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Physical assessment - musculoskeletal & abdomen Flashcards

1
Q

What are the bone’s function?

A 
Bones (206) 
 Support and protect organs and tissues 
 Provide leverage 
 Store minerals (calcium) 
 Contain bone marrow
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2
Q

What are the joint’s structure and function?

A

 Junction of 2 or more bones
 Allow movement
 Synovial joint: ball & socket / hinge
 Non synovial joint: fibrous tissue or cartilage

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3
Q

What are skeletal muscle’s structure and functions?

A 
Skeletal Muscle (>600) 
Voluntary 
Muscle fibres 
Connective tissue 
Tendons  
Posture 
Body movement
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4
Q

What are examples of range of motion?

A 
 Abduction 
 Adduction 
 Circumduction 
 Flexion 
 Extension 
 Dorsi flexion 
 Plantar flexion 
 Rotation (internal/external) 
 Eversion 
 Inversion 
 Pronation 
 Supination
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5
Q

What is past health history in muscoskeletal assessment?

A

– Medical: injuries, menopause, osteoporosis, HRT, scoliosis, lordosis, kyphosis
– Surgical: fractured bones, muscle damage, joint replacements
– Medications: calcium supplements

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6
Q

What is family history in muscoskeletal assessment?

A

Rheumatoid arthritis, gout, osteoporosis

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7
Q

What is Environmental and psychosocial history in muscoskeletal assessment?

A

– Diet: constant dieting, low calcium intake.
– Environment: occupation, posture at work/leisure, ADLs, sport
– Psychosocial: self-esteem, coping mechanisms, support system

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8
Q

What equipment is used in musckoskeletal assessment?

A

 Maintain privacy & dignity
 Ensure room is quiet, warm and with good lighting
 Test equipment: pen torch, goniometer, tape measure

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9
Q

What should you do before you start the examination?

A

 Overall appearance: height & weight
 Posture: erect & upright
 Gait: coordinated & rhythmic

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10
Q

What should you palpate in muscokskeletal examination?

A 
With each body area, palpate: 
 Muscle tone 
 Joints 
 Passive ROM 
 Muscle strength 
- Normal 
- Good 
- Fair 
- Poor 
- None
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11
Q

Which major skeletal joints should you examine?

A 
 TMJ 
 Cervical spine 
 Spine 
 Shoulders 
 Elbows 
 Wrists 
 Hands 
 Hips 
 Knees 
 Ankles 
 Feet
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12
Q

What should you inspect for shoulders?

A

anterior & posterior

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13
Q

What should you palpate for shoulders?

A

sternoclavicular joint to shoulders

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14
Q

What ROM should you do for shoulders?

A 
 Flex: raise arms forward 
 Extend: move behind body 
 Abduct/adduct: raise arm 
sideways/lower arm past midline 
 Internal/external rotation: flex elbow 
and rotate shoulder up (external) & down 
(internal) 
 Raise shoulders (shrug)
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15
Q

What should you inspect for elbows?

A

flexed & extended

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16
Q

What should you palpate for elbows?

A

olecranon & tissue

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17
Q

What ROM should you do for elbows?

A

 Flex: bend elbow & move up
 Extend: straighten elbow
 Pronate: palm down
 Supinate: palms up

18
Q

How would you test muscle strength for elbows?

A

 Stabilise elbow & grasp wrist
 Instruct to flex against opposite force
 Instruct to extend against opposite force

19
Q

What should you inspect for wrists and hands?

A

wrists, palms & dorsum

20
Q

What should you palpate for wrists and hands?

A

wrists, metacarpophalangeal & interphalangeal joints

21
Q

What ROM should you do for wrists?

A

 Flex/extend: bend wrist down & up
 Hyperextend: move up
 Ulnar deviation: outward
 Radial deviation: inward

22
Q

What ROM should you do for hands?

A

 Flex/extend: bend down & up
 Abduct/adduct: open/close fist
 Thumb: away & to base of little finger

23
Q

What should you inspect for hips?

A

alignment & symmetry

24
Q

What should you palpate for hips?

A

hip joints in supine position

25
Q

What ROM should you do for hips?

A 
 Flex/extend: bend down & up 
 Abduct: away from midline 
 Adduct: toward midline 
 Internal rotation: move medially 
 External rotation: move laterally 
 Hyperextend: prone position
26
Q

What should you inspect for knees?

A

position standing, contour sitting

27
Q

What should you palpate for knees?

A

thigh down suprapatellar pouch; tibial margins, collateral ligaments

28
Q

What should you inspect for ankles and toes?

A

alignment, shape, position

29
Q

What should you palpate for ankles and toes?

A

heel, tendon, ankle, feet, toes

30
Q

What is past health history for abdominal assessment?

A

– Medical: indigestion, cancer, allergies, constipation/diarrhea, ulcers, kidney disease
– Surgical: gastric banding, cosmetics, bowel resections, stoma
– Medications: anti- inflammatories, antibiotics

31
Q

What is family history for abdominal assessment?

A

Cancer, IBS, polyps, kidney disease

32
Q

What is Environmental and psychosocial history for abdominal assessment?

A

– Diet: food allergies, alcohol, smoking
– Environment: occupation, travel hx
– Psychosocial: self-esteem, coping mechanisms, support system, body image

33
Q

What equipment do you need for abdominal examination?

A

 Maintain privacy & dignity
 Ensure room is quiet, warm and with good lighting
 Test equipment: stethoscope with diaphragm & bell,
blanket, light & gloves

34
Q

What do you inspect for abdominal examination?

A 
Skin: 
 colour, scars, striae, venous pattern 
 lesions, integrity, masses 
Contour & symmetry: 
 Side of bed at level of abdomen 
 Foot of bed 
Abdominal movements: 
 Respiratory: smooth & even 
 Peristalsis: only if very thin 
 Pulsations: slight only – ALERT if vigorous 
Umbilicus: 
 Skin 
 Contour
35
Q

How to auscultate bowel sounds?

A 
 Warm diaphragm, place lightly 
 Begin RLQ, proceed clock wise 
 Confirm bowel sounds in each quadrant 
 5-30 intermittent gurgles per minute 
 Note intensity, pitch and frequency
36
Q

How to auscultate vascular sounds?

A 
 Warm bell, no pressure 
 Begin midline over aorta 
 Move side to side 
 Renal arteries 
 Iliac arteries 
 Femoral arteries 
 Listen for bruits - low-pitched murmur-like sound
37
Q

How to percuss abdomen?

A

 Systematically percuss all quadrants for tone
 Begin in RLQ
 Generalised tympany over air in intestines and abdomen
 Dullness over liver, spleen and distended bladder

38
Q

How to percuss the bladder?

A

 Begin at the symphysis pubis
 Percuss midline upwards to the umbilicus
 Normal bladder is not percussable therefore tympany is heard
 Dullness indicates bladder distention

39
Q

How to palpate abdomen?

A

 All quadrants to identify areas of tenderness, masses and muscular resistance
 Assess painful or tender area/s last
 Use finger pads & apply light (1cm) pressure

40
Q

How to palpate the liver?

A

 Stand on right side
 Curl fingers of both hands over edge of right costal margin
 Ask patient to take deep breath
 Gently but firmly pull inwards and upwards
 Palpate liver’s edge as it descends
 Normal liver not palpable, unless very thin: firm, smooth & even

MCQ Exam (9 decks)

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