lewis ch 61 assessment musculoskeletal system

Question 1

Pain in ankle and posterior calf, initially when running or walking. Can progress to pain at rest.

Answer 1

achilles tendonitis

Question 2

Stiffness and fixation of a joint

Answer 2

ankylosis

Question 3

Shortened stride with minimal weight bearing on the affected side, resulting in a limp.

Answer 3

antalgic gait

Question 4

Staggering, uncoordinated gait often with sway.

Answer 4

ataxic gait

Question 5

↓ Size and strength of muscle leading to ↓ function and tone.

Answer 5

atrophy

Question 6

Finger abnormality, flexion of proximal interphalangeal (PIP) joint and hyperextension of the distal interphalangeal (DIP) joint of the fingers

Answer 6

Boutonnière deformity

Question 7

Resistance of movement of muscle or joint due to fibrosis of supporting soft tissues

Answer 7

contracture

Question 8

Frequent, audible crackling sound with palpable grating that accompanies movement.

Answer 8

crepitation (crepitus)

Question 9

Separation of 2 bones from their normal position within a joint.

Answer 9

dislocation

Question 10

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

Answer 10

festinating gait

Question 11

Small fluid-filled mass over a tendon sheath or joint, usually on dorsal surface of wrist or foot.

Answer 11

ganglion cyst

Question 12

Exaggerated thoracic curvature.

Answer 12

kyphosis

Question 13

Dull ache along outer aspect of elbow, worsens with twisting and grasping motions.

Answer 13

lateral epicondylitis

Question 14

Joint does not achieve expected degrees of motion.

Answer 14

limited ROM

Question 15

Exaggerated lumbar curvature.

Answer 15

lordosis

Question 16

↑ Muscle tone (rigidity) with sustained muscle contractions ; stiffness or tightness may interfere with gait, movement, speech.

Answer 16

muscle spasticity

Question 17

General muscle tenderness and pain.

Answer 17

myalgia

Question 18

Numbness and tingling, often described as a “pins and needles” sensation

Answer 18

paresthesia

Question 19

Abnormal flatness of the sole and arch of the foot

Answer 19

pes planus (flat foot)

Question 20

Burning, sharp pain on heel and sole of foot. Worse in the morning with first step out of bed.

Answer 20

plantar fasciitis

Question 21

Asymmetric elevation of shoulders, scapulae, and iliac crests with lateral spine curvature

Answer 21

scoliosis

Question 22

A limp, unless corrective footwear used

Answer 22

short leg gait

Question 23

Short steps with dragging of foot. Jerky, uncoordinated, cross-knee (scissor) movement.

Answer 23

spastic gait

Question 24

↑ Hip and knee flexion to clear the foot from the floor. Foot drop is evident, foot slaps down and along walking surface.

Answer 24

steppage gait

Question 25

Partial dislocation of joint

Answer 25

subluxation

Question 26

Hyperextension of the PIP joint with flexion of the metacarpophalangeal (MCP) and DIP joints of the fingers

Answer 26

swan neck deformity

Question 27

Enlargement, often of a joint due to fluid collection. Usually leads to pain, stiffness.

Answer 27

swelling

Question 28

Superficial swelling, pain, and tenderness along a tendon sheath

Answer 28

tenosynovitis

Question 29

Neck is rotated and laterally bent in unusual position to one side.

Answer 29

torticollis

Question 30

Fingers drift to ulnar side of forearm

Answer 30

ulnar deviation

Question 31

When knees are together and there is <1 in (2.5cm) between the medial malleoli.

Answer 31

valgum deformity (knock knees)

Question 32

When knees are apart and the medial malleoli are together, a space of >1 in (2.5cm) exists.

Answer 32

varum deformity (bow legs)

Question 33

S+S musculoskeletal impairment (6)

Answer 33

• pain
• weakness
• deformity
• limited ROM
• stiffness
• joint crepitation

Question 34

illnesses known to affect the musculoskeletal system (8)

Answer 34

• TB
• polio
• diabetes
• parathyroid problems
• hemophilia
• rickets
• soft tissue infection
• neuromuscular disabilities

Question 35

musculoskeletal adverse effect of antiseizure drugs

Answer 35

osteomalacia

Question 36

musculoskeletal adverse effect of phenothiazines

Answer 36

gait disturbances

Question 37

musculoskeletal adverse effect of corticosteroids

Answer 37

• avascular necrosis

- decreased bone and muscle mass

Question 38

musculoskeletal adverse effect of potassium-depleting diuretics

Answer 38

muscle cramps and weakness

Question 39

order of physical exam (6)

Answer 39

inspect
palpate
ROM
strength
reflexes
neurovascular

Question 40

tool used to assess ROM in degrees

Answer 40

goniometer

Question 41

muscle strength scale: no detection of muscular contraction

Answer 41

0/5

Question 42

muscle strength scale: barely detectable flicker or trace of contraction with observation or palpation

Answer 42

1/5

Question 43

muscle strength scale: active movement of body part with elimination of gravity

Answer 43

2/5

Question 44

muscle strength scale: active movement against gravity only and not against resistance

Answer 44

3/5

Question 45

muscle strength scale: active movement against gravity and some resistance

Answer 45

4/5

Question 46

muscle strength scale: active movement against full resistance without evident fatigue

Answer 46

5/5

Question 47

2 measurements of musculoskeletal system

Answer 47

• limb length

- circumferential muscle mass

Question 48

how to assess for scoliosis

Answer 48

patient has hands together above head like diving and slowly bends forward at waist

Question 49

how to assess for sciatica

Answer 49

straight-leg-raising test

raise patients leg 60 degrees (positive = pain)

Question 50

if a patient has a disturbed gait, what should the nurse assess next

Answer 50

measure length of both legs