musculoskeletal assessment exam 2 Flashcards
when asking PT about Musculoskeletal history what should the nurse ask?
- have they had any injury?
- back pain?
- skeletal complaints (ask how their gait is)
- joint complaints
- any changes in the ability to participate in ADL’s
What questions should the nurse ask regarding ADL’s?
- are activities limited by musculoskeletal disorder
- how is their pain or disorder effecting their ADL’s
- how is PT with chronic or debilitating disease compensating?
when inspecting pt with musculoskeletal disorder what should the nurse look for?
- posture
- symmetry (ex: one side is atrophy)
- gait / patters of movement
- shape of spine
when palpatating pt with musculoskeletal disorder what should the nurse look for?
- muscle tone
- temp variations
- tremor/fasciculation (uncontrolled movements)
- crepitus (popping, clicking, under the skin in the joints)
- tenderness
when assessing gait and balance what should the nurse be looking for?
- assess foot placement and arm swing
- tandem walking or heal to toe walking (sobriety test)
- tiptoe walking to look at balance
- Bomberg test of balance
what is the Bomberg test of balance?
- pt closes eyes and we assess their balance, if they sway too far and could fall we think they may have a skeletal muscle issue or neurological
what is kyphosis?
curve of the spine, in older people
what are the 2 types of range of motion
- active = can do independently
- passive = needs assistance
What is the muscle strength test and what is the nurse doing?
- pt shoulder shrugs w/ nurse pushing down against the shoulders to assess strength
- same thing with arms, legs, feet
what do nurses assess for when they ask the pt to squeeze both hands equally?
- atrophy
- stroke
- flaccid muscles
- spasticity
- symmetry
- if pt can squeeze both hands equally it means that pt has equal bilateral hand symmetry
how is muscle strength graded?
- with a numerical scale that goes 0 - 5
- 0 = no muscle contraction detected
- 1 = trace contraction of muscle, 10% of strength
- 2 = Moves muscle when gravity is eliminated about 25% of muscle strength
- 3 = Moves muscle with gravity about 50% of muscle strength
- 4 = Moves muscle against some resistance of examiner, about 75% of muscle strength
- 5 = Moves muscle against examiner w/ full resistance, expected or 100% of muscle strength
what is abducted?
- away from the center of body
what is addictive?
- towards center of body
what is inversion?
- towards the midline
define eversion?
- moving away from the midline
what is supinate
- outward rolling
what is pronation?
- inward rolling
what is plantar flexion?
- downward motion
what is extension?
- decreases the angle b/t bones of the limb & joint
what are the cardinal signs of musculosketal disease
- pain
- redness
- swelling
- warmth
- deformity
- loss of function
