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Musculoskeletal Exam 4 Health Assessment
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- Denver School Of Nursing
In depth Musculoskeletal Study Guide!
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MusculoskeletalInversion:Moving the sole of the foot inward at the ankle
Eversion:Moving the sole of the foot outward at the ankle
Rotation:Moving the head around a central axis
Protraction:Moving a body part forward and parallel to the ground
Retraction:Moving a body part backward and parallel to the ground
ElevationRaising a body part
DepressionLowering a body part
Circumduction: circular motionPronation: palms down
Supination:palms up
Flexion: Bending limb at joint
Extension: straightening limb at joint
Hyperextension: past straight line
Abduction: moving away from midline
Adduction: moving toward midline
Internal/medial rotation : rotating toward midline
External/lateral rotation: rotating away from midline
Dorsiflexion: ankle/toes up
Plantar flexion: point toes down
Health History
PMH
●previous/chronic musculoskeletal conditions?
●Trauma? Injuries? Surgeries? ●Medications? Smoker? ○Corticosteroids: muscle weakness, myopathy, osteoporosis, pathologic fracture
○Pain meds: chronic pain? Acute
○Potassium-depleting diuretics: Muscle cramping and weakness
○Cholesterol-lowering agents: generalized muscle soreness
●Arthroplasty= joint replacement Review of Systems
●Myalgia: muscle cramping
●Ostealgia: bone paint
●Arthralgia: joint pain ●Changes in muscle strength? ●Health promotion (Calcium/Vitamin D, exercise)
Functional Assessment
●Limitations in ADLs? - bathing, toileting, dressing, grooming, eating, mobility, communicating
●Sports, hobbies, work?
●Mobility aids?
●Check Temperature (sign of joint pain)
●Baby Delivery trauma: use of vacuum or forceps (aid in deliver that not progressing) Any resuscitation needed. Musculoskeletal Examination
Screening Exam: everyone gets (inspection and palpation of joints each body region Complete Musculoskeletal Exam: Pts with diseases of changes in functional ability) use cephalocaudal approach with bilateral comparisons
Active ROM: me doing circumduction at the wrist Passive ROM: guided range of motion Muscle Strength Head and Neck ●Inspect and Palpate: cervical spine and TMJ ●Assess ROM: lateral bending, rotation, flex/extend ○Laterally: 40° ○Extension: 55°(Flexion: 45°) ○Rotation: 70°
●Test Muscle Strength: turn head against resistance (CN XI) Spinal Curvatures ●Inspect profile: first, normal is double S shape
●Inspect posteriorly: have patient bend at waist ●Assess ROM: flex/extend, rotation, lateral bend
○Extend: 30°(Flexion: 90°) ○Lateral: 36°
○Rotation: 30° ●Scoliosis (bilateral curvature) ○Lateral curvature ○Back Pain ○Uneven shoulder, hip levels
○Rib and flank asymmetry ●Kyphosis ○Excessive outward curvature of thoracic spine
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