morning and after rest periods.
Osteoarthritis
is a loss of bone density occurs with aging when the loss of bone matrix (reabsorption) occurs more than new bone growth (deposition)
osteoporosis
Is worse later in the day
Decreased ROM
May be due to joint injury to cartilage or capsule or to muscle contracture
Myalgia
Tenderness or pain in the muscles; muscular rheumatism
Anoxia
Absence of oxygen; complete oxygen deprivation.
Hypotonia
an abnormally low intrinsic resting tension, i.e., low tone in muscles
Goniometer
To measure joint angles
Musculoskeletal
Objective data
Inspection: note size and contour of the joint color swelling and any masses or deformities of the skin and tissue over the bone; swelling signal joint irritation
Palpation: each joint including skin for temp. Notice any heat tenderness swelling or masses
Joint are not tender to touch
Range of Motion [ROM]: ask for active ROM and check for issues using passive motion
Synovial membrane
Normally not palpable when thickened it feels doughy or boggy a small amount of fluid is present in the normal joint but it is not palpable
The membrane lining the capsule of a joint and secreting synovial fluid. The synovial membrane is pink, smooth, and shiny
Crepitation
Is an audible and palpable crunching or grating that accompanies movement it occurs when the articulate surfaces in the joints age roughened
Range of Motion ROM
Abnormal findings
Limited ROM, head titled to one side asymmetry of muscles tenderness muscle spasm, pain with motion , crepitus with motion
Subluxation
Of the elbow shows the forearm dislocated posteriorly
Subluxation means A partial or incomplete dislocation.
Phalen’s Test
Ask the person to hold both hands back while flexing the wrists 90 degrees. Acute flex ion of the wrist for 60 seconds produces no symptoms in the normal hand
Phalen’s test will reproduce numbness and burning in a person with carpal tunnel syndrome
Tinel’s Sign
Direct percussion of the location of the median nerve at the wrist produces no symptoms in the normal hand
In carpal tunnel syndrome percussion of the median nerve produces burning tingling along its distribution which is a positive tingels sign
Leg / knee deformities
Genu Varum
Genu Valgum
Genu Varum - bowlegs
Genu Valgum - knock knees
Flexion contracture - when the knees contour
Bulge sign
Confirms the presence of small amounts of fluid.
To test:
Firmly stroke up on the medial aspect of the knee two or three times to displace any fluid . Tap the lateral aspect. Watch the medial side in hollow for distinct bulge from fluid wave. Normal none is present
McMurray’s Test
If you complete this test and hear or feel a click the test is positive for a torn meniscus
Knee abnormal findings
Sudden locking ; occurs with painful and sudden audible pop or click
Sudden Buckling: occurs with ligament injury which causes weakness and instability
LaSegue’s Test
Straight leg raising these maneuver reproduce back and leg pain and helps confirm the presence of a herniated nucleus purposes
Straight leg raising while keeping the knee extended normally produces no pain
Ortolani’s Maneuver
Checks the hips of an infant for congenital dislocation
Should be done at every visit until the 1 yrs old
Allis test
Also test infants for dislocations by comparing the length of the leg
Trendelenburg’s sign
To screen progressive subluxation of the hip. Watching from behind ask the child to stand on one leg then the other
Forward Bend Test
Screen for scoliosis seat yourself behind the standing child and have the child bend forward to inspect the spine
Ballottement of the Patella
A test to check the patella for fluid
