Musculoskeletal Impairments Assessment

Questions and Answers

What is the reported pain level for the patient's right knee at rest?

8/10

6/10

4/10 (correct)

2/10

What is the maximum knee flexion achieved in the right leg during the assessment?

90 degrees

130 degrees

65 degrees (correct)

120 degrees

Which joint has a range of motion limitation due to pain in the assessment?

Shoulder

Knee (correct)

Hip

Ankle

What is the degree of passive range of motion (PROM) for knee extension on the right side?

-10 degrees Signup and view all the answers

How does the muscle strength of the left elbow compare to the right elbow based on the findings?

Equal strength in both elbows Signup and view all the answers

Which of the following indicates a significant limitation in the knee flexion strength?

Left knee flex strength 3 Signup and view all the answers

In terms of functional mobility interventions, what is the primary concern based on the pain levels and range of motion?

Enhancing knee mobility Signup and view all the answers

What does a passive range of motion (PROM) of +10 degrees indicate for the left knee?

Knee is slightly flexed Signup and view all the answers

Which assessment finding shows no activity limitations for the patient?

Overall functional mobility Signup and view all the answers

What is the level of muscle strength in both wrists according to the assessment?

5 Signup and view all the answers

What was the pain level reported at the fusion site during resting?

2/10 Signup and view all the answers

What is the range of motion for hip flexion on both the right and left side?

45 degrees Signup and view all the answers

Which muscle strength assessment scored lower than the maximum on the hip flexors?

Hip flexion Signup and view all the answers

What is indicated by the terms 'WNL' for knee flexion/extension and ankle dorsiflexion/plantarflexion?

Within Normal Limits Signup and view all the answers

In which area was muscle strength tested but fell short compared to other muscle groups?

Hip extension Signup and view all the answers

What does a strength score of '5' indicate for the tested muscle groups?

Normal strength Signup and view all the answers

What limitation was indicated for hip range of motion during assessments?

Limited by pain Signup and view all the answers

What is the primary concern when assessing mobility post-surgery?

Pain management Signup and view all the answers

Which functional mobility assessment's outcome was noted as 'No'?

Activity limitations Signup and view all the answers

Which joint movement assessed showed limitations on both sides?

Hip external rotation Signup and view all the answers

How is a joint's range measured during assessments?

Using a goniometer Signup and view all the answers

What is the purpose of conducting a musculoskeletal assessment?

Identify areas needing rehabilitation Signup and view all the answers

What ankle movement was observed as normal during assessments?

Dorsiflexion and plantarflexion Signup and view all the answers

What is the main goal during post-surgery rehabilitation?

Manage pain and restore function gradually Signup and view all the answers

What does a 'limited by pain' status indicate during muscle strength testing?

Inability to perform full range due to pain Signup and view all the answers

What is the primary approach described for the surgery?

Posterior approach Signup and view all the answers

Which measure suggests that the patient is capable of safe mobility post-surgery?

Independent in activities of daily living Signup and view all the answers

What is the appropriate duration for the standard hip precautions as noted in the surgical plan?

6 weeks Signup and view all the answers

Which of the following medications was administered 1 hour ago for pain management?

Endone Signup and view all the answers

What significant vital sign indicates the patient's respiratory condition?

SaO2 of 99% Signup and view all the answers

What is the primary complaint regarding the patient's mobility assessment?

Pain at rest in the hip Signup and view all the answers

Which of the following assessments indicates a limitation in hip extension?

Hip ext 0 degrees on the right Signup and view all the answers

Which hip strength assessment score suggests normal functionality?

5 Signup and view all the answers

What rehabilitation intervention is suggested following the surgery?

Weight bearing as tolerated Signup and view all the answers

What is a key component of fall risk assessment for the patient living alone?

Presence of handrails at home Signup and view all the answers

What symptom was noted in the nursing assessment that may indicate underlying respiratory issues?

Coarse crackles bilaterally Signup and view all the answers

What aspect of the patient's social history is relevant for rehabilitation planning?

Lives in a multi-story home Signup and view all the answers

What indicates that the patient's pain management protocol is effective?

Reported good effect after medication Signup and view all the answers

What is a potential complication that needs to be monitored following the surgery?

Aspiration pneumonia Signup and view all the answers

Study Notes

Impairments and Activity Limitations

Pain rating at fusion site: 2/10 at rest for the right hip, NAD (no abnormalities detected) for the left.
Knee pain: 4/10 for the right knee at rest, NAD for the left knee.

Joint Range of Motion

Right and left hip flex: 45 degrees
Right and left hip abduction: 25 degrees
Knee flexion: Right 65 degrees (limited), Left 130 degrees (full range)
Knee extension: Right -10 degrees (limited), Left +10 degrees (full range)
Ankle dorsiflexion/plantarflexion: Both within normal limits (WNL)

Muscle Strength Assessment

Shoulder flexion and abduction strength: 5 for both sides
Elbow flexion and extension strength: 5 for both sides
Hip flexion: Right 3- (limited by pain), Left 5
Hip extension: Right 3- (limited by pain), Left 5
Knee flexion: Right 3 limited (due to pain), Left 5
Knee extension: Right 2 limited (due to pain), Left 5
Ankle and finger strength: 5 for both sides

Functional Assessment

Previous independent mobility without assistance, able to perform activities of daily living (ADLs) and drive
Lives alone in a split-level house with specific stairs and railings
Engages in social activities like bingo and walking with friends
BMI is 18

Surgical and Recovery Context

Underwent surgery with a posterior approach; no complications reported
Post-operative management includes oral analgesia, weight bearing as tolerated (WBAT), and standard post-operative hip precautions for 6 weeks
Use of TED (thromboembolic deterrent) socks recommended

Vital Signs and Nursing Notes

Heart rate: 69 bpm, oxygen saturation: 99%, respiratory rate: 18 breaths/min, blood pressure: 118/70 (lying)
Temperature: 37.6°C, ECG shows normal sinus rhythm
Recent pain management included Panadol 500mg and Endone 10mg taken 1 hour prior with good effect
Observed decreased breath sounds and coarse crackles in the lower zones of the lungs

Past Medical History

Relevant conditions include hypothyroidism and a history of smoking (quit 15 years ago, 14 pack-years)

Summary of Functional Ability

Currently experiencing limitations in hip function and strength, particularly affecting mobility and daily activities due to pain and range of motion challenges.

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Description

This quiz focuses on evaluating musculoskeletal impairments and activity limitations. It aims to help assess current conditions and monitor progress over time. Ideal for healthcare professionals involved in rehabilitation and therapy.