Term
| Order of musculoskeletal exam |
|
Definition
- Inspection
- Palpation
- ROM
- Muscle strength
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Term
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Definition
| Twitching or involuntary movement of muscle fibers |
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Term
|
Definition
| stiffness or fixation of joint (joint fuses) |
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Term
| Possible Etiologies of swelling/edema in musculoskeletal system |
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Definition
Fluid in joint (effusion)
thickening of synovial lining
inflammation
bony enlargement
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Term
| Normal findings for general inspection of musculoskeletal system |
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Definition
- Joints & muscles symmetrical
- No fasiculations
- No deformities or masses
- No swelling, edema
- Posture upright
- Gait smooth & even
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Term
Musculoskeletal palpation
Assess for: |
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Definition
Pain/tenderness (injury, inflammation, etc.)
Swelling (may be evident only with palpation)
Temperature (Increased warmth - inflammation)
Masses (nodules)
Crepitation (cracking or grating sound) |
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Term
| Two types of Range of Motion (ROM) |
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Definition
- Active: patient moves joint
- Passive: you move joint (for patient)
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Term
| Should you test ROM or muscle strength first? |
|
Definition
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Term
|
Definition
- Full, active ROM without pain
- may normally feel crepitations
- Active ROM should be about the same as passive
- (Stroke pt, accident victims: passive ROM greater)
- Passive > active associated with muscle weakness or joint instability. Also tendonitis, bursitis.
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Term
Situations where passive ROM may be greater than active ROM
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Definition
Stroke
Muscle weakness
Joint instability
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Term
| Decreased ROM happens with: |
|
Definition
Pain
Inflammation of tissues around joint
Ankylosis
Foreign body
Fluid due to swelling |
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Term
| Increased ROM happens with: |
|
Definition
hypermobility - may be benign
or associated with ligament/fracture |
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Term
|
Definition
Apply resisting force and have patient oppose it.
Assess strength bilaterally
Assess muscle groups for coordination, pain and resistance to opposing force |
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Term
| Normal findings: muscle assessment |
|
Definition
Coordinated, painless
Greater in dominant arm & leg
May use scale to grade 0 - 5
0=no muscle contraction
5=full ROM against gravity with full resistance
May also use descriptive terms (paralysis, severe weakness, moderate weakness)
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Term
| Specific muscle assessment |
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Definition
- Tone: N=firm
- Mass: size based on function
- may have difference of up to 1cm between dominant (usu. greater) and non-dominant side
- Length of extremities:
- use if suspected asymmetry
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Term
|
Definition
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Term
| Seven basic types of joint movement |
|
Definition
- Flexion
- Extension
- Abduction
- Adduction
- Internal rotation
- External Rotation
- Circumduction
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Term
|
Definition
| Bending of limb at a joint |
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Term
|
Definition
| Straightening of limb at a joint |
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Term
|
Definition
| Movement of a limb away from midline |
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Term
|
Definition
| Movement of a limb toward central axis of body or beyond |
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Term
|
Definition
| Turning of a body part inward toward the central axis |
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Term
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Definition
| Turning of a body part away from midline |
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Term
|
Definition
| Movement in a circular pattern |
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Term
| General inspection of musculoskeletal system |
|
Definition
- General body alignment
- Hypertrophy/Atrophy of muscle
- Joint involvement
- Rheumatoid arthritis (several joints, symmetrical)
- Osteoarthritis (one-2 joints, asymmetrical)
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Term
| Examples of Gross Deformities of the musculoskeletal system |
|
Definition
Flexion contractures (due to muscle shortening)
Heberdon & Bouchard nodes
Sub-Q nodules
Bowlegs (genu varum)
Knock-knees (genu valgum)
Hypertrophy/atrophy of muscle
Ankylosis (stiffness or fixation of joint) |
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Term
| Normal findings for general inspection of musculoskeletal system |
|
Definition
- Joints & muscles symmetrical
- No fasiculations
- No deformities or masses
- No swelling, edema
- Posture upright
- Gait smooth & even
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Term
| Normal findings for musculoskeletal general palpation |
|
Definition
No pain or tenderness
No swelling
No masses or crepitation |
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