Musculoskeletal System Flashcards
Active Range of Motion
Ask the patient to move the extremity a certain way and the patient does it on their own.
Passive Range of Motion
Patient relaxes the extremity and you move it for them.
What is the scale for muscle strength?
0- No contraction
1- Slight contraction
2- FROM with gravity eliminated- Passive ROM
3- FROM with gravity and no resistance
4- FROM against gravity and some resistance
5- FROM against gravity and full resistance
How do you assess ROM of the Temporomandibular joint?
- Place the tips of your fingers in front of their ears and have them open and close their mouth. The motion should be smooth.
- Have patient slightly open their mouth and move the jaw laterally.
- Have the patient slightly open their mouth and stick out their jaw. There should be no deviation.
- Have the patient clench their jaw and palpate the temporalis and masseter muscle.
How do you assess ROM of the Cervical Spine?
Ask the patient to complete these motions first alone then with opposing force:
- Hyperextension (lift chin towards ceiling)
- Flexion (touch chin to chest)
- Lateral bending (touch ear to corresponding shoulder without lifting the shoulder)
- Rotation- turn the chin towards each shoulder)
How do you assess ROM of the shoulders?
Ask the patient to complete the following motions:
- Forward flexion and hyperextension- With arms at sides and elbows extended, move both arms forward and up in wide vertical arcs and then move them back.
- Internal rotation- Rotate arms internally behind back; place back of hands as high as possible toward scapulae.
- Abduction and Adduction- With arms at sides and elbows extended, raise both arms in wide arcs in the coronal plane. Touch palms together above head.
- External rotation- • Touch both hands behind the head with elbows flexed and rotated posteriorly
How do you assess ROM of the elbow?
Ask the patient to complete these motions:
- Flexion and extension- Bend and straighten the elbow
- Pronation and supination- hold the hand midway and touch front and back sides of hand on the table.
*To test strength- have them flex against resistance and extend against resistance
How do you assess ROM of the wrist and hand?
Ask the patient to complete the following motions:
- Hyperextension- Bend hand up at wrist
- Palmar flexion- bend hand down at wrist
- Hyperextension and flexion of the fingers- bend fingers up and down
- Ulnar and radial deviation- hands flat on the table, turn them inwards and outwards.
- Abduction and adduction of the fingers- spread fingers apart, make a fist
- Touch thumb to each finger and base of little finger
What are the 2 assessments for Carpal Tunnel Syndrome and how are they performed?
-Phalen Test: Ask the patient to hold hands back to back while flexing the wrist at 90 degrees.
This acute flexion of the wrist for 60 seconds produces no symptoms in the normal hands. If they have numbness and tingling into the hand and middle fingers—this is a positive Phalen test—not normal.
Tinel sign: Direct percussion on the medial nerve of the wrist. This should not produce any symptoms. If they have numbness, tingling, burning through the hand and fingers—this is a positive Tinel’s sign—not normal.
How do you assess ROM of the hip?
- Hip flexion- Raise each leg with knee extended, bend each knee up to the chest while keeping the other leg straight.
- Internal and external rotation- Flex knee and hip to 90 degrees. Stabilize by holding the thigh with one hand and the ankle with the other hand. Swing the foot outward. Swing the foot inward. Foot and thigh move in opposite directions.
-Abduction and adduction- move leg in and out
Hyperextension- while standing or bending over table, swing straight leg backwards
How do you assess ROM of the knee?
- Flexion- bend each knee
- Extension- straighten each leg out
What are two assessments for the knee?
- Bulge sign: For swelling in the suprapatellar pouch. Firmly stroke up on medial aspect of knee two to three times to displace any fluid. Then tap the lateral aspect of the knee. Watch the medial side in the hollow for a distinct bulge from a fluid wave. Normally, none is present. If there is a fluid wave—this is a positive Bulge sign (not normal).
- Ballottement of the patella: Use left hand to compress the supra-patellar pouch to move any fluid into the knee joint. With your right hand, push the patella sharply against the femur. If no fluid is present, the patella will fit snug against the femur. IF the patella ballots (like a bobber in water), this is a positive ballottement sign (not normal).
How do you assess ROM of ankle and foot?
- Plantar flexion- point toes toward the floor
- Dorsiflexion- point toes towards the nose
- Eversion- Soles of foot out
- Inversion- Soles of foot in
How do you assess ROM of the spine?
- Lateral bending- bend sideways
- Hyperextension- bend backwards
- Rotation- turn to one side then the other
What is rheumatoid arthritis?
inflammatory disease of the joints and surrounding connective tissue. Limits movement.
