Chapter 23: Musculoskeletal Assessment

Chapter 23: Musculoskeletal Assessment Anatomy Review *** should probably review old notes cause the PowerPoint had a lot of anatomy stuff Connective Tissues: · cartilage: allows bones to slide over one another, reduces friction, prevents damage, absorbs shock · tendons: connects muscles to bones · ligaments: connects bones to bones to stabilize joints and limit movement · bursae: fluid-filled sacs in areas of friction to cushion bones or ligaments that might rub against each other · meniscus: cartilage disc between bones to absorb shock, and cushion joints · fascia: flat sheets that line and protect muscle fibres, attach muscle to bone, and provides structure for nerves, blood vessels, and lymphatics Angular Movements: Rotational Movements: · Flexion · medial/internal rotation Bones, Muscles, and Joints · Extension · lateral/external rotation · Bones · pronation · Hyper extension ↳ compact vs. spongey bone · supination · Adduction ↳ short, flat, long, irregular, round... · Abduction · Muscle (skeletal muscle! ) Special Movements: · Joints · inversion vs. eversion ↳ synarthrosis, amphiarthrosis, diarthrosis · dorsiflexion vs. Plantar flexion ↳ aka. fibrous, cartillagenous, synovial · opposition · lateral flexion - - - Physical Assessment Focused Health History · inspection · demographics ↳ compare sides! · previous trauma/injury ↳ posture, gait, mobility etc. · nutrition · palpation · medications ↳ joints, muscle bulk & tone · family history ↳ bumps, swelling, pain, deformity · occupation & lifestyle behaviour · ROM (active vs. passive) · pain or tenderness · muscle strength · broken bones · limited ROM Morse Fall Scale · Health Promotion: ↳ back injury and occupational hazards ↳ lifestyle considerations ↳ bone density ↳ falls risk - MSK Assessment · move from head to toe, beginning with the neck and jaw · always inspect and palpate before ROM · do passive ROM test if you are concerned for falls or over-exersion · passive ROM = you move patient · active ROM = patient moves themselves · make sure to assess the fluidity of the patients motions, and any pain or tenderness · grade the strength of your patients muscles by pushing against your hands Urgent Assessment · Fractures · Dislocations · Spinal Injury · Compartment syndrome CSMT: · circulation · sensation · movement · temperature