Objective & Abnormal Flashcards
Make the person comfortable as your general approach, compare _____ to affected side, and proceed in a cephalocaudal order (proximal to distal -from the midline outward), look at ______ appearance, ________, and gait and mobility patterns….what do these include? 3 things
unaffected, overall, posture, weight-bearing status, gait patterns, and transfer ability
Abnormal Gait patterns:
- ) limited weight bearing: _________
- ) Foot dragged across floor in semicircle: ________
- ) Staggering (cerebellar) : ________
- ) Foot flaps floor (polio) : ________
- ) Difficulty starting; shuffling (alzheimer’s) : _____________
antalgic, scissors , ataxia ,steppage, apraxic
A general assessment includes:
- Height and weight are __________.
- Full ROM
- Ambulate independently.
- No structural _______.
- Shoulders & hips are level.
- Head & torso are upright
- ________ gait.
proportionate, defects, stable
Inspection includes:
- muscle size and shape: _________, atrophy, __________ muscle mvmt’s, limb circumference.
- Joint ______ and periarticular tissue
Hypertrophy, involuntary, contour
Normal findings of Inspection:
- ________ muscle contour.
- No involuntary muscle movements.
- Bilateral limb circumference is within __-__ cm of each other
- Joints are _____ when extended, and smooth/round during ______.
- No joint enlargement or deformity.
symmetrical, 1-3, flat, flexion
Palpation includes:
- Measure muscles and use _______ or gravity against to assess.
- Look for heat, _____, tenderness, limitation, masses on joints.
- Assess muscle strength, Scale (5/5)= WNL
- The ______ membrane normally is not palpable, when thickened with fluid, it feels “spongy”, can visibly see the fluid shift from side to side
resistance, edema, synovial
What are some special techniques for assessing joints?
- temporomandibular
- cervical spine
- shoulders
- elbows
- wrist & hands
- knees
- ankles & feet
- spine
On the patellar ballotement assess for large ______, No palpable click.
effusions
Normal findings of Joints & muscles:
- _______ muscle tone
- No ______ or masses
- Joints without _____, tenderness, or edema.
- Full ROM
- Muscle strength 5/5, and equal bilaterally
- No lordosis, _______, or scoliosis.
bilateral, crepitus, pain, kyphosis
Gerontological variations:
- bone density decreases
- weaker bones increases risk of ________
- Muscle ______.
- decreased muscle strength
- deterioration of articulating cartilage.
- vertebral ________
- thoracic _________
osteoporosis, atrophy, inflexibility, kyphosis
On inspection, ______ may be due to excess joint fluid, thickening of the _____ lining, inflammation of surrounding soft tissue ( _____, tendons), or bony _________.
swelling, synovial, bursae, enlargement
Deformities include:
- complete loss of contact btw the two bones in a joint: _______
- Two bones in a joint stay in contact, but their alignment is off : ________
- Shortening of a muscle leading to limited ROM of joint: _________
- Stiffness or fixation of a joint: _________
dislocation, subluxation, contracture, ankylosis
Limitation in ____ ____ _______ is the most sensitive sign of joint disease.
- Disease inside the joint capsule (e.g. Arthritis): ________, produces swelling and tenderness around the whole joint, and it limits all planes of ROM in both ____ and passive motion.
- Injury to a specific tendon, ligament, nerve : ________, produces swelling and tenderness to that ___ spot in the joint and affects only certain planes of ROM, especially during ______ (voluntary) motion
Range of motion, Articular, active, Extra-articular disease, one, active
An audible and palpable crunching or grating that accompanies movement: _______, It occurs when the articular surfaces in the joints are roughened, as with ______ arthritis.
Crepitation, Rheumatoid
Degenerative conditions:
- Noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchrondral bone and formation of new bone (osteophytes) at joints surfaces: __________.
- A decrease in skeletal bone mass occuring when rate of bone resorption is greater than that of bone formation. the weakened bone increases risk for stress fractures esp at wrist, hip and vertebrae: _________
Osteoarthritis (degenerative joint disease), Osteoporosis
Inflammatory conditions:
- A chronic, systemic inflam. disease of joints and surrounding connective tissue. inflam of synovial membrane leads to thickening; then to fibrosis, which limits motion, and finally to bony ankylosis. Head, redness, swelling, and painful motion of affected joints: ________ ______
- A chronic, progress, inflam of spine, sacroilliac, and larger joints of the extremities, leading to bony ankylosis and deformity, a form of RA : _____ spondylitis
Rheumatoid arthritis, ankylosing
*Crepitus and pain occur with _________ joint dysfunction.
*______ motion may be lost earlier and more significantly than vertical.
temporomandibular, lateral
When assessing muscle strength, the nurse observes that a patient has complete range of motion against gravity with full resistance. What Grade should the nurse record using a 0 to 5 point scale?
A) 2
B) 3
C) 4
D) 5
5
Pages: 578-579. Complete range of motion against gravity is normal muscle strength and is recorded as Grade 5 muscle strength.
The nurse is assessing the joints of a woman who has stated, “I have a long family history of arthritis, and my joints hurt.” The nurse suspects that she has osteoarthritis. Which of these are symptoms of osteoarthritis? Select all that apply.
A) Symmetric joint involvement
B) Asymmetric joint involvement
C) Pain with motion of affected joints
D) Affected joints are swollen with hard, bony protuberances
E) Affected joints may have heat, redness, and swelling
B) Asymmetric joint involvement
C) Pain with motion of affected joints
D) Affected joints are swollen with hard, bony protuberances
Page: 608. In osteoarthritis, asymmetric joint involvement commonly affects hands, knees, hips, and lumbar and cervical segments of the spine. Affected joints have stiffness, swelling with hard bony protuberances, pain with motion, and limitation of motion. The other options reflect signs of rheumatoid arthritis.
What are some abnormalities of the shoulder?
Atrophy, dislocated shoulder, joint effusion, tear/rotator cuff, frozen shoulder (adhesive capsulitis), and subacromial bursitis
Loss of muscle mass is exhibited as a lack of fullness surrounding the deltoid muscle from a shoulder abnormality (picture representation is axillary nerve palsy). Also occurs from disuse, muscle tissue damage, or motor nerve damage.
atrophy
Anterior ________ of the shoulder is exhibited when hunching the shoulder forward and the tip of the clavicle dislocates. it occurs with trauma involving abduction, _______, and rotation (ex. falling on an outstretched arm or diving into a pool)
dislocation, extension
Swelling from excess fluid in the joint capsule,(picture from rheumatoid arthritis), best observed anteriorly. fluctuant to palpation. considerable fluid must be present to cause a visible distention b/c the capsule is normally is so loose.
joint effusion
Characteristic “hunched” position and limited abduction of arm. Occurs from traumatic adduction while arm is held in abduction, or from fall on shoulder, throwing, or heavy lifting.
*Positive drop arm test: if the arm is passively abducted at the shoulder, the person is unable to sustain the position and the arm falls to the side
Tear or rotator cuff
