TOPIC 13 Flashcards
Nonsynovial joints
Joints that do not have a joint cavity, connective tissue, or cartilage.
synovial joints
created where two bones articulate to permit a variety of motions; freely movable joint
muscle
tissue composed of fibers that can contract, causing movement of an organ or part of the body
flexion
bending limb at joint
extension
straightening limb at joint
abduction
moving limb away from midline of body
adduction
moving limb toward midline of body
pronation
turning forearm so that palm is down
supination
turning forearm so that palm is up
circumduction
moving arm in circle around shoulder
inversion
moving sole of foot inward at ankle
eversion
moving sole of foot outward at ankle
rotation
moving head around central axis
protraction
moving body part forward, parallel to ground
retraction
moving body part backward, parallel to ground
elevation
raising a body part
depression
lowering a body part
what spinous processes are prominent at the base of the neck
C7 and T1
Inferior angle of scapula normally at level of interspace between
T7 and T8
Imaginary line connecting highest point on each iliac crest crosses
L4
fetus bone and muscle development
skeleton of cartilage by 3 months
adolescents bone and muscle development
rapid growth
adulthood bone and muscle development
Longitudinal growth continues until about 20
After 40, bone resorption _____ and deposition _____
increases
decreases
aging adult: postural changes
-Decreased height
-Kyphosis
aging adult: subQ fat
Different distribution
-Decreases in forearms
-More apparent in abdomen/hips
In eighties and nineties, fat further decreases in…
periphery, especially noticeable in forearms and apparent over abdomen and hips
aging adult: bony prominences
Loss of subcutaneous fat leaves bony prominences more marked
aging adult: muscle mass
o Absolute loss in muscle mass occurs; some decrease in size, and some atrophy, producing weakness
o Lifestyle affects musculoskeletal changes (activity level affects M/S)
functional assessment of ADLs
Bathing, toileting, dressing, grooming, eating, mobility, communicating
self care behaviors: muscles/joints
Occupational hazards, exercise program, recent weight gain, medications, chronic disability or crippling illness
purpose of M/S exam
o Assess function for ADLs
o Screen for abnormalities
what is the orderly approach for a physical exam
head to toe, proximal to distal, and from midline outward
Compare corresponding paired joints:
Expect symmetry of structure and function and normal parameters for each joint
order of examination for M/S
inspection
palpation
range of motion
muscle testing
Active voluntary ROM
pt moves joint area while you are stabilizing the body area proximal to that being moved
what do you do if a patient has ROM limitations
gently attempt passive motion;
anchor joint with one hand while other hand slowly moves it to its limit; normal ranges of active and passive motion should be same
Joint motion normally causes…
no tenderness, pain, or crepitation
SCALE for MUSCLE TESTING-against gravity and resistance
0-5 grading=0-100%
5 Full ROM and resistance-normal
4 full ROM and some resistance
3 full ROM with gravity
2 full ROM with no gravity(eliminated)
1 slight contraction
0 NO contraction
assessment: TMJ
Place tips of first two fingers in front of each ear and ask person to open and close mouth
what is normal during TMJ assessment
Audible and palpable snap or click occurs in many healthy people as mouth opens
what tests the integrity of CN V (trigeminal)
Ask person to move jaw forward and laterally against your resistance, and to open mouth against your resistance