lewis ch 61 assessment musculoskeletal system Flashcards
Pain in ankle and posterior calf, initially when running or walking. Can progress to pain at rest.
achilles tendonitis
Stiffness and fixation of a joint
ankylosis
Shortened stride with minimal weight bearing on the affected side, resulting in a limp.
antalgic gait
Staggering, uncoordinated gait often with sway.
ataxic gait
↓ Size and strength of muscle leading to ↓ function and tone.
atrophy
Finger abnormality, flexion of proximal interphalangeal (PIP) joint and hyperextension of the distal interphalangeal (DIP) joint of the fingers
Boutonnière deformity
Resistance of movement of muscle or joint due to fibrosis of supporting soft tissues
contracture
Frequent, audible crackling sound with palpable grating that accompanies movement.
crepitation (crepitus)
Separation of 2 bones from their normal position within a joint.
dislocation
While walking, neck, trunk, and knees flex and the body is rigid. Delayed start with short, quick, shuffling steps. Speed may ↑ as if patient is unable to stop
festinating gait
Small fluid-filled mass over a tendon sheath or joint, usually on dorsal surface of wrist or foot.
ganglion cyst
Exaggerated thoracic curvature.
kyphosis
Dull ache along outer aspect of elbow, worsens with twisting and grasping motions.
lateral epicondylitis
Joint does not achieve expected degrees of motion.
limited ROM
Exaggerated lumbar curvature.
lordosis
↑ Muscle tone (rigidity) with sustained muscle contractions ; stiffness or tightness may interfere with gait, movement, speech.
muscle spasticity
General muscle tenderness and pain.
myalgia
Numbness and tingling, often described as a “pins and needles” sensation
paresthesia
Abnormal flatness of the sole and arch of the foot
pes planus (flat foot)
Burning, sharp pain on heel and sole of foot. Worse in the morning with first step out of bed.
plantar fasciitis
Asymmetric elevation of shoulders, scapulae, and iliac crests with lateral spine curvature
scoliosis
A limp, unless corrective footwear used
short leg gait
Short steps with dragging of foot. Jerky, uncoordinated, cross-knee (scissor) movement.
spastic gait
↑ Hip and knee flexion to clear the foot from the floor. Foot drop is evident, foot slaps down and along walking surface.
steppage gait
Partial dislocation of joint
subluxation
Hyperextension of the PIP joint with flexion of the metacarpophalangeal (MCP) and DIP joints of the fingers
swan neck deformity
Enlargement, often of a joint due to fluid collection. Usually leads to pain, stiffness.
swelling
Superficial swelling, pain, and tenderness along a tendon sheath
tenosynovitis
Neck is rotated and laterally bent in unusual position to one side.
torticollis
Fingers drift to ulnar side of forearm
ulnar deviation
When knees are together and there is <1 in (2.5cm) between the medial malleoli.
valgum deformity (knock knees)
When knees are apart and the medial malleoli are together, a space of >1 in (2.5cm) exists.
varum deformity (bow legs)
S+S musculoskeletal impairment (6)
- pain
- weakness
- deformity
- limited ROM
- stiffness
- joint crepitation
illnesses known to affect the musculoskeletal system (8)
- TB
- polio
- diabetes
- parathyroid problems
- hemophilia
- rickets
- soft tissue infection
- neuromuscular disabilities
musculoskeletal adverse effect of antiseizure drugs
osteomalacia
musculoskeletal adverse effect of phenothiazines
gait disturbances
musculoskeletal adverse effect of corticosteroids
- avascular necrosis
- decreased bone and muscle mass
musculoskeletal adverse effect of potassium-depleting diuretics
muscle cramps and weakness
order of physical exam (6)
inspect palpate ROM strength reflexes neurovascular
tool used to assess ROM in degrees
goniometer
muscle strength scale: no detection of muscular contraction
0/5
muscle strength scale: barely detectable flicker or trace of contraction with observation or palpation
1/5
muscle strength scale: active movement of body part with elimination of gravity
2/5
muscle strength scale: active movement against gravity only and not against resistance
3/5
muscle strength scale: active movement against gravity and some resistance
4/5
muscle strength scale: active movement against full resistance without evident fatigue
5/5
2 measurements of musculoskeletal system
- limb length
- circumferential muscle mass
how to assess for scoliosis
patient has hands together above head like diving and slowly bends forward at waist
how to assess for sciatica
straight-leg-raising test
raise patients leg 60 degrees (positive = pain)
if a patient has a disturbed gait, what should the nurse assess next
measure length of both legs
