Ch 22 Musculoskeletal

Question 1

Supination

Answer 1

Turning the forearm so that the palm is up

Question 2

Inversion

Eversion

Answer 2

Moving the sole of the foot inward at the ankle

Moving the sole of the foot outward at the ankle

Question 3

Lordosis

Answer 3

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

Question 4

Epiphyses

Answer 4

Is the growth plate

Lengthening occurs at the epiphyses

Question 5

Joint pain

Answer 5

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

Question 6

Rheumatoid arthritis

Answer 6

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.

Question 7

Osteoarthritis

Answer 7

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

Question 8

Decreased ROM

Answer 8

May be due to joint injury to cartilage or capsule or to muscle contracture

Question 9

Myalgia

Answer 9

Tenderness or pain in the muscles; muscular rheumatism

Question 10

Anoxia

Answer 10

Absence of oxygen; complete oxygen deprivation.

Question 11

Hypotonia

Answer 11

an abnormally low intrinsic resting tension, i.e., low tone in muscles

Question 12

Goniometer

Answer 12

To measure joint angles

Question 13

Musculoskeletal

Objective data

Answer 13

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

Question 14

Synovial membrane

Answer 14

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

Question 15

Crepitation

Answer 15

Is an audible and palpable crunching or grating that accompanies movement it occurs when the articulate surfaces in the joints age roughened

Question 16

Range of Motion ROM

Abnormal findings

Answer 16

Limited ROM, head titled to one side asymmetry of muscles tenderness muscle spasm, pain with motion , crepitus with motion

Question 17

Subluxation

Answer 17

Of the elbow shows the forearm dislocated posteriorly

Subluxation means A partial or incomplete dislocation.

Question 18

Phalen’s Test

Answer 18

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

Question 19

Tinel’s Sign

Answer 19

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

Question 20

Leg / knee deformities

Genu Varum

Genu Valgum

Answer 20

Genu Varum - bowlegs

Genu Valgum - knock knees

Flexion contracture - when the knees contour

Question 21

Bulge sign

Answer 21

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

Question 22

McMurray’s Test

Answer 22

If you complete this test and hear or feel a click the test is positive for a torn meniscus

Question 23

Knee abnormal findings

Answer 23

Sudden locking ; occurs with painful and sudden audible pop or click

Sudden Buckling: occurs with ligament injury which causes weakness and instability

Question 24

LaSegue’s Test

Answer 24

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

Question 25

Ortolani’s Maneuver

Answer 25

Checks the hips of an infant for congenital dislocation

Should be done at every visit until the 1 yrs old

Question 26

Allis test

Answer 26

Also test infants for dislocations by comparing the length of the leg

Question 27

Trendelenburg’s sign

Answer 27

To screen progressive subluxation of the hip. Watching from behind ask the child to stand on one leg then the other

Question 28

Forward Bend Test

Answer 28

Screen for scoliosis seat yourself behind the standing child and have the child bend forward to inspect the spine

Question 29

Ballottement of the Patella

Answer 29

A test to check the patella for fluid

Question 30

Pronation

Answer 30

Turning the forearm so that the palm is down