Ch 24. Musculoskeletal

Question 1

Developmental Considerations: Older adults

Answer 1

Osteoporosis
Decreased height
Influence of exercise on skeletal mass

Lengthening of arm-trunk axis, kyphosis
Functional assessment for ADLs
Walk with shoes on
Climb up stairs
Pick up objects from floor
Rise from sitting in chair
Rise from lying in bed

Question 2

Subjective Data: Health History

Answer 2

• Joints
> Pain
> Stiffness
> Swelling, heat, and redness
> Limitation of movement

• Bones
> Pain
> Deformity
> Trauma (fractures, sprains, dislocations)

• Muscles
> Pain (cramps)
> Weakness

• Functional assessment (activities of daily living)
• Self-care behaviours

For adolescents
Athletics
Sports equipment
Warming up 
Injury
Time management

For older adults
Weakness
Injury
Mobility

Question 3

Inspection

Answer 3

Size and contour of joint
Skin and tissues over joint
colour, shape, deformity

Question 4

Palpation

Answer 4

Skin temperature

Muscles, bony articulations, area of joint capsule

Question 5

Temporomandibular Joint

Answer 5

Clench teeth
Open jaw
Stick out jaw
Move jaw laterally/forward against resistance (CNV)

Question 6

Cervical Spine

Answer 6

Tilt head to one side (ear to shoulder)
Chin to chest then to ceiling
Chin towards each shoulder

Question 7

Shoulder

Answer 7

Arms at sides: move forwards and back
Adduction/abduction of hands
Soilder stance (arms crossed behind back move towards scapula)
Arrest (arms behind head)

Question 8

Elbow

Answer 8

Bend/straighten elbow
Hold hand midway and touch front/back of hand to table
Resistance arm wrestle (hold their wrist and get them to flex elbow)

Question 9

Wrist and Hand

Answer 9

Bend at wrist up/down
Bend fingers ar metacarpal joints
Flip hands out/in while resting on table
Spread fingers appart
Make fist
Touch Thumb to each finger then to base of little finger
Stabilize hand and get them to flex wrist against resistance

Question 10

Hip

Answer 10

Raise leg with knee extended
Bend 1 knee to chest (keep other straight)
Flex knee/hip 90º then swing leg out/in
Swing leg laterally/medially
While standing swing leg back (hyperextend)

Question 11

Knee

Answer 11

Bend knee
Extend knee
Abulate (walk)

Question 12

Ankle and Foot

Answer 12

Point toes up/down (planter/dorsiflexion)
Turn soles in/out
Flex/straighten toes

Question 13

Spine

Answer 13

Bend sideways
Bend backwards
touch toes
twist shoulders to one side then other