Musculoskeletal

Question 1

What are all the parts of MS and Neuro?

Answer 1

Assess
Inspect Muscles
Variations in Older Adults
AAO x 4
Glasgow Coma Score
Activity Levels and Exercise
Patient’s views on exercise
Patient standing and sitting
Joint Function

Question 2

Assessments

Answer 2

Assess activity and mobility:
ROM
GAIT: stance and swing, head erect, heel strikes ground before toe, opposite hands swing
BALANCE
PATIENT DOING ADLs

Inspect and Palpate Joints: Pain, swelling, erythema, temperature, symmetry, crepitus

Spine:
Kyphosis - Outward curve of spine (think: hunched)
Lordosis - Inward curve of spine (Think: lumbar, ant. pelvic tilt)
Scoliosis - Lateral curvature of spine

Question 3

Inspect Muscles

Answer 3

Size: hypertrophy, atrophy
Strength: hand grasp and push (strong, weak, equal)
Muscle tone: Flaccid, spastic

Question 4

Variations in older adults

Answer 4

Neurological:
Diminished pain perception, slower reaction time

Musculoskeletal:
Sarcopenia - Decrease size and number of muscle fibers
Osteoporosis - Decrease bone mineral and mass
Decrease ROM
Joint degeneration

Question 5

AAO x 4

Answer 5

Person, time, place and situation

Question 6

Glasgow Coma Score

Answer 6

Tests for:
Eye Opening Response; how responsively pt opens eyes
Verbal Response; responsiveness/appropriateness in convo
Motor Response; responsiveness to pain

Best score = 15
Worst score = 3; severe brain injury

Question 7

Assess activity levels and exercise

Answer 7

Focused hx:
Current activity?
Usual form of exercise?
Frequency?
Has activity increased or decreased in the last 10 years?
What kind of work do you do?

Obstacles to exercise:
-Depression, anxiety?
-Fractures, weakness, cardiac/resp. disorders
-Assistive devices, neighborhood, restrictions in home
-Any issues affecting mobility?
-What medications do you take?

Question 8

Assess personal views on exercise

Answer 8

What aspect of exercise do you enjoy?
What are the benefits of exercise?
What motivates you to exercise?

Question 9

Assess patient standing and sitting

Answer 9

Observe patient standing:
Anterior, posterior and lateral views

Expected findings: Shoulder and hips are level, toes pointed forward, posture erect

Sitting:
Instruct patient to sit, note any difficulty, slumping, posture
Note if pt cannot sit/stand on their own

Question 10

Joint Function

Answer 10

Begin at neck
Compare muscle size above and below joint on both sides

NECK-PIVOT JOINT: Extension, flexion, rotation, lateral flexion
SHOULDER-BALL AND SOCKET JOINT: Flexion, extension, hyperextension, abduction, adduction, circumduction
ELBOW-HINGE JOINT: Extension, flexion
WRIST-CONDYLOID JOINT: rotation, flexion
HIP-BALL AND SOCKET JOINT: Flexion, extension, hyperextension, abduction, adduction, circumduction
NKEE, ANKLE, TOES-HINGE JOINT: flexion and extension
Foot: gliding joint