ch 23 - musculoskeletal objs Flashcards
what changes do older adults experience in their muscoskeletal system ?
- decreased height
- kyphosis
- knee flexion
- hip flexion
- osteoporosis
how do you asses ROM actively vs. passively?
actively: ask for them to move the joint while holding body area near it
passively: ask them to move while holding the body part
what is crecipitation?
an audible and palpable crunching or grating that accompanies movement of the joint
what is rheumatoid arhthrisi?
chronic autoimmune disease that causes the body’s immune system to attack healthy joint tissue
what is osteoarthiritis?
degeneration of the cartilage between the bones
what are you looking for when inspecting the spine?
- that the spine is straight
- that the spine has its four curves in the right places= cervical, thoracic, lumbar and sacral
what are two common spine abnormalities?
herniated nucleus pulposus and scoliosis
what are the key six subjective data to look for in the muscoskeletal system?
joints, knee joint (if injured), muscles, bones, functional assesment (ADL), patient centered care
are joints normally tender to palpation?
no
is the synovial membrane usually palpable? what happens when it is thickened?
- no
- when it is thickened it feels “doughy” or “boggy”
what is a normal finding for joint motion?
no tenderness, pain or crecipitation
how should normal muscle strength be?
- equal bilaterally and fully resist the opposing force
what is an important thing to note when checking for muscle strength?
muscle and joints are interdependent and should be interpreted together
what is a normal finding when inspecting the temporomandibular joint?
- an audible and palpable snap or click occurs as the mouth opens
what are normal findings when palpating the muscles around the cervical spine?
- they should feel firm, with no muscle spasm or tenderness
what does the normal functional position of the hand show?
-it shows the wrist in a slight extension
what are the muscles of the palm like?
- rounded mound proximal to the thumb
- smaller rounded mound proximal to the pinky
what is a normal lower leg alignment?
the lower leg should extended in the same axis as the thigh
what are normal findings in the patella?
distinct hollows known as “paripatellar grooves”
what are normal findings when palpating joints?
smooth, with no swelling, bogginess, nodules or tenderness
what does the bulge sign confirm?
the presence of small amounts of fluid as you try to move the fluid from one side of the joint to the other
what is the ballottement of the patella used for?
when large amounts of fluid is present
what are subcutaneous nodules?
raise , firm and nontender and overlying skin moves freely
what is contracture?
shortening of a muscle which limits ROM
what is articular disease?
swelling around the whole joint that limits all planes of ROM
what is extra articular disease?
swelling and tenderness to one spot in the joint and affects only certain planes of ROM
what is subluxation?
two bones in a joint stay in contact but their alignment is off
how should foot alignment be?
the foot should align with the long axis of the lower leg–> an imaginary line would fall from midpatella to between the first and second toes
how should the joint spaces in the ankle feel?
smooth and depressed
where should weight bearing fall?
in the middle of the foot
what is hallux valgus?
when the distal part of the big toe is pointed away from the body
who is lordosis common in?
obese people
