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Management Of Nursing Care 2 > Musculoskeletal Assessment > Flashcards

Musculoskeletal Assessment Flashcards

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1
Q

What are the objectives of the musculoskeletal physical assessment?

A

To understand the role and function of the muscular/skeletal system. To safely and accurately preform a muscular skeletal assessment (subjective and objective) and clearly and accurately document assessment data.

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2
Q

What are the primary structures of the musculoskeletal system?

A

Bones, muscles, joints, cartilage, ligaments & tendons

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3
Q

Define synovial joints

A

The type of joint found between bones that move against each other, such as the joints of the limbs. They are enclosed in a joint cavity lubricated by synovial fluid and cartilage covers the surface of opposing bones.

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4
Q

Define non-synovial joints

A

These joints provide structural integrity and minimal movement. United by fibrous tissue or cartilage. Example: Skull or vertebrae.

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5
Q

What are the function of ligaments?

A

They support the bones, and strengthen the joint preventing undesirable directional movement. They are a fibrous band running directly from one bone to another.

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6
Q

What are the function of muscles?

A

They are a skeletal muscle which produce movement or motor functions when contracted under conscious control

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7
Q

What do we look for in a subjective review?

A

Lifestyle and health history such as: Surgical/medical history, medication history, mobility/activity patterns, and any difficulty’s with adls

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8
Q

What does coldspa stand for?

A

Character, onset, location, duration, severity, pattern, additional information.

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9
Q

What questions under C of coldspa would we ask when concerning joints.

A

What does the pain feel like (aching, stiff, sharp, dull, shooting pain)

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10
Q

What questions under O of coldspa would we ask when concerning joints.

A

When did it start?

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11
Q

What questions under L of coldspa would we ask when concerning joints.

A

Where is it, which joints, one side or both?

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12
Q

What questions under D of coldspa would we ask when concerning joints.

A

Any specific time of the day, how long has it been there for, how long does the pain last?

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13
Q

What questions under S of coldspa would we ask when concerning joints.

A

Pain Scale 0 being no pain to 10 being the worst pain imaginable.

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14
Q

What questions under P of coldspa would we ask when concerning joints.

A

What makes it better/worse? Is it aggravated by movement, improved by rest?

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15
Q

What questions under A of coldspa would we ask when concerning joints.

A

What is the clients understanding of the problem? What do they think is wrong? Does it stop them from doing anything (ADLs), and any other symptoms?

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16
Q

What are the 3 things we do in an objective review (physical examination)

A

Preparation, Inspection, and Palpation

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17
Q

What is involved in preparation for the Objective review?

A

Informed consent, privacy & infection control

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18
Q

What is involved in Inspection for the Objective review?

A

Size & contour of joint, skin & tissues over joints for colour, swelling & deformity. Compare both sides of body.

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19
Q

What is involved in palpation for the Objective review?

A

You need to place your hand over the joint and palpate it. Feel if it is swollen/tender/any heat/ any fluid on or over joint. Joints are not usually tender to palpate.

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20
Q

You need to inspect and palpate each joint prior to what?

A

Assessing ROM

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21
Q

What does ROM stand for?

A

Range of motion.

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22
Q

How do you check for range of motion of the joints?

A

Hold onto the joint as the patient moves their limb/body part. Note what you feel.

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23
Q

What do you need to make sure you dont confuse when looking at the ROM of joints?

A

Dont confuse crepitation with normal discrete ‘crack’ heard as tendons/ligaments slip over bone.

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24
Q

What’s involved in muscle resistance testing?

A

The testing of prime mover muscle groups for each joint.

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25
Q

How do you do a muscle resistance test for the upper limbs?

A

Rotation/lateral bending or flexion/extension of neck, shoulder shrug, grip strength, flexion/extension of elbow, and wrist strength.

26
Q

How do you do a muscle resistance test for the lower limbs?

A

Look at knee strength and Doris/plantar flexion of the foot.

27
Q

What does the muscle resistance assessment determine?

A

The strength of opposing muscles.

28
Q

What do we do before preforming a musculoskeletal assessment?

A

Explain the procedure to the patient and gain consent, preform hand hygiene.

29
Q

What is important about performing a musculoskeletal assessment?

A

That you are comparing both sides of the body to each other.

30
Q

What’s involved in a musculoskeletal assessment?

A

ROM testing, Muscle resistance testing and explaining findings.

31
Q

How to we do an ROM test?

A

Inspect and palpate each joint prior to and during ROM. Identify any swelling, tenderness, temperature changes, crepitus or masses.

32
Q

When assessing ROM in the osces what parts of the body are we assessing?

A

You will decide to do either the upper or lower body joints relating to presenting concern and you will always assess the spine.

33
Q

How do you position your hands for an ROM assessment?

A

Over the joint being moved - this enables identification of crepitus and stabilization of the movement.

34
Q

How do we assess the ROM of the neck?

A

Assess flexion and hyperflexion of the chin + lateral bending of the head (70 degrees)

35
Q

How do we assess the ROM of the shoulders?

A

Assess forward flexion (180 degrees) + hyperextension + internal rotation (90 degrees) + external rotation (90 degrees) + abduction and adduction.

36
Q

How do we assess the ROM of the elbow?

A

Flexion (150-160 degrees) and Extension (0). + Pronation and supination.

37
Q

How do we assess the ROM of the wrist?

A

Palmer flexion and hyperextension + ulnar/radial deviation.

38
Q

How do we assess the ROM of the fingers?

A

Abduction of fingers (20 degrees) + fist tight.

39
Q

How do we assess the ROM of the spine?

A

Flexion and hyper extension + lateral bending (rotation of 30 degrees).

40
Q

How do we assess the ROM of the hip?

A

Leg raise + Flexion/Extension + External/Internal rotation + Abduction/adduction.

41
Q

How do we assess the ROM of the knee?

A

Flexion/extension.

42
Q

How do we assess the ROM of the ankle?

A

Plantar/Dorsiflexion + Inversion/Eversion.

43
Q

What are we identifying in an ROM assessment?

A

Any limitations, and whether the movement is active or passive.

44
Q

What is muscle resistance testing?

A

Where we assess opposing muscle groups against resistance comparing both sides of the body and using the same hand to test resistance where appropriate.

45
Q

During the osces what do we do we chose between regarding the muscle resistance testing?

A

We chose two upper body resistance tests or two lower body resistance tests relating to our patients presenting concern.

46
Q

How do we preform a muscle resistance test for the neck?

A

Provide resistance with your hand against the rotation (either lateral bending or flexion/extension).

47
Q

How do we preform a muscle resistance test for the shoulders?

A

The patient will shrug their shoulders by flexing shoulders forward and up abducting against resistance.

48
Q

How do we preform a muscle resistance test for the upper arms?

A

Flexion and extension of the elbow whilst providing resistance with hand proximal to wrist, stabilizing patients arm with other hand.

49
Q

How do we preform a muscle resistance test for the forearms?

A

Position patients arm supinated on a flat surface. Stabilize the forearm by holding your hand on the mid forearm and ask patient to flex the wrist against your resistance of the hand.

50
Q

How do we preform a muscle resistance test for grip?

A

You will ask the patient to grip two fingers of each of your hands at the same time.

51
Q

How do we preform a muscle resistance test for the upper knees?

A

Ask the patient to maintain flexion while you try to provide resistance by pulling the leg forward.

52
Q

How do we preform a muscle resistance test for below the knees?

A

Ask the patient to maintain dorsiflexion and plantar flexion against resistance.

53
Q

After preforming the ROM and muscle resistance tests what do you need to do?

A

Ask the patient if they wish to know their findings, describe what is found in each assessment using correct terminology and comparing to normal findings, then handover using ISBAR.

54
Q

What does ISBAR stand for?

A

Identidy, Situation, Background, Assessment, Request.

55
Q

Whats important related to the muscle resistance test?

A

That you use the same hand to test muscle resistance.

56
Q

What is flexion?

A

When two body parts come together.

57
Q

What is extension?

A

When two body parts go away from each other

58
Q

What is abduction?

A

When a body part is going away from the bodys midline

59
Q

What is adduction?

A

When a body part is going towards the bodys midline.

60
Q

What are we observing before an assessment begins.

A

Spine alignment, muscle size (upper vs lower), muscle atrophy (loss of muscle), stance, and gait (feet placement).

Management Of Nursing Care 2 (11 decks)

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