Musculoskeletal Assessment Chapter 14

Front 1

Routine Techniques

Back 1

*INSPECT axial skeleton and extremities.
*INSPECT muscles.
*PALPATE bones.
*OBSERVE each major joint and adjacent muscles.
*TEST muscle strength and compare sides.

Front 2

What is the first step in a musculoskeletal assessment?

Back 2

Wash hands.

Front 3

INSPECT axial skeleton and extremities for alignment and symmetry.

Back 3

Observe patient standing upright and straight from front, back and sides. Body should appear relatively symmetric.
Spine- straight with expected curvature.
Knees should be in line with hips and ankles and feet should be flat on floor and pointed forward.

Front 4

INSPECT muscles for size and symmetry.

Back 4

Muscle size should appear relatively symmetric bilaterally.

Front 5

PALPATE bones for...

Back 5

tenderness

Front 6

PALPATE joints for...

Back 6

tenderness, heat and edema

Front 7

PALPATE muscles for...

Back 7

tenderness, heat, edema and tone

Front 8

OBSERVE rand of motion for major joints and adjacent muscles.

Back 8

Pt. to perform active range of motion.

Front 9

Neck and Cervical Spine (Pivotal Joint) Movements

Back 9

Flexion, Extension, Hyperextension

Front 10

Flexion (Neck & Cervical Spine)

Back 10

bring chin to rest on chest

Front 11

Extension (Neck & Cervical Spine)

Back 11

Return head to erect position.

Front 12

Hyperextension (Neck & Cervical Spine)

Back 12

Bend head back as far as possible.

Front 13

Lateral flexion (Neck & Cervical Spine)

Back 13

tilt head as far as possible toward each shoulder

Front 14

Rotation (Neck & Cervical Spine)

Back 14

Turn head as far as possible to right and left.

Front 15

Shoulder (Ball and Socket Joint) Flexion

Back 15

Raise arm from side position forward to position above head.

Front 16

Shoulder (Ball and Socket Joint) Extension

Back 16

Return arm to position at side of the body.

Front 17

Shoulder (Ball and Socket Joint) Hyperextension

Back 17

Move arm behind body, keeping elbow straight.

Front 18

Shoulder (Ball and Socket Joint) Abduction

Back 18

Raise arm to side to position above head with palm away from head.

Front 19

Shoulder (Ball and Socket Joint) Adduction

Back 19

Lower arm sideways and across body as far as possible.

Front 20

Shoulder (Ball and Socket Joint) Internal rotation

Back 20

With elbow flexed, rotate shoulder by moving arm until thumb is turned inward and toward back.

Front 21

Shoulder (Ball and Socket Joint) External rotation

Back 21

With elbow flexed, move arm until thumb is upward and lateral to head.

Front 22

Shoulder (Ball and Socket Joint) Circumduction

Back 22

Move arm in full circle. Circumduction is combination of all movements of ball-and-socket joint.

Front 23

Elbow (Hinge Joint) Flexion

Back 23

Bend elbow so lower arm moves towards its shoulder joint and hand is level with shoulder.

Front 24

Elbow (Hinge Joint) Extension

Back 24

Straighten elbow by lowering hand.

Front 25

Elbow (Hinge Joint) Hyperextension

Back 25

Bend lower arm back as far as possible. Not all elbows hyperextend.

Front 26

Forearm (Pivotal Joint) Supination

Back 26

Turn lower arm and hand so palm is up.

Front 27

Forearm (Pivotal Joint) Pronation

Back 27

Turn lower arm so palm is down.

Front 28

Wrist (Condyloid Joint) Flexion

Back 28

Move palm toward inner aspect of the forearm.

Front 29

Wrist (Condyloid Joint) Extension

Back 29

Move fingers so fingers, hands and forearm are in same plane.

Front 30

Wrist (Condyloid Joint) Hyperextension

Back 30

Bring dorsal surface to hand back as far as possible.

Front 31

Wrist (Condyloid Joint) Radial flexion

Back 31

Bend wrist medially toward thumb.

Front 32

Wrist (Condyloid Joint) Ulnar flexion

Back 32

Bend wrist laterally toward fifth finger; referred to as radial/ulnar deviation.

Front 33

Fingers (Condyloid hinge) Flexion

Back 33

Make fist.

Front 34

Fingers (Condyloid hinge) Extension

Back 34

Straighten fingers.

Front 35

Fingers (Condyloid hinge) Hyperextension

Back 35

Bend fingers back as far as possible.

Front 36

Fingers (Condyloid hinge) Abduction

Back 36

Spread fingers apart.

Front 37

Fingers (Condyloid hinge) Adduction

Back 37

Bring fingers together.

Front 38

Thumb (Saddle Joint) Flexion

Back 38

Move thumb across palmar surface of hand.

Front 39

Thumb (Saddle Joint) Extension

Back 39

Move thumb straight away from hand.

Front 40

Thumb (Saddle Joint) Opposition

Back 40

Touch thumb to each finger of the same hand.

Front 41

Hip (Ball and Socket Joint) Flexion

Back 41

Move leg forward and up.

Front 42

Hip (Ball and Socket Joint) Extension

Back 42

Move leg back beside other leg.

Front 43

Hip (Ball and Socket Joint) Hyperextension

Back 43

Move leg behind body.

Front 44

Hip (Ball and Socket Joint) Abduction

Back 44

Move leg laterally away from body.

Front 45

Hip (Ball and Socket Joint) Adduction

Back 45

Move leg back toward medial position and beyond if possible.

Front 46

Hip (Ball and Socket Joint) Internal rotation

Back 46

Turn knee toward the inside.

Front 47

Hip (Ball and Socket Joint) External rotation

Back 47

Turn knee toward the outside.

Front 48

Hip (Ball and Socket Joint) Circumduction

Back 48

Move leg in circle.

Front 49

Knee (Hinge Joint) Flexion

Back 49

Bring heel back toward back of thigh.

Front 50

Knee (Hinge Joint) Extension

Back 50

Return heel to floor.

Front 51

Ankle (Hinge Joint) Dorsiflexion

Back 51

Move foot so toes are pointed upward.

Front 52

Ankle (Hinge Joint) Plantar Flexion

Back 52

Move foot so toes are pointed downward.

Front 53

Foot (Gliding Joint) Inversion

Back 53

Turn sole of foot medially.

Front 54

Foot (Gliding Joint) Eversion

Back 54

Turn sole of foot laterally.

Front 55

Toes (Condyloid Joint) Flexion

Back 55

Curl toes downward.

Front 56

Toes (Condyloid Joint) Extension

Back 56

Straighten toes.

Front 57

Toes (Condyloid Joint) Abduction

Back 57

Spread toes apart.

Front 58

Toes (Condyloid Joint) Adduction

Back 58

Bring toes together.

Front 59

What is a goniometer?

Back 59

A tool to measure joint range of motion.

Front 60

What is crepitus?

Back 60

crackling sound produced by bone fragments or articular surfaces rubbing together.

Front 61

Muscle Strength Grade 5 -Normal [N]

Back 61

Complete range of motion against gravity with full resistance. (100%)

Front 62

Muscle Strength Grade 4 -Good [G]

Back 62

Complete range of motion against gravity with some resistance. (75%)

Front 63

Muscle Strength Grade 3 -Fair [F]

Back 63

Complete range of motion with gravity. (50%)

Front 64

Muscle Strength Grade 2 -Poor [P]

Back 64

Complete range of motion with gravity eliminated. (25%)

Front 65

Muscle Strength Grade 1 -Trace [T]

Back 65

Evidence of slight contractivity. (10%)

Front 66

Muscle Strength Grade 0 -Zero [0]

Back 66

No evidence of contractility. (0%)

Front 67

OBSERVE symmetry for...

Back 67

conformity, symmetry and rhythm.

Front 68

INSPECT musculature of the face and neck for...

Back 68

symmetry

Front 69

What is the degree for range of motion of the thoracic and lumbar spine during flexion?

Back 69

75 degrees

Front 70

What is the degree for range of motion of the thoracic and lumbar spine during hyperextension?

Back 70

30 degrees

Front 71

Kyphosis

Back 71

posterior curvature (convexity) of the thoracic spine

Front 72

Lordosis

Back 72

anterior curvature (concavity) of the spine

Front 73

Scoliosis

Back 73

lateral curvature of the spine

Front 74

What is a goniometer?

Back 74

A instrument used to measure joint range of motion.

Front 75

Hypertrophy

Back 75

Increase in muscle size and shape.

Front 76

Atrophy

Back 76

Reduction in muscle size and shape; thin, flabby muscles.

Front 77

Hypotonicity

Back 77

Flaccidity; decreased muscle tone

Front 78

Spasticity

Back 78

increased muscle tone

Front 79

Rheumatoid arthritis

Back 79

chronic, autoimmune inflammatory disease of the connective tissue

Front 80

What is Gout?

Back 80

hereditary disorder with increase in serum uric acid, which accumulate in joints such as wrists, hands, ankles and knees

Front 81

What is Herniated nucleus pulposus

Back 81

fibrocartilage surrounding intervertebral disk ruptures and nucleus pulposus is displaced and compresses adjacent spinal nerves.=

Front 82

Carpal tunnel syndrome

Back 82

median nerve compressed between carpal ligament and other structures

Front 83

Proximal

Back 83

Close to center of body

Front 84

Distal

Back 84

Away from the center of the body

Front 85

Abduction

Back 85

Moving the extremity laterally, away from the midline

Front 86

Adduction

Back 86

Moving the extremity medially, toward the midline

Front 87

Internal rotation

Back 87

Rotating the extremity medially along its own axis

Front 88

External rotation

Back 88

rotating the extremity laterally along its own axis

Front 89

Circumduction

Back 89

Moving the extremity in a conical fashion so the distal aspect moves in a circle

Front 90

Opposition

Back 90

Moving the thumb outward to touch the little finger

Front 91

Pronation

Back 91

rotating forearm medially so palm faces down

Front 92

Supination

Back 92

rotating forearm laterally so palm faces up

Front 93

Inversion

Back 93

Tilting the sole of the foot inward with the lateral side of the foot lowered

Front 94

Eversion

Back 94

Tilting the sole of foot outward with medial side of the foot lowered

Front 95

Flexion

Back 95

Bending a joint so the articulating bones are moved closer to each other

Front 96

Extension

Back 96

Bending a joint so the articulating bones are moved away from each other

Front 97

Hyperextension

Back 97

extension beyond the neutral (180 degrees) position

Front 98

Dorsiflexion

Back 98

Flexing the foot at the ankle so that the toes move toward chest

Front 99

Plantar Flexion

Back 99

Moving the foot at the ankle so the toes move away from chest

Front 100

Six Signs and Symptoms in Musculoskeletal Examination

Back 100

*Pain
*Redness
*Swelling
*Warmth
*Deformity
*Loss of function