physical assessment of musculoskeletal system
DESCRIPTION
Physical Assessment Of Musculoskeletal SystemTRANSCRIPT
![Page 1: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/1.jpg)
musculoskeletal system assessment
BY,Ashwini K N Lecturer in Pediatric NursingPadmashree college of nursingBangalore , Karnataka
![Page 2: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/2.jpg)
TYPES OF BONE
There are 206 bones in the human body, divided into four categories:
Long bones (e.g, femur)
Short bones (e.g., metacarpals)
Flat bones (e.g., sternum)
Irregular bones (e.g., vertebrae)
![Page 3: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/3.jpg)
STRUCTURE OF LONG BONE AND HAVERSION SYSTEM
![Page 4: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/4.jpg)
TYPES OF JOINTS
Ball-and-socket joints,
Hinge joints
Saddle joints
Pivot joints
Gliding joints
![Page 5: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/5.jpg)
STRUCTURE OF SYNOVIAL JOINT
![Page 6: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/6.jpg)
TYPES OF MUSCLE CONTRACTIONS
Isometric Contraction
Isotonic Contraction
![Page 7: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/7.jpg)
COLLECTING SUBJECTIVE DATA
Current symptoms
Have you had any recent weight gain?
Describe any difficulty chewing you have.
Is it associated with tenderness or pain?
Describe any joint, muscle, or bone pain you have.
![Page 8: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/8.jpg)
CON….
Past History
Describe any past problems or injuries you have had to your joints, muscles, or
bones. What treatment was given? Do you have any after effects from the
injury or problem? When were your last tetanus and polio immunizations?
Have you ever been diagnosed with diabetes mellitus, sickle cell anemia,
systemic lupus erythematous(SLE), or osteoporosis?
For middle aged and female clients:
Have you started menopause? Are you receiving estrogen replacement therapy?
![Page 9: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/9.jpg)
CON
Family History
Do you have a family history of rheumatoid arthritis, gout, or osteoporosis?
Life-style and health practices
What activities do you engage in to promote the health of your
musculoskeletal system (e.g., exercise, diet, weight reduction)?
Do you smoke tobacco? How much and how often?
Do you drink alcohol or caffeinated beverages? How much and how often?
Describe your typical 24- hours diet. Are you able to consume milk or milk-
containing products? Do you take any calcium supplements?
Describe your activities during a typical day. How much time do you spend in
the sunlight?
![Page 10: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/10.jpg)
CON….
Describe any routine exercise in which you engage.
Describe your occupation.
Describe your posture at work and at leisure. What type of shoes do you usually
wear?
Do you have difficulty performing normal activities of daily living? Do you use
assistive devices (e.g., walker, cane, braces) to promote your mobility?
How have your musculoskeletal problems interfered with your ability to interact
or socialize with others? Have they interfered with your usual sexual activity?
How did you view yourself before you had this musculoskeletal problem, and
how do you view yourself now?
Has your musculoskeletal problems added stress to your life? Describe.
![Page 11: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/11.jpg)
COLLECTING OBJECTIVE DATA
Physical Assessment Guidelines
Inspection
Palpation
Test the range of motion
Test muscle strength
![Page 12: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/12.jpg)
RATING SCALE
Movement Classification Score
Active motion against full
resistance
Normal 5
Active motion against some
resistance
Slight weakness 4
Active motion against gravity Average weakness 3
Passive range of motion Poor ROM 2
Slighter flicker of contraction Severe weakness 1
No muscular contraction Paralysis 0
![Page 13: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/13.jpg)
GAIT
Observe Gait
Observe the client’s gait as the client enters and walks around the room.
Note:
Base of support
Weight bearing stability
Feet position
Stride
Stride length
Cadence
Arm swing
Posture
“nudge test.”
![Page 14: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/14.jpg)
TEMPOROMANDIBULAR JOINT(TMJ)
Inspect, palpate, and test ROM
![Page 15: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/15.jpg)
STERNOCLAVICULAR JOINT
Inspect and palpate
With client sitting, inspect the sternoclavicular joint for location in
midline, color, swelling, and masses. Then palpate for tenderness or
pain.
![Page 16: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/16.jpg)
CERVICAL,THORASIC,AND LUMBAR SPINE
Inspect and palpate
![Page 17: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/17.jpg)
![Page 18: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/18.jpg)
![Page 19: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/19.jpg)
TEST ROM OF THE CERVICAL SPINE
Test ROM by asking the client to:
Touch chin to chest(flexion).
Look up at ceiling(hyperextension).
Touch each ear to the shoulder on that side (lateral bending).
![Page 20: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/20.jpg)
CERVICAL ROM
![Page 21: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/21.jpg)
TEST ROM OF THE THORACIC AND LUMBER SPINE
![Page 22: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/22.jpg)
LATERAL BENDING
![Page 23: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/23.jpg)
TEST FOR BACK AND LEG PAIN
Lasegue’s test
![Page 24: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/24.jpg)
MEASURE LEG LENGTH
![Page 25: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/25.jpg)
SHOULDERS
INSPECT AND PALPATE
With the client standing or sitting, inspect for symmetry, color,
swelling, and masses.
Palpate for tenderness, swelling, or heat.
![Page 26: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/26.jpg)
TEST ROM OF SHOULDER
![Page 27: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/27.jpg)
ELBOWS
INSPECT AND PALPATE
Inspect for size, shape, deformities, redness, or swelling.
With the elbow relaxed and flexed about 70o, use your thumb and
middle fingers to palpate the olecranon process and epicondyles.
![Page 28: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/28.jpg)
TEST ROM OF ELBOW
![Page 29: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/29.jpg)
SUPINATION AND PRONATION
![Page 30: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/30.jpg)
WRISTS
INSPECT AND PALPATE
Inspect for size, shape, symmetry, color, and swelling.
Palpate for tenderness and nodules.
![Page 31: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/31.jpg)
TEST ROM OF WRIST
![Page 32: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/32.jpg)
TEST FOR CARPAL TUNNEL SYNDROME(PHALEN’S TEST)
![Page 33: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/33.jpg)
TINEL’S SIGN
![Page 34: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/34.jpg)
HANDS AND FINGERS
INSPECT AND PALPATE
Inspect for size, shape, symmetry, swelling, and color.
Palpate for tenderness and nodules.
![Page 35: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/35.jpg)
TEST ROM
Ask the client to: Spread the fingers apart.
![Page 36: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/36.jpg)
ROM OF FINGERS
![Page 37: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/37.jpg)
HIPS
INSPECT AND PALPATE
With the client standing inspect for symmetry and shape.
Palpate for stability, tenderness, and crepitus.
![Page 38: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/38.jpg)
TEST ROM
![Page 39: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/39.jpg)
ABDUCTION AND ADDUCTION
![Page 40: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/40.jpg)
INTERNAL ROTATION
![Page 41: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/41.jpg)
EXTERNAL ROTATION
![Page 42: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/42.jpg)
THOMAS’S TEST.
![Page 43: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/43.jpg)
TRENDELENBERG TEST.
![Page 44: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/44.jpg)
KNEES
INSPECT AND PALPATE
![Page 45: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/45.jpg)
TEST FOR SWELLING
BULGE TEST.
![Page 46: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/46.jpg)
BALLOTTMENT TEST.
![Page 47: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/47.jpg)
FLEXION AND EXTENSION
![Page 48: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/48.jpg)
TEST FOR PAIN
McMurry’s test.
![Page 49: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/49.jpg)
ANKLES AND FEET
Inspect and palpate
With the client sitting, standing, and walking, inspect
position, alignment, shape, and skin.
Palpate for tenderness, heat, swelling, or nodules.
![Page 50: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/50.jpg)
TEST ROM
![Page 51: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/51.jpg)
ABNORMAL SPINAL CURVATURE
![Page 52: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/52.jpg)
ABNORMAL WRISTS, HANDS, AND FINGERS
Boutonniere and swan-neck deformities
![Page 53: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/53.jpg)
Ganglion.
![Page 54: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/54.jpg)
Osteoarthritis.
![Page 55: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/55.jpg)
Tenosynovitis.
![Page 56: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/56.jpg)
Acute rheumatoid arthritis.
![Page 57: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/57.jpg)
Chronic rheumatoid arthritis
![Page 58: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/58.jpg)
Thenar atrophy
![Page 59: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/59.jpg)
ABNORMAL ANKLES, FEET, AND TOES
Acute gouty arthritis.
![Page 60: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/60.jpg)
Callus.
![Page 61: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/61.jpg)
Corn.
![Page 62: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/62.jpg)
Flat feet.
![Page 63: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/63.jpg)
Hallux valgus
![Page 64: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/64.jpg)
Hammer toe.
![Page 65: Physical Assessment of Musculoskeletal System](https://reader036.vdocuments.net/reader036/viewer/2022062405/556daa9ed8b42a875d8b4ccd/html5/thumbnails/65.jpg)
Thank you……