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Questions and Answers
Which symptom is associated with a tendon injury?
Which symptom is associated with a tendon injury?
What is the primary purpose of the musculoskeletal system?
What is the primary purpose of the musculoskeletal system?
What does the COLDSPA mnemonic help to evaluate during a musculoskeletal assessment?
What does the COLDSPA mnemonic help to evaluate during a musculoskeletal assessment?
What type of imaging would best assess soft tissue injury?
What type of imaging would best assess soft tissue injury?
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Which evaluation technique is used to determine the flexibility of joints?
Which evaluation technique is used to determine the flexibility of joints?
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What condition is indicated by an abnormal curvature of the spine?
What condition is indicated by an abnormal curvature of the spine?
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Which imaging technique would be chosen if an MRI is not possible due to the presence of metal?
Which imaging technique would be chosen if an MRI is not possible due to the presence of metal?
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Which of the following is a key component to assess during an upper extremities assessment?
Which of the following is a key component to assess during an upper extremities assessment?
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Which of the following is NOT a normal finding when assessing posture?
Which of the following is NOT a normal finding when assessing posture?
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What abnormal finding indicates a deviation in the alignment of the vertebral column?
What abnormal finding indicates a deviation in the alignment of the vertebral column?
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During the assessment of abnormal findings in the upper extremities, which of the following should be noted?
During the assessment of abnormal findings in the upper extremities, which of the following should be noted?
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Which finding is associated with an inability to rise from a chair without difficulty?
Which finding is associated with an inability to rise from a chair without difficulty?
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Which of the following represents a normal finding during the palpation of the vertebral column?
Which of the following represents a normal finding during the palpation of the vertebral column?
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What is typically assessed to identify abnormalities within the upper extremities?
What is typically assessed to identify abnormalities within the upper extremities?
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Which of the following shows a sign of impaired balance?
Which of the following shows a sign of impaired balance?
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What is a common finding when assessing for lordosis in a patient?
What is a common finding when assessing for lordosis in a patient?
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Which of the following findings would indicate a normal assessment of the lower extremities?
Which of the following findings would indicate a normal assessment of the lower extremities?
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What is the position of the ankle in a normal assessment of the lower extremities?
What is the position of the ankle in a normal assessment of the lower extremities?
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Which condition is characterized by a progressive, inflammatory, autoimmune disorder?
Which condition is characterized by a progressive, inflammatory, autoimmune disorder?
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What assessment is used to evaluate the limitations in range of motion (ROM) in the lower extremities?
What assessment is used to evaluate the limitations in range of motion (ROM) in the lower extremities?
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When inspecting for spinal abnormalities, which of the following is NOT a characteristic condition?
When inspecting for spinal abnormalities, which of the following is NOT a characteristic condition?
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What is indicated by asymmetric range of motion during the evaluation of the lower extremities?
What is indicated by asymmetric range of motion during the evaluation of the lower extremities?
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Which of the following findings suggests a potential abnormal assessment in the hip region?
Which of the following findings suggests a potential abnormal assessment in the hip region?
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What does the absence of pain or altered sensation indicate during the assessment of lower extremities?
What does the absence of pain or altered sensation indicate during the assessment of lower extremities?
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Study Notes
Inspecting and Palpating the Lower Extremities
- Assess the presence of size, shape, symmetry, deformities, alignment, tenderness, depressions, bulges, temperature change, redness, or swelling, and range of motion (ROM).
- Normal findings: Weight evenly distributed between legs, Hips in neutral position, slightly bend at the knee, ankle perpendicular to the lower leg, and the foot straight.
- Abnormal findings: Uneven weight distribution, hips not in neutral position, no or excessive bend at the knee, ankle not perpendicular to the lower leg, pain, altered sensation, temperature change, deformities, limited range of motion, and asymmetrical findings.
Assessing ROM and Strength of Lower Extremities
- Purpose: To assess strength and limitations in ROM in the lower extremities; assess any differences in symmetry of motion and the fluid nature of the motion; compare one side with the other side.
- Normal findings: Symmetrical ROM from right to left with no pain or altered sensation.
- Abnormal findings: Asymmetrical ROM from right to left with presence of pain or altered sensation.
Healthy People 2030
- Goal: Prevent illness and disability related to arthritis, other rheumatic conditions, osteoporosis, and chronic back conditions.
- Work-related musculoskeletal disorders including those of the neck, upper extremities, and low back are one of the leading causes of lost workday injury and illness.
Scoliosis, Kyphosis, and Lordosis
- Scoliosis: Curvature of the spine laterally and can be a C curve or an S curve.
- Kyphosis: Exaggerated curvature of the thoracic spine causing a hunchback appearance.
- Lordosis: Exaggerated curvature of the lumbar spine causing a swayback appearance.
Rheumatoid Arthritis
- A progressive, inflammatory, autoimmune disorder.
Functions of the Musculoskeletal System
- Provides structure, support, protection, and ability to move
- Skeletal system also provides attachment points for ligaments and tendons.
- Controlled and innervated by the nervous system.
Movement in the Musculoskeletal System
- Movement occurs when muscles contract in response to neurological stimuli from the nervous system.
- Movement is generally voluntary, but can be involuntary in situations such as removing a hand from heat or a reflex.
- The neurological system coordinates functions of the skeletal and muscle systems.
Diagnostics for the Musculoskeletal System
- Blood test (creatine phosphokinase [CPK] increases with muscle injury)
- X-ray assesses bones and bony structures
- Magnetic resonance imaging (MRI) assesses soft tissue injury to tendons, ligaments, bones, and soft tissues
- Computed tomography (CT scan) assesses bones, ligaments, joints, and the axial skeleton
- Dual-energy X-ray absorptiometry (DEXA) scan assess bone mineral density.
Health History
- Assess the client’s level of functioning with ADLs because the musculoskeletal system affects the entire body and greatly influences what physical activities the client will or will not be able to do.
- Proper functioning of the musculoskeletal system is important for the performance of ADLs.
- Use COLDSPA mnemonic to identify attributes of a symptom.
Inspecting Posture
- Normal findings: No pain or altered sensation; shoulders level and even; head centered on axial skeleton; balance unaltered; able to stand, ambulate without assistive devices, and rise from a chair without difficulty; weight evenly distributed on feet.
- Abnormal findings: Presence of pain or altered sensation; shoulders not level or even; head not centered on axial skeleton; unable to maintain balance; unable to stand, ambulate without assistive devices, or rise from a chair without difficulty; uneven weight distribution on feet; wide-based gait; shuffling gait; limps.
Inspecting and Palpating the Vertebral Column
- Purpose: To assess for abnormalities in the structure of the vertebral column.
- Have patient stand.
- Inspect alignment of vertebral column.
- Using two or three finger pads, starting at the top of the vertebral column, palpate the vertebral column for tenderness, deviations, or protrusions.
Inspecting and Palpating the Vertebral Column: Normal vs. Abnormal Findings
- Normal findings: No pain or alteration of sensation; no deformities found.
- Abnormal findings: Presence of pain or altered sensation; deformities found; scoliosis, kyphosis, or lordosis.
Inspecting and Palpating the Upper Extremities
- Purpose: To determine if there are any abnormalities within the upper extremities
- Always compare the right to the left side for symmetry
- Assess the shoulder, elbow, wrist, hand, and fingers.
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