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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

Health History

Physical Assessment

Inspection

Palpation

Range of Motion

Muscular Strength

Muskuloskeletal Assessment

Rachel S. Natividad, RN, MSN


Physical assessment cont

Cervical spine

Shoulders

Elbows

Wrists/hands

Hips

Knees

Ankles/feet

Spine

Functional assessment

Physical Assessment- Cont.


Inspection palpation
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

ROM’s


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
Deformities joints, and surrounding tissues, hand, knees, hips, and feetof RA

Ulnar Shift

Boutinniere Deformity

Swan neck deformity



Osteoarthritis1
Osteoarthritis trauma

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

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


Osteoporosis

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

Osteoporosis


Contractures
Contractures trauma


Assessment guide activity rest
Assessment Guide: Activity & Rest trauma

  • 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 trauma

  • 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 trauma

  • Posture/Gait

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


Assessment guide activity rest2
Assessment Guide: Activity & Rest trauma

  • 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 trauma

  • Rest/Sleep Patterns

    • Sleeps most of the day

    • Takes midday naps


Assessment guide activity rest4
Assessment Guide: Activity & Rest trauma

Interventions in use:

  • Assistive device, equipment

    • Cast, trapeze, foot cradle,

    • Special beds

      • Air bed, eggcrate mattress

    • Med List:

      • Glucosamine, Allopurinol, NSAIDS, etc.