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The Musculoskeletal System

The Musculoskeletal System. RACHEL S. Natividad, RN, MSN. Subjective and Objective Data. Obtaining a health history Assessment Inspection/Palpation Range of Motion passive and active Muscular strength. Inspection/Palpation.

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The Musculoskeletal System

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  1. The Musculoskeletal System RACHEL S. Natividad, RN, MSN

  2. Subjective and Objective Data • Obtaining a health history • Assessment • Inspection/Palpation • Range of Motion • passive and active • Muscular strength

  3. Inspection/Palpation • Inspect swelling, mass or deformities, stiffness or instability of joints, limbs and body regions • Palpate for temperature, tenderness surrounding joint

  4. Have the pt perform active ROM If unable to, use passive ROM Palpate for unusual joint movement during ROM ROM’s

  5. Measuring Range of Motion

  6. Assess muscle tone and strength Strength against gravity/full resistance note as 0/5-5/5 “5/5” = normal Assessing Muscles

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

  8. Deformitiesof RA Ulnar Shift Boutinniere Deformity Swan neck deformity

  9. A chronic degeneration of joint cartilage caused by aging or trauma Pain, stiffness, swelling Osteoarthritis

  10. Osteoarthritis: Cont. Hard, nontender nodes Bouchards Nodes Heberdens Nodes

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

  12. Contractures

  13. Assessment Guide: Activity & Rest • Objective Data • Activity Level and Tolerance: • ambulates with walker independently/ with minimal assistance; bedrest; up in wheelchair

  14. 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

  15. Assessment Guide: Activity & Rest • Posture/Gait • Slumped, kyphosis, erect; gait unsteady, shuffling, ataxia

  16. 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

  17. Assessment Guide: Activity & Rest • Rest/Sleep Patterns • Sleeps most of the day • Takes midday naps

  18. 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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