Musculoskeletal Flashcards
Inspect joints for ? (4)
Size, contour, color, swelling
Swelling of the joints indicate ___ or ___
Joint irritation; effusion
Excess joint fluid
Effusion
An enhanced thoracic curve indicates __, and is more common in elderly people
Kyphosis
A pronounced lumbar curve; more common in obese people
Lordosis
When inspecting body alignment, check symmetry of the ___, ___, ___, and ___
Shoulders, iliac crests, scapulae, and glute folds
Uncoordinated or unsteady gait
Ataxia
Patient actively moving their joints through all the planes of movements without assistance
Active ROM
Nurse moves patient’s joints through all plans of movement because patient is unable to do it themself
Passive ROM
Produces swelling and tenderness around the whole joint, limiting all planes of active and passive motion
Example?
Articular disease
Arthritis 
Produces swelling and tenderness in only one spot of the joint, affecting only certain planes of ROM
Example?
Extra-articular disease
Injury to a specific tendon, ligament, or nerve
Audible and palpable crunching that accompanies movement
Crepitation
Degree of tension in voluntarily relaxed muscles
Tone
Overreactive contraction, sustain contraction longer than needed, difficulty relaxing
Hypertonic
Cannot contract fully or sustained contraction
Hypotonia
How do you assess patient’s muscle TONE?
Supporting limb at the joint, have patient go limp, and move each extremity through a full ROM
Expected finding for patients muscle tone?
Mild, even resistance to movement
Decreased resistance is also known as ___
Flaccidity
Muscle strength grading scale
0-5
Grade 5 on the muscle strength scale
Full ROM against gravity and full resistance
Grade 4 on the muscle strength scale
Full ROM against gravity, some resistance
Grade 3 on the muscle strength scale
Full ROM with gravity
Grade 2 on the muscle strength scale
Full ROM with gravity eliminated (passive motion)
Grade 1 on the muscle strength scale
Slight contraction
Grade 0 on the muscle strength scale
No contraction
What do you use to measure someone’s joints in degrees?
Goniometer
Shoulder joint movements (7)
Flexion, extension, hyperextension, internal rotation, external rotation, abduction, adduction
Forward flexion of shoulder joint is ___ degrees
What are you doing?
180
Raising hands straight forward and up
Extension of shoulder joint is __ degrees
What are you doing?
0
Hands at sides
Hyperextension of shoulder joint is __ degrees
What are you doing?
50
Hands behind back, elbows extended
Internal rotation of shoulder joint is __ degrees
What are you doing?
90
Hands behind back; put belt on in back, wash back, zip up dress in back
External rotation of shoulder joint is __ degrees
What are you doing?
90
Touching hands to back of head; brushing or washing hair
Abduction of shoulder joint is __ degrees
Example?
180
Sweeping hands from sides to above head
Adduction of shoulder joint is __ degrees
Example?
50
Sweep arms across front of body
Seatbelt, tying shoe on opposite foot
Joint movements of the elbow (4)
Flexion, extension, pronation, supination
Flexion of the elbow is __ degrees
Example?
150-160
Bending arm at the elbow; bringing something to your face to smell it
Extension of the elbow is ___ degrees
What are you doing?
0
Straightening arm at the elbow
Pronation of the elbow is ___ degrees
What are you doing?
90
Touching palm of hand to table or lap
Supination of the elbow is ___ degrees
Example?
90
Touching back of hand to table
Joint movements of the wrist (4)
Hyperextension, palmar flexion, ulnar deviation, radial deviation
Hyperextension of the wrist is ___ degrees
Example?
70
Bending hand up at the wrist
Palmar flexion of the wrist is ___ degrees
Example?
90
Bending hand down at the wrist
Ulnar deviation of the wrist is __ degrees
What are you doing?
50-60
With palms facedown, turning hand outward towards pinky
Radial deviation of the wrist is __ degrees
What are you doing?
20
With palms facedown,
turning hand inward towards thumb
Joint movements of the hand (3)
Flexion, hyperextension, abduction
Flexion of the hand is __ degrees
What are you doing?
90
Bending fingers down at the metacarpophalangeal joints
Hyperextension of the hand is __ degrees
What are you doing?
30
Bending fingers up at the metacarpophalangeal joints
Abduction of the hand is __ degrees
What are you doing?
20
Spreading fingers apart
Joint movements of the hip (7)
Flexion with bent knee, flexion with extended knee, internal rotation, external rotation, abduction, addiction, hyperextension
Flexion of hip with knee bent is __ degrees
120
Flexion of hip with extended knee is __ degrees
90
Internal rotation of hip is __ degrees
What are you doing?
40
Flexing knee and hip to 90°, swing foot outward
External rotation of the hip is ___ degrees
What are you doing?
45
Flexing knee and hip at 90°, swing foot inward
Abduction of the hip is __ degrees
What are you doing?
40-45
Swinging leg out with straight knee
Adduction of the hip is __ degrees
What are you doing?
20-30
Bringing leg back to midline with a straight knee
Hyper extension of the hip is __ degrees
What are you doing?
15
When standing, bring leg straight back behind body
Joint movements of the knee (3)
Flexion, extension, hyperextension
Flexion of the knee is __ degrees
130
Extension of the knee is __ degrees
0
Hyperextension of the knee is __ degrees
15
Joint movements of the ankle (4)
Plantar flexion, dorsiflexion, eversion, inversion
Plantar flexion of the ankle is __ degrees
What are you doing?
45
Pointing toes toward the floor
Dorsiflexion of the ankle is __ degrees
What are you doing?
20
Pointing toes toward nose
Eversion of the ankle is __ degrees
What are you doing?
20
Turning soles of feet outwards
Inversion of the ankle is __ degrees
What are you doing?
30
Turning soles of feet inward
Standing behind patient inspecting for symmetry checks for their ___
Body alignment
Where do you inspect for symmetry for patient’s body alignment? (4)
Shoulders, scapula, iliac crest, and gluteal folds
Patient may have __ with extreme thoracic curve; common in elderly
Kyphosis
Patient may have ___ with a pronounced a lumbar curve; common in obese people
Lordosis
Forward flexion of the spine is __ degrees
90
Extension of the spine is __ degrees
30
A difference in shoulder elevation and level of scapular and iliac crest occurs with ___ 
Scoliosis
How to inspect for scoliosis (5 steps)
Sit behind patient. For girls, have them pull their hair away. Inspect shoulders and iliac crest for symmetry. Then, have patient lean forward to inspect spine. Use scoliometer to check spine for straightness
Thoracic and lumbar spines must be ___
Straight
If thoracic and lumbar spines are not straight, this may indicate ___ 
Scoliosis