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Health History Physical Assessment Inspection Palpation Range of Motion Muscular Strength. Muskuloskeletal Assessment. Rachel S. Natividad, RN, MSN. Cervical spine Shoulders Elbows Wrists/hands Hips Knees Ankles/feet Spine. Functional assessment. Physical Assessment- Cont.

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Muskuloskeletal Assessment

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Muskuloskeletal assessment

Health History

Physical Assessment



Range of Motion

Muscular Strength

Muskuloskeletal Assessment

Rachel S. Natividad, RN, MSN

Physical assessment cont

Cervical spine








Functional assessment

Physical Assessment- Cont.

Inspection palpation


  • Note size and symmetry color, swelling, masses & deformities of joints, limbs and body regions

  • Palpate for temperature, pain, tenderness,



Rom s

Have the pt perform active ROM

If unable to, use passive ROM


Assessing muscles

Strength against gravity, full resistance

note as 0/5-5/5

“5/5” = normal

Assessing Muscles

Rheumatoid arthritis

Chronic, systemic, inflammatory disease that attacks the joints, and surrounding tissues, hand, knees, hips, and feet

Rheumatoid arthritis

Deformities of ra

Deformitiesof RA

Ulnar Shift

Boutinniere Deformity

Swan neck deformity


A chronic degeneration of joint cartilage caused by aging or trauma




  • Heberden’s nodes on distal interphalangeal joints (DIP’s )

  • Bouchards nodes on proximal interphalangeal joints (PIPs) as disease progresses


A decrease in bone mass, porous, brittle, and prone to fracture




Assessment guide activity rest

Assessment Guide: Activity & Rest

  • Objective Data

  • Activity Level and Tolerance:

    • ambulates with walker independently/ with minimal assistance; bedrest; up in wheelchair

Assessment guide activity rest muscles and joints

Assessment Guide: Activity & Rest Muscles and joints

  • Description: fair muscle tone, no atrophy; atrophy to RLE. No stiffness or contractures; R wrist contracted

  • Movement: limited ROM to RUE; FROM all extremities

  • Strength: strong UE, LE; weak RUE & RLE

  • Coordination: able to perform most ADLs; can comb hair and reach for water glass

Assessment guide activity rest1

Assessment Guide: Activity & Rest

  • Posture/Gait

    • Slumped, kyphosis, erect; gait unsteady, shuffling, ataxia

Assessment guide activity rest2

Assessment Guide: Activity & Rest

  • Circulation, Sensation, and Movement

    • Describe:

      • CSM intact;

      • no sensation to R big toe and second toe;

      • numbness and tingling to LEs;

      • Decreased ROM to LUE due to contractures

Assessment guide activity rest3

Assessment Guide: Activity & Rest

  • Rest/Sleep Patterns

    • Sleeps most of the day

    • Takes midday naps

Assessment guide activity rest4

Assessment Guide: Activity & Rest

Interventions in use:

  • Assistive device, equipment

    • Cast, trapeze, foot cradle,

    • Special beds

      • Air bed, eggcrate mattress

    • Med List:

      • Glucosamine, Allopurinol, NSAIDS, etc.

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