musculoskeletal objectives Flashcards
Abduction
Moving a limb away from the midline of the body.
Adduction
Moving a limb toward the midline of the body.
Extension
Straightening a limb at a joint, increasing the angle between bones.
Flexion
Bending a limb at a joint, decreasing the angle between bones.
Rotation
Moving a body part around its axis (e.g., turning the head side-to-side).
Plantarflexion
Pointing the toes downward, like pressing a gas pedal.
Dorsiflexion
Pulling the foot upward, opposite of plantarflexion.
What is the TMJ?
The articulation between the mandible and temporal bone.
Where can the TMJ be felt?
In the depression anterior to the tragus of the ear.
What functions does the TMJ permit?
Speaking and chewing.
What are the three motions of the TMJ?
- Hinge action (open and close jaws)
- Gliding action (protrusion and retraction)
- Gliding side-to-side movement.
What should be assessed during TMJ palpation?
Crepitus (crackling sound) or pain with motion or palpation.
What is the purpose of both Phalen and Tinel tests?
To assess for carpal tunnel syndrome by evaluating the function of the median nerve.
How is the Phalen test performed?
Ask the person to hold both hands back-to-back while flexing the wrists to 90 degrees for 60 seconds.
What is a normal Phalen test result?
No symptoms (numbness or tingling) in the hand.
How is the Tinel sign performed?
Tap (percuss) directly over the median nerve at the wrist.
What is a normal Tinel sign result?
No symptoms (tingling or pain) are felt when percussing the nerve.
What is a positive result for either test?
Tingling, numbness, or pain over the median nerve distribution (thumb, index, middle, and part of the ring finger).
What do positive Phalen and Tinel tests indicate?
Both suggest carpal tunnel syndrome.
How do the tests differ?
Phalen test assesses symptoms after prolonged wrist flexion, while Tinel sign identifies irritability of the median nerve by direct percussion.
What is Genu Varum?
A condition where the legs curve outward, creating a bow-legged appearance: _ _/.
What is Genu Valgum?
A condition where the knees come inward, creating a knock-kneed appearance: _/ _. The Disknees
What are non-synovial joints?
Joints where bones are united by fibrous tissue or cartilage.
What are examples of non-synovial joints?
Immovable: Skull sutures
Slightly movable: Vertebrae.
What are synovial joints?
Joints where bones are separated by a joint cavity and enclosed, allowing free movement.
What fills the joint cavity in synovial joints?
Synovial fluid, which lubricates the joint for smooth movement.
Example of a synovial joint?
The knee joint.
What subjective data should be collected during joint assessment?
- Pain?
- Stiffness?
- Swelling, heat, or redness?
What do you inspect during joint assessment?
Size, contour, color, swelling, and deformities of the joint and surrounding tissues.
What does the presence of swelling suggest?
Possible joint irritation or inflammation.
How is palpation performed on joints?
Palpate the joint and surrounding tissues to assess temperature, muscle tone, stability, and tenderness.
Is tenderness normal during joint palpation?
No, joints should not be tender. If tenderness is found, localize it to a specific structure (skin, muscle, ligament, tendon).
What is assessed during Range of Motion (ROM)?
Active voluntary ROM, ensuring movements are within normal limits for the specific joint.
What does the Bulge Sign assess?
Detects fluid in the suprapatellar pouch of the knee joint.
How is the Bulge Sign performed?
- Firmly stroke up on the medial knee to move fluid.
- Tap lateral aspect and watch for a fluid bulge on the medial side.
What does a positive Bulge Sign indicate?
Joint effusion or fluid accumulation in the knee.
What is McMurray’s test used for?
To assess for a meniscus tear in the knee.
What position is the person placed in for McMurray’s test?
Supine position, with the examiner standing on the affected side.
How is McMurray’s test performed?
- Hold the heel and flex the knee and hip.
- Place your other hand on the knee with fingers on the medial side.
- Rotate the leg in and out to loosen the joint.
- Externally rotate the leg while applying valgus (inward) stress on the knee.
- Slowly extend the knee.
What is a normal finding during McMurray’s test?
The leg extends smoothly without pain.
What indicates a positive McMurray’s test?
Clicking, locking, or pain during the maneuver, suggesting a meniscus tear.
Why is McMurray’s test important?
It helps confirm suspected meniscal injuries, which are common in athletes or after knee trauma.
What is a goniometer?
A device used to measure the degrees of movement at a joint.
What does it assess?
Range of motion (ROM) and angle of joints.
In what scenarios is it used?
Commonly used in rehabilitation, such as after an ACL repair, to track progress (e.g., increasing from 10 to 20 degrees of flexion).
Why are weight-bearing considerations important?
They affect safety and mobility during ambulation.
What does FWB stand for?
Full Weight Bearing - the patient can place full weight on the affected limb.
What does PWB stand for?
Partial Weight Bearing - the patient can place a limited amount of weight (e.g., 10-15 pounds) on the limb.
What does TTWB stand for?
Toe-Touch Weight Bearing - the patient uses toes for balance but does not put weight on them.
What does NWB stand for?
Non-Weight Bearing - the patient cannot put any weight on the limb.
What are key observations during a musculoskeletal assessment?
- Gait: Observe as the patient enters.
- Steadiness: Check balance.
- Posture: Note seated and standing posture.
What should be assessed during the removal of clothing?
The ability to manipulate and raise arms without discomfort or difficulty.
What should be noted when the patient raises from a supine position?
Assess ease of movement and any potential pain or instability.
What should be observed when manipulating small objects?
Fine motor skills and coordination.
What specific assessments should be conducted?
Assess strength and sensation in both upper and lower extremities, especially in patients with strokes or injuries
What is polydactyly?
A condition characterized by multiple fingers or toes (extra digits).
What is syndactyly?
A condition where fingers or toes are fused together (webbed).
What age can syndactyly be fixed?
Typically corrected once the child is over one year old.
What health issue can be associated with syndactyly?
May indicate potential kidney issues or other congenital conditions.
What is an open (compound) fracture?
A fracture where the bone is exposed and breaks through the skin.
What is a major risk associated with open fractures?
Very high risk for infection due to exposure to the environment.
What is a closed fracture?
A fracture that does not break through the skin; the bone remains enclosed.
Kyphosis
Hunchback; excessive forward rounding of the upper back. Common in older adults; associated with weak spinal bones.
Lordosis
Excessive inward curvature of the lower back, creating an arch. Can progress during pregnancy; may cause back pain.
Scoliosis
Lateral curvature of the spine, leading to asymmetry. Can cause breathing difficulties and compress organs.
Morse Scale
An objective fall risk stratification tool used in clinical settings.
Score Range
Scores fall risk from 0 to 125.
High Fall Risk
A score of > 45 indicates high fall risk.
Interpretation
A higher score correlates with higher fall risk.
