Musculoskeletal Assessment Flashcards
Flexion
Bend limb at a joint
Extension
Straighten limb at a joint
Abduction
Move limb away from the midline of the body (abduct = move away)
Adduction
Move limb towards the midline of the body (add = move together)
Pronation
Turn forearm palm down
Supination
Turn forearm palm up
Circumduction
Move arm in circle around shoulder
Inversion
Move sole inward at ankle
Eversion
Move sole outward at ankle
Rotation
Move head around a central axis
Protraction
Move body part forward and parallel to ground
Retraction
Move body part backward and parallel to ground
Elevation
Raise body part
Depression
Lower body part
Health History Points
- Joints
a. pain
b. stiffness
c. swelling, heat, redness
d. limitation in ROM - Muscles
a. pain (cramps)
b. weakness - Bones
a. pain
b. deformity
c. trauma - fractures, strains, sprain, dislocation - Functional Assessment - impact of ADLs
- Knee Joint (if injured)
Temporomandibular Joint
Inspection: SEATED
-
Palpation: SEATED
- palpate TMJ with opening and closing –> feel
for smoothness, crepitation
- palpate temporalis and masseter muscles
for size, firmness and strength with teeth
clenched
Testing CN V
Trigeminal Nerve
- ask the patient to move jaw forward and
laterally against resistance
Cervical Spine
Inspection: SEATED
- alignment of head and neck (straight and
erect)
Palpation: SEATED
- palpate spinous processes
- palpate neck muscles for firmness, size,
symmetry
Shoulders
Inspection: SEATED
- inspect and compare both shoulders
posteriorly and anteriorly
Palpation: SEATED
- palpate both shoulders –> note muscular
spasm, atrophy, swelling, heat, tenderness
Elbow
Inspection: SEATED
- inspect for size and contour in flexed and
extended positions
Palpation: SEATED
- palpate the elbow when flexed 70 degrees
and relaxed
Wrist and Hand
Inspection (dorsal and palmar side)
- note contour and shape
- coloration (no redness)
- no swelling, deformity, nodules
Palpation
- joints –> feel smooth, no swelling,
tenderness
Wrist and Hand Strength Testing
position the patient’s forearm supinated on a table, stabilize by holding the patient’s arm with your hand
1. ask patient to flex hand up against
resistance
2. ask patient to extend hand down against
resistance
Hip
Inspection: STANDING
- inspect hip joint WITH spine when
STANDING
- note symmetry bilaterally = levels of the iliac
crests, gluteal folds, equal sized buttocks
- note gait = even, smooth
Palpation: SUPINE
- palpate hip joints in a SUPINE position
- shoud feel stable, symmetrical
- no tenderness or crepitation
Knee
Inspection: SUPINE
- legs extended fully –> legs should extend on
same axis as thighs
- skin intact, even colouration
Palpation: SUPINE
- quads should be completely relaxed
- joints are smooth –> NO warmth,
tenderness, thickening
Ankle and Foot
Inspection: STANDING and SEATED
- compare feet –> should align with long axis of lower leg, toes point forward
- weight bearing should be borne on middle
of the foot, from the heel, along the
midfoot
Palpation: SEATED
- palpate metatarsophalangeal joints
Ankle and Foot Strength Testing
with the patient sitting, support their lower leg with your hand
- ask the patient to dorsiflex against
resistance
- ask the patient to plantarflex against
resistance
Thoracic and Lumbar Spine
Inspection: STANDING
- inspect for spine curvature (abnormal) –>
note normal convex thoracic curve and
concave lumbar curve
- ask the patient to toe walk a few steps, then
heel walk –> assess stability and gait
Palpation: STANDING
- palpate spinous processes
Rheumatoid Arthritis
Chronic, systemic inflammatory disease of the joints and surrounding connective tissue
- Inflammation of the synovial membrane leads
to thickening, then to fibrosis (which limits
motion), and finally to bony ankylosis]
- Disorder is symmetrical and bilateral,
characterized by heat, redness, swelling, and
painful motion of the affected joints
Osteroarthritis
Noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral bone and formation of new bone (osteophytes) at joint surfaces
- Asymmetrical joint involvement commonly
affects hands, knees, hips, and lumbar and
cervical spine
Osteoporosis
Decrease in skeletal bone mass occurring when the rate of bone resorption is greater than that of bone formation
→ this weakened bone state increases risk for
stress fractures, especially at the wrist, hip,
and vertebrae
Older Adult Considerations (5)
- Postural changes
- decreased height
- kyphosis
- osteoporosis - bone breakdown surpasses bone deposition (
- distribution of subcutaneous fat changes
- body contour changes, boney prominences more evident - loss of muscle mass occurs
- some decrease in size, atrophy (weakness)
- senile tremors normal
- ROM and functional assessment normal if no musculoskeletal issues are present
