Musculoskeletal Assessment Standards <ul><li>Know the Normal ROM for each joint </li></ul><ul><li>Never force a joint beyo...
Skeletal Muscle Movements: <ul><li>Flexion --------- Extension </li></ul><ul><li>Abduction-----Adduction </li></ul><ul><li...
Health History <ul><li>Joints: </li></ul><ul><ul><li>Pain, stiffness </li></ul></ul><ul><ul><li>Swelling, heat, redness </...
Health History <ul><li>Functional Assessment  </li></ul><ul><ul><li>(ADL)  </li></ul></ul><ul><ul><li>(IADL) </li></ul></u...
Physical exam <ul><li>Routine Examination </li></ul><ul><ul><li>Inspect the skeleton and extremities comparing sides </li>...
Physical Exam <ul><li>Palpate all bones, joints, surrounding muscles </li></ul><ul><li>Assess each joint  </li></ul><ul><u...
TEST MUSCLE STRENGTH <ul><li>UE  </li></ul><ul><ul><ul><li>Hand – flexion, extension </li></ul></ul></ul><ul><ul><ul><li>F...
Measure Strength  <ul><li>Overcomes resistance with normal power  </li></ul><ul><li>Overcomes resistance </li></ul><ul><li...
Special Assessment Techniques <ul><li>Testing for Carpal Tunnel Syndrome </li></ul><ul><ul><li>1  Phalen’s </li></ul></ul>...
Common Musculoskeletal Conditions <ul><li>TMJ joint syndrome </li></ul><ul><li>Carpal tunnel syndrome </li></ul><ul><li>Go...
Older Adult <ul><li>Kyphosis </li></ul><ul><li>Height </li></ul><ul><li>Muscle Strength </li></ul>Spring 2012
Nursing Diagnoses <ul><li>Impaired Physical Mobility </li></ul><ul><li>Risk for Disuse syndrome </li></ul><ul><li>Risk for...
Health Promotion <ul><li>Risk Factors for Osteoporosis </li></ul><ul><li>Maintaining Healthy Body Weight and Exercising Re...
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N 295 lecture 12 13 musculoskeletal student copy

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N 295 lecture 12 13 musculoskeletal student copy

  1. 1. Musculoskeletal Assessment Standards <ul><li>Know the Normal ROM for each joint </li></ul><ul><li>Never force a joint beyond current ROM </li></ul><ul><li>Use caution when examining an injury </li></ul><ul><li>Support the full length of the body part </li></ul><ul><li>Consider the client’s level of fatigue </li></ul>Spring 2012
  2. 2. Skeletal Muscle Movements: <ul><li>Flexion --------- Extension </li></ul><ul><li>Abduction-----Adduction </li></ul><ul><li>Pronation----------Supination </li></ul><ul><li>Circumduction </li></ul><ul><li>Inversion--------Eversion </li></ul><ul><li>Rotation </li></ul><ul><li>Protraction----Retraction </li></ul><ul><li>Elevation----Depression </li></ul>Spring 2012
  3. 3. Health History <ul><li>Joints: </li></ul><ul><ul><li>Pain, stiffness </li></ul></ul><ul><ul><li>Swelling, heat, redness </li></ul></ul><ul><ul><li>Limitation of movement </li></ul></ul><ul><li>Muscles: </li></ul><ul><ul><li>Pain (cramps) </li></ul></ul><ul><ul><li>Weakness </li></ul></ul><ul><li>Bones: </li></ul><ul><ul><li>Pain </li></ul></ul><ul><ul><li>Deformity </li></ul></ul><ul><ul><li>Trauma (fractures, sprains, dislocations) </li></ul></ul>Spring 2012
  4. 4. Health History <ul><li>Functional Assessment </li></ul><ul><ul><li>(ADL) </li></ul></ul><ul><ul><li>(IADL) </li></ul></ul><ul><li>Self-Care Behaviors </li></ul><ul><li>Self-Care Ability Scale: </li></ul><ul><ul><ul><ul><li>Full self care- independent 0 </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Need to use equipment or device I </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Needs supervision II </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Needs equipment/ device and supervision III </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Unable to help self-dependent IV </li></ul></ul></ul></ul>Spring 2012
  5. 5. Physical exam <ul><li>Routine Examination </li></ul><ul><ul><li>Inspect the skeleton and extremities comparing sides </li></ul></ul><ul><ul><li>Size, alignment, contour, symmetry, gross deformities </li></ul></ul><ul><ul><li>Gait </li></ul></ul>Spring 2012
  6. 6. Physical Exam <ul><li>Palpate all bones, joints, surrounding muscles </li></ul><ul><li>Assess each joint </li></ul><ul><ul><li>AROM </li></ul></ul><ul><ul><li>PROM </li></ul></ul><ul><ul><li>Tenderness </li></ul></ul><ul><ul><li>Joint stability </li></ul></ul><ul><ul><li>Deformity </li></ul></ul><ul><ul><li>Contracture </li></ul></ul><ul><li>Assess muscle strength </li></ul><ul><ul><li>Compare contralateral sides </li></ul></ul><ul><ul><li>Describe / Scale </li></ul></ul>Spring 2012
  7. 7. TEST MUSCLE STRENGTH <ul><li>UE </li></ul><ul><ul><ul><li>Hand – flexion, extension </li></ul></ul></ul><ul><ul><ul><li>Forearm - flexion, extension </li></ul></ul></ul><ul><ul><ul><li>Upper Arm - flexion, extension </li></ul></ul></ul><ul><ul><ul><li>Abduction / Adduction </li></ul></ul></ul><ul><li>LE </li></ul><ul><ul><ul><li>Feet - flexion, flexion </li></ul></ul></ul><ul><ul><ul><li>Lower Leg - flexion, extension </li></ul></ul></ul><ul><ul><ul><li>Thigh - flexion, extension </li></ul></ul></ul><ul><ul><ul><li>Abduction / Adduction </li></ul></ul></ul>Spring 2012
  8. 8. Measure Strength <ul><li>Overcomes resistance with normal power </li></ul><ul><li>Overcomes resistance </li></ul><ul><li>Unable to overcome resistance </li></ul><ul><li>Overcomes gravity </li></ul><ul><li>Unable to overcome gravity </li></ul><ul><li>Flicker </li></ul>Spring 2012
  9. 9. Special Assessment Techniques <ul><li>Testing for Carpal Tunnel Syndrome </li></ul><ul><ul><li>1 Phalen’s </li></ul></ul><ul><ul><li>2 Tinel’s </li></ul></ul><ul><li>Testing for Fluid in the Knee </li></ul><ul><ul><li>1 Bulge </li></ul></ul><ul><ul><li>2 Ballottement </li></ul></ul>Spring 2012
  10. 10. Common Musculoskeletal Conditions <ul><li>TMJ joint syndrome </li></ul><ul><li>Carpal tunnel syndrome </li></ul><ul><li>Gout </li></ul><ul><li>Osteomyelitis </li></ul><ul><li>Bursitis </li></ul><ul><li>Rheumatoid arthritis </li></ul><ul><li>Osteoarthritis </li></ul><ul><li>Injuries: muscle strain, sprains, dislocation, fracture </li></ul>Spring 2012
  11. 11. Older Adult <ul><li>Kyphosis </li></ul><ul><li>Height </li></ul><ul><li>Muscle Strength </li></ul>Spring 2012
  12. 12. Nursing Diagnoses <ul><li>Impaired Physical Mobility </li></ul><ul><li>Risk for Disuse syndrome </li></ul><ul><li>Risk for Trauma </li></ul><ul><li>Pain </li></ul><ul><li>Activity Intolerance </li></ul>Spring 2012
  13. 13. Health Promotion <ul><li>Risk Factors for Osteoporosis </li></ul><ul><li>Maintaining Healthy Body Weight and Exercising Regularly </li></ul><ul><li>Preventing Injuries </li></ul>Spring 2012

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