Week 9 - MSK Flashcards
(28 cards)
purpose of MSK system
body support and movement
to protect and encase the vital inner organs
compromise = systemic effect
bone marrow produces RBCs, WBCs and platelets
a reservoir for storage of essential minerals in bone
- calcium and phosphorus
myalgia
muscle pain (cramping or aching)
crepitation
audible and palpable crunching or grating sounds that accompanies movement in the joint
articular
inside joint capsule
i.e., arthritis is an articular disease
contracture
shortening of a muscle leading to limited ROM of joint
ankylosis
stiffness or fixation of a joint
dislocation
one or more bones in a joint being out of position
subjective data
Any pain in the joints?
Any stiffness in the joints?
Any swelling, heat, redness in the joints?
Any limitation of movement?
Any muscle pain or cramping?
Any deformity of bone or joint?
Any accidents or trauma to bones?
Ever had pack pain?
Any problems with the ADLs? Bathing, toileting, dressing, grooming, eating, mobility, communicating?
If symptom reported use LOTTARRPP
Location: Which joints/muscle? On one side or both sides?
Onset: When did this pain start?
Timing: What time of day does the pain occur? How long does it last? How often does it occur?
Type: What does the pain feel like aching, stiff, sharp or dull, shooting? Severity: How strong is the pain?
Aggravating: Is the pain aggravated by movement, rest, position, weather?
Alleviating: Is the pain relieved by rest, medications, application of heat or ice?
Radiating: Does the pain radiate to any other part of the body? Compensation by other side/part of body now becoming sore?
Related symptoms: Is the pain associated with chills, fever, recent sore throat, trauma, repetitive activity?
Personal perception: What movements/activities cause a problem? How would you rate your pain? What do you expect could be the solution?
Precipitating event: What do you think caused the symptom/pain?
osteoporosis screening
loss of bone mass, at risk population is women over age 65 yrs
Risk factors: lack of exercise, alcohol consumption, smoking, poor diet (lack of calcium)
objective data
Inspection and palpation of joints, muscles, bones: AS NEEDED BASIS
What are you looking for?
Size
Color
Mass or deformity
Temperature
Pain
Swelling
Range of Motion (ROM)
screening MSK
suffices for most patients, and includes:
- inspection and palpation of joints (do this simultaneously and observe for expressions of discomfort). Compare bilateral joints.
- observation of ROM
- age-specific screening measures (ie. Osteoporosis)
comprehensive/complete MSK
MSK exam for patients with articular disease (ie. Arthritis), a history of MSK symptoms, or problems with ADLs
CWMS
arterial blood supply is adequate to the limb
Colour (Should be pink or flesh AND check peripheral pulses)
- Always compare color of the nailbeds, temperature, ability to wiggle fingers or toes, and presence of swelling on bilateral limbs
Warmth (Are fingers and toes warm to touch?)
Movement (Can your patient wiggle fingers or toes?)
Sensation (Pinch fingers or toes. Any numbness or tingling?)
muscle strength grading
0 - no contraction
1 - slight contraction
2- full ROM w/ gravity eliminated (passive)
3 - full ROM w/ gravity
4 - full ROM against gravity; some resistance
5 - full ROM against gravity; full resistance
S&S of compartment syndrome
Compartment Syndrome – the 5 “P’s”
Pain
Pallor
Paresthesia - numbness
Paralysis
Pulselessness
puffiness - swelling
polar sensation - cool to touch
peripheral neurovascular assessment
record Neuro Vascular (NVAx)
Used for postoperative patients, but also for any potential vascular/nerve compromising injury
Not to be confused with Neuro Vital Signs (NVS) – a neurological assessment
mobility
does your patient have aids to assist in walking?
does your patient need help w/ mobility and ambulation?
- independent
- 1PA
- 2PA
- sabina lift
- golvo or ceiling lift
use functional assessment history questions
identify any loss of function, self-care deficit, or safety risk:
-Do problems with your joints/muscles/bones impose any limits on your ADLs, and if so, which ones?
-Bathing – getting in and out of the tub, turning faucets
-Toileting – ability to get on an off, wiping self
-Dressing – pulling clothes over the head, typing shoes, manipulating buttons/zippers
-Grooming – shaving, brushing teach, doing hair/makeup
-Eating – preparing meals, pouring liquids, cutting up foods.
- Mobility – walking, stairs, getting in and out of bed, out of the home
-Communicating – talking, using phone or tablet, writing
For older adults, also assess:
-Any change in weakness over the past months or years
-An increase in falls or stumbling
-Use of mobility aids
propulsive gait
parkinsons
scissors gait
cerebral palsy
steppage
foot drop
hemiplegia
dragging a limb
CVA
