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Health Assessment

Articular Structures: include the joint capsule and articular cartilage, the synovium and synovial fluid, intra-articular ligaments, and juxta-articular bone.
Extra-articular structures: (outside joint) include periarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve, and overlying skin.
Ligaments: are rope-like bundles of collagen fibrils that connect bone to bone.
Tendons: are collagen fibers connecting muscle to bone.
Bursae: are pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures. (close sac filled with fluid in a place where friction occurs - tendon crosses over bone).
Synovial: freely movable (knee, shoulder).
Cartilaginous: slightly movable (vertebral bodies of the spine).
Fibrous: immovable (skull structures)
Spheroidal (ball and socket): shoulder, hip
Hinge: interphalangeal joints of the hand and foot; elbow.
Condylar: knee, temporomandibular joint
Muscles: the 600 skeletal muscles account for 40%-50% of the body's weight.
Skeletal Muscle: Voluntary muscles, those under conscious control. Muscle that is connected with a bone.
Smooth Muscle: Muscle tissue that is involuntary in action and found principally in visceral organs. (not under conscious control)
Cardiac Muscle: Myocardium (causes ventricles to contract, pushes blood out to the body)
Compact Bones: long bones -> dense, hard, rigid. bone marrow = yellow & red
Cancellous Bone: inner bones, spongy bone.
Flexion: bending limb at joint
Extension: straightening limb at joint
Abduction: moving limb away from midline
Adduction: moving limb towards midline
Pronation: turning forearm so palm is down
Supination: turning forearm so palm is up
Inversion: moving sole of foot inward at ankle
Eversion: moving sole of foot outward at the ankle
Rotation: moving head around a central axis
Elevation: raising a body part
Depression: lowering a body part
Dorsiflexion: point toe at nose
Plantar flexion: point toe to floor
Spine: the vertebrae are 33 connecting bones stacked in a vertical column.
Cervical: 7
Thoracic: 12
Lumbar: 5
Sacral: 5
Coccygeal Vertebrae: 3-4
Subjective Data - Joints: Pain (old cart), stiffness, swelling, heat, redness, limitation of movement, systemic symptoms (fever, chills, rash, weakness, weight loss).
Subjective Data - Neck pain: Old Cart.
Subjective Data - Low back pain: Old Cart. On the midline, over the vertebrae or off the midline. Radiation to the legs? Numbness or paresthesias (tingling).
Subjective Data - Muscles: Pain - Old Cart, weakness. (Statins for cholesterol cause muscles pain)
Subjective Data- Bones: Pain - Old Cart. Deformity, trauma (fractures, sprains, dislocations). Functional Assessment (ADL's), self-care behaviors, Meds (statins cause back pain)
Additional History for the Aging Adult: Any change in weakness over the past months or years? Any increase in falls or stumbling over the past months or years? Do you use any mobility aids to help you get around: cane or walker?
History for the Pediatric patient: Trauma during labor and delivery. Motor milestones. Any fractures or broken bones. Any bony deformities, spinal curvature, unusual shape to feet/toes? Sports/protective equipment.
Objective Information: Inspection (size and contour of the joint, skin color and characteristics). Palpitation (skin, muscles, bony articulations, joint capsules, pulses) Range of Motion (ROM), Muscle testing
Exam - Objective Data: neck, upper extremities, lower extremities, spine.
Neck: range of motion (flexion, extension, lateral movements and rotation), strength testing
Upper extremities: shoulders, arms, wrists, hands -> inspect, palpate, check pulses, ROM and strength testing.
Lower extremities: hips, knees, ankles, feet and toes - inspect, palpate, check pulses, ROM and strength testing.
Spine: inspect, palpate, check for curvature of the spine and ROM.
Objective Data for Pedi: Infant Positional deformities of the foot, Congenital hip...ortolani's maneuver/allis test (make sure there is no clicking noise in hips), Check clavicle after birth (make sure no trauma/injury at birth). Check back for any cyst/tuft of hair, dimple/mass.
Objective Data for Pedi: Infant (cont) Check muscle tone. Child: screen for scoliosis.
Created by: mr209368