Franchi Musculo Skeletal Assessment
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Musculoskeletal System Joint structure and function • Articular structures • Extra-articular structures • Ligaments • Tendons • Bursae The 600 skeletal muscles account for 40% 50% of the body’s weight. Three Types: • Skeletal: Voluntary muscles, those under conscious control. Muscle that is connected with a bone. • Smooth: Muscle tissue that is involuntary in action and found principally in visceral organs. • Cardiac: Myocardium 1 Flexion: bending limb at joint limb at joint Abduction: moving limb away from midline Adduction: moving limb toward midline Pronation: turning forearm so palm is down Supination: turning forearm so palm is up Extension: Straightening Inversion - moving sole of foot inward at the ankle Eversion - moving sole of foot outward at the ankle Rotation - moving head around a central axis Elevation - raising a body part Depression - lowering a body part Dorsiflexion – point toe to nose Plantar flexion – point toe to floor The vertebrae are 33 connecting bones stacked in a vertical column. • Cervical- 7 • Thoracic- 12 • Lumbar- 5 • Sacral- 5 • Coccygeal Vertebrae- 3 - 4 2 Joints • Pain (onset, location, duration, characteristic symptoms, associated manifestations, relieving/ exacerbating factors) • Stiffness • Swelling, heat, redness • Limitation of Movement • Systemic symptoms (fever, chills, rash, weakness, weight loss) Neck pain (onset, location, duration, characteristic symptoms, associated manifestations, relieving/exacerbating factors) Low back pain – (onset, location, duration, characteristic symptoms, associated manifestations, relieving/exacerbating factors) • on the midline, over the vertebrae or off the midline • Radiation to the legs? Numbness or paresthesias Muscles • Pain (onset, location, duration, characteristic symptoms, associated manifestations, relieving/ exacerbating factors) • Weakness 3 Bones • Pain (onset, location, duration, characteristic symptoms, associated manifestations, relieving/ exacerbating factors) • Deformity • Trauma (fractures, sprains, dislocations) Functional Assessment (ADL’s) Behaviors Meds (statins cause back pain) Self-care Trauma during labor and delivery milestones Any fractures or broken bones Any bony deformities, spinal curvature, unusual shape to feet/toes? Sports/protective equipment Motor Inspection • Size and Contour of the Joint • Skin Color and Characteristics Palpation • Skin • Muscles • Bony Articulations • Joint Capsules • Pulses 4 Range of Motion (ROM) Muscle Testing Neck - range of motion (flexion, extension, lateral movements and rotation), strength testing Upper extremities - shoulders, arms wrists, hands – inspect, palpate, check pulses, ROM and strength testing Lower extremities - hips, knees, ankles, feet and toes – inspect, palpate, check pulses, ROM and strength testing Spine – inspect, palpate, check for curvature of the spine and ROM 5
