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Health Assessment Exam 4
GI/GU, musculoskeletal
28
Nursing
Undergraduate 3
02/14/2012

Additional Nursing Flashcards

 


 

Cards

Term
Order of musculoskeletal exam
Definition
  1. Inspection
  2. Palpation
  3. ROM
  4. Muscle strength
Term
Muscle fasiculations
Definition
Twitching or involuntary movement of muscle fibers
Term

Ankylosis

 

Definition
stiffness or fixation of joint (joint fuses)
Term
Possible Etiologies of swelling/edema in musculoskeletal system
Definition

Fluid in joint (effusion)

thickening of synovial lining

inflammation

bony enlargement

 

Term
Normal findings for general inspection of musculoskeletal system
Definition
  • Joints & muscles symmetrical
  • No fasiculations
  • No deformities or masses
  • No swelling, edema
  • Posture upright
  • Gait smooth & even
Term

Musculoskeletal palpation

Assess for:

Definition

Pain/tenderness (injury, inflammation, etc.)

Swelling (may be evident only with palpation)

Temperature (Increased warmth - inflammation)

Masses (nodules)

Crepitation (cracking or grating sound)

Term
Two types of Range of Motion (ROM)
Definition
  • Active: patient moves joint
  • Passive: you move joint (for patient)
Term
Should you test ROM or muscle strength first?
Definition
ROM
Term
Normal ROM findings
Definition
  • Full, active ROM without pain
  • may normally feel crepitations
  • Active ROM should be about the same as passive
    • (Stroke pt, accident victims: passive ROM greater)
    • Passive > active associated with muscle weakness or joint instability. Also tendonitis, bursitis.
Term

Situations where passive ROM may be greater than active ROM

 

Definition

Stroke

Muscle weakness

Joint instability

 

Term
Decreased ROM happens with:
Definition

Pain

Inflammation of tissues around joint

Ankylosis

Foreign body

Fluid due to swelling

Term
Increased ROM happens with:
Definition

hypermobility - may be benign

or associated with ligament/fracture

Term
Muscle assessment
Definition

Apply resisting force and have patient oppose it.

Assess strength bilaterally

Assess muscle groups for coordination, pain and resistance to opposing force

Term
Normal findings: muscle assessment
Definition

Coordinated, painless

Greater in dominant arm & leg

May use scale to grade 0 - 5

0=no muscle contraction

5=full ROM against gravity with full resistance


May also use descriptive terms (paralysis, severe weakness, moderate weakness)

Term
Specific muscle assessment
Definition
  • Tone: N=firm
  • Mass: size based on function
    • may have difference of up to 1cm between dominant (usu. greater) and non-dominant side
  • Length of extremities:
    • use if suspected asymmetry
Term
Shoulder Joint
Definition
Glenohumeral joint
Term
Seven basic types of joint movement
Definition
  • Flexion
  • Extension
  • Abduction
  • Adduction
  • Internal rotation
  • External Rotation
  • Circumduction
Term
Flexion
Definition
Bending of limb at a joint
Term
Extension
Definition
Straightening of limb at a joint
Term
Abduction
Definition
Movement of a limb away from midline
Term

Adduction

 

Definition
Movement of a limb toward central axis of body or beyond
Term
Internal Rotation
Definition
Turning of a body part inward toward the central axis
Term
External Rotation
Definition
Turning of a body part away from midline
Term
Circumduction
Definition
Movement in a circular pattern
Term
General inspection of musculoskeletal system
Definition

 

  • General body alignment
  • Hypertrophy/Atrophy of muscle
  • Joint involvement
    • Rheumatoid arthritis (several joints, symmetrical)
    • Osteoarthritis (one-2 joints, asymmetrical)

 

Term
Examples of Gross Deformities of the musculoskeletal system
Definition

Flexion contractures (due to muscle shortening)

Heberdon & Bouchard nodes

Sub-Q nodules

Bowlegs (genu varum)

Knock-knees (genu valgum)

Hypertrophy/atrophy of muscle

Ankylosis (stiffness or fixation of joint)

Term
Normal findings for general inspection of musculoskeletal system
Definition
  • Joints & muscles symmetrical
  • No fasiculations
  • No deformities or masses
  • No swelling, edema
  • Posture upright
  • Gait smooth & even
Term
Normal findings for musculoskeletal general palpation
Definition

No pain or tenderness

No swelling

No masses or crepitation

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