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Heal assessment Exam 3 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Flexion

A

bending

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2
Q

Extension

A

straightening

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3
Q

Abduction

A

moving away from body

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4
Q

Adduction

A

moving toward the midline

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5
Q

Pronation

A

turning forearm so that palm is down

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6
Q

Supination

A

turning forearm so that palm is up

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7
Q

Circumduction

A

moving arm in circle around shoulder

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8
Q

Rotation

A

moving head around central axis

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9
Q

Inversion

A

moving sole of foot inward at ankle

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10
Q

Eversion

A

moving sole of foot outward at ankle

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11
Q

Protraction

A

moving body part forward parallel to ground (jaw)

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12
Q

Retraction

A

moving body part backward parallel to ground (jaw)

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13
Q

Elevation

A

raising a body part (shoulder)

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14
Q

Depression

A

lowering a body part (shoulder)

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15
Q

ROS

A

General and Chronic Diseases
Congenital joint/bone/muscle defects
Family history of arthritis
Chronic diseases: obesity, osteoarthritis, osteopenia, osteoporosis, cancer, gout, rheumatoid arthritis
Surgical history
Medications
Any changes to your ability to move around and participate in ADLs and IADLs
Amount of exercise, safety measures when exercising
Routine daily activities, job-related activities, risk of injuries
Diet, tobacco & alcohol use

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16
Q

Osteopenia

A

reduce bone mass

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17
Q

Osteoporosis

A

bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D.

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18
Q

Osteoarthritis

A

degeneration of joint cartilage and the underlying bone, most common from middle age onward. It causes pain and stiffness, especially in the hip, knee, and thumb joints.

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19
Q

ADL (activities of daily living)

A

bathing, toileting, dressing, grooming, eating, mobility, communicating

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20
Q

IADL (instrumental ADL)

A

driving, cooking, using household devices

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21
Q

Joints: Five cardinal signs of inflammation

A

pain, swelling, heat, redness, ROM limitation (stiffness)

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22
Q

Myalgia

A

Muscle (pain or cramps),

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23
Q

Atrophy

A

loss of muscle mass and weakness

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24
Q

Bones subjective data

A

Pain, deformity, trauma/accidents (fractures)

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25
Q

Patient-Centered Care

Musculoskeletal issues affecting life

A

Self-esteem, independence, body-image, role performance, social isolation
Effects on family and friends

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26
Q

Joints injury

A

(sprains, strains, dislocation) to any joint

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27
Q

6 Ps of Musculoskeletal Injury

A 
Pain
Paresthesia (numbness, tingling)
Paralysis/Paresis
Pallor 
Pulse (weak)
Poikilothermia (cool)
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28
Q

Preparing the patient

A

General
-Posture, Gait, Position Changes

Preparing the Patient and Environment

  • Hygiene (environment, hands), Standard Precautions Always in Effect
  • Proper Room Temperature
  • Privacy
  • Proper Exposure of The Body Part (only as needed)
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29
Q

Would should you always do when getting objective information?

A

Inspection & Palpate for inflammation, masses (nodules), injury, deformity, atrophy

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30
Q

Skin

A

inflammation signs/symptoms may indicate skin problem and/or MS problems

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31
Q

Muscle

A

Use contralateral side for comparison (asymmetry)

Muscle size (assess for atrophy)

muscle tone (tension)

Strength (0-5) paresis (weakness), paralysis (flaccidity or -plegia)

Involuntary movement (tics, tremors)

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32
Q

Joints

A

Size and contour of every joint
Swelling, effusion, deformity
Range of motion (ROM)

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33
Q

Range of Motion (ROM): Health promotion

A

Passive ROM exercise prevents joint contracture

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34
Q

Range of Motion (ROM)

A

Active- When you move apart of your body using your muscles

Passive- when a outside source causes the movement of a joint

Full-The act of moving as far as anatomically possible during a given exercise

Limited-when you can’t move a joint as fully and easily as it should move

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35
Q

Normal ROM

A

“full active ROM” for each joint

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36
Q

Abnormal ROM

A

contracture (no ROM)
full passive ROM
limited active ROM
rigidity

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37
Q

How do you assess Muscle Strength ?

A
  1. Instruct to repeat the active 2. ROM against your resistance
    3.Assess for symmetry
    Grading system
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38
Q

Muscle grading

A

0- No contraction of muscle (flaccid)
1-Slight contraction (flicker/trace movement)
2- Active ROM with gravity eliminated
3- Active ROM against gravity
4- Active ROM against gravity and some resistance
5- Active ROM against gravity and full resistance (normal)

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39
Q

How many stacked bones are in your spine?

A

33 stacked bones

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40
Q

Cervical vertebrae

A

7 bones at the top of the spine

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41
Q

Thoracic vertebrae

A

12 bones (below cervical)

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42
Q

Lumbar vertebrae

A

5 bones (below thoracic)

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43
Q

Sacral

A

5 bones (below lumbar)

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44
Q

Coccyx or coccygeal

A

4 bones ( below sacrum or sacral)

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45
Q

Where is the spinous processes felt?

A

felt in a furrow down the midline of the back

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46
Q

Cervical and lumbar curves

A

concave (inward or anterior)

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47
Q

Thoracic and sacrococcygeal curves

A

convex (outward)

48
Q

You should inspect your spine to see?

A

Skin: smooth, even skin color, no lesions/inflammation

Entire spine for abnormal curvature (kyphosis, lordosis, scoliosis)

Equal horizontal positions for the shoulders, scapulae, iliac crests, gluteal folds

Knees and feet alignment with the trunk and pointing forward

49
Q

You should palpate your spine to see ?

A

Spinous processes, straight (alignment & symmetry), nontender

Abnormal curvature: kyphosis, lordosis, scoliosis (see terminology slides)

Paravertebral muscles firm, nontender, no spasm

50
Q

What should you see with spine ROM ?

A

Flexion, extension, lateral bending, rotation (without moving hips)

Assess normal gait (symmetry, rhythm, balance, alignment) may assess walking on heels

Flexion: will allow better inspection of abnormal curvature

you do not test muscle strength for your spine

51
Q

Neck inspection

A 
Symmetry
Skin without any inflammatory changes, lumps, swelling, pulsation
Alignment of head and neck, midline
Neck: neutral position & posture
Neck round, symmetric muscles
52
Q

Palpate Nails

A

Spinous processes and neck muscles

Normal: no spasms, tenderness, lumps, muscle atrophy, swelling

53
Q

ROM Neck

A

Supple (flexible)
Flexion, extension (chin to chest & chin to ceiling)
Right & left lateral bend (ears to shoulders)
Right & left Rotation (chin to shoulders)
Note any tenderness or limitation
Motion is smooth and controlled

Strength
Assess strength by repeating the ROM against your resistance

54
Q

TMJ Inspection

A

Skin: smooth, even skin color, no lesions/inflammation, swelling

55
Q

TMJ palpation

A

Felt in depression anterior to tragus of ear

Crepitus, tenderness with ROM

56
Q

TMJ ROM 3 types

A

Hinge Action: 1- open/close the jaws
Gliding Action: 2- Protrusion & retraction;

3- side-to-side movement

57
Q

TMJ strength

A

Palpate masseter muscles while instructing to clench the teeth

Instructing to open the jaw against resistance

58
Q

Joint of 3 Bones for the shoulder

A

humerus, scapula, clavicle

59
Q

Rotator Cuff

A

4 muscles & tendons that support and stabilize it

60
Q

Inspection of shoulder

A

Skin: smooth, even skin color, no lesions/inflammation

Bilaterally for round contour & symmetry

Normal: no inflammatory changes, lumps, swelling, deformity, atrophy

61
Q

Palpation of shoulder

A

Normal: no spasm, atrophy, swelling, heat, tenderness, adenopathy

62
Q

ROM of shoulder

A

Normal: full active ROM bilaterally without any palpated crepitation

63
Q

ROM strength

A

Assess strength by repeating the ROM against your resistance

64
Q

Joint of 3 Bones for elbow

A

humerus, radius, ulna

65
Q

Palpation for elbow

A

Normal skin, joint, biceps & triceps: no spasm, atrophy, symmetrical, nodules, lumps, Inflammatory changes, joint effusion, heat, tenderness

66
Q

ROM for elbow

A

Flexion, extension (assessing the elbow)

Pronation, supination (assessing 2 radioulnar joints at elbow & wrist)

67
Q

Strength for Elbow

A

Assess strength of biceps and triceps by repeating the ROM against your resistance

68
Q

Wrist

A

radiocarpal (radius with 8 carpals)

69
Q

Carpals

A

midcarpal
Carpometacarpal
metacarpophalangeal

70
Q

Digits

A

Proximal interphalangeal

distal interphalangeal

71
Q

Inspect, palpate for wrist, hand and elbow

A

Inspect
Skin: smooth, even skin color, no lesions/inflammation
Bilateral dorsal and palmar sides for position, shape, symmetry, contour
Normal: skin without any inflammatory changes, lumps, swelling, deformity, nodules
Palpate
Each joint and compare bilaterally
Normal: no atrophy, swelling, heat, tenderness, subcutaneous nodules/lumps
ROM
Flexion/extension of wrist & digits
Deviation wrist (ulnar/radial)
Abduction/adduction of fingers
Strength
Assess strength of wrist/fingers by repeating the ROM against your resistance

72
Q

Joints of Hips

A

acetabulum and femur, ball-and-socket

73
Q

Inspect
Palpate
ROM for hips

A

Inspect
Skin: smooth, even skin color, no lesions/inflammation
Symmetric level of iliac crest, gluteal folds, buttocks
Equal leg lengths (assessed by smooth and even gait)

Palpate
Bilateral hips for symmetry and stability
Normal: no swelling, heat, tenderness, deformity, crepitus with motion

ROM
Abduction/adduction
Flexion/extension (with extended knee)
Flexion/extension (with flexed knee) should increase ROM
Internal/external rotation
Strength
Assess strength by repeating the ROM against your resistance

74
Q

Joint of 3 bones in the knew

A

femur, tibia, patella; hinge joint

75
Q

Inspect
Palpate
ROM
Strength for knee

A

Inspect
Skin: smooth, even skin color, no lesions/inflammation
Contour, symmetric shape, lower leg same axis as the thigh
Quadriceps (anterior thigh), hamstrings (posterior thigh) for atrophy
No locking, giving way (buckling), local pain

Palpate
Bilateral knees for symmetry, smoothness
Normal: no swelling, heat, tenderness, deformity, crepitus with motion

ROM
Flexion/extension

Strength
Assess strength of quadriceps and hamstrings by repeating the ROM against your resistance

76
Q

Inspect
Palpate
strength for feet and ankle

A

Inspect

Skin: smooth, even skin color, no lesions/inflammation, callus

Position, joints contour, symmetric shape, feet alignment with axis of leg

Toes straight forward and flat (abnormal: hammertoe)

Medial/ lateral malleoli smooth

Palpate

Ankles, feet (dorsum/plantar surfaces), toes (interphalangeal joints) for symmetry, smoothness

Normal: no swelling, heat, tenderness, deformity, crepitus with motion

Strength
Assess muscle strength by repeating the ROM against your resistance

77
Q

Joints of 3 bones Ankle

A

Tibia , Fibula, Talus

78
Q

Ankle

A

Joint of 3 bones: tibia, fibula, talus

Hinge joint

ROM: Flexion (Dorsiflexion) & Extension (Plantar Flexion)

79
Q

Feet

A

Many bones and joints

ROM: Inversion (Supination) & Eversion (Pronation)

80
Q

Toes

A

ROM: Flexion & Extension

81
Q

Morse Fall Risk Assessment Tools

A
  1. History of Falls
  2. Secondary Diagnosis
  3. Ambulatory Aids
  4. IV Therapy
  5. Gait
  6. Mental Status
82
Q

Phalen Test

A

Hold both hands back-to-back while flexing wrist for 60 seconds

Normal (negative): No symptoms

Abnormal (positive): Numbness and burning

83
Q

Tinel Test

A

Directly percuss on the median nerve at the wrist

Normal (negative): No symptoms

Abnormal (positive): tingling and burning

84
Q

Bone Remodeling

A

cyclic process of:

resorption by osteoclasts and
deposition by osteoblasts

85
Q

How to measure for Bone Mass Density

A

X-Ray imaging test, measure bone mineral mass

86
Q

What is osteopenia and osteoporosis

A 
low BMD (osteopenia) -1 to -2.25
porous bone (osteoporosis) < -2.25
higher risk of fractures
87
Q

Cultural and Genetic Considerations for Osteopenia and Osteopenia

A

Bone resorption occurs more rapidly than bone deposition

more common in Caucasian women

The function of osteoblasts (bone deposition) is estrogen dependent
estrogen decreases with age in both sexes

Abnormal: low BMD (bone mass density)

Higher risk of complications associated with falls

88
Q

Muscle Atrophy

A

loss of muscle mass due to disuse, nerve/muscle disorders

89
Q

Dislocation

A

often caused by trauma

the articulating bones are out of their appropriate place

Results in joint deformity, severe pain, ROM limitation

90
Q

Sprain

A

damaged (stretching/tearing) ligament
Ligament connects bone to bone, surrounding a joint

Ankle is a common site

91
Q

Strain

A

damaged (stretching/tearing) tendon
Tendon connects a muscle to a bone

Lower back is a common site

92
Q

Joint Effusion

A

swelling from excess fluid in the joint capsule

93
Q

Crepitation

A

palpable crunching or grating in the joint while performing ROM
may be audible if severe

94
Q

Weight-Bearing Exercise

A

exercise against gravity

walking, hiking, jogging, climbing stairs, dancing

95
Q

Non-Weight-Bearing Exercise:

A

exercise without supporting your weight

swimming, rowing, bicycle riding

using resistant bands while seated

ROM exercise

96
Q

Isometric Exercise

A

tensing the muscle without moving the joint

pushing the heels into the bed

holding a posture

exercise while a limb is in a cast

exercise while on bedrest

97
Q

Isotonic Exercise

A

active ROM exercise

98
Q

Kyphosis

A

abnormal increase in the thoracic curve

Ex: hump back

99
Q

Lordosis

A

abnormal increase in lumbar curve

100
Q

Scoliosis

A

lateral curvature of thoracic and lumbar spine

101
Q

Contracture

A

develops when the normally stretchy (elastic) tissues are replaced by non-stretchy (inelastic) fiber-like tissue often due to disuse

Ex: Foot drop

102
Q

Children and Adolescents

A

Children

Assess for any bone deformity, particularly scoliosis
Hight and weight (growth range)
History of increasing falls or balance problems

Adolescents

Assess for any bone deformity, particularly scoliosis
Assess for risk of injuries related to sports and extracurricular activities

103
Q

Aging Adults

A

Decrease in muscle mass (less strength & elasticity)

Bone resorption occurs more rapidly than bone deposition

Postural changes & decreased height/ROM

Loss of subcutaneous fat leaves bony prominences more observable

Get-Up-&-Go Test

Time the client as they rise from an armchair, walk 10 feet (3m), turn, walk back, and sit down again
Normal: < 10 sec
High risk for fall: >10 sec

104
Q

Health Promotion

A 
Safety
Diet
Tobacco Products
Alcohol
Exercise
Osteoporosis Screening
105
Q

Functions of MS

A 
Posture
Movement
Protect organs
Production of blood cells
Ca++ & phos- storage
106
Q

Joints function

A

functional units where two or more bone surfaces come together

107
Q

Synovial

A

freely movable, hip

108
Q

Cartilaginous

A

slightly movable, vertebra

109
Q

Fibrous

A

immovable, sutures in skull

110
Q

cartilage

A

resilient tissue

covers the surface of opposing bones in synovial joints

Absorb stress and weight

111
Q

Ligaments

A

Strong, dense, flexible, fibrous band of connective tissue

holding bones to bones at the joint and providing support

112
Q

Tendon

A

flexible, non-elastic, strong

fibrous collagen tissue
attaching muscles to bones

Support bone movement in response to skeletal muscle contraction

113
Q

Bursa

A

enclosed sac filled with synovial fluid

prevent friction

114
Q

Skeletal

A

voluntary

connected to bones by tendons (fibrous cords)

Facilitate movement

115
Q

Smooth

A

autonomic, airways, vasculature, GI organs

116
Q

Cardiac

Heal assessment Exam 3 (4 decks)

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