Podcast
Questions and Answers
A patient presents with difficulty turning their palm up and down. What type of joint movement is most likely impaired?
A patient presents with difficulty turning their palm up and down. What type of joint movement is most likely impaired?
- Radial and Ulnar Deviation
- Flexion and Extension
- Abduction and Adduction
- Pronation and Supination (correct)
In evaluating a patient's hip joint range of motion, what maneuver is MOST important to assess flexion?
In evaluating a patient's hip joint range of motion, what maneuver is MOST important to assess flexion?
- Have them bend one knee up towards chest (correct)
- Have them lift one leg laterally
- Have them extend their leg backwards
- Have them rotate their hip internally and externally
During a musculoskeletal assessment, a patient complains of pain and tenderness at the lateral epicondyle of the elbow. Which of the following movements would MOST likely exacerbate this pain?
During a musculoskeletal assessment, a patient complains of pain and tenderness at the lateral epicondyle of the elbow. Which of the following movements would MOST likely exacerbate this pain?
- Turning the palm down (correct)
- Extending the elbow
- Bending the elbow
- Turning the palm up
A patient has difficulty extending their arm backward. Which joint movement is MOST likely affected?
A patient has difficulty extending their arm backward. Which joint movement is MOST likely affected?
During a musculoskeletal assessment, you observe crepitation at the knee joint. This finding is most likely associated with which type of joint articulation?
During a musculoskeletal assessment, you observe crepitation at the knee joint. This finding is most likely associated with which type of joint articulation?
During the assessment of abduction and adduction of the hip, what is the purpose of stabilizing the opposite hip/iliac?
During the assessment of abduction and adduction of the hip, what is the purpose of stabilizing the opposite hip/iliac?
Which of the following movements is assessed during the "Straight leg raising test"?
Which of the following movements is assessed during the "Straight leg raising test"?
When assessing the knee, what is the main purpose of palpating the patella anterior and lateral?
When assessing the knee, what is the main purpose of palpating the patella anterior and lateral?
What is the purpose of the "heel to shin test" performed during a neurological assessment?
What is the purpose of the "heel to shin test" performed during a neurological assessment?
When assessing the gait, which of these movements is NOT specifically examined during the "tandem walking" component?
When assessing the gait, which of these movements is NOT specifically examined during the "tandem walking" component?
During the assessment of the back and spine, why is it important to have the patient stand and then bend forward for examination?
During the assessment of the back and spine, why is it important to have the patient stand and then bend forward for examination?
What is the purpose of the "pronator drift" test performed during a neurological assessment?
What is the purpose of the "pronator drift" test performed during a neurological assessment?
Which of the following is NOT a component of the cerebellar function assessment?
Which of the following is NOT a component of the cerebellar function assessment?
What is the primary objective of assessing the mental status of a patient during a neurological examination?
What is the primary objective of assessing the mental status of a patient during a neurological examination?
Which of the following is NOT a standard piece of equipment used during a neurological assessment?
Which of the following is NOT a standard piece of equipment used during a neurological assessment?
Which of the following is NOT a factor considered during the preparation phase of a musculoskeletal assessment?
Which of the following is NOT a factor considered during the preparation phase of a musculoskeletal assessment?
When gathering subjective data during the assessment, which of the following factors would NOT be included?
When gathering subjective data during the assessment, which of the following factors would NOT be included?
According to the COLDSPA acronym, what aspect is being assessed when asking a client "What makes it worse?"
According to the COLDSPA acronym, what aspect is being assessed when asking a client "What makes it worse?"
Which of these factors is NOT considered when documenting the 'Duration' of a symptom using the COLDSPA framework?
Which of these factors is NOT considered when documenting the 'Duration' of a symptom using the COLDSPA framework?
What makes joints the functional units of the musculoskeletal system?
What makes joints the functional units of the musculoskeletal system?
Flashcards
Client Preparation for Assessment
Client Preparation for Assessment
Ensuring a conducive environment, necessary equipment, and client comfort for assessment.
Subjective Data
Subjective Data
Information gathered from the client, including history of present illness and lifestyle practices.
Objective Data
Objective Data
Information gathered through observation, including physical assessment findings.
COLDSPA
COLDSPA
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Musculoskeletal System
Musculoskeletal System
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Types of joint articulation
Types of joint articulation
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Synovial joints
Synovial joints
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Flexion
Flexion
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Abduction
Abduction
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ROM (Range of Motion)
ROM (Range of Motion)
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Knee ROM
Knee ROM
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Plantar flexion
Plantar flexion
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Dorsiflexion
Dorsiflexion
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Inversion
Inversion
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Eversion
Eversion
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Spine ROM
Spine ROM
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Straight leg raising test
Straight leg raising test
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Cerebellar function
Cerebellar function
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Pronator drift
Pronator drift
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Mental status assessment
Mental status assessment
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Study Notes
Neuro-Musculoskeletal Assessment
- Presentation by: Karon Jones-Fraser
- Credentials: PhD Candidate, MScN, BScN, Cert. Ed., RN
Objectives
- Outline client preparation for assessment
- Explain musculoskeletal and neurological systems assessed
- View assessment videos describing system assessment
- Discuss abnormal findings from system assessment
Musculoskeletal Assessment - Preparation
- Ensure appropriate environment (privacy, lighting, ventilation)
- Have necessary equipment readily available at the start
- Ensure client comfort
- (Kozier, Erb, Berman & Snyder, 2018) (Weber & Kelley, 2018)
Musculoskeletal Assessment - Data Gathering
- Assessment of body systems involves gathering subjective and objective data
- Client interview gathers subjective data, including:
- History of present complaint (COLDSPA)
- Past health history
- Family history
- Lifestyle and health practices
- (Kozier, Erb, Berman & Snyder, 2018) (Weber & Kelley, 2018)
COLDSPA
- Character: Describe the sign/symptom (sound, smell).
- Onset: When did it begin?
- Location: Where is it? Does it radiate?
- Duration: How long does it last? Does it recur?
- Severity: How bad is it?
- Pattern: What makes it better/worse?
- Associated factors: What other symptoms occur with it?
- (Weber & Kelley, 2018)
Musculoskeletal System
- Composed of bones, joints, and muscles.
- Joints are the functional units enabling mobility.
- Three primary joint types:
- Synovial: Freely movable (e.g., shoulder, knee).
- Cartilaginous: Slightly movable (e.g., vertebrae).
- Fibrous: Immovable (e.g., skull sutures).
Movement Types
- Flexion: Bending a limb at a joint
- Extension: Straightening a limb at a joint
- Abduction: Moving a limb away from the body's midline
- Adduction: Moving a limb toward the body's midline
- Pronation: Turning the forearm so the palm faces down
- Supination: Turning the forearm so the palm faces up
Musculoskeletal Assessment Procedure
- Inspect each joint for size, contour, masses, and deformities
- Palpate for muscle tone, tenderness, crepitation, swelling, and temperature
- Start assessment at the temporomandibular joint (TMJ) and proceed to the neck
- Assess shoulders, sterno-clavicular, and acromio-clavicular joints, anteriorly and posteriorly, palpating the area.
Range of Motion (ROM) Assessments
- Specific ROM assessment procedures for:
- Elbows
- Wrists & hands
- Hips
- Knees
- Ankles & feet
- Spine/back
Neurological Assessment - Equipment
- Tuning fork
- Reflex hammer
- Cotton
- Needles
- Coin/paper clip/key
Neurological Assessment - Procedure
- Mental Status:
- Orientation (person, place, time)
- Memory (3 objects after 5 minutes)
- Digit span (forward and backward)
- Simple calculation
Neurological Assessment - Cerebellar Function
- Gait (tandem walking, heel-to-toe)
- Walking on heels and toes
- Hop on one foot
- Rapid alternating movements (e.g., pronation/supination of forearms)
- Finger-to-nose test
- Heel-to-shin test
Neurological Assessment - Motor Function
- Muscle tone (upper and lower extremities)
- Pronator drift test (holding arms out for 20-30 seconds)
- Motor strength (biceps, hand grasps)
Neurological Assessment - Sensory Function
- Light touch (distal and proximal areas)
- Vibration sense (applying tuning fork)
- Pain (pinprick)
- Two-point discrimination
- Kinesthesia (assessing position sense)
- Graphesthesia (identifying letters/numbers drawn on palm)
- Stereognosis (identifying objects placed in hands)
Neurological Assessment – Deep Tendon Reflexes
- Reflex scoring (0-absent, 1+, 2+, 3+, 4+)
- Biceps, triceps, brachioradialis, patellar, Achilles reflexes
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