MOBILITY - ABNORMALITY

Question 1

Observe posture

is erect and comfortable for age

Answer 1

Poor posture - slumped shoulders

Lordosis -inward curve

scoliosis - sideways curve

kyphosis - outward (hunching )

Question 2

observe gait

• Base of support
• Weight-bearing stability
• Foot position
• Stride and length and cadence of stride
• Arm swing
• Posture

Answer 2

• Uneven weight bearing is evident.
• Client cannot stand on heels or toes.
• Toes point in or out. Client limps, shuffles, propels forward, or has wide-based gait

Question 3

Nudge Test?

older or handicapped pt.

Answer 3

Stand behind the client and put your arms around the client while you gently nudge the sternum.

normal :Client does not fall backward.

Question 4

nudge test abnormality

Answer 4

Falling backward easily is seen with cervical spondylosis and Parkinson disease.

Question 5

spondylosis

Answer 5

arthritis spurred by wear and tear to the spine.

Question 6

Inspect and palpate the TMJ.

client sit; put your index and middle fingers just anterior to the external ear opening. Ask the client to open the mouth as widely as possible.

Normal finding?

Answer 6

Snapping and clicking may be felt and heard in the normal client.

Mouth opens 1–2 in

Jaw moves laterally 1–2 cm. Jaw protrudes and retracts easily.

Question 7

TMJ abnormalities

Answer 7

Decreased ROM, swelling, tenderness, or crepitus may be seen in arthritis

Decreased ROM, and a clicking, popping, or grating sound may be noted with TMJ dysfunction.

Question 8

Test ROM TMJ

• open the mouth and move the jaw laterally against resistance.
• clenches the teeth, feel for the contraction of the temporal and masseter muscles to test cranial nerve V (trigeminal nerve).

normal findings

Answer 8

There is no visible bony overgrowth, swelling, or redness; joint is nontender

Question 9

Test ROM TMJ abnormal

Answer 9

Lack of full contraction with cranial nerve V lesion.

Pain or spasms occur with myofascial pain syndrome.

Question 10

myofascial pain syndrome

Answer 10

• muscle pain

pain and inflammation in the body’s soft tissues

Question 11

inspect the sternoclavicular joint

pt. sitting in a chair. inspect - location, color, swelling masses, tenderness/ pain

Normal findings

Answer 11

no visible bony overgrowth, swelling, or redness; joint is nontender

Question 12

sternoclavicular joint abnormalities

Answer 12

Swollen, red, or enlarged joint or tender, painful joint is seen with inflammation of the joint.

Question 13

Observe the cervical, thoracic, and lumbar curves

from lateral and posterior view, Observe for symmetry, noting differences in height of the shoulders, iliac crests, and buttock creases.

normal findings

Answer 13

• Cervical and lumbar spines are concave;
• thoracic spine is convex.
• Spine is straight (when observed from behind).

Question 14

cervical, thoracic, and lumbar curves

abnormalities

Answer 14

flattened lumbar curvature may be seen with a herniated lumbar disc or ankylosing spondylitis.

. Lateral curvature of the thoracic spine with an increase in the convexity on the curved side is seen in scoliosis

lumbar curve (lordosis) is often seen in pregnancy or obesity

Unequal heights of the hips suggest unequal leg lengths.

Question 15

Palpate the spinous processes and the paravertebral muscles

both sides of the spine for tenderness or pain.

Normal findings

Answer 15

• Nontender spinous processes;
• well-developed,
• firm and smooth, –nontender paravertebral muscles.
• No muscle spasm.

Question 16

spinous processes and the paravertebral muscles

abnormalities

Answer 16

Compression fractures and lumbosacral muscle strain can cause pain and tenderness of the spinal processes and paravertebral muscles.

Question 17

Test ROM of the cervical spine.

asking the client to touch the chin to the chest (flexion) and to look up at the ceiling (hyperextension)

normal findings

Answer 17

is 45 degrees. Extension of the cervical spine is 45 degrees.

Question 18

ROM of the cervical spine

abnormal

Answer 18

• characterized by impaired ROM and neck pain from abnormalities of the
• soft tissue (muscles, ligaments, and nerves)
• due to straining or injuring the neck.

-Causes of strains can include
- sleeping in the wrong position,
-carrying a heavy suitcase,
being in an automobile crash.

Cervical disc degenerative disease and spinal cord tumors are associated with impaired ROM and pain that radiates to the back,

Question 19

Cervical disc degenerative disease

Answer 19

one or more of the cushioning discs in the cervical spine starts to break down due to wear and tear

Question 20

cervical spinal cord compression.

Answer 20

shoulder, or arms. Neck pain with a loss of sensation in the legs may occur

Question 21

meningitis related to neck pain

Answer 21

Impaired ROM and neck pain associated with fever, chills, and headache could be indicative of a serious infection

Question 22

Test lateral bending.

Ask the client to touch each ear to the shoulder
normal findings

Answer 22

bend 40 degrees to the left side and 40 degrees to the right side.

Question 23

lateral bending

abnormal

Answer 23

Limited ROM is seen with neck injuries, osteoarthritis, spondylosis, or with disc degeneration.

Question 24

Evaluate rotation.

Ask the client to turn the head to the right and left

Normal findings

Answer 24

about 70 degrees of rotation is normal.

Question 25

Limited ROM is seen with neck injuries, osteoarthritis, spondylosis, or with disc degeneration.

Abnormal findings are seen in ?

Answer 25

• Lateral bending

- Evaluate rotation

Question 26

Test ROM of the lumbar spine.

Ask the client to bend forward and touch the toes.
Observe for symmetry of the shoulders, scapula, and hips.
normal findings

Answer 26

Flexion of 75–90 degrees, smooth movement, lumbar concavity flattens out, and the spinal processes are in alignment.

Question 27

functional scoliosis vs, structural scoliosis.

abnormal of lumbar spine

Answer 27

Lateral curvature disappears in functional scoliosis;
-unilateral exaggerated thoracic convexity increases in structural scoliosis.

• Spinal processes are out of alignment.

Question 28

describe bending type (relation to back)

1. bend sideways is
2. bend backward
3. twist the shoulders one way then the other.

Answer 28

(lateral bending),

(hyperextension) ,
(rotation) .

Question 29

Test for back and leg pain.

when to preform this test :
If the client has low back pain that radiates down the back

Answer 29

Ask the client to lie flat and raise each relaxed leg independently to the point of pain. At the point of pain, dorsiflex the client’s foot

Note the degree of elevation when pain occurs, the distribution and character of the pain, and the results from dorsiflexion of the foot.

Question 30

Inspect and palpate shoulders and arms.

normal findings

Anteriorly palpate the clavicle, acromioclavicular joint, subacromial area, and the biceps.

Posteriorly palpate the glenohumeral joint, coracoid area, trapezius muscle, and the scapular area.

Answer 30

Shoulders are symmetrically round; no redness, swelling, or deformity or heat. Muscles are fully developed. Clavicles and scapulae are even and symmetric. The client reports no tenderness.

Question 31

Inspect and palpate shoulders and arms

Answer 31

dislocation.
Muscle atrophy
Tenderness, swelling, and heat may be noted with shoulder strains, sprains, arthritis, bursitis, and degenerative joint disease

Question 32

Flat, hollow, or less-rounded shoulders are seen with

Answer 32

dislocation

Question 33

is seen with nerve or muscle damage or lack of use.

Answer 33

Muscle atrophy

Question 34

Test ROM shoulders, arms, elbows

flexion, extension, adduction, abduction, and motion against resistance).

normal findings

Answer 34

Extent of forward flexion should be 180 degrees; hyperextension, 50 degrees; adduction, 50 degrees; and abduction 180 degrees.

Question 35

ROM shoulders, arms, elbows

abnormalities

Answer 35

• rotator cuff tear.
• rotator cuff tendinitis
  calcified tendinitis.
  -inability to shurg
  -Decreased muscle strength is seen with muscle or joint disease.

Question 36

calcified tendinitis.

Answer 36

Chronic pain and severe limitation of all shoulder motions

Question 37

rotator cuff tear

Answer 37

Painful and limited abduction accompanied by muscle weakness and atrophy

Question 38

rotator cuff tendinitis.

Answer 38

Client has sharp catches of pain when bringing hands overhead

Question 39

Inability to shrug shoulders against resistance is seen with a lesion of

Answer 39

cranial nerve XI (spinal accessory)

Question 40

Inspect for size, shape, deformities, redness, or swelling of elbow
abnormal findings

Answer 40

• bursitis of the olecranon process due to trauma/arthritis
• rheumatoid arthritis or rheumatic fever
• Tenderness or pain over the epicondyles may be palpated in epicondylitis (tennis elbow) due to repetitive movements of the forearm or wrists

Decreased ROM against resistance is seen with joint or muscle disease or injury.

Question 41

bursitis

Answer 41

occurs when bursae become inflamed.

Redness, heat, and swelling

common in e shoulder, elbow and hip

Question 42

Wrist abnormalities

Answer 42

• rheumatoid arthritis
• Tenderness and nodules
• A nontender, round, enlarged, swollen, fluid-filled cyst (ganglion) may be noted on the wrists (

Question 43

wrist fracture include pain

Answer 43

• tenderness, swelling, and inability to hold a grip
• pain that goes away and then returns as a deep, dull ache. -Extreme tenderness occurs when pressure is applied on the side of the hand between the two tendons leading to the thumb

Question 44

Perform the squeeze test

abnormal

Answer 44

Extreme pain may indicate rheumatoid arthritis and psoriatic arthritis of the hand
scaphoid fracture,

Question 45

rheumatoid arthritis

Answer 45

autoimmune disease that can cause joint pain and damage throughout your body. The joint damage that RA causes usually happens on both sides of the body.

Question 46

scaphoid fracture,

Answer 46

break of the scaphoid bone in the wrist.

The anatomic snuffbox is generally tender and swelling may occur.