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Health Assessment Exam 4 > Musculoskeletal Assessment > Flashcards

Musculoskeletal Assessment Flashcards

1
Q

What are the types of connective tissue found in this assessment?

A 
cartilage
tendons
ligaments
bursae
meniscus
fascia
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2
Q

What types of bones are there?

A

compact

cancellous

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3
Q

What types of joints are there?

A

fibrous
cartilaginous
synovial

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4
Q

Define Synovial Joints.

A

freely movable because they have bones that are separated from each other and are enclosed in a joint cavity. This cavity is filled with a lubricant (synovial fluid). Just like grease on gears, synovial fluid allows sliding of opposing surfaces, and this sliding permits movement.

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5
Q

Define Bursa.

A

an enclosed sac filled with viscous synovial fluid, much like a joint. Bursae are located in areas of potential friction (subacromial bursa of the shoulder, prepatellar bursa of the knee) and help muscles and tendons glide smoothly over bone

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6
Q

What is the difference between ligaments and tendons?

A

Ligaments are fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions.

Tendons are a strong fibrous cord that attaches skeletal muscle to bone

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7
Q

Flexion

A

bending a limb at a joint

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8
Q

Extension

A

straightening a limb at a joint

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9
Q

Abduction

A

moving a limb away from the midline of the body

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10
Q

Adduction

A

moving a limb toward the midline of the body

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11
Q

Pronation

A

turning the forearms so that the palm is down

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12
Q

Supination

A

turning the forearm so that the palm is up

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13
Q

Circumduction

A

moving the arm in a circle around the shoulder

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14
Q

Inversion

A

moving the sole of the foot inward at the ankle

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15
Q

Eversion

A

moving the sole of the foot outward at the ankle

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16
Q

Rotation

A

moving the head around a central axis

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17
Q

Protraction

A

moving a body part forward and parallel to the ground

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18
Q

Retraction

A

moving a body part backward and parallel to the ground

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19
Q

Elevation

A

raising a body part

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20
Q

Depression

A

Lowering a body part

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21
Q

Discuss the TMJ

A
  • the articulation of the mandible and the temporal bone

- permits the jaw function for speaking and chewing

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22
Q

What 3 motions does the TMJ allow for?

A
  1. hinge action to open and close the jaws
  2. gliding action for protrusion and retraction
  3. gliding for side-to-side movement of the lower jaw
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23
Q

Discuss the Spine

A
  • 33 vertebrae
    • 7 cervical
    • 12 thoracic
    • 5 lumbar
    • 5 sacral
    • 3 or 4 coccygeal vertebrae
  • has four curves
  • intervertebral disks (absorbs shock, helps with movement)
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24
Q

What types of movement can the spine allow?

A

Flexion (bending forward)
Extension ( bending back)
Abduction (to either side)
Rotation

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25
Q

What is the rotator cuff? (shoulder)

A

a group of four powerful muscles and tendons that support and stabilize the glenohumeral joint (of the shoulder)

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26
Q

What is the glenohumeral joint? (shoulder

A

-the glenohumeral joint in the articulation of the humerus with the glenoid fossa of the scapula. Its ball-and-socket action allows great mobility of the arm on many axes.

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27
Q

What is the Subacromial bursa? (shoulder)

A

helps during abduction of the arm so that the greater tubercle of the humerus moves easily under the acromion process of the scapula

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28
Q

Discuss the elbow.

A

permit pronation and supination of the hand and forearm

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29
Q

Discuss the Wrist and Carpals.

A

Radiocarpal joint

  • thumb and carpals joint
  • its condyloid action permits movement in two planes at right angles: flexion and extension, side to side deviation

Midcarpal Join

  • between the two parallel rows of carpals
  • allows for flexion, extension, and some rotation

Metacarpophalangeal and interphalangeal Joints
-permit finger flexion and extension

the flexor tendons of the wrist and hand are enclosed in synovial sheaths

30
Q

Discuss the Hip

A
  • ball in socket

- permits wide ROM on many axes

31
Q

Discuss the knee.

A
  • largest joint of the body
  • hinge joint
  • permits flexion and extension of the lower leg on a single plane
  • its synovial membrane is the largest in the body
  • menisci provide cushion for the tibia and femur
32
Q

Discuss the Ankle and Foot.

A

Tibiotalar Joint

  • hinge joint
  • dorsiflexion (flexion) and plantar flexion (extension)

Subtalar Joint
-permits inversion and eversion of the foot

33
Q

How does the spine curve?

A
  • in a double S shape
  • cervical and lumbar curves are concave (inward/anterior)
  • thoracic and sacrococcygeal curves are convex
34
Q

Musculoskeletal systems of infants and children

A
  • 3 months gestation : scale model of skeleton made out of cartilage
  • bone growth occurs rapidly during infancy and steadily during childhood
  • epiphyses (growth plates) where lengthening of the bones occur
  • at birth spine has single C shape
35
Q

Musculoskeletal systems of pregnant women

A
  • increased hormones can cause increased mobility of the joints (think of pelvis/pubic symphysis and birth)
  • Lordosis (curvature in back which compensates for enlarging Fetus)
  • anterior flexion of the neck and slumping of the shoulder girdle are other postural changes that compensate for the Lordosis.
  • back pain, nerve pressure
36
Q

Musculoskeletal systems of the aging adult

A
  • osteoporosis/ decreased bone density
  • increased bony prominences
  • cartilage degeneration
  • joint stiffness and lax ligaments
  • muscle atrophy
  • kyphosis
  • get shorter/postural changes
37
Q

Compare the bones of men to the bones of women.

A

men have larger and stronger bones than women

38
Q

Who has the highest risk of developing problems from loss of bone density?

A

Caucasian women (osteoporosis)

39
Q

What age group is more prone to injuries? why?

A

children, teenagers

related to risky behavior

40
Q

What subjective data should be collected during the musculoskeletal assessment.

A
  1. Joints (pain, stiffness, swelling, heat, redness, limitation of movement)
  2. Muscles (pain, cramps, weakness)
  3. Bones (pain, deformity, trauma: fractures, sprains, dislocations)
  4. Functional Assessment (activities of daily living)
  5. Self-care behaviors
41
Q

Smoking increases the risk of what musculoskeletal issue?

A

increased risk of developing vertebral fracture

42
Q

Alcohol increases the risk of what?

A

osteoporosis because alcohol raises parathyroid hormone with affects calcium activity in the body

43
Q

What is osteomyelitis ?

A

inflammation/infection of the bone

44
Q

why is a history of polio significant ?

A

can cause one leg to be shorter than the other, walk with a limp

45
Q

what is myalgia?

A

felt as cramping or aching feeling

46
Q

Compare the timings of the pains experienced with RA, Osteoarthritis and tendinitis.

A

RA pain is worse in the morning when arising
Osteoarthritis is worse later in the day
Tendinitis is worse in the morning and improves during the day

47
Q

Movement increases most joint pain except in…

A

RA, in which movement decreases pain

48
Q

Compare how RA and other musculoskeletal illnesses affect specific joints.

A

RA involves symmetric joints, other musculoskeletal illnesses involve isolated or unilateral joints.

49
Q

When does RA stiffness occur?

A

during the morning and after rest periods

50
Q

What may decreased ROM be due to?

A

joint injury to cartilage or capsule
or
to muscle contraction

51
Q

what kind of illnesses is myalgia often seen with?

A

viral illnesses

52
Q

what does the functional assessment do?

A

screens the safety of independent living, the need for home health services, and quality of life

53
Q

What are some common musculoskeletal symptoms?

A 
pain/discomfort
weakness
stiffness or limited movement
deformity
lack of balance and coordination
54
Q

What do we inspect during a musculoskeletal assessment?

A 
posture
gait and mobility
balance
coordination
extremities (size, shape,  and limb measurements only if there is an issue)
55
Q

What do we palpate during a musculoskeletal assessment?

A 
Joints
    - contour
    - size
    -ROM
Muscles
    -tone
    -strength
56
Q

Atony

A

lack of normal muscle tone or strength

57
Q

Hypotonicity

A

diminished tone of skeletal muscles

58
Q

Spasticity

A

hypertonic, so the muscles are stiff and movement awkward

59
Q

Fasciculation

A

involuntary twitching of muscle fibers

60
Q

Tremors

A

involuntary contraction of muscles

61
Q

Describe the rating scale for muscle strength

A

5/5 100% Normal
-complete ROM against gravity and full resistance

4/5 75% Good
-complete ROM against gravity and moderate resistance

3/5 50% Fair
-complete ROM against gravity

2/5 25% Poor
-complete ROM with the joint supported; cannot perform RPM against gravity

1/5 10% Trace
-muscle contraction detectable but no movement of the joint

0/5 0% Zero
-no visible muscle contraction

62
Q

Describe how you would collect objective data of the TMJ

A

Inspection
-symmetry, swelling, and redness

Palpation
-joint while having the patient open and close jaw

ROM
-open mouth, push jaw forward, move from side to side

Muscle strength
-do the above while exerting force

63
Q

Describe how you would collect objective data of the Cervical Spine

A

Inspection
-observe for concave curve of the cervical spine

Palpation
- for the spinous process C7

ROM

  • touch chin to chest
  • look up toward the ceiling
  • touch each ear to the shoulder
  • turn chin to shoulder

Muscle Strength
-rotate neck against the resistance of hand

64
Q

Describe how you would collect objective data of the shoulder

A

Inspection
-comparison of each shoulder for size and contour

Palpation
-note any muscular spasm, atrophy, swelling, heat or tenderness

ROM
-forward flexion, extension, hyperextension, adduction, abduction, internal and external rotation

Muscle Strength
-shrug shoulders, flex forward and upward and abduct against resistance

65
Q

Describe how you would collect objective data of the Elbow

A

Inspection
-size and contour while extended and flexed

Palpation
-with joint flex to 70 degrees - olecranon process and medial lateral epicondyles

ROM
-Flex, extend pronate and supinate

Muscle Strength
-while applying resistance flex and extend

66
Q

Describe how you would collect objective data of the wrist and hand

A

Palpation
-each joint using thumbs

ROM
-flexion and extension, radial ulnar deviation and thumb opposition

Muscle Strength
-perform ROM with resistance

67
Q

Describe how you would collect objective data of the Hip

A

Inspection

  • while standing assess for symmetry
  • while Supine assess for swelling, lacerations, lesions, deformity, size of muscle and symmetry

Palpation
-while supine palpate hip joints, iliac crest, and muscle tone

ROM
-flexion, extension, abduction, adduction, internal rotation, external rotation

Muscle Strength
-pressure upon flexion and abduction

68
Q

Describe how you would collect objective data of the knee

A

Inspection
-standing and sitting for contour and shape

Palpation
-while flexed and quad for muscle tone; palpate patella

ROM
-flexion and extension

Muscle Strength
-apply pressure upon extension

69
Q

Describe how you would collect objective data of the ankle and foot

A

Inspection
-sitting and standing for symmetry, swelling, lacerations, deformity

Palpation
-each joint

ROM
-dorsiflexion, plantar flexion, eversion and inversion flexion, hyperextension and extension of the toes

Muscle Strength
-dorsiflexion and plantar flexion against resistance

70
Q

Describe how you would collect objective data of the thoracic and lumbar spine

A

Inspection
-while standing inspect from the side for normal S pattern

Palpation
-spinous processes

ROM
-flexion, extension, hyperextension, and lateral flexion

Health Assessment Exam 4 (4 decks)

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