MUSCULOSKELETAL ASSESSMENT
ANATOMY & PHYSIOLOGY
● Structure
● Bones
● Joints
● Muscles
● Function
● Postural Support
● Movement
● Organ Protect
● Cell Production
● Mineral Storage
SKELETAL MUSCLE MOVEMENTS
● Flexion
● Inversion
● Extension
● Eversion
● Abduction
● Rotation
● Adduction
● Protraction
● Pronation
● Retraction
● Supination
● Elevation
● Circumduction
● Depression
SUBJECTIVE DATA
● Pain (Joint, Back, Muscles)
● Stiffness, Rigidity
● Swelling, Heat, Redness
● Movement Limitations
● Deformity (Bone or Joint)
● History of Accident(s) or Trauma(s)
● Occupational/Recreational Hazards
● Exercise Habits
● Medications or Supplements
● Smoking or Alcohol/Drug Use
FUNCTIONAL ASSESSMENTS – ADLS/IADLS
● Activity Limitations
Bathing
○ Toileting
○ Dressing
○ Grooming
○ Eating
○ Mobility
○ Communication
● Lawton-Brody Instrumental Activities of Daily Living (IADL)
● Katz Index of Independence in Activities of Daily Living (ADL)
○
INSPECTION & PALPATION
● Joints & Muscles
○ Size
○ Contour
○ Color
○ Temperature
○ Swelling
○ Tenderness
○ Masses or Deformity
Bony Articulations
● Range of Motion (ROM)
○ Crepitation
○
MUSCLE TESTING SCALE
Grade
Description
% Normal
Assessment
5
Full ROM against gravity, full
resistance
100
Normal
4
Full ROM against gravity , some
resistance
75
Good
3
2
Full ROM with gravity
Full ROM with gravity eliminated
(passive ROM)
50
25
Fair
Poor
1
0
Slight contraction
No contraction
10
0
Trace
Zero
TEMPOROMANDIBULAR JOINT (TMJ)
❏ Palpate temporalis and masseter muscles as person clenches teeth
❏ Ask person to move jaw forward and laterally against your resistance, and
to open mouth against your resistance (cranial nerve V; trigeminal)
CERVICAL SPINE
❏ Alignment of head and neck
❏ Palpate spinous processes and sternomastoid, trapezius, and paravertebral muscles
❏ Person normally can maintain flexion against full resistance (CN XI)
SHOULDER
❏ Shoulder also shrug tests integrity of CN XI
ELBOW
❑
Check olecranon bursa and the normally present hollows on either side
of the olecranon process for abnormal swelling.
WRIST AND HAND
❏ Palpate each joint in wrist and hands
❏ Spread fingers, make fist, and touch thumb to each finger
POSITIVE (+) = CARPAL TUNNEL
Phalen Test
Tinel Sign
HIP
❑ Inspect for symmetric levels of iliac crests and gluteal folds
KNEE
❑
Check quadriceps muscle in anterior thigh for any atrophy
ANKLES AND FEET
❏ Inspect alignment
❏ Palpate metatarsophalangeal joints
SPINE
❑
Inspect Alignment
❑ Kyphosis: Enhanced thoracic curve
❑ Lordosis: Pronounced lumbar curve
❑ Scoliosis: Lateral curvature of the spine
STRAIGHT LEG RAISING OR LASÈGUE’S TEST
❏
❏
These maneuvers reproduce back and leg pain and may confirm the presence of
herniated nucleus pulposus.
Positive (+) if it reproduces sciatic pain