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N307 E2 MSK
N307 Musculoskeletal Assessment [Ch 22]
| Question | Answer |
|---|---|
| Identify the 6 components of the musculoskeletal system. | bones, joints, cartilage, ligaments, tendons, muscle |
| Identify the five functions of the musculoskeletal system. | Support/stand erect; movement; protect inner vital organs; hematopoiesis; reservoir for storage of essential minerals |
| hematopoiesis | the formation of blood cells in the living body (especially in the bone marrow) |
| Identify the 3 types of muscle. Which of these is our focus during the assessment? | Skeletal (*focus); smooth; cardiac |
| flexion | bending of a limb at a joint |
| extension | straightening a limb at a joint to maximally increase its angle |
| abduction | movement of a body part away from the body’s midline |
| adduction | movement of a body part toward the body’s midline |
| pronation | movement of the forearm to place the palm downward |
| supination | movement of the forearm to place the palm upward |
| circumduction | moving the arm in a circle around the shoulder |
| inversion | movement of ankle inward |
| eversion | movement of ankle outward |
| rotation | movement of one bone turning on another or moving the head around a central axis |
| elevation | raising a body part |
| depression | lowering a body part |
| dorsiflexion | movement of hand or foot upward |
| plantar flexion | movement of food downward |
| protraction | moving a body part forward and parallel to ground; away from vertebral column |
| retraction | moving a body part backward and parallel to the ground, moves toward vertebral column |
| Identify the ethnicity that has decreased incidence of osteoporosis. | African-Americans |
| Identify the ethnicities that have an increased incidence of osteoporosis. | Chinese, Japanese, Inuits |
| At what age do we recommend a bone density test to a patient? | 50 years old |
| Describe the pain associated with a fracture. | Sharp pain that increases with movement |
| Identify the 4 possible reasons for swelling at a joint. | Excess joint fluid, thickening of the synovial lining, inflammation of surrounding soft tissue, or bony enlargement |
| Identify the 4 deformities of a joint. | Dislocation, subluxation, contracture, ankylosis |
| What does warmth and tenderness at a joint signal? | Inflammation |
| Is palpable fluid normal or abnormal? | Abnormal |
| If the patient is able to move the joint without any limitations, how do you document it? | Full active ROM (range of motion) |
| If you observe a patient having difficulty performing range of motion, how do you document it? | Passive ROM *CHECK |
| crepitation | an audible and palpable crunching or grating that accompanies movement |
| How and when does crepitation occur? | Occurs when articular surfaces in the joints are roughened, as with RA |
| What is articular disease and what s/s does it produce? | inside the joint (e.g. arthritis) produces swelling/tenderness around entire joint affecting ROM in both active and passive motion |
| What is extra-articular disease and what s/s does it produce? | Injury to specific tendon/ligament/nerve that produces swelling and tenderness to one spot in the joint; affects only certain planes of ROM, esp. during voluntary motion |
| Identify the 2 tests for carpal tunnel syndrome. | Phalen's Test; Tinel's Sign |
| rheumatoid arthritis (RA) | chronic, systemic inflammatory disease of joints and surrounding connective tissue; characterized by heat, redness, swelling, and painful motion of the affected joints |
| Describe the timing of pain for a patient with RA. | Pain is worse in the morning, gets better throughout the day |
| osteoarthritis | non-inflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral bone, and formation of new bone at joint surfaces |
| Identify the clinical manifestation(s) of osteoarthritis. (5) | Affected joints have stiffness, swelling, hard bony protuberances, pain with motion, limited motion |
| osteoporosis | decrease in skeletal bone mass occurring when rate of bone resorption is greater than that of bone formation |
| atrophy | loss of muscle mass |
| dislocated shoulder | anterior dislocation (95%) exhibited as hollow where it would normally look round |
| joint effusion | swelling from excess fluid in the joint capsule |
| Identify the clinical manifestation(s) of a person with a torn rotator cuff. | characteristic “hunched” position and limited abduction of arm |
| gouty arthritis | joint effusion or synovial thinking |
| Identify the clinical manifestation(s) of gouty arthritis. | Redness, heat, soft, boggy or fluctuant fullness to palpation and limited ROM |
| Identify the medical term for tennis elbow. | epicondylitis |
| epicondylitis | chronic disabling pain at lateral epicondyle of humerus, radiates down extensor surface of forearm |
| ganglion cyst | round, cystic, non-tender nodule overlying tendon sheath or joint capsule, usually on dorsum of wrist |
| Is a ganglion cyst malignant or benign? | Benign |
| carpal tunnel syndrome | atrophy occurs from interference with motor function due to compression of the median nerve inside the carpal tunnel, caused by chronic repetitive motion |
| syndactyly | webbed fingers; congenital deformity |
| polydactyly | extra fingers; congenital deformity |
| osgood schlatter disease | painful swelling of the tibial tubercle just below the knee, due to repeated stress on the patellar tendon |
| Osgood schlatter disease is common in which sports participants? | Soccer players and runners |
| gout | metabolic disorder of disturbed purine metabolism, associated with elevated serum uric acid; primarily in men > 40 y/o |
| scoliosis | curvature of the spine |
| Identify and describe the 2 types of scoliosis. | Functional (flexible, apparent with standing, disappears w/ bending) and structural (fixed, curvature shows on standing and bending) |
| spina bifida | incomplete closure of the posterior part of vertebrae results in a neural tube defect, usually occurs 4th week if gestation |
| If you hear crepitus while moving a patient's joint, the joint must be _______. | synovial, a joint that is freely movable |
| A patient with kyphosis has ______. | rounded back in the thoracic region |
| If your patient's arm drifts down after he extends it for 10 seconds, he probably has _______. | shoulder-girdle weakness |
| Your patient cannot move his right arm away from his side, this is noted as impaired ______. | impaired abduction |
| Pt complains of pain and tingling in her right wrist. During assessment, pt reports pain when the nurse flexes the wrist for 30 sec. This indicates _______. | carpal tunnel syndrome via Phalen's test |
Created by:
nikkirosety
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