Term
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Definition
| movement of a limb away from the midline or axis of the body |
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Term
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Definition
| movement of a limb toward the midline or axis of the body |
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Term
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Definition
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Term
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Definition
| wasting or decreasing in size or physiologic activity of a part of the body because of the disease or other influences , ex muscle cells, brain cells ect |
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Term
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Definition
| abnormal cartilaginous or body enlargment of a proximal interphalangeal joint of a finger, usually occuring in disease of the joints , such as rheumatoid arthritis |
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Term
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Definition
| common, usually painless thickening of the stratum corneum at locations of external pressure or friction |
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Term
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Definition
| combo of abduction, adduction, extension, and flexion |
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Term
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Definition
| clicking sound heard in the movements of the joints, for example in temporomandibular joint resulting from joint irregularities |
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Term
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Definition
| away from or the farthest point fom the orgin of attachment |
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Term
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Definition
| upward or backward flexion of a part of the body |
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Term
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Definition
| Tilting the sole of foot outward with the medial side of the foot lowered |
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Term
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Definition
| turning outwardly or away from the midline of the body , such as when a leg is externally rotated with the toes turned outward |
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Term
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Definition
| a "straightening" movement allowed by certain joints of the skeleton that increase the angle between the two adjoining bones |
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Term
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Definition
| localized , uncordinated, uncontrollable twitching of a single motor nerve fiber or filament that may be palpated and seen under the skin. Fasciculation of the heart muscles is fibrillation |
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Term
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Definition
| movement that decreases the angle between the two adjacent bones |
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Term
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Definition
| manner or style of walking, including rythm , cadience, and speed |
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Term
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Definition
| deformity in which one or both legs ar bent outward at the knee |
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Term
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Definition
| deformity in which one or both legs are curved inward at the knee |
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Term
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Definition
| instrument used to measure angles, particularly ROM , angle of a joint |
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Term
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Definition
| abnormal cartliages or bony enlargement of a distal interphalangeal joint of a finger, usually occuring in digenerative disease of the joints |
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Term
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Definition
| movement at a joint to a position beyond the joints normal max extension |
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Term
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Definition
| increase in the size of an organ caused by an increase in the size of the cells rather than the number of cells, the cells of heart and kidney are extremly prone |
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Term
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Definition
| turning of a limb about its axis of rotation toward the midline of the body |
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Term
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Definition
| Tilting the sole of the foot inward with the lateral side of the foot lowered |
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Term
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Definition
Excessive convexity of the thoracic spine
Forward and downward hunching of head, neck, shoulders
“Hunchback” |
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Term
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Definition
Excessive concavity of the lumbar spine
“Swayback” |
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Term
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Definition
| diffuse muscle pain usually accumpanied by tiredness |
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Term
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Definition
| resistance to the flexion of the neck, condition seen in patients with meningitis |
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Term
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Definition
Wrist flexed and dorsum of hands pressed together
Hold for 1 minute
Sensations of numbness and paresthesia in palmar aspects of hand, especially the first 3 fingers
Positive sign is associated with carpal tunnel syndrome |
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Term
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Definition
| toe down motion of the foot at the ankle |
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Term
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Definition
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Term
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Definition
| rotation of the forearm so the palm faces downward |
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Term
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Definition
| extent of movement of a joint, measured in degrees |
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Term
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Definition
| movement of a bone around its central axis |
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Term
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Definition
Lateral curvature of the spine
Becomes accentuated on forward flexion at the waist |
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Term
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Definition
| rotation of palm so it faces upward |
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Term
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Definition
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Term
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Definition
indication of irratibilty of a nerve
Strike the median nerve
Tingling or prickling sensation radiating from wrist to the hand especially to the thumb, index and middle fingers
Positive sign is associated with carpal tunnel syndrome |
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Term
| Chief complaints of muscle pain and/or weakness |
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Definition
| mylgia is usually felt as cramping or aching. Viral illness can also include Mylagia. Weakness may involve muscosckeletal or neurological systems. Atrophy. Sharp pain weakness. |
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Term
| Chief complaint of joint pain and/or swelling |
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Definition
could be aching, stiff, hard, dull, or shooting. Joint pain is the most common muscoskeletal concerns that prompt a person to seek care. Rheumatoid arthritis involves symetric joints; other muscoskeletal illness involve isolated or unilateal joints. Exquisitly tender with acute inflamation.
- RA pain is usually worst in the morning when arising; osteoporosis is worse later in the day.
-movment increases most joint pain except in RA, in which movement decreases pain.
- Joint pain 10 to 14 days after an untreated strep throat suggest rheumatic fever. Joint injurys occur from from trauma, repetitive motion
-RA stiffness occurs in the morning and after rest periods.
-suggest acute inflamation
-swelling, heat, redness
-limitation of movement
-pain
-tenderness
-warmth
-nodules |
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Term
| chief compaint of limitation of mobility |
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Definition
the joints or muscles usually create a limit on my usual activities of daily living (ADL).
-Bathing ( getting in andout turning faucet on)
-tolieting( urinating, bowel movemnts, able to wipe, get on and off toliet
-Dressing- doing buttons, zipper, tieing shoes, puling up pants
-Grooming
-Eating
-mobility
-communication- talking, using the phone, writing |
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Term
| Indications of gait disturbance |
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Definition
Hesitancy
Unsteadiness
Staggering
Grasping for external support
High stepping
Floor scraping
Excessive pointing of toes inward or outward
Shuffling gait
Waddling gait
Slow, rapid step speed
Asymmetry of step height or length
Limping
Stooping during walking |
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Term
| elicit a fcused health history for someone who had muscle pain or weakness |
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Definition
Any problem in the muscles, such as any pain or cramping? which muscles?
If in calve muscle: Is the pain with walking? Does it go away with rest?
Are your muscle aches associated with fever?chills?flu?
any weakness in the muscles?
Location: where is the weakness? Howlon have you noticed the weakness?
Do the muscles look smaller there? |
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Term
| focused healt history on someone who has joint pain or swelling |
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Definition
Any problems with your joint? Any pain?
Location: Which joints? on one side or both sides?
QUality: What does the pain feel like? aching?stiff?sharp? dull? shooting?
Severity: how strong is the pain?
Onset: When did this pain start?
Timing: what time of day does the pain occur? How long? how often?
Is the pain aggrivated by movement, rest, position, weather? Is the pain relieved by rest, medication, application of heat or ice?
Is the pain associated with chills, fever, recent sore throat, trauma, repetitiv activity?
Any stiffness in your joints?
Any swelling, heat, redness in the joints?
Any limitation of movement in any joints? which joints?
Whic activities give you problems? |
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Term
| focused health history on somone with limitation of mobility |
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Definition
Do your joints/ muscle problems create any limitations on your usual acivities of daily living? which ones? ( ask about each category, if person says yes ask about each activity in each catagory)
- bathing
-tolieting
-dressing
-grooming
-eating
-mobiity
-communication |
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Term
| focused health history on someone who is experiencing gait disturbance |
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Definition
do have any trouble with walking?
any pain? |
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Term
| How do you perform active Range of Motion exercises |
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Definition
person does the moving
Have person move joint through each of its various ROM movements
Note the angle of each joint movement
Note any pain, tenderness, or crepitus |
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Term
| How do you perform passive range of motion |
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Definition
Passive
person relaxes and allows you to move the joints
Done if person is unable to do active ROM
ALWAYS stop if the person complains of pain
NEVER push a joint beyond its anatomic angle
Use a Goniometer to determine exact ROM in joints with limited ROM |
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Term
| What is included in the musculoskeltal system |
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Definition
Bones
Joints
Skeletal muscles
Supportive connective tissue
Tendons: connect muscles to bones
Ligaments: connect bones to each other at the joint level
Cartilage: cushioning tissue within a joint |
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Term
| Positional terminology of the musculoskeltal system |
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Definition
-Proximal:Close to the center of the body
-Distal: Away from the center of the body
Abduction: Moving the extremity laterally, away from the midline
Adduction: Moving the extremity medially, toward the midline
-Internal Rotation:Rotating the extremity medially along its own axis
-External Rotation: Rotating the extremity laterally along its own axis
-Circumduction: Moving the extremity in a conical fashion so the distal aspect moves in a circle
-Opposition: Moving the thumb outward to touch the little finger
-Pronation: Rotating forearm medially so palm faces down
-Supination:Rotating forearm laterally so palm faces up
-Inversion: Tilting the sole of the foot inward with the lateral side of the foot lowered
-Eversion: Tilting the sole of foot outward with the medial side of the foot lowered |
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Term
| Position terminology related to change in joint angles |
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Definition
-Flexion: Bending a joint so the articulating bones are moved closer to each other Decreasing the joint angle
-Extension: Bending a joint so the articulating bones are moved away from each other Increasing the joint angle
-Hyperextension:Extension beyond the neutral (180 degrees) position
-Dorsiflexion
Flexing the foot at the ankle so that the toes move toward chest
Decreasing the joint angle
Plantar Flexion
Moving the foot at the ankle so the toes move away from chest
Pointing toes |
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Term
| Review of Related history: Current Complaints |
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Definition
With full symptom analysis:
Joint complaints
Muscular complaints
Skeletal complaints
Injury
Back pain |
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Term
| Review of related History: Past History |
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Definition
-Trauma:Nerves,Joints,Bones, Soft tissue
-Surgery on bone or joint
-Skeletal deformities
-Chronic illness |
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Term
| Review of Related History: Family |
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Definition
-Congenital abnormalities or genetic disorders:
Hip or foot deformities,
Osteogenesis imperfecta
-Scoliosis or back problems
-Arthritis:
Rheumatoid arthritis (RA)
Osteoarthritis joint disease caused by cartilage loss in joints
Ankylosing spondylitis- type of arthritis in your spine causes back pain and stiffness
Gout: chronic form of arthritis from high uric acid levels in the blood |
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Term
| Review of related History: Social and personal |
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Definition
Employment – potential for injury
Exercise patterns
Functional abilities
Weight changes
Height changes
Nutrition
Tobacco
Alcohol |
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Term
| What are soe risk factors for a persons muscoskeletal system dealing with sport injurys |
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Definition
-Poor physical conditioning
-Failure to warm up muscles adequately
-Intensity of competition
-Collision and contact sports participation
-Rapid growth
-Overuse of joints |
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Term
| What are some risk factors for Osteoarthritis - a joint dieases caused by cartilage loss in bones |
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Definition
-Obesity
-family History
-Lax Ligaments with postural deformity
-if you are greater than 40 years of age |
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Term
| what are some risk factors for Osteoporosis ( disease in which bones become fragile and likely to break) |
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Definition
*Race: caucasian, Asian,Native American
*Northwestern European
*Blonde or red hair with freckles
*Light body frame, thin
*Family History
*Nulliparous( a woman who has never given birth)
* post menopause( because the decrease in estrogen levels weakens th bones)
* Constant dieting
* Scolipsis, RA
* Metabolic disorders
* Some drugs
* poor teeth
* Smoking
* Alcohol
* calcium intake <1500mg |
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Term
| What equpiment will we need to perform an examination |
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Definition
Skin marking pencil
Goniometer
Measuring tape
Reflex hammer
Sphygmomanometer |
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Term
| what techniques will we use |
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Definition
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Term
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Definition
Alignment
Contour
Symmetry
Height/weight
Gross deformity
Posture:Standing,Sitting |
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Term
| inspection: Weight bearing tolerance |
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Definition
Non-weight bearing
Affected foot/leg does not touch the floor
Touchdown weight bearing
Touches floor, but no weight placed
Partial weight bearing
30-50% of weight born
Weight bearing as tolerated
>50% but < 100%
Full weight bearing |
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Term
| Inspection: Overall Gait and mobility |
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Definition
Walking normally:
Forward
Backward
Step to right, then to left
Walking on toes
Walking on heels
Tandem walking ( heel-to-toe)
Walking with eyes closed |
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Term
| What are indications of fait disturbance |
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Definition
Hesitancy
Unsteadiness
Staggering
Grasping for external support
High stepping
Floor scraping
Excessive pointing of toes inward or outward
Shuffling gait
Waddling gait
Slow, rapid step speed
Asymmetry of step height or length
Limping
Stooping during walking |
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Term
| When you inspect and you Palpate you have to make sure to always do what |
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Definition
| compare CONTRALATERAL SIDES!!! |
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Term
| the first step in inspection and palpation of the muscles |
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Definition
you want to check the overall appearance of the muscle mass
*hypertophy- is an increase in the muscls size and shape
*atrophy- is a decrease in the muscle size and shape; thin flabby muscles
Note - if a limb looks smaller or larger that its counterpart you going to want to measure both limbs during muscle relaxation, measure both limbs at exactly the same distance from a nearby joint at the site of maximum limb diameter
* if the difference between the two measures is greater than 3 cm its abnormal |
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Term
| What is the second step you do when inspecting nd palpating the muscles |
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Definition
you have the person cntract muscle isometrically ( squeeze it )- isometric contraction without inducing any movement.
- Then you relax the muscle
- The you contract again
YOU AS THE NURSE: are looking for any involuntary movements |
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Term
| what is the 3rd step you do when inspecting and palpating the muscles |
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Definition
- you going to apply light pressure with the finger pads
- palpate while person's muscles are relaxing, and while they are isometrically contracting
SOME THINGS YOU MIGHT SEE:
* hypotonicity: Flaccidity, decreased muscle tone
OR
*Spasticity- increased muscle tone, often noted with extreme flexion or extension |
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Term
| What is the first thing you do when inspecting and palpatig the joints |
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Definition
you want to observe the shape of the jointd while the joint is in the neutral anatomic position
SOME THINGS YOU MIGHT COME ACROSS:
* CONTOUR
dislocation: dislodgment of one bone out of the joint cavity
-subluxation: partial dislodgment of the bone from its place in the joint cavity
*SYMMETRY |
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Term
| What is the second thing you want to do when ispecting and palpating the joints |
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Definition
you want to visually inspect the 2-3 inches of skin ad subcutaneous tissue surrounding the joint for :
Erythema- skin condition with redness or rash
Edema- fluid in the skin
Ecchymosis- rupture of blood vessel that shows a small discoloration of the skin
Nodules- solid raised bumps
Deformities
Masses
Skin atrophy
Skin breakdown |
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Term
| What is the 3rd step palpation of the joints |
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Definition
Palpate the joint from the periphery inward toward the center of the joint for:
Swelling
Tenderness
Warmth
Nodules |
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Term
| How do you perform active range of motion |
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Definition
Active
person does the moving
Have person move joint through each of its various ROM movements
Note the angle of each joint movement
Note any pain, tenderness, or crepitus |
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Term
| How do you perform passive range of motion |
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Definition
Passive
person relaxes and allows you to move the joints
Done if person is unable to do active ROM
ALWAYS stop if the person complains of pain
NEVER push a joint beyond its anatomic angle
Use a Goniometer to determine exact ROM in joints with limited ROM |
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Term
| when do you test muscle strength |
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Definition
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Term
| How do we test muscle strength |
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Definition
by seeing their ability to perform ROM against resistance
we also look for
-symmetry- if both muscles are the same strength
-involuntary movements |
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Term
| what is the muscle strength grading scale |
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Definition
its on a scale of 0-5; 5 being normal and 0 being no muscle strength
5.Normal 100%-Complete ROM against full
resistance
4. Good 75%-Complete ROM against
moderate resistance
3. Fair 50%-Complete ROM without
resistance
2. Poor 25%-Complete ROM only if joint
fully supported
1. Trace 10%-Muscle contraction visible
but insufficient to move joint
0. None 0%-No visible or palpable muscle
contraction |
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Term
| what are the joints that deserve particular attetion |
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Definition
Temperomandibular Joint
Cervical Spine
Thoracic and Lumbar Spine
Shoulders
Elbows
Hands and Wrists
Hips
Legs and Knees
Feet and Ankles |
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Term
| How do you palpate the Tempermandibular Joint? |
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Definition
Place the tips of your index fingers directly in front of the tragus of each ear
Ask the person to open and close the mouth
Note any decreased range of motion, tenderness, or swelling |
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Term
| How do you test the Temperomandibular Joint (TMJ)Range of motion, how do you palpate during rang of motion, and how do you test the strength of tempralis and masseter muscles |
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Definition
tell patient to :
- open and close mouth
- move jaw laterally from side to side
- protrusing and retracting jaw
Palpate joint space during these motions for
-clicking
-popping
-pain
Test the stregnth of tmporalis and masseter muscles
- palpate contracted muscles with jaw clenching
-you are simintaneously testing CN: trigeminal V |
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Term
| What are the test you perform on the Cervical Spine |
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Definition
* inspect neck for:
alignment
symmetry of skin folds and muscles
ROM
Forward flexion (45°)
Hyperextension (55°)
Lateral bending (40°)
Rotation (70°)
-Strength of sternocleidomastoid and trapezius muscles
ROM against resistance
With rotation, you are simultaneously testing CN
XI Spinal accessory |
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Term
| What are you testing the patient for when checking the thoracic and Lumbar Spine |
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Definition
you want to inspect spine for alignment
* scoliosis: lateral curavture of the spine, and it becomes accentualted on forwardflexion of the waist
* Kyphosis- excessive convexity of the thoracic spine, forward and down ward hunching of the head,neck,and shoulders, hunchback
*Lordosis- excessive concavity of the lumbar spine, swayback
* List- leaning of the spine,May be from herniated lumbar disc/painful paravertebral muscles |
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Term
| How do you inspect and palpate the Thoracic and Lumbar spine |
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Definition
palpate the spinal processes and paravertebral muscles for :
-nodules
-tenderness
ROM
Forward flexion (75°)
Hyperextension (30°)
Lateral bending (35°)
Rotation |
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Term
| How do you inspect the shoulders |
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Definition
Inspect shoulders and shoulder girdle for contour
Palpate the joint spaces and bones of shoulders
ROM
Shrugging shoulders
Forward flexion (180°)
Hyperextension (up to 50°)
Abduction (180°)
Adduction (50°)
Internal and external rotation (90°)
- muscles strength
Shrugging shoulders:Tests CN
XISpinal accessory
Forward flexion
Abduction |
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Term
| How do you inspect the elbows |
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Definition
* inspectelbows i flexed and extended postion
-contour
-carrying angle (5-15 degrees)
Palpate the extensor surfaces for tenderness, warmth,nodules
*ulna
*olecranon process
*medial and latrnal epicondyles
ROM:
Flexion 160
extension 180
pronation and suination 90
Muscle strength:
flexion
extension |
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Term
| How do you examine the hands and the wrists |
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Definition
inspect the dorsm and the palms of the hands:
contour
postion
shape
number and completeness of digits
*palpate each joint of the hand and wrists |
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Term
| How do you test's for tinel's sign |
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Definition
- strike the medial nerve
-tingling or prickling sensation radiating from the wrist to the hand especially to the thumb, index and middle fingers
* positive sign is associated with carpal tunnel syndrome |
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Term
| How do you test for Phelan's sign |
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Definition
* wrist flxed and dorsum of hands pressed together
*hold for one minute
*sensations of numbness an paresthesia in palmar aspects of hand, especially in first 3 fingers
* positive sign associated with carpal tunnel syndrome |
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Term
| testing hand and wrist ROM and muscle strength |
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Definition
ROM
Metacarpophalyngeal flexion (180°) and extension (30°)
Thumb opposition
Forming a fist
Finger abduction and adduction
Wrist hyperextension (70°) and flexion (90°)
Radial (20°) and ulnar movement (55°)
Muscle strength
Wrist extension and hyperextension
Finger abduction and adduction
Hand grip |
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Term
|
Definition
Inspect hips for symmetry and level of gluteal folds
Palpate hips and pelvis for:
Instability
Tenderness
Crepitus
ROM
Flexion (120°), extension (90°), and hyperextension (30°)
Abduction (45°) and adduction (30°)
Internal (40°) and external (45°) rotation
Muscle strength
Knee in flexion and extension
Abduction and adduction |
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Term
| Legs and knees examination |
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Definition
Inspect knees for natural concavities
Palpate the popliteal space and joint space
ROM
Flexion (130°)
Extension (0-15°)
Muscle strength
Flexion
Extension |
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Term
|
Definition
Inspect feet and ankles during weight bearing and non weight bearing
Contour
Alignment
Size
Number of toes
Palpate the Achilles tendon and each metatarsal joint |
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Term
| what ar developmental variations with newborns |
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Definition
you need to look for abnormalties
Simian crease:
Single crease across entire palm
Associated with Down syndrome
Polydactyly
Extra digits
Syndactyly
Webbed digits
Signs of hip dislocation
Hip clicks
Asymmetric gluteal folds |
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Term
| What are some developmental variations with infants |
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Definition
-Should be able to lift the head and trunk from the prone position by 2 months of age
Forearm strength
-Kyphosis of the thoracic and lumbar spine is normal until the infant can sit without support
About 7 months
-All babies are flat-footed
Forefoot should be flexible. Straightening with abduction |
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Term
| what are some developmental variations with children |
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Definition
- young children have a protuberant belly and lumbar curvature
- watch alignment especially
-feet often slightly invert until about 30 months
-caution parents about reverse tailor sitting because it places stress on the joints and can lead tofuture problems in lower lumbar limb alignment |
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Term
| devlopmental variations: children abnormalties |
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Definition
* Genu Varium- "bow leg", measure distance between knees when ankles are together
* Genu Valgum- "knock knee", measure dustance between ankles when knees are together, 2.5cm space = genu valgum |
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Term
| developmental variations in adolescents |
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Definition
adolescents may have slight kyphosis and rounded shoulders
- bone growth is complete by age 20
* peak bone mass not until 35 |
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Term
| developmental variations with pregnancy |
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Definition
postural changes
*increased lordosis
increased mobility and instability of sacroiliac joints
-pregnancy waddle
symptoms of carpel tunnel syndrome rlated to fluid retention
-abate after birth |
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Term
| developmental variations with older adults |
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Definition
Joint agility can be grossly assessed by functional ADLs
Posture
Increased kyphosis, especially with osteoporosis
Reduction in total muscle mass
Joint and muscle agility have tremendous extremes among older adults
“If you don’t use it, you lose it!” |
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Term
| definition of impaired physical mobility |
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Definition
| a limitation in independent, purposeful physical movement of the body or one or more extremedies |
|
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Term
| what are the related to factors of impaired physical mobility |
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Definition
| activity intolerance, altered cellular metabolism; anxiety, body mass index above 75th age appropriate percentile. conitive impairment, contractures, cultural beiefs reguarding age apprpriat activities, deconditioning, decreased endurance,depressive mood state, decreased muscle control; decreased muscle mass, decreased muscl strength, defiecient knowldge regaurding value of physical activity, developmental delay, discomfort, dissuse, joint stiffness, lack of enviromental support, limited cardiovascular endurace, loss of integrity ofbone structure, malnutrition, medications, muscoskeltal impairment, nueromuscular impairment, pain, prescribed movement restrictions, reluctance to initiate movement, sedentary lifestle, sensoriperceptaul impairments |
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Term
| defining characteristics impaired physical mobility |
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Definition
| decreased retention time, difficulty turning, engaging in subsitutions for movement ( increased attention to other activites, controlling behavior, focus on pre-illness disability/ activity) exertional dyspnea; gait changes, jerky movements, limited abilty to perform gross motor skills; limited ability to perform fine motor skills. limited range of motion. movement induced tremor; postual instability; slowed movement, uncordinated movement |
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