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NUR 109 - Health Assessment > Musculoskeletal System > Flashcards

Musculoskeletal System Flashcards

1
Q

Joint types

A

fused: in skull ireggular and flat

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2
Q

Ball and socket

A

shoulder and hip

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3
Q

hinge

A

elbow and fingers and knee and toes

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4
Q

Gliding

A

wrist hand ankle foot

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5
Q

Plane

A

vertibrae

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6
Q

condyloid

A

wrists

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7
Q

Spine bones

A 
33 total
7 am cervical
12 pm thoracic
5 pm lumbar
1 am coccyx
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8
Q

Abduction

A

move from midline

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9
Q

adduction

A

move to midline

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10
Q

pronation

A

rotation from anatomical neutral

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11
Q

supination

A

rotation to anatomical neutral

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12
Q

eversion

A

bending away moving from midline (ankle)

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13
Q

inversion

A

bending toward midline (ankle)

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14
Q

Dorsiflexion

A

upward flex of foot

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15
Q

plantarflexion

A

down flex of foot

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16
Q

flexion

A

moving toward body

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17
Q

extension

A

moving away from body

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18
Q

elevation

A

movement that raises a part in its plane (shoulder shrug)

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19
Q

Tendons

A

力 to joint

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20
Q

Ligament

A

力 to 力

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21
Q

Strain

A

tendon injury

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22
Q

Sprain

A

ligament injury

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23
Q

Hand vs foot bones

A

Carpels and tarsals

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24
Q

力(muscle/musculoskeletal) diagnostics

A 
CPK 
xray
MRI
CT scan
DEXA (dual energy xray absorptiometry) for mineral density (osteoperosis)
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25
Q

Creatine phosphokinase (CPK) blood tests

A

shows increased CPK ↑ protein levels → 力 injury secondary to 力 disease (dystrophy), strenuous exercise

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26
Q

力 HH

A 
Family 力 disease 
surgical H (limited ROM)
Past (chronic) 
Nutrition (▲weight= ▲stress on joints)
Pain (numbness, edema, ▲skin color)
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27
Q

力 dystrophies

A

progressive 力 weakness

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28
Q

Osteoarthritis (OA)

A

progressive
wear down of protective cartilage
affects distal interphalangeal joins

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29
Q

Osteoporosis

A

progressive loss of bone density

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30
Q

Rheumatoid Arthritis (RA)

A

progressive inflammatory autoimmune that attacks metacarpophalangeal synovial joints in hands and feet

31
Q

Risk factors for RA

A

smoking, genetics, 40-60 yrs, woman

32
Q

OA riskfactors

A

woman, joint injuries, obesity, malnutrition, sedentary lifestyle, contact sports (length and type)

33
Q

力 Assessment sequence

A

Inspection
palpation
ROM
strength

34
Q

5 Ps of 力 problems

A 
Pain
paralysis
paresthesia
pallor 
pulsations
35
Q

paresthesia

A

burring, tingling, prickling

Serious, needs further assessment and should notify HCP

36
Q

Inspecting the gait

A

Person may need assistive walking help
have walk to and from me
assess joints ROM limps swing pain

N: 1.5 m for adults w/o problems
swing and step are contralateral
no loss of balance w/each step

37
Q

Limping with gait →

A

力 weakness, bone pain, injury to (力,tendon, ligament) or deformaty

38
Q

Alterations in gait (↑, ↓ and no) indicate

A

↑ loss in ligamentous or bony support in joint
↓ edema or injury
None: frozen/fused joint

39
Q

Ataxia

A

unsteady gait

from injury, pain or cerebellar function

40
Q

Diplegic gait (Scissors gait)

A

Legs swing across midline to compensate for lack of motion

common w/cerebral palsy

41
Q

Shuffling gait

A

Problem with balance, Parkinson’s (characteristic), ↓lower extremity strength

42
Q

Foot drop

A

weakness or paralysis of 力 in lower leg or inabliiy to control plantar flexsion of the ankle (cant bring foot to neutral)
→peroneal nerve injurst or 力/nerveological disroder

43
Q

Assessing Posture steps

A

While walking/sitting (Shoulders even, head over axial, head in relation to trunk.)
ask about back pain or ROM
Ask to rotate and tilt head
Ask to flex neck and look up
bend forward/ back and side to side for spinal curvature and ROM

44
Q

Posture normal

A

shoulder width apart at stand; even with no sloping
upright, looking forward, and head centered
wt evenly distributed
ROM symmetrical fluid and w/o pain

45
Q

Posture abnormal

A

Pain, tingling, numbness, ROM limits, asymmetry

caused by 力 weakness/tightness/injury, develop(ing/ed) deformity in bones

46
Q

Vertebral column Inspection and Palpation

A

Check spine at stand with posture note deviations from ant-post plane
have them bend forward check spine with 2-3 fingers
note devi from lateral plane

Look for deviations from ant-post or lateral planes, tenderness (bony/ligament problem), protrusions (displacement of vertebrae), or drop offs

47
Q

Scoliosis

A

S or C shaped curvature in the lateral plane of spine

48
Q

Kyphosis

A

hunchback curvature in thoracic spine

can affect thorax contents

49
Q

Lordosis

A

↑lower back arch curvature

50
Q

Inspection and Palpation of the upper extremities

A

I & Palp (2-3 fingers): shoulders elbow wrist and fingers and joints – Assess for tenderness, depressions, bulges and ▲temperature

N: Sym, no rounding straight arms, slight bend in elbow, wrists aligned w/ arm, slight flexion in fingers

51
Q

Upper extremities I & P findings for 力

A

A: Shoulder rounding (力 tightness in front over back),
Elbow straightened/hyperextension=loss of bony structure or flexed=serious joint problem,
bony/nerve damage to ROM
======
▲temp= joint infection/disease
missing finger= trauma/disease process

52
Q

Upper extremities Tenderness →

A

incurs to bone, 力 , tendon, ligament

53
Q

Upper extremities depressions →

A

dislocated joint, joint subluxation (partial dislocation), or significant 力 injury

54
Q

Upper extremities Protrusions →

A

disloci/subluxed joint, fracture, Ca++ buildup in 力, type of arthritis (Bouchard’s nodes, Heberden’s nodes)

55
Q

Bouchard’s nodes

A

bony enlargements of proximal interphalangeal joints (PIP), common in people with OA and RA

56
Q

Heberden’s nodes

A

bony enlargements of distal interphalangeal joints

common in people with OA

57
Q

Upper extremities ROM tests

A

Check the 10 cardinal motions where applicable w/o then w/resistance
At: shoulders, elbow, wrists, fingers
For ROM, fluidity, pain, strength

58
Q

Tinel’s sign

A

for Carpel tunnel syndrome: Palm up and fingers at natural curl, tap median nerve at wrists (thumb side)
Tingling or pain radiating to thump, index or middle finger is positive

59
Q

Phalen’s test

A

flex both wrists in and fingers extended pointing down (╦) and press together for 1 min
Positive if tingling or numbness in the palmar aspect of the fingers

60
Q

Expected Shoulder ROM

A

Flextion vs Extenstion: 180 (1π) vs 45-60 (1/4π to 1/3π)
Abduction vs adduction: 150 vs 10-20 (180-10-20)=150)
Rotation internal vs external: 70-90 vs 90
(shoulder extension (backward) at -80º )

61
Q

Elbow and forearm expected ROM

A

Flexion vs extension: 150 vs 0

Pronation vs Supination: 70 vs 85

62
Q

Wrist expected ROM

A

Flexion vs extension: 90 vs 70

Deviation radial vs ulnar: 20 vs 50

63
Q

Muscle Strength scale

A

0: unable to contract in gravity eliminated position
1: Able to contract slightly
2: Able to move joint in gravity eliminated position
3: Able to move joint against gravity
4: Able to move joint with some resistance through ROM
5: Able to move joint in full ROM

64
Q

Upper extremities ROM abnormal

A

Anything less than ROM angles→ injury, surgery, disease, neurological
Carpel tunnel syndrome
Strength ≤4 → muscle weakness from injury or deconditioning
Pain →injury note as (4/5 with pain)

65
Q

Carpel tunnel syndrome

A

Compression of median nerve that runs from forearm to palm caused by repetitive movements

66
Q

Inspection and Palpation of the Lower extremities

A

Sitting or in supine - Hip, knee, ankle, foot, toes

Assess for tenderness, depressions, bulges and ▲temperature, weight on both sides, no hip bent forward, straight upper legs

knees bent forward slightly, ankle perpendicular to lower leg, and foot (forward, aligned with knee, with slight arch at median)

67
Q

Lower extremities abnormal

A

Uneven wt bearing, shortened extremity (injury, disease, surgery), defomities
Unusual Flexion → joint, tightness, bony/opposing muscle injury, bony buildup, disease, a loose body
Unusual Laxness → poor ligaments, opposing muscle injury
General edema: circulatory problem (note this)

68
Q

Hallux Valgus

A

Bunion

lateral deviation and enlarged joint of the great toe

69
Q

Hammertoe

A

permanent contracted-toe deformity proximal interphalangeal joint of 2-4th toe can be affected

70
Q

Lower extremities

A

Check the 10 cardinal motions where applicable w/o then w/resistance
Hip, knee, ankle, foot, toes
For ROM, fluidity, pain, strength

71
Q

Expected hip ROM

A

Flexion vs extension: 120 vs 20

Abduction vs adduction: 45-50 vs 10-20

72
Q

Expected Knee ROM

A

Flexion vs Extension: 130- 150 vs 0-(-3)

73
Q

Expected Ankle ROM

A

Plantar vs Dorsi- flexion: 50 vs 20

In vs e- version : 20 vs 15

74
Q

Musculoskeletal HP 2020

A

Prevent OA, OP, RA, back pain via exercise, diet (Ca++, Mg, vit D, P), weight, posture

NUR 109 - Health Assessment (6 decks)

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