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?

<p>Walking straight and staying balanced (C)</p> Signup and view all the answers

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

<p>To assess sensory nerve pathways (D)</p> 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?

<p>Indicates abnormal gait parameters (A)</p> Signup and view all the answers

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

<p>To evaluate the symmetry of limb movements (C)</p> Signup and view all the answers

How is reinforcement used in reflex testing?

<p>By performing an isometric exercise in another muscle group (C)</p> Signup and view all the answers

What is the first step in conducting a reflex test?

<p>To use a reflex hammer to tap a tendon (C)</p> Signup and view all the answers

Which of the following best describes poorly coordinated tandem walking?

<p>Frequent loss of balance and foot positioning errors (C)</p> Signup and view all the answers

What should be documented when performing reflex tests?

<p>Symmetry of reflex responses comparing both sides (B)</p> Signup and view all the answers

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

<p>Sprinting to test speed and agility (B)</p> Signup and view all the answers

Which technique improves the reliability of reflex testing?

<p>Reinforcing the reflex by having the patient do isometric exercises (A)</p> Signup and view all the answers

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

<p>Reflex activity of specific tendons (C)</p> Signup and view all the answers

Why is symmetry important during a neurological assessment?

<p>It provides insight into the overall neurological function. (A)</p> Signup and view all the answers

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

<p>To document reflex findings graphically (B)</p> Signup and view all the answers

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

<p>Sensory function (A)</p> Signup and view all the answers

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

<p>It increases the reflex response measured. (D)</p> Signup and view all the answers

What is the primary function of the Oculomotor nerve?

<p>Movement of eyeball and eyelid (C)</p> Signup and view all the answers

Which cranial nerve is responsible for visual acuity?

<p>Cranial Nerve II (D)</p> Signup and view all the answers

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

<p>Assess one nerve at a time for accuracy (C)</p> Signup and view all the answers

What sensory function does the Olfactory nerve primarily test?

<p>Sense of smell (C)</p> Signup and view all the answers

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

<p>Cranial Nerve XI (A)</p> Signup and view all the answers

What is the purpose of the corneal reflex test?

<p>To evaluate facial sensation and movement (A)</p> Signup and view all the answers

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

<p>Patellar reflex (B)</p> Signup and view all the answers

How is the corneal reflex test properly performed?

<p>Bringing a wisp of cotton in from the side of the eye (A)</p> Signup and view all the answers

What grading indicates a normal deep tendon reflex?

<p>2+ (C)</p> Signup and view all the answers

What should be done before performing the corneal reflex test?

<p>Remove contact lenses if present (B)</p> Signup and view all the answers

Which reflex is NOT a deep tendon reflex?

<p>Corneal reflex (A)</p> Signup and view all the answers

What does a decreased or absent corneal reflex indicate?

<p>Possible abnormality in facial functions (B)</p> Signup and view all the answers

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

<p>Responses are elicited by stroking skin or muscle (B)</p> Signup and view all the answers

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

<p>A robust and bilateral blink response (A)</p> Signup and view all the answers

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

<p>Normal reflex response (D)</p> Signup and view all the answers

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

<p>Plantar flexion of the toes (B)</p> Signup and view all the answers

What indicates an abnormal plantar reflex in adults?

<p>Fanning of all toes (D)</p> Signup and view all the answers

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

<p>Provides motor efferent responses to close the eye (B)</p> Signup and view all the answers

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

<p>Broca's Area (A)</p> Signup and view all the answers

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

<p>Fanning and extension of toes (C)</p> Signup and view all the answers

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

<p>Leading cause of long-term disability (B)</p> Signup and view all the answers

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

<p>Changes in personality and behavior (C)</p> Signup and view all the answers

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

<p>Cranial Nerve V (B)</p> Signup and view all the answers

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

<p>Stroke (A)</p> Signup and view all the answers

What does a positive Babinski sign indicate in adults?

<p>Possible damage to the upper motor neurons (C)</p> Signup and view all the answers

Flashcards

Normal Gait

A smooth, rhythmic, and effortless walk with coordinated arm swing and consistent step length (about 15 inches from heel to heel).

Abnormal Gait

A walk that is unsteady, uncoordinated, or demonstrates difficulty with balance and rhythm.

Tandem Walking

Walking in a heel-to-toe fashion, testing balance and coordination.

Romberg Test

A test to assess balance and proprioception by having the patient stand with feet together and eyes open, then closed, observing stability.

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Rapid Alternating Movements

Assessment of coordination by quickly alternating movements, such as patting knees with palms then backs of hands, or touching each finger to thumb.

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Balance Test

Assessment of the body's ability to maintain equilibrium during walking, using different methods like gait observation and tandem walking.

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Gait Assessment

Observing a person's walk, posture, and stability when they are moving.

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Coordination Assessment

Assessing a person's ability to execute controlled, precise movements.

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Patient Identification of Touch

Have the patient identify the location where they were touched.

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Reflex Testing

Use a reflex hammer to tap a tendon, noting symmetry of responses between sides.

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Reflex Symmetry

Compare the strength and response of reflexes in corresponding areas on both sides of the body.

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Graphic Representation

Use a stick figure to visually document reflex findings.

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Reflex Reinforcement

Enhance a reflex by having the person perform an isometric exercise in a different muscle group.

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Isometric Exercise

A muscle contraction without significant movement.

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Reflex Hammer

Tool used to trigger reflexes.

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Stick Figure Representation

Diagram depicting body regions for recording reflex findings.

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Muscle Group

A collection of muscles that work together to perform a certain action or movement.

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Tendon

A tough band of fibrous connective tissue that connects muscle to bone.

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Cranial Nerves

12 pairs of nerves that connect the brain to different parts of the body, controlling sensory and motor functions.

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Sensory Nerves

Nerves that carry information from your senses (like sight, smell, touch) to your brain.

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Motor Nerves

Nerves that carry instructions from your brain to your muscles, controlling movement.

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Mixed Nerves

Nerves that carry BOTH sensory and motor information, meaning they can receive and send signals.

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Cranial Nerve Assessment

Examining each cranial nerve individually or in groups to check their function.

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Corneal Reflex

A reflex where a person blinks when the cornea (the front part of the eye) is touched.

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Deep Tendon Reflexes (DTR)

Reflexes measured by tapping specific tendons to check nerve function.

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Biceps Reflex

A DTR tested by tapping the tendon below the biceps muscle.

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Triceps Reflex

A DTR tested by tapping the tendon below the triceps muscle.

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Brachioradialis Reflex

A DTR tested by tapping the tendon in the forearm.

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Patellar/Quadriceps Reflex

A DTR tested by tapping the patellar tendon.

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Achilles Reflex

A DTR tested by tapping the Achilles tendon.

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Grading Reflexes

Evaluating and quantifying the strength of a reflex response (e.g., 2+ =normal).

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Plantar Superficial Reflexes

Reflexes elicited by stroking the skin.

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Abnormal Reflex

A reflex that is decreased or absent during testing.

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Plantar Reflex

A reflex tested by stroking the sole of the foot, typically eliciting toe flexion. A positive Babinski sign indicates abnormal extension of the big toe and fanning of the other toes.

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Babinski Sign

An abnormal response to the plantar reflex, where the big toe extends upwards and the other toes fan out. This is typically seen in infants but can indicate neurological issues in adults.

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Stroke

A brain attack caused by a blockage or rupture of a blood vessel, leading to brain damage.

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Lobes of the Brain (Frontal)

The largest brain lobe, responsible for personality, behavior, emotions, and intellectual functions. Broca's area in the frontal lobe controls motor speech.

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Broca's Area

Located in the frontal lobe, this area of the brain controls motor speech. Damage to Broca's area can lead to expressive aphasia, difficulty speaking.

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Expressive Aphasia

A disorder where a person has difficulty speaking fluently and forming complete sentences, despite understanding language.

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Fifth Leading Cause of Death

Stroke is responsible for a significant proportion of deaths, making it a major public health concern.

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Leading Cause of Long-Term Disability

Stroke can often cause permanent disabilities affecting mobility, speech, and cognitive function.

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Preventing Stroke

Taking proactive measures to reduce the risk of stroke, such as managing blood pressure, cholesterol, and diabetes, and maintaining a healthy lifestyle.

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Transient Ischemic Attack (TIA)

A temporary disruption of blood flow to the brain, causing symptoms similar to stroke, but resolving without lasting damage.

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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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Musculoskeletal Neuro Assessment PDF

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.

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