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HA Week 10

Health Assessment Exam 3- Musculoskeletal & Neurological

QuestionAnswer
What is the key concept of the musculoskeletal system? mobility
ligaments connect bone to bone
tendons connect muscle to bone
bursae pouches of synovial fluid that cushions movement of tendons and muscles over bones
synovial joints freely moveable ex: knee, shoulder
cartilaginous joints slightly moveable ex: vertebral column
fibrous joints no appreciable movement; hold bones together ex: sutures of skull
crepitus grinding sound heard when there is a lack of bursae
flexion movement that decreases the angle between 2 bones
extension movement that increases the angle between 2 bones
hyperextension movement of a body part beyond what is expected
supination movement of a body part so the front side faces up
pronation movement of a body part so the front side faces down
abduction movement of a body part away from the midline
adduction movement of a body part toward the midline
dorsiflexion flexing the foot and toes upward
plantar flexion bending the foot and toes downward
eversion turning a body part away from the midline
inversion turning a body part towards the midline
external rotation rotating a joint outward
internal rotation rotating a joint inward
red flags for serious underlying systemic disease older than 50, history of cancer, unexplained weight loss, pain lasting > 1 month or not responding to treatment, pain at night or increased by rest, history of IV drug use, presence of infection
passive range of motion HCP or equipment moves the joint through the range of motion with no effort from the patient
active range of motion patient performs the exercise to move the joint without any assistance
paresis weakness
plegia paralysis in which all voluntary movement is lost
atrophy decrease in muscle size due to disuse
hypertrophy increase in muscle size due to strengthening
hypotonia decreased muscle tone
flaccidity weakness or paralysis with reduced muscle tone
spasticity certain muscles are continuously contracted
what should you dod is joint trauma is present? ask for an X-ray before attempting movement
no evidence of contractility grade 0
evidence of slight contractility grade 1
complete range of motion with gravity eliminated grade 2
complete range of motion with gravity grade 3
complete range of motion against gravity with some resistance grade 4
complete range of motion against gravity with full resistance grade 5
signs of inflammation and arthritis swelling, warmth, tenderness, redness
strain tearing or a tendon
sprain trauma that results in stretching or tearing of ligaments
what device measures range of motion? goniometer
acute rheumatoid arthritis swelling and tenderness of the joints
chronic rheumatoid arthritis muscular atrophy, swelling, deformities, ulnar deviation
palpation of vertebral step-offs assess for pain/tenderness when palpating down spine
trapezius muscle strength shrug shoulders test
kyphosis exaggerated curvature of the thoracic spine
lordosis exaggerated curvature of the lumbar spine
scoliosis exaggerated curvature of the lateral spine
nerve root compression pain in the back of the leg with 30-60 degrees indicates pressure or peripheral nerve caused by intervertebral disk
what is a sign og hip fracture? lower leg external rotation
what is the largest joint in the body? knee
what type of joint is the knee? hinge joint
what bones are connected by the knee? femur, tibia, patella
morse fall scale variables history of falling, secondary diagnosis, ambulatory aid, IV access, gait, and mental status
morse fall scale 45 or higher high risk
morse fall scale 25-44 moderate risk
morse fall scale 0-24 low risk
primary prevention for osteoporosis and arthritis diet rich in calcium and vitamin D, weight bearing exercises, avoid smoking, avoid excessive alcohol use
secondary prevention for osteoporosis and arthritis screening for women age 65 and older
what is the key concept for the neurological system? intracranial regulation
somatic nervous system conscious perception and voluntary motor response ex: reflexes
autonomic nervous system involuntary control of the body for the sake of homeostasis
enteric nervous system controlling the smooth muscle and glandular tissue in. your digestive system
mental status exams mini-mental exam Glasgow coma scale
CN I (Olfactory) test sense of smell on each side
CN II (Optic) shelley chart for vision, check vision fields, and optic discs, pupillary reactions to light (wiggle finger test, cardinal fields)
CN III (Olfactory) pupillary reactions to light, extra-ocular movements
CN IV (Trochlear) extra-ocular movements
CN V (Trigeminal) palpate the contractions of temporal and master muscles (jaw clinching), test corneal reflexes
CN VI (Abducens) assess extra-ocular movements
CN VII (Facial) ask the patient to raise eyebrows, frown, close eyes, show teeth, smile, puff out cheeks
CN VIII (Vestibulocochlear or Acoustic) test hearing with whisper test, webber test, and rinne test
CN IX (Glossopharyngeal) & CN X (Vagus) observe swallowing, listen to voice, and watch the soft palate rise with "AH", test gag reflexes
CN XI (Accessory) sternocleidomastoid - have patient turn head against head; Trapezius (strength of shoulder shrug)
CN XII (Hypoglossal) listen to the patient talk, inspect the resting tongue and protruding tongue
Romberg test have the patient stand with feet together, arms resting at sides with eyes open and then eyes closed
positive Romberg test patient moves a foot to maintain balance
what are ways you can assess balance? Romberg test, standing on 1 foot with eyes closed, heal to toe walk, hopping
stereognosis identification of a familiar object by touch
graphesthesia draw letter or number on palm and ask patient to identify by touch
deep tendon reflex (0) no response
deep tendon reflex (1+) sluggish or diminished
deep tendon reflex (2+) active or expected response
deep tendon reflex (3+) slightly hyperactive, more brisk than normal; not necessarily pathologic
deep tendon reflex (4+) brisk, hyperactive with intermittent clonus associated with disease
disease specific risk factors of stroke atrial fibrillation, coronary artery disease, sleep apnea, sickle cell disorder
modifiable risk factors of stroke HTN, smoking, hyperlipidemia, obesity, diabetes, poor diet/nutrition, physical inactivity, alcohol
stroke treatment BE FAST balance, eyes, face, arms, speech, time
traumatic brain injury prevention use seat belts, safe riding/driving, do not drive under the influence, distracted driving, safety goggles, risk of falls, increase home safety
Created by: ballen9519
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