musculoskeletal assessment Flashcards
examples of subjective data
pain or discomfort, weakness, stiffness, limited movement, swelling/heat, deformity, lack of balance
examples of past medical history
MSK trauma, surgery, skeletal anomalies, chronic illness
how does chronic illness affect the bones
long term steroids can weaken the bones
health history tips
always obtain mechanism of injury, timing of pain, popping/clicking/grating, joint instability, swelling, effect on ADLs
what is the purpose of the MSK exam?
do assess function for ADLs and to screen for abnormalities
how should the physical exam be performed
head to toe, proximal to distal, bilateral comparison
what are the components of the MSK exam
inspection and palpation only
what should you inspect/palpate for
- posture and gait
- muscle characteristics (tone/bulk)
- ROM
- strength
- joint exam
what is the joint exam looking for
tenderness, swelling, redness, heat, crepitus, reduced ROM
inspection of MSK includes…
size and contour of joint
inspection of skin and tissues for color change
swelling
any masses or deformity
palpation of MSK includes…
palpate each joint, including skin for temperature, muscles, bony articulations, and area of capsule
- joints are normally not tender
muscle strength testing
0/5- no muscle contraction
1/5- slight muscle contraction evident, no joint movement
2/5- full ROM with gravity eliminated (passive only)
3/5- full ROM with gravity
4/5- full ROM against gravity with some resistance
5/5- full ROM against gravity and full resistance
normal spinal curvature
thoracic convexity, cervical and lumbar concavity
abnormal spinal curvatures
scoliosis - lateral curve
kyphosis - hunchback
lordosis - exaggerated lumbar concavity
gait - smooth and rhythmic
balance and coordination tests
walk on heels, toes, tandem walk, sit and stand
rapid alternating movements (ex fingers to thumb and heel to shin)