Transcript The Musculoskeletal System

Muskuloskeletal
Assessment
 Health History
 Physical Assessment
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Inspection
Palpation
Range of Motion
Muscular Strength
Rachel S. Natividad, RN, MSN
Physical AssessmentCont.
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Cervical spine
Shoulders
 Functional
assessment
Elbows
Wrists/hands
Hips
Knees
Ankles/feet
Spine
Inspection/Palpation
 Note size and symmetry color, swelling,
masses & deformities of joints, limbs and body
regions
 Palpate for temperature, pain, tenderness,
Spine
ROM’s
 Have the pt perform
active ROM
 If unable to, use
passive ROM
Assessing Muscles
 Strength against
gravity, full
resistance
 note as 0/5-5/5
 “5/5” = normal
Rheumatoid arthritis
 Chronic, systemic,
inflammatory
disease that attacks
the joints, and
surrounding tissues,
hand, knees, hips,
and feet
Deformities
of RA
Ulnar Shift
Boutinniere Deformity
Swan neck deformity
Osteoarthritis
 A chronic
degeneration of
joint cartilage
caused by aging
or trauma
Osteoarthritis
•Heberden’s nodes on distal interphalangeal
joints (DIP’s )
•Bouchards nodes on proximal interphalangeal
joints (PIPs) as disease progresses
Osteoporosis
 A
decrease
in bone
mass,
porous,
brittle, and
prone to
fracture
Contractures
Assessment Guide:
Activity & Rest
 Objective Data
 Activity Level and Tolerance:
 ambulates with walker independently/
with minimal assistance; bedrest; up in
wheelchair
Assessment Guide: Activity
& Rest Muscles and joints
 Description: fair muscle tone, no atrophy;
atrophy to RLE. No stiffness or contractures; R
wrist contracted
 Movement: limited ROM to RUE; FROM all
extremities
 Strength: strong UE, LE; weak RUE & RLE
 Coordination: able to perform most ADLs; can
comb hair and reach for water glass
Assessment Guide:
Activity & Rest
 Posture/Gait
 Slumped, kyphosis, erect; gait
unsteady, shuffling, ataxia
Assessment Guide:
Activity & Rest
 Circulation, Sensation, and Movement
 Describe:
 CSM intact;
 no sensation to R big toe and second
toe;
 numbness and tingling to LEs;
 Decreased ROM to LUE due to
contractures
Assessment Guide:
Activity & Rest
 Rest/Sleep Patterns
 Sleeps most of the day
 Takes midday naps
Assessment Guide: Activity
& Rest
Interventions in use:
 Assistive device, equipment
 Cast, trapeze, foot cradle,
 Special beds
 Air bed, eggcrate mattress
 Med List:
 Glucosamine, Allopurinol, NSAIDS,
etc.