Musculoskeletal Assessment Overview

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Questions and Answers

What does a normal gait assessment indicate?

Uncoordinated movements with a shuffling walk

Frequent stumbling and difficulty turning

Gait that is smooth, rhythmic, and effortless (correct)

Inconsistent step length with abrupt changes

Which is a component of the Romberg Test?

Walking heel-to-toe in a straight line

Pacing back and forth to assess coordination

Standing with feet together first with eyes open (correct)

Balancing on one leg with the opposite knee raised

During the rapid alternating movements test, the client is expected to do which of the following?

Pat knees with palms followed by backs of hands (correct)

Kick a ball while maintaining balance

Roll their shoulders while standing on one leg

Jump in place while coordinating arm swings

What indicates a normal performance on tandem walking?

Walking straight and staying balanced Signup and view all the answers

What is the purpose of having a patient identify where they were touched during a neurological assessment?

To assess sensory nerve pathways Signup and view all the answers

If a client has a measured step length of 10 inches during a gait assessment, how would this be interpreted?

Indicates abnormal gait parameters Signup and view all the answers

What is the primary purpose of assessing opposing arm swing during a gait evaluation?

To evaluate the symmetry of limb movements Signup and view all the answers

How is reinforcement used in reflex testing?

By performing an isometric exercise in another muscle group Signup and view all the answers

What is the first step in conducting a reflex test?

To use a reflex hammer to tap a tendon Signup and view all the answers

Which of the following best describes poorly coordinated tandem walking?

Frequent loss of balance and foot positioning errors Signup and view all the answers

What should be documented when performing reflex tests?

Symmetry of reflex responses comparing both sides Signup and view all the answers

Which movement is least likely to be assessed by a cerebellar function test?

Sprinting to test speed and agility Signup and view all the answers

Which technique improves the reliability of reflex testing?

Reinforcing the reflex by having the patient do isometric exercises Signup and view all the answers

What component is primarily evaluated through the use of a reflex hammer?

Reflex activity of specific tendons Signup and view all the answers

Why is symmetry important during a neurological assessment?

It provides insight into the overall neurological function. Signup and view all the answers

Which of the following best describes the usage of a stick figure representation in neurological assessments?

To document reflex findings graphically Signup and view all the answers

What aspect of the neurological assessment does identifying touch sensations predominantly assess?

Sensory function Signup and view all the answers

What is the effect of performing an isometric exercise away from the tested muscle group during reflex testing?

It increases the reflex response measured. Signup and view all the answers

What is the primary function of the Oculomotor nerve?

Movement of eyeball and eyelid Signup and view all the answers

Which cranial nerve is responsible for visual acuity?

Cranial Nerve II Signup and view all the answers

How should cranial nerve assessments be conducted for the best results?

Assess one nerve at a time for accuracy Signup and view all the answers

What sensory function does the Olfactory nerve primarily test?

Sense of smell Signup and view all the answers

Which of the following nerves is involved in controlling muscle strength for neck movement?

Cranial Nerve XI Signup and view all the answers

What is the purpose of the corneal reflex test?

To evaluate facial sensation and movement Signup and view all the answers

Which reflex is assessed to check the functioning of the quadriceps muscle?

Patellar reflex Signup and view all the answers

How is the corneal reflex test properly performed?

Bringing a wisp of cotton in from the side of the eye Signup and view all the answers

What grading indicates a normal deep tendon reflex?

2+ Signup and view all the answers

What should be done before performing the corneal reflex test?

Remove contact lenses if present Signup and view all the answers

Which reflex is NOT a deep tendon reflex?

Corneal reflex Signup and view all the answers

What does a decreased or absent corneal reflex indicate?

Possible abnormality in facial functions Signup and view all the answers

Which of the following is true concerning the plantar superficial reflex?

Responses are elicited by stroking skin or muscle Signup and view all the answers

What does the term 'normal' refer to in grading reflex responses?

A robust and bilateral blink response Signup and view all the answers

In the context of reflex testing, what does the term '2+' signify?

Normal reflex response Signup and view all the answers

What is the normal response when the plantar reflex is elicited?

Plantar flexion of the toes Signup and view all the answers

What indicates an abnormal plantar reflex in adults?

Fanning of all toes Signup and view all the answers

What is the role of cranial nerve VII in the context of the plantar reflex?

Provides motor efferent responses to close the eye Signup and view all the answers

Which area of the brain is primarily responsible for motor speech?

Broca's Area Signup and view all the answers

How does the plantar reflex typically present in infants before they can walk?

Fanning and extension of toes Signup and view all the answers

Which of the following best describes a stroke in terms of its impact?

Leading cause of long-term disability Signup and view all the answers

What is a potential consequence of damage to the frontal lobe due to a stroke?

Changes in personality and behavior Signup and view all the answers

Which cranial nerve is involved in the sensory afferent pathway during a plantar reflex test?

Cranial Nerve V Signup and view all the answers

What is the fifth leading cause of death related to neurological health?

Stroke Signup and view all the answers

What does a positive Babinski sign indicate in adults?

Possible damage to the upper motor neurons Signup and view all the answers

Study Notes

Musculoskeletal Assessment Objectives

Identify key landmarks of each joint
Obtain accurate history of the musculoskeletal system
Complete a physical assessment of the musculoskeletal system, including inspection and palpation of joints, bones, and muscles, and range of motion
Assess muscle strength using a grading scale
Identify risk factors for osteoporosis
Discuss health promotion strategies to reduce risk of osteoporosis, low back pain, and falls

Common or Concerning Symptoms

Joint pain, associated with systemic symptoms (fever, chills, rash, weakness, weight loss)
Low back pain
Neck pain
Bone pain
Muscle pain or cramps, or weakness

Obtaining Health History

Inquire about pain in joints, bones, or muscles
Assess for myalgias (muscle pain) and arthralgias (joint pain)
Evaluate any complaints of pain or discomfort using the OLDCART method (Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, and Treatment)
Assess current self-care behaviors, including exercise and medications

Terms

Dislocation: One or more bones in a joint are out of place.
Subluxation: Partial dislocation of a joint.
Contracture: Shortening of a muscle, limiting range of motion.

Low Back Pain (Common)

Pain may be on the midline, over the vertebrae, or off the midline
Assess for irradiation, numbness, paresthesia, and associated bladder or bowel dysfunction

Neck Pain

Assess for radiation to the arm, arm or leg weakness or paraesthesia, and any changes in bladder or bowel function
Patients with persistent pain following blunt trauma or motor vehicle accidents require referral to a specialist

Examination of the Joints

Inspect joint symmetry, alignment, and bony deformities
Inspect and palpate surrounding tissues for skin changes, nodules, muscle atrophy, and crepitus
Assess range of motion (ROM) to determine joint function and stability
Assess for signs of inflammation, swelling, warmth, tenderness, and redness
Palpate all bones, joints, and surrounding muscles, noting any heat, tenderness, swelling, and masses.
Note muscle tone and palpate inflamed joints last
Active and passive ROM testing for each major joint, including related muscle groups, should be assessed.

Specific Joints and Muscles

Temporomandibular Joint (TMJ): Inspect, palpate, assess range of motion (opening/closing and lateral movements of jaw) and muscle strength.
Shoulder: Assess ROM (forward flexion, hyperextension, abduction, adduction, internal/external rotation) and muscle strength
Elbow: Assess ROM (flexion/extension) and muscle strength.
Wrist and Hand: Assess ROM (bend/straighten, radial/ulnar deviation, flexion/hyperextension of fingers/toes) and muscle strength.

The Spine

Inspect posture; head, shoulders, and pelvis should be level.
Assess spinal curvature (lordosis, kyphosis, scoliosis).
Palpate the spinous processes.
Assess ROM (flexion, hyperextension, lateral bending, rotation) of the cervical, thoracic, and lumbar spine.

Hips

Assess gait.
Assess ROM (flexion, hyperextension, abduction, adduction, internal/external rotation).

Ankles & Feet

Assess ROM (dorsiflexion, plantar flexion, inversion, eversion, abduction, adduction) and muscle strength.

Special Tests

Phalen's test: Tests for carpal tunnel syndrome
Tinel's sign: Tests for carpal tunnel syndrome
Muscle strength of major muscle groups using resistance testing

Health Promotion

Proper calcium intake to prevent osteoarthritis
Increased bone mass to reduce mechanical wear and tear
At least 2 hours and 30 minutes of moderate-intensity aerobic activity per week or 1 hour and 15 minutes of vigorous-intensity activity per week
At least 2 days of muscle-strengthening activities per week
Prevention of osteoporosis, low back pain, and falls
Low back pain prevention in most elderly
Exercise for healthy aging
Preventing falls prevention
95% of hip fractures are due to falls
Preventing falls in the elderly

Neurological Assessment

Cranial nerves
Motor and sensory functions
Sensation
Reflexes

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Description

This quiz covers essential objectives and common symptoms related to musculoskeletal assessment. It includes key landmarks of joints, methods for obtaining health history, and risk factors for conditions like osteoporosis. Understand the physical assessment techniques and health promotion strategies critical for musculoskeletal health.