Musculoskeletal Exam

Question 1

Flexion

Answer 1

Bending motion that decreases the angle between two body parts

Question 2

Abduction

Answer 2

motion that pulls a structure or part away from midline

Question 3

Extension

Answer 3

Bending motion that increases the angle between two body parts

Question 4

Adduction

Answer 4

Motion that brings a structure or part to/ across midline

Question 5

Hyperextension

Answer 5

Added movement (extension) beyond normal limits

Question 6

Internal Rotation

Answer 6

Rotation towards the axis of the body

Question 7

Rotation

Answer 7

rotating, turning action of a body part from another, internal or external

Question 8

External Rotation

Answer 8

Rotation away from axis of the body

Question 9

Lateral Bending

Answer 9

Spine - standing tall and tilting side to side with torso. Neck = ear to shoulder (not rotation, just tilting)

Question 10

Inversion

Answer 10

Rotation inward, medially (most common method of a sprained ankle) sole of the foot is tilted in

Question 11

Supination

Answer 11

rotation that is turned outwards - laterally - holding a bowl of soup

Question 12

Eversion

Answer 12

rotation outward, laterally, sole of the foot is tilted out

Question 13

Pronation

Answer 13

rotation that is turned inwards - towards medial line

Question 14

Plantar flexion

Answer 14

where the toes are pointed - away from the shin

Question 15

Radial Deviation

Answer 15

Hands in neutral (flat) position and turned in towards thumb

Question 16

Dorsiflexion

Answer 16

Where the toes are brought closer to the shin

Question 17

Ulnar Deviation

Answer 17

Hands in neutral (flat) position and turned out towards pinkie

Question 18

Rationale for examining the joint above and below the area of musculoskeletal complaint

Answer 18

Musculoskeletal injuries can cause a person to guard, limp, shift weight, or otherwise compensate for the injured site. The injury may have been caused by instability (or other injury) of a different joint.

Question 19

Rationale for examining the contralateral side from the area of musculoskeletal complaint

Answer 19

Comparison for what is normal on each particular person. Everyone has slight anatomical variations of normal.

Question 20

Grading system used to classify muscle strength

Answer 20

0 - No firing of muscle fibers
1 - No movement, slight contractility
2 - Movement with gravity eliminated
3 - Movement against gravity
4 - Movement against slight resistance
5 - Movement against full resistance

Question 21

Reason for evaluating range of motion actively first, then passively, the against resistance

Answer 21

• This allows you to see what the patient is capable of before you perform passive range of motion.
• AROM and PROM should be equal bilaterally
• Diminished AROM can mean muscle, tendon, or ligament problems or weakness
• Pain with PROM indicates joint problems
• PROM usually exceeds AROM by 5 degrees
• Last against resistance, to first assess if there was pain

Question 22

Supplies and equipment necessary for examination of the musculoskeletal system.

Answer 22

• Marker (to make sure measurements are taken in the same spot bilaterally)
• Tape measure (lengths and atrophy)
• Goniometer (to determine degree of joint flexion and extension

Question 23

Goniometer and its use

Answer 23

Used when there’s increase or decrease ROM or if 2 sides are not symmetrical.
-Place center of protractor over joint and align straight arms with long axes of extremities and take reading

Question 24

Myopathy

Answer 24

affects muscles directly, most have proximal weakness or fatigue, normal sensation, and reflexes intact until significant atrophy, pain not common

Question 25

Neuropathy

Answer 25

damage to nerves caused by trauma, disease, or component of systemic illness

Question 26

Polyneuropathy

Answer 26

occurs when multiple nerves involved, most of the time signs and symptoms are symmetric and begin with sensory loss in longest nerves in body (toes/feet occur first then hands/fingers)

Question 27

Fracture

Answer 27

partial or complete break in continuity of a bone from trauma. - Subjective: pain, limited movement, can't bear weight, swelling, pop or snap heard, more often with patients with bone disorders - Objective: deformity, edema, pain, loss of function, color changes, and paresthesia.

Question 28

Sprain

Answer 28

trauma to ligaments that causes pain and disability, depending on the degree of injury to the ligaments, most severe cases ligaments are torn, most common in ankle joint

Question 29

Strain

Answer 29

from excessive stretch or forceful contraction beyond muscle capacity. Associated with: improper warm up, fatigue, or previous injury. Subjective: muscle pain, ranges from mild intrafibrous tear to total rupture Objective: temporary muscle weakness, spasm, pain, contusion

Question 30

Dislocation

Answer 30

complete separation of contact between 2 bones in a joint caused by pressure/force in acute trauma Subjective: occurs more easily with hyper extensibility (Marfans) Objective: deformity and inability to use extremity or joint as usual

Question 31

Subluxation

Answer 31

partial or incomplete dislocation

Question 32

Reasoning behind examining additional body systems when evaluating a musculoskeletal complaint

Answer 32

Assess peripheral circulation and neurological innervation of any injured extremity. Examine pallor/cyanosis, temp, capillary refill, swelling, numbness, tingling, loss of movement, radiating pain - because indicative of other pathologies such as: - Cardiovascular: angina, MI, aortic abdominal aneurysm - Pleura: pneumonia, cancer, pneumothorax, pleurisy - Stomach: gastritis, peptic ulcer, cancer - Liver/Gallbladder/Pancreas: Hepatitis, pancreatitis, etc - Neurological: HSV, tumor