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NURS 2910 > Musculoskeletal assessment > Flashcards

Musculoskeletal assessment Flashcards

1
Q

What is the musculoskeletal system

A
  • Bones, muscles, and joints
  • controlled by the nervous system
  • contains calcium and phosporus
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2
Q

Purpose of the musculoskeletal system

A

provide structure and movement for body parts

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3
Q

Structure and Function: Bones

A
  • Provide structure, protection, serve as levers, store calcium, and produce red blood cells
  • 206 bones in the body
  • Long bones, Short bones, Flat bones, irregular bones
  • bones are constantly building and remodeling w/ osteoclast and osteoblast
  • bones contain red and yellow bone marrow
  • living tissue, needs blood supply
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4
Q

Long bone examples

A

humerus & tibia

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5
Q

Short bone examples

A

metatar(car)pals & filanges

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6
Q

Flat bone examples

A

Sternum & ribs

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7
Q

Irregular bone examples

A

vertebrae & sacrum

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8
Q

Osteoclast

A
  • clean up crew
  • breakdown old bone
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9
Q

Osteoblast

A
  • building crew
  • build new bone
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10
Q

Structure and function: Joints

A
  • place where two or more bones meet
  • 3 types of joints: Synarthoses, Amphiarthroses, and synovial
    purpose: provide range of motion
  • needs further investigation if joint has a color change or joint deformity*
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11
Q

Synarthrotic Joints

A
  • Connects two bones with fibrous connective tissue
  • immovable
  • ex. sutures between skull bones
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12
Q

Amphiarthrotic joints

A
  • Joining of bone together via cartilage
  • ex. vertebrae
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13
Q

Diarthroses(Synovial) joints

A
  • Bones attach together via ligaments
  • Have a space between bone-filled synovial fluid
  • ex. shoulders, wrist, knees
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14
Q

How does the musculoskeletal system stay attached?

A
  • Cartilage, Ligaments, and Tendons
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15
Q

Cartilage

A
  • smooth, elastic connective tissue that cushions around the joint
  • rib cage, nose, vertebral discs
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16
Q

Tendons

A
  • Fibrous connective tissue attaches muscles to bone
  • MUSCLE TO BONE
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17
Q

Ligaments

A
  • Fibrous tissue that connects most moveable joints
  • Allow freedom of movement but strong to prevent overextension
  • BONE TO BONE
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18
Q

Structure and Function: Muscle

A
  • Skeletal muscles attaches to bone via tendons
  • 3 types: skeletal, smooth, and cardiac
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19
Q

Skeletal muscle

A

Purpose: movement, posture, body heat
- surrounds skeletal system(bones)

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20
Q

Smooth muscle example

A
  • digestive system
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21
Q

Cardiac muscle example

A
  • muscles surrounding the heart
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22
Q

Motor Nervous system

A
  • controls the movement of the musculoskeletal system
  • Autonomic: controls involuntary muscles
  • Somatic: controls voluntary skeletal muscles
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23
Q

What is the purpose of osteoclast

A
  • To breakdown old or damaged tissue
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24
Q

Which type of joint provides the greatest range of motion and protects the joint with a fluid-filled space

A

Synovial

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25
Q

Which connects muscles to bone

A

Tendons

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26
Q

Health history of Musculoskeletal assessment

A
  • Past health history
  • family history
  • lifestyle and health practices
  • ADL’s
  • Medication
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27
Q

Exercise can increase bone density T or F,
Low calcium can increase bone density T or F

A

True, False

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28
Q

Steps of Musculoskeletal assessment

A
  • Posture
  • Gait
  • Bone structure
  • Muscle function
  • Joint mobility
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29
Q

Considerations for assessment

A
  • ensure client has the ability to participate and follow directions
  • ensure they are healthy enough to safely participate, adapt as nec.
  • provide clear, simple directions
  • Demonstrate movements first
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30
Q

Passive ROM

A

Someone helping moving muscles

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31
Q

Active ROM

A

Independently moving muscles

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32
Q

Steps of assessment: Joints

A
  • inspect: size, shape, color, symmetry
  • Palpate: for edema, heat, tenderness, and pain
  • Test each joint’s ROM
  • Demonstrate and ask client to return demo
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33
Q

Steps of assessment: Muscles

A
  • Test muscle strength by asking client to move extremity through full ROM against resistance
  • Will apply resistance with our hands
  • DO NOT FORCE
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34
Q

Steps: Posture and body alignment

A
  • observe: cervical thoracic and lumber curve from the side and from behind
  • Note: symmetry, differences in height, buttock crease midline, iliac crest height symmetry
    -Palpate: along the spinous process
  • Note: tenderness and pain
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35
Q

What things can cause posture problems?

A
  • slouching
  • sitting all-day
  • being overweight
  • bad shoes
  • muscle weakness
  • visual difficulties
  • poor core muscles
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36
Q

assessment: Spine

A
  • Assess spinal curvature while standing and while bending at the waist
  • look for scoliosis, kyphosis, and lordosis
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37
Q

Assessment: Gait

A
  • observe posture, sitting and standing
  • observe gait
  • look at base of support, weight bearing stability, foot position, stride and cadence, arm swing, posture
  • baseline is what is normal for the patient
38
Q

Assessing Balance

A
  • Walk heel to toe
  • Walking on heel
  • Drop knee bend
  • Hop on one foot
  • Romberg test
  • DO NOT ASSESS IF PATIENT CAN’T WALK*
39
Q

Assessing Coordination

A
  • Finger-thumb opposition
  • Supinating and pronating hand rapidly
  • Rhythmic toe tapping
  • Run the heel of one foot down the shin of the other leg
  • if one can’t do maybe a cerebellum disorder*
40
Q

Expected findings: coordination

A

movements are preformed smoothly and in a coordinate way

41
Q

Developmental variations: coordination

A

Older adults may present with decreased coordination due to slower nerves and loss of muscle tone

42
Q

Assessment: TMJ

A
  • Flex and extend
  • move side to side
  • protrude and retract
43
Q

ROM: Neck

A

cervical spine ROM
- Flexion: touch chin to chest
- Hyperextension: look up
- Rotation: turn head side to side
- Lateral bending: bring ear towards shoulder on each side

44
Q

ROM: Spine

A

Thoracic spine ROM
- Flexion: ask client to bend forward and touch toes
- Extension: ask client to bend backward
- Lateral flexion: ask client to bend sideways
- Rotation: ask client to turn each way, legs straight

45
Q

Assessment: Shoulder

A
  • Inspect: symmetry, color, swelling/masses
  • Palpate: tenderness or swelling
    ROM
46
Q

Shoulder ROM

A
  • Flexion: straight arms above head
  • Hyperextension: Straight behind back
  • Abduction: arms straight, above to make triangle
  • Adduction: arms straight, down and across body
  • Circumduction
    - external: bring arm to shoulder level and bend at elbow at right angle, move up, fingers pointed upward
    - internal: bring arm down so finger are downward
  • repeat with resistance to test strength
47
Q

Steps of assessment: elbows

A
  • inspect: size, shape, deformities, swelling, redness
  • palpate: tenderness, nodules
48
Q

ROM: Elbows

A
  • Flexion: With arm straight and palm supine bring palm toward the face
  • Extension: Keep palm supine and bring palm down
  • Supination and pronation: bring elbows to sides and make 90 degree angle with elbow, SOUP PLEASE
  • repeat with resistance
49
Q

assessment: Wrist

A

-Inspect: size, shape, deformities/nodules, swelling, and redness
- Palpate: tenderness and nodules

50
Q

ROM: Wrists

A
  • Flexion: palm down, make a 90 degree angle downward, KITTIE PAWS
  • Extension: hold out hand with palm down, extend hand up and make 70 degree angle upward, STOP
51
Q

Steps of assessment: Hands

A
  • Inspect: size, shape, symmetry, swelling, and color
  • Palpate: palpate each finger, note tenderness/ nodules
52
Q

ROM: Hands

A
  • Abduction: Spread fingers
  • Adduction: Bring fingers together
  • Flexion: Make a fist
  • Extension: Extend the hand
  • Hyperextension: Hold hand prone and extend fingers upas far as they can go
53
Q

Assessing Strength: Hands

A
  • hold out two fingers and have patient squeeze
  • measure bilaterally to compare strength on each side
54
Q

ROM: Thumb

A
  • Extension: thumb up and away from fingers
  • Flexion: thumb to touch base of small finger
    Opposition: bring thumb to each finger on same hand
55
Q

Assessment: Hips

A
  • Inspect: symmetry, shape of hips, for a thoracic curve or lumbar curve
  • Palpate: stability and tenderness
56
Q

ROM: Hips

A
  • Have client lay down*
  • Flexion: raise extended leg
  • Extension: Bend knee up to chest with opposite leg extended
  • Rotation: Turn bent knee inward, then outward
57
Q

Assessment: Knees

A
  • Inspection: Size, symmetry, swelling, deformities, alignment
  • Palpate: Begin 10cm above patella, use fingers and thumb to move downward over and around the knees
  • note: tenderness, warmth, consistency, and nodules
58
Q

ROM: Knees

A
  • Ask client to stand*
  • Flexion: bend knee, bringing foot up towards butt
  • Extension: Straighten the knee> kick someone
  • repeat with resistance
59
Q

Assessment: Ankles and feet

A
  • Inspection: note position, alignment, shape, color
  • palpation: palpate ankles, feet, and toes
  • Note: tenderness, swelling, bony prominences, nodules
60
Q

ROM: Ankles and feet

A
  • Dorsiflexion: point toes up
  • Plantar flexion: point toes downward
  • Eversion: Turn soles outward
  • Inversion: Turn soles inward
  • Adduction: Turn foot inward
  • Abduction: Turn foot outward
  • repeat with resistance
61
Q

Pediatric Considerations: Newborn/ infant

A
  • Assess the clavicle of newborn, often breaks during birth
  • Infants learn to sit up by 8 mo
  • Spine will have a single C shape for first 3 mo
  • Cervical spine curve begin 3-4 mo
  • should be able to move all extremities
  • Legs appear bowed but should be able to straighten them
62
Q

Pediatric Considerations: Toddler

A
  • Walk with a wide gait, swayed walk, protruding abdomen
  • lumbar spine will develop, as walking advances 12-18mo
  • Leg bowing will decrease by 2-3 y.o. or as the add more weight
  • Flat arch is normal
63
Q

Pediatric Considerations: Child

A
  • S-shaped spine similar to adults
  • Flexible spine, good muscle tone
  • Gait and leg appearance similar to adult
  • foot arch develops
64
Q

Pediatric Considerations: Adolescents

A
  • Assess back, hips, and shoulder height
  • Screening for scoliosis should begin in middle school and through high school
65
Q

Older Adult considerations

A
  • loss of bone density
  • articulating cartilage deterioration
  • changes in muscle and redistribution of fat
  • joint stiffness
  • kyphosis and decrease in height
  • vertebral changes and inflexibility
  • cartilage breakdown> reason height decreases
66
Q

Osteoporosis

A
  • a decrease in bone density due to osteoclast activity outpacing osteoblast
  • bone resorption increases
  • calcium absorption decrease
  • Production of osteoclasts decreases
    1/10 people over age 50 have osteoporosis
67
Q

Osteoporosis mostly occurs in men T or F

A

False, it mostly occurs in women

68
Q

Osteoporosis two main risk factor groups

A

Uncontrollable risk factors and Modifiable risk factors

69
Q

Uncontrollable risk factors

A
  • age, sex, genetics, family history
  • menopause/hysterectomy, RA, long-term glucocorticoid therapy
70
Q

Modifiable risk factors

A

-Alcohol, smoking, caffeine use, low BMI, poor nutrition, eating disorders
- low calcium intake, insufficient exercise

71
Q

Osteoporosis: Primary prevention

A
  • Balanced diet
  • Mineral supplements> if levels are low
  • Weight-bearing exercise
  • Avoiding tobacco
  • Alcohol in moderation
72
Q

Osteoporosis: Secondary prevention

A
  • Osteoporosis screening
73
Q

Decreased estrogen levels after menopause increase risk of osteoporosis T or F

A

TRUE

74
Q

Health promotion activities

A
  • Healthy diet
  • Weight management (mobility is key)
  • Activity> increased activity increases bone density
  • Fall preventions
  • Avoid smoking and drinking alcohol
75
Q

Abduction

A

Move away from midline

76
Q

adduction

A

Move towards midline

77
Q

Circumduction

A

Move in a circular motion

78
Q

Pronation

A

Turning down

79
Q

Supination

A

Turning up

80
Q

Internal rotation

A

turning toward body

81
Q

external rotation

A

turning away from body

82
Q

Inversion

A

Moving inward

83
Q

Eversion

A

Moving outward

84
Q

Extension

A

Straightening extremity by the joint

85
Q

flexion

A

Bending the extremity at the joint (which decreases the angle at the joint)
ex. bending your arm

86
Q

Hyperextension

A

Joint bends more than 180 degrees

87
Q

Protraction

A

Moving forward (so moving your head forward at the neck)

88
Q

Retraction

A

Moving backward (so moving head backward at the neck)

89
Q

Rotation

A

Turning a bone on its own long axis

90
Q

Dorsal flexion

A

Toes draw up toward the ankle

91
Q

Plantar flexion

A

Toes point away from the ankle

NURS 2910 (16 decks)

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