Transcript The Musculoskeletal System Fall 07_website version

The Musculoskeletal System
RACHEL S. Natividad, RN, MSN
Subjective and Objective Data


Obtaining a health
history
Assessment

Inspection/Palpation

Range of Motion


passive and active
Muscular strength
Inspection/Palpation


Inspect swelling, mass or deformities, stiffness or
instability of joints, limbs and body regions
Palpate for temperature, tenderness surrounding joint
ROM’s



Have the pt perform
active ROM
If unable to, use
passive ROM
Palpate for unusual
joint movement
during ROM
Measuring Range of Motion
Assessing Muscles


Assess muscle tone
and strength
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
Pain, stiffness,
swelling
Osteoarthritis: Cont.
Hard, nontender nodes
Bouchards Nodes
Heberdens Nodes
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.