Nursing Assessment of the Musculoskeletal System Flashcards
What are gerontologic changes in muscles?
Decreased number and diameter of muscle cells; replacement of muscle cells by fibrous connective tissue
Loss of elasticity in ligaments and cartilage
reduced ability to store glycogen; decreased ability to release glycogen as quick energy during stress
What are gerontologic changes in joints?
Increased risk for cartilage erosion that contributes to direct contact between bone ends and overgrowth of bone around joint margins
Loss of water from disks between vertebrae; narrowing of intervertebral spaces
What are gerontologic changes in bones?
Decrease in bone density
What are gerontologic differences in assessment findings for muscles?
Decreased muscle strength and bulk; abdominal protrusion; flabby muscle
Increased rigidity in neck, shoulders, hips, and knees
Decreased fine motor dexterity, decreased agility
Slowed reaction times and reflexes as a result of slowing of impulse conduction along motor units; earlier fatigue with activity
What are gerontologic differences in assessment findings for joints?
Joint stiffness, decreased mobility, limited ROM, possible crepitation on movement; pain with motion and/or weight bearing
Loss of height from disk compression; posture change
What are gerontologic differences in assessment findings for bones?
Loss of height from vertebral compression, back pain; deformity such as dowager’s hump (kyphosis) caused by vertebral compression
What subjective data would you collect when performing a musculoskeletal assessment?
Past medical history Medications (how do the medications work and how are they doing for you) Surgery or other treatments Functional health patterns health perception-healthmanagement pattern nutritional-metabolic pattern elimination pattern activity-exercise pattern, sleep-rest pattern cognitive-perceptual pattern self-perception-self-concept pattern role-relationship pattern sexuality-reproductive pattern coping-stress tolerance pattern value-belief pattern
What objective data would you collect when performing a musculoskeletal assessment?
Physical examination
Inspection, Palpation, Motion, Muscle-strengh testing, Observe HT and WT, Measurement, Observing of movements, gaits and assess for abnormalities
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to health perception-health management pattern?
Describe your usual daily activities
Do you experience any difficulties performing these activities
Describe what you do if you experience difficulty in dressing, preparing meals and feeding yourself, performing basic hygiene, or maintaining your home
Do you have to lift heavy objects? Describe any specialized equipment you use or wear when you work or exercise that helps protect you from injury
Do you take any drugs or herbal products to manage your musculoskeletal problems? If so, what are their names and what are the expected effects
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to nutritional-metabolic pattern?
Obtain a 24-hour diet recall
What dietary supplements do you take? (Ask specifically about calcium, vitamin D supplements, and herbal products)
What is your weight? Describe any recent weight loss or gain
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to elimination pattern?
Does your musculoskeletal problem make it difficult for you to reach the toilet in time?
Do you need any assistive devices or equipment to achieve satisfactory toileting?
Do you experience constipation related to decreased mobility or to drugs taken for your musculoskeletal problem?
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to activity-exercise pattern?
Do you require assistance in completing you usual daily activities because of a musculoskeletal problem?
Describe your usual exercise pattern. Do you experience musculoskeletal symptoms before, during, or after exercising?
Are you able to move all your joints comfortably through full range of motion?
Do you use any prosthetic or orthotic devices?
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to sleep-rest pattern?
Do you experience any difficulty sleeping because of a musculoskeletal problem?
Do you require frequent position changes at night?
Do you wake up at night because of musculoskeletal pain?
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to cognitive-perceptual pattern?
Describe any musculoskeletal pain you experience. How do you manage your pain? (Ask specifically about adjunctive therapies such as heat and cold or alternative therapies such as acupuncture)
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to self-perception-self-concept pattern?
Describe how changes in you musculoskeletal system (posture, walking, muscle strength) and decreased ability to do certain things have affected how you feel about yourself. How have these changes affected your lifestyle?
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to role-relationship pattern?
Do you live along?
Describe how family members or others assist you with your musculoskeletal problem?
Describe the effect of your musculoskeletal problem on your work and on your social relationships?
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to sexuality-reproductive pattern?
Describe any sexual concerns related to your musculoskeletal problem?
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to coping-stress tolerance pattern?
Describe how you deal with problems such as pain or immobility that have resulted from your musculoskeletal problem
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to a value-belief pattern?
Describe any cultural practices or religious beliefs that may influence the treatment of your musculoskeletal problem
What is abduction?
Movement of part away from midline of body
What is adduction?
Movement of part toward the midline of body
What is circumduction?
Combination of flexion, extension, abduction, and adduction resulting in circular motion of a body part
What is dorsiflexion?
Flexion of the ankle and toes toward the shin
What is eversion?
Turning of sole outward away from midline of body
Qhat is extension?
Straightening of joint that increases angle between two bones
What is external rotation?
Movement along longitudinal axis away from midline of body
What is flexion?
Bending of joint as a result of muscle contraction that results in decreased angle between two bones
What is hyperextension?
Extension in which angle exceeds 180 degrees
What is internal rotation?
movement along longitudinal axis toward midline of body
What is inversion?
Turning of sole inward toward midline of body
What is opposition?
Moving the first and fifth metacarpals anteriorly from a flattened palm (cupping position); makes it possible to hold objects between the thumb and fingers
What is plantar flexion?
Flexion of the ankle and toes toward the plantar surface of the foot (toes pointed)
What is pronation?
Turning of palm downward
What is supination?
Turning of palm upward
What diagnostic studies do you perform for the musculoskeletal system?
X-rays
CT
MRI - soft tissue, to see if there is bleeding
Bone Mineral Density tests (check how brittle their bones are)
Bone scan - for tumors or abuse
Arthroscopy - looking at the joints
Mineral Metabolism and Serological testing-blood work
