Musculoskeletal Assessment 3

Question 1

Range of Motion is documented as

Answer 1

active (pt performs movement) or passive (nurse puts the joint through rom) movement, intact and if not intact document which joint

Question 2

inspection and palpation of joints and muscles

Answer 2

Size, shape, color, symmetry; Pain, tenderness ; Nodules; Crepitus—joint clicking or creaking; Range of Motion (ROM)

Question 3

information about ROM

Answer 3

Every joint has normal ROM; Motion may be possible in several directions depending on type of joint; Joint motion occurs with ease if within 10%-20% of maximum possible; ROM normal if occurs without stiffness, pain, or crepitation; Joint movement past normal possible may be abnormal, indicating ligament tears, connective tissue disease, or fracture

Question 4

How is ROM measured

Answer 4

Measured in degrees—use Goniometer

Question 5

Abduction

Answer 5

movement of a part away from the center of the body

Question 6

Adduction

Answer 6

movement of a part toward the center of the body

Question 7

Circumduction

Answer 7

a circular motion that combines flexion, extension, abduction, and adduction

Question 8

Flexion

Answer 8

decreases the angle between bones or brings bones together

Question 9

Extension

Answer 9

increases the angle to a straight line or zero degrees

Question 10

Pronation

Answer 10

turning the forearm so the palm is down

Question 11

Supination

Answer 11

turning the forearm so the palm id up

Question 12

Internal Rotation

Answer 12

Rotating an extremity medially along its axis

Question 13

External Rotation

Answer 13

rotating an extremity laterally along its axis

Question 14

muscle strength

Answer 14

Assess muscle strength by having patient move against resistance; Compare for symmetry; Observe for - Atrophy (↓ in size), Tremors (involuntary movements), Tone (flaccid, weakness of muscle), Pain, swelling

Question 15

Screening for Muscle Strength: Biceps

Answer 15

elbow flexion

Question 16

Screening for Muscle Strength: triceps

Answer 16

elbow extension

Question 17

Screening for Muscle Strength: wrist

Answer 17

flexion

Question 18

Screening for Muscle Strength: fingers

Answer 18

abduction

Question 19

Screening for Muscle Strength: should

Answer 19

abduction

Question 20

Screening for Muscle Strength: quadriceps

Answer 20

knee extension

Question 21

Screening for Muscle Strength: hamstring

Answer 21

knee flexion

Question 22

Screening for Muscle Strength: ankle

Answer 22

Plantar flexion—toes pointed down; Dorsi-flexion—toes pulled back toward knee

Question 23

Osteoarthritis (OA)

Answer 23

Degenerative joint disease; Progressive loss of articular cartilage

Question 24

Rheumatoid arthritis (RA)

Answer 24

Autoimmune disorder; Tender, painful, swollen, stiff joints; Ulnar drift

Question 25

Nodules (seen with RA and OA)

Answer 25

Heberden’s nodes (hard, painless nodules over distal interphalangeal joints; Bouchard’s nodes (hard, painless nodules over proximal interphalangeal joints

Question 26

Carpal Tunnel

Answer 26

Compression of medial nerve of hand; Phalen’s test; Tinel’s sign

Question 27

Gout

Answer 27

Abnormal purine metabolism; Excessive uric acid; Severe pain, redness, swelling of great toe (usually)

Question 28

Hypokalemia

Answer 28

Potassium determines rate of firing of muscle cells; Weakness, lassitude, spasm

Question 29

Tetany

Answer 29

Involuntary spasm of muscle due to ↓Calcium; Chvostek’s sign (facial muscle spasm with tapping over facial nerve); Trouseau’s sign (spasm, claw-like flexion of wrist with BP cuff inflate)

Question 30

Chvostek’s sign

Answer 30

(facial muscle spasm with tapping over facial nerve)

Question 31

Trouseau’s sign

Answer 31

(spasm, claw-like flexion of wrist with BP cuff inflate)

Question 32

Osteoporosis

Answer 32

loss of bone density

Question 33

Osteoporosis risk factors

Answer 33

Female, >70 years; Male, >80 years ; White or Asian, small frame; Postmenopausal—lack of estrogen; Low calcium intake; Sedentary life style; Excessive caffeine,; ETOH; Smoking; Steroid use

Question 34

Osteoporosis risk reduction measures

Answer 34

↑ physical activity; ↑ calcium intake; Avoid excessive caffeine, ETOH; Stop smoking; Avoid use of steroids; Consider HRT

Question 35

phalen’s test

Answer 35

wrist to wrist

Question 36

tinel’s sign

Answer 36

palpate nerve in wrist

Question 37

what’s not good for gout

Answer 37

red or processed meats

Question 38

too much Ca

Answer 38

kidney stones

Question 39

bones regulate

Answer 39

Ca serum levels

Question 40

Ca too high

Answer 40

osteoblast

Question 41

Ca too low

Answer 41

osteoclast