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Health Promotion and Assessment > MSK and mobility assessment > Flashcards

MSK and mobility assessment Flashcards

1
Q

What is probably the most important health promotion aspect of the MSK system for older adults?

A

Fall prevention

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2
Q

What is the amount of physical activity that one should be engaging in on a weekly basis?

A

30-60 minutes a day, a couple times a week

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3
Q

What is a major purpose of weight-bearing exercises in the geriatric population?

A

Prevent osteoporosis by stimulating osteoblasts

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4
Q

What are weight-bearing exercises?

A

foot on pavement type activities

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5
Q

How much vitamin D should someone be taking a day to prevent osteoporosis?

A

1000-2000 international units

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6
Q

How much exogenous calcium should someone be supplementing their diet with?

A

500 mg at most

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7
Q

What are some past medical history conditions related to MSK?

A

Arthritis, osteoporosis, congenital issues (e.g. spina bifida), scoliosis, autoimmune diseases

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8
Q

What are meds/drugs that affect the MSK system?

A

Depo provera - birth control - reduces bone formation
exogenous estrogen - reduces hip fractures
chemo - reduces bone density
steroids - risk factor for osteoporosis
meds affecting thyroid and kidneys
meds for hypertension and gout

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9
Q

How can psychosocial factors affect the MSK system?

A

Social isolation can put old people at risk for immobility

depression - exercise isn’t at the forefront of the person - not taking care of bones or joints

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10
Q

What is important to know when someone has an MSK issue related to trauma?

A

The mechanism of injury

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11
Q

What does a functional assessment as part of the MSK system relate to?

A

ADLs

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12
Q

What are some common MSK symptoms or signs?

A 
Pain or discomfort
Weakness
Stiffness or limited movement
Deformity
Swelling
Joint pain
Lack of balance/coordination
Bruising and erythema
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13
Q

Stiffness in the morning is mainly associated with what MSK condition?

A

Osteoarthritic pain

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14
Q

Stiffness that persists throughout the day is related to what MSK condition?

A

Rheumatoid arthritis

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15
Q

Medical emergency related to lower back pain?

A

Saddle paresthesia

caude equina

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16
Q

What is one of the best assessments for older individuals?

A

Gait assessment - get lots of information on functional ability and neurological status

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17
Q

What are some circulating hormones that increase joint mobility in pregnancy?

A

Relaxin

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18
Q

What are the changes in maternal posture seen in pregnancy?

A

Lordosis

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19
Q

In late pregnancy, what kind of pain occurs?

A

Strain or lower back muscle pain

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20
Q

There are upper neck changes in pregnancy, what does this cause?

A

Pressure on radial and ulnar nerves in 3rd trimester

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21
Q

Are the changes in pregnancy in the MSK system pathological?

A

No, but clinicians should keep in mind that there may be pain.

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22
Q

Children below 18 months tend to walk how? What does this change to?

A

Walk bow-legged until about 18 months

Transition to knock-knee

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23
Q

What is another name for bowlegged?

A

Genu varus

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24
Q

What is another word for knock knee?

A

Genu valgus

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25
Q

At about what age do legs straighten?

A

6-7 years old

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26
Q

These are not fused when the child is born to accomodate the birthing process; located on the head

A

Fontanels

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27
Q

When are the anterior fontanels closed by?

Posterior?

A

anterior - 18-24 months

Posterior - 2 months

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28
Q

When should we check for scoliosis, mainly?

A

10-16 years of age

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29
Q

At what time does the fetal cartilage skeleton form?

A

3 months gestation

30
Q

Closure of the epiphysial plates occurs at about what age?

A

around 20 years olds

31
Q

Spine curvature at birth can be described as what?

A

C-shaped

32
Q

What establishes the cervical curve? When does this happen?

A

At about 3-4 months - raising the head

33
Q

What develops the anterior curve in a child? Time frame?

A

Standing - 1-18 months

34
Q

What is the most common fracture type in children?

A

Greenstick fracture

35
Q

What do we always have to look for when viewing MSK issues in children?

A

Potential abuse cases

36
Q

What do we do in preparation for objective data collection?

A

Promote patient comfort, dignity, and safety

37
Q

What is part of the initial survey for MSK assessment?

A

Posture
Gait and mobility
Balance
Coordination

38
Q

What kind of posture do we have?

A

Static

39
Q

What is an antalgic gait?

A

Walking with a limp

40
Q

IF you see a child limping under the age of four, what should you do?

A

Children cannot fabricate a limp under that age - must be investigated

41
Q

In the unaffected leg, hip will drop due to glute weakness.

A

Trendelenburg gait

42
Q

Function of the cerebellum - integration of somatosensory vestibular, and visual stimuli

A

Balance

43
Q

For posture, we think _______.
For gait and mobility, we think _________.
For balance, we think ______.
For coordination, we think _________.

A

Foundation
Locomotion
Base
Organizing

44
Q

Coordination is typically an assessment of the __________ system but is a common test for ______ function.

A

neurological

motor

45
Q

When inspecting joints, muscles and extremities, what do we look for?

A 
size
symmetry
contour
colour
edema/deformity
facial expression
curvature of spine
46
Q

When palpating for muscle tone, what are we looking for?

A

Flaccid, stiff, symmetry

47
Q

When we palpate for temperature variations, what are we looking for?

A

Inflammation or injury;

coolness - lack of perfusion (Arterial insufficiency)

48
Q

Small muscle twitching

A

fasciculations

49
Q

When palpating for tenderness, what is important to keep in mind?

A

Don’t go for the money shot first - palpate around to get extent of pain, then leave most tender area last

50
Q

What is the point of ROM testing?

A

move joinst through different ROMS to see if there is pain or immobility

51
Q

What is the difference between active and passive ROM testing?

A

Active - when client is able to move own joints

Passive - nurses uses both hands to assist client

52
Q

When would you not do passive ROM testing?

A

IF active ROM can be done in all joints, without pain

53
Q

Which ROM testing do we start with?

A

Active first – only do passive if active is abnormal

54
Q

For either passive or active ROM, what do we note and do?

A

Note:

  • degree and type of limitation
  • increased ROM or instability
  • compare side to side
55
Q

What is an example of an injury causing hypermobility of a joint?

A

MCL or ACL tear

56
Q

Full muscle strength requires what?

A

complete active ROM

57
Q

How is strength testing accommodated for a person laying down?

A

Assess legs specifically with person lying down

will only have issues (although doable) for upper body

58
Q

Lack of residual tension

A

atony

59
Q

Diminished tone of skeletal muscles

A

Hypotonicity

60
Q

Hypertonic, so the muscles are stiff and movements awkward

A

spasticity

61
Q

Sudden, violent, involuntary contraction of a muscle

A

Spasm

62
Q

Involuntary twitching of muscle fibers

A

Fasciculations

63
Q

Involuntary contractions of muscles

A

Tremors

64
Q

What are some lifespan considerations for older adults?

A

Kyphotic posture
- lower bone density in post-menopausal women
age in general is a risk factor for MSK and falls

65
Q

Buildup of uric acid in a joint. Where does it usually manifest? What types of foods should be avoided?

A

gout
tends to target great toe
avoid high in purine foods

66
Q

Normal movement that causes a fracture.

A

Fragility fracture

67
Q

What is the number one risk for falls?

A

Being afraid to fall

68
Q

You will be hardpressed to find a neurological issue if this is intact.

A

Gait

69
Q

What is the TUG test?

A

Get up and go test

have then sit in chair, get out, walk 3m, turn around and walk back within 20 seconds

70
Q

What is a dynamic gait test?

A

Adding distractions when the person is walking - ex: talking to them

71
Q

Indicator of total body strength.

A

Grip strength

72
Q

What are some fall prevention guidelines for older adults?

A 
Tape down rugs,
exercise
good footwear
night lights
railings
raised toilet seats
don't rush to answer the phone

Health Promotion and Assessment (13 decks)

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