Free Essay

Musculoskeletal Assessment

In:

Submitted By nvbm
Words 911
Pages 4
MUSCULOSKELETAL WEEK 4
Provide privacy, wash hands, introduce self, and check ID vital signs
HISTORY:
-Reason for the visit, PQRSTU
-if there isn’t one: so, from my understanding we are going to be doing an assessment on your muscles, joints, and bones/ ROM and muscles strength do I have that correct?
-Do you have any pain, stiffness, weakness, swelling, twitching in your joins or muscles? Any redness, heat limited ROM you have noticed?
-Any PHx of injury to your arms/ legs/ bones, muscles, joints (broken bones, strain, fractures)?
-Is there any physical problems that limit your ADL?
-Do you exercise or participate in sports on a regular basis? (how much, how often)
-Women: Calcium and Vit. D supplements?
-FHx of scoliosis, osteoporosis, osteoarthritis, rheumatoid arthritis?
-Medication (OTC, herbal, prn), Allergies, Alcohol, Smoking/Tobacco, Street Drugs
ORDER OF THE EXAM: 1. Inspection: symmetry of structures and function (ROM), size, contour, skin for color, swelling, masses, atrophy, deformities, nodules. 2. Palpation: Joint and skin for temp, muscles, articulations. Notice heat, tenderness, swelling (inflammation), atrophy, masses, hard muscles, muscles spasms 3. ROM: No tenderness, pain, or crepitation 4. Muscle Testing: Prime mover, “I’m going to push, don’t let me push, I’m going to pull, don’t let me pull” resistance. Equal, bilaterally, and fully resist my opposing force
-Full or limited ROM- use goniometer to measure angle
-Strength: 5 pt. scale 5=Full ROM and Full resistance 100% 4=Full ROM and some resistance 75% 3=Full ROM 50% 2=Passive Motion 25% 1=Slight Contraction 10% 0=No contraction
CERVICAL SPINE:
-Inspect: alignment of spine and processes, shoulders, scapula,
-Palpate: spinous process, sternomastoid, trapezius, paravertebral muscles- firm, no spasm or tenderness
-ROM: Chin to chest, look up, ear to shoulder (lateral bending), and look over shoulder (rotation)
-Strength CN XI Spinal Accessory: Repeat all motions, W/Resistance
UPPER EXTREMITIES
Shoulders:
-Inspect: Posteriorly and anteriorly, equality of bony landmarks
-ROM: Arms straight up (flexion), behind (hyperextension), clap overhead (abduction/ adduction), internal (getting arrested) and external rotation (getting an itch o your shoulder blade), across the body
-Strength CN XI spinal accessory: Shoulder Shrug and one w/resistance
Elbow:
-Inspect: joints
-Palpate: Olecranon process and bursa, epicondyles of the humorous hollow spaces
-ROM: flexion, pronation, supination
-Strength: Push and pull
Wrist and Hand:
-Inspect: Dorsal and Palmar sides, fingers in same axis as forearm, knuckle wrinkles
-Palpate: EVERY joint
-ROM: fingers towards celling (hyperextension), towards floor (flexion), point fingers in and out (ulnar and radial deviation), spread fingers apart (abduction), touch thumb to each finger
-Strength: Squeeze my fingers as tight as you can, hold at finger tips and have them bring wrist towards them
LOWER EXTREMITIES
HIP: Laying down
-Inspect: symmetry of gluteal folds, iliac crest, equally sized buttock
-Palpate: push down on hips (pain=hip problems)
-ROM: Raise each leg (flexion), over body, adduction and abduction bend knee to chest (flexion/ opposite hip on table), internal and external rotation, slide heal down shin -limited abd, add, and internal and external rotation suggest hip disease
KNEE:
-Inspect: swelling
-Palpate: tibia turbosity, medial and later condyles of tibia and epicondyles or femur, hollow, fullness, check atopy of quad
-Strength: Push and pull
ANKLE and FOOT
-Inspect: foot aligned/ same axis as lower leg, toes pointing straight, calluses, bursal
-Palpate: tibiotalar joint, malleolus, toe joints, pitting edema
-ROM: Point toes down (plantar flexion), toes up (dorsiflexion), soles of feet in and out (eversion/ inversion), curl and straighten toes -Strength: Push and pull -Pedial pulse: (3+ full/ bounding, 2+normal, 1+weak, 0 absent)
SPINE: Pt stands
-Inspect: alignment of spine and processes, shoulders, scapula, iliac crest, gluteal folds
-Palpate: hips
-Scoliosis screening: pt. touch toes. Im BEHIND pt. to feel down spine (Pull shirt up)
-ROM: Bend backwards (hyperextension), bend to the side (later bending/ herniated nucleus pulposus), rotation
-Trendelenburg’s Test: Stand on one leg, note symmetry of iliac crest, shoulders, and scapula -if not: weakness in the opposite gluteal muscles

ASSESS GAIT
-Pt. should walk
-Heal to toe

TEACHING:
-Healthy weight
-Proper body mechanics when lifting
-Osteoporosis: low bone mineral density, increases risk for fractures
-Calcium intake and vitamin D intake (salmon, sardines)
-leafy green vegies, spinach, kale, broccoli
-limit caffeine, smoking, alcohol intake
-Weight-bearing exercise, 30 min, 3x/day

KEY TERMINOLOGY
-Rheumatoid Arthritis: chronic autoimmune disease causing inflammation of synovial tissues, causes fibrosis/ thickening and scaring of the CT and bone destruction
-Osteoarthritis: stiffening in joints, deterioration of cartilage which keeps your bones from touching/ cushions. Hands, hip, knees, vertebra. Osteophytes-bone spurs. Pain worse later in the day, nodes in hands, fluid in knee, limited ROM.
EXAMPLE DOCUMENTAION
S: Ptn denies Hx of musculoskeletal problems, any discomfort, weakness, or stiffness in spine bones, or joints. Reports no musculoskeletal difficulties with work, hobbies, or ADLs. No Family Hx; Denies taking Medications, NKA. Denies having ever smoked.
O: B/P-114/78; P-68, R-16; 32 year old male nursing student, stands erect with even gate, head midline, shoulder, hips, scapulae, and Iliac crest level. Spinous processes straight and non-tender. Extremities & muscles symmetrical, proportional and non-tender bilaterally. Muscle strength of head, neck, chin, shoulders, forearms, hands, calf, and feet is 5/5 for all. Gross ROM full for all of head/neck, cervical spine, shoulders, hands, hip, and ankle. No pitting edema, no tenderness or pain on palpation. Negative Trendelenburg & Babinski.
A: (1) Healthy musculoskeletal function.
(2) At risk for back injury as evidenced by being a nursing student.

Similar Documents

Free Essay

Orthopedic and Musculoskeletal Disorders

...This essay makes an attempt to address Orthopedic and Musculoskeletal Disorders. Also attempted, is a developmental design and evaluation of an appropriate individualized education goals and the issues surrounding the disorder of the above mentioned disease. Within the design, several directives will be accomplished: two (2), appropriate individualized education goals to meet the needs of the student. An analytical view, of the disorder, and what the specifics are associated with these type(s) of disorders. What the salient complications are as a result of the disorder, the particulars of finances and assistance as they affect the educational system. What treatment options are available, rehabilitation, and are there any appropriate educational interventions to address the situation. Lastly, what are the teacher's responsibilities, in terms of meeting the needs of students with curvature of the spine, hip conditions, limb deficiency, juvenile rheumatoid arthritis, and musculoskeletal disorders? (2) Appropriate Individualized Educational Goal: Two appropriate individualized education goals; Annual Goals: Jessica is a 14 year girl who is also a sophomore, with an orthopedic and musculoskeletal disorder, she will have the ability to join in with her classmates in activities that; will allow her the use of her hands, shoulders and much more, far more than she was previously able to do. These activities include; the ability to produce her own written assignments and use...

Words: 2104 - Pages: 9

Free Essay

Orthopedic and Musculoskeletal Disorders Iep

...Running Head: ORTHOPEDIC and MUSCULOSKELETAL DISORDERS IEP 1 Orthopedic and Musculoskeletal Disorders IEP Cynthia Read Grand Canyon University: SPE-573 July 24, 2013 Orthopedic and Musculoskeletal Disorders IEP 2 Orthopedic and Musculoskeletal Disorders IEP Introduction Orthopedic impairments consist of a broad variety of pupils that have a need for special education because of the impact that the orthopedic impairment has caused with their performance at school. Deficiencies might consist of inborn abnormalities, and origins from other disorders like breaks, losing body extremities, and cerebral palsy (Heller, 2001). Pupils with bone disorders seldom are in regular classrooms. This paper evaluates an orthopedic and musculoskeletal disorder along with an advocated educational intervention: Osteogenesis Imperfecta. Musculoskeletal Disorders Bottom of Form Osteogenesis imperfecta is also known as the “brittle bone” disorder. It is an inherited disease where a person’s bones are broken with no problem. Almost all incidences of osteogenesis imperfecta are triggered by a domineering chromosomal imperfection. A lot of the population of kids that have osteogenesis imperfecta were born with this disease and they received it from one or both of their parents and other children that have this disease have no idea how or why they got it because no one in their family has had this ailment. There are four types of osteogenesis imperfecta that researchers have identified...

Words: 1661 - Pages: 7

Free Essay

Paper

...Assignment: Clinical Assessment Chaz Hedgspeth Axia College What other information would you like to learn during the interview with the family? What questions would you ask? If I were interviewing the family I would want to know extensive information about the child, including her home life, her life at school, and what types of relationships she has in both environments. Does she interact with the children well at school? Does she get punished for doing bad and rewarded for doing well? I would also want to know when she started behaving this way in the first place. Has she always behaved in this fashion? When did the behavior begin? Knowing if the behavior has affected her everyday living would be essential as well and if they feel like she is a threat to herself. Do her teachers say anything about her in the classroom? Is her attitude affecting her grades? Do you as the parents feel like your child is a threat to herself or anyone else around her? Finding out all of the information about the child’s life is essential to getting a complete outlook on what the possibilities of her behavior are. In addition to the clinical interview, what other types of assessments would you utilize? What would you hope to learn with each type of assessment? Since a patient is able to be assessed from the different psychological perspectives, I would want to assess the child with a combination of each of the perspective theories. First, I would want to assess the...

Words: 826 - Pages: 4

Premium Essay

Nurse Prescribing V150 a Case Study

...UNIVERSITY OF THE WEST OF SCOTLAND NURSE PRESCRIBING V150 CASE STUDY COURSE: NURS09125 BANNER NUMBER: B00113677 DATE OF SUBMISSION 13/12/10 COURSE LEADER FRANCES DOWNER WORD COUNT: 3745 CONTENTS PAGE 1. INTRODUCTION & GENERAL OVERVIEW, Pgs3-4. 2. ASSESSMENT PROCESS, Pgs 5-8 3. TREATMENT OPTIONS, Pgs 9-12. 4. EVALUATION, Pgs 13-16 5. CONCLUSION. Pg 17 6. COPY OF PRESCRIPTION, Pg 18 7. REFERENCE SECTION, Pgs 19-23 8. BIBLIOGRAPHY, Pg 24. INTRODUCTION In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of prescribing in the community setting. The author a (trainee nurse prescriber) will display the need for a robust assessment, exploring all areas of health and well-being in order to achieve a safe outcome. The author will further follow current guidelines and be mentored by a senior nurse prescriber throughout the process. The aim of the case study is to display the implications involved in issuing a nurse prescription if deemed appropriate. With regard to writing a prescription as a qualified practioner, the author will adhere to the guidance within the Nursing and Midwifery Council (NMC 2006a) standards for safe prescribing. To protect this patient’s identity and maintain confidentiality, she will be referred to as Mrs X throughout the...

Words: 4607 - Pages: 19

Premium Essay

Essay Questions

...Essay Questions Kristy Bazzanella Liberty University Essay Questions Assessment is a vital component in the counseling process. Use of both informal and formal assessment methods ensure that clinicians judgments are non-biased, and when utilized correctly aide in formulating of case conceptualizations and treatment plans (Whitson, 2013). The primary purpose of assessments, for the counselor, is to obtain information to effectively counsel clients. According to Whitson (2013), once all information is gained, the counselor, can “either formally or informally, diagnose the client” (p.285). It is critical that the counselor choose assessments that are both reliable and valid. The choice of assessment type and instrument will vary depending on the presenting problem, age, and cognitive and developmental state of client. Assessments will also vary according to settings. For example, the choice of assessment instruments utilized by a school counselor will differ greatly from the assessments utilized in a drug treatment or psychiatric facility. Assessments can have either a negative or positive impact on treatment planning. Counselors who use informal assessment techniques, such as unstructured interviews may find that the information gathered is not reliable and, therefore, prone to error (Whitson, 2013, p.111). Inexperienced counselors who use unstructured interviews have been observed to focus on minor issues and have failed to collect adequate data...

Words: 750 - Pages: 3

Premium Essay

Financial Analysis

...Weeks 13 and 14 (4/21-5/1): Lease Financing and Course Conclusion Yikes! We are at the bittersweet time in our course together. It is almost over. We’ll miss it so much, but we might also want to do something else with the rest of our lives. In these last 1.7 weeks, we’ll cover another topic which, in addition to Financial Analysis and Planning, serves the function of integrating much of the material we have covered. That topic is Lease Financing. There is a lot of material on the structure of the lease and on the accounting treatment of leases, but the analytical focus will be on the lease-buy decision. The lease-buy decision is actually a financing decision. The analysis of the advisability of a lease typically follows a prior decision to acquire an asset (based on an investment decision analysis). In lease analyses we are comparing lease financing (which is a type of debt) to “regular” debt financing. Video 20 and Chapter 25 in BMA are the main materials. As you review the video, work through the lease example in the Excel file (financing uma 13.xlsx). Toward the end of video 20 is described the concept of adjusted present value. Pay close attention to this material as well, because it describes how in some very specific cases the results of an investment decision and a financing decision must be considered together. The deliverable for this two-week period is Exercise 4, which is an individual, i.e., not a team, exercise. We’ll also use the time to review...

Words: 666 - Pages: 3

Premium Essay

Informal Assessment of a Student

...Running Title: Informal Assessment Informal Assessment of a Student Barbara Brown Grand Canyon University: SPE-536 Professor Haynes October 31, 2012 Informal Assessment of a Student In the process of developing an informal assessment I have discovered how important it is to effectively develop an assessment that matches the criteria that I want to assess my students’ progress. To do an informal assessment on my students, I chose the unit that we are working on in Biology. At the moment we are learning about the parts of the cells and how the cell works to maintain life. As I did an informal observation on different students in the classroom, I observed that several of the students were having difficulties remembering the parts of the cell and their functions. To solve this problem, I developed an informal assessment that would allow students to learn the cell parts and its functions. The informal assessment that I developed is a game of battle ship on Quia. Quia is a learning tool that I have had the opportunity to use and observe other educators use to help educate and enhance their students learning. The game consists of the game battleship. Like the game, the player is looking for the ships of the enemy. When the student picks a spot that the enemy ship is located on, a question pops up asking a question supply a multiple choice of four answers that the student can choose from. If answered correctly the student gets a hit. There are about 17 questions;...

Words: 796 - Pages: 4

Premium Essay

Gung Ho Training in Organization Need Assessment, Development, and Evaluation

...Gung Ho Training in Organization Need Assessment, Development, and Evaluation Peer Shmelzer-Moratin MGMT 3441 HPU Term 2 2012 Gung Ho is a 1986 Ron Howard comedy film, released by Paramount Pictures, and starring Michael Keaton and Gedde Watanabe. The film's story portrayed the takeover of an American car plant by a Japanese corporation. While it might seem like just another fun movie to watch on a Friday night, it is actually a great movie with great lesson to teach to those who underestimate the power of training. Training is defined as the systematic acquisition of skills, rules, concepts, or attitudes that result in improved performance in another environment (Goldstein 1). The above movie is great example of how training can lead to much better results and performance. Irwin Goldstein, a leader in the training field, teams up with Kevin Ford and wrote "Training in Organization” to provide readers with a framework for examining and establishing viable training programs in education, business, and government. Capturing the excitement of training research and systems issues, the author discusses training as it occurs in real organizations. In their book they present different types of training programs and their effectiveness, ways in which training needs to be assessed and evaluated. With today’s technology the concern for utilizing training systems and developing new ones increase. Trainers are struggling with how to work with teams. The movie Gung Ho presents...

Words: 2482 - Pages: 10

Premium Essay

• Compare and Contrast the Constructs and Measures of Intelligence and Achievement.

...stated that a test is a systematic and standardized qualification procedure or device that produces information about behavior, and cognitive processes, and measures a sample of behavior rather than an extensive examination of the variety of individual’s behaviors Describe the major categories of tests and identify the major uses of these tests. The major categories of psychological tests are, mental ability, achievement, personality, interests and attitudes, and neuropsychological tests. Mental ability tests measure cognitive functions, such as intelligence, memory, spatial visualization, and creative thinking. Achievement tests assess capability within certain areas of expertise, and sometimes include assessments of reading, math, science, and social studies, at the same time identify more specific achievement. Personality tests are designed to produce information about personality and are most widely applied of all psychological tests. These tests compare an individual’s responses to different clinical groups for similarity, and sometimes measure depression, eating disorders, pathological or disabling conditions, or fascinations of the human personality. Interests and attitudes tests include vocational interest...

Words: 758 - Pages: 4

Free Essay

Assignment

...| | FACULTY OF BUSINESS School of Accounting & Management | SEMESTER 2, 2012 | | | | 353.503 – Organisation and Management Assignment 2 – Group Wiki | | | DUE DATE: See course outline for due dates | INSTRUCTIONS: * Your group will create a Wiki page within eMIT. * You may work in groups of up to 3 people or individually. * You must cite any information that comes from the internet or text books APA style. * Be creative when preparing your wiki - assume it will be used on Wikipedia. * You must ensure that you check spelling and grammar - make the wiki interesting for your readers. * This assessment is 10% weighting over 30 marks. | LEARNING OUTCOME ASSESSED: LO 3: Students will use analytical tools to evaluate the impact that internal and external environments have on organisations. | | | | | | Preparation: Using Pumpkin Patch Ltd, as a Case Study: Read the case study page 57 of your textbook: Crunch Time: What would you do? For further information go to: http://www.pumpkinpatch.biz/documents/762_Press_Release_FY11.pdf http://www.pumpkinpatch.co.nz Task: 1. Analyse the external environmental (mega and task) for this organization, and then assess the characteristics of the environment and comment on the environmental elements in relation to their external environment (10 marks). 2. Analyse the internal environmental conditions for this organisation by: assessing the type of culture...

Words: 335 - Pages: 2

Free Essay

Ww1104 Case Study

...environmental management as developed in previous modules. The emphasis throughout will be to complement theoretical knowledge gained in classroom activities with practical application. Students will work in groups to present their work, and most of the module assessment is associated group activity and interaction. Module Format The intensive five-day course is conducted at the University of Abertay Dundee, with visits to industrial and utility sites. The programme consists of seminars and group activities. Emphasis is given to developing teamwork skills and all group sessions will be interactive and will involve group working / discussion. Accommodation Rooms have being reserved at Dudhope Castle and details are given in the Case Study Week programme(see page 4). Module Assessment The module is assessed is by coursework only, which comprises the following THREE elements :- an individual report based on one of the industrial visits. a group report on the evaluation of the information collected in the data gathering exercise. an inter-group debate. Fuller details of the assessment process and associated weightings are given on the following page. Case Study Assessments. Report 1 – Individual Report on Industrial Site visit Each student should present an individual report on one of the industrial sites visited on Wednesday 14th February 2006. The...

Words: 2336 - Pages: 10

Premium Essay

Stuff

...formative. I believe that the most relevant evaluations which I have received included both summative and formative evaluation. While evaluating my effectiveness in the classroom, it also provided specific areas of my practice which could improve to make me a better teacher. Quality control evaluation, according to Sergiovanni and Starratt, “protects students and the public from incompetent teaching while evaluation focused on professional improvement “guarantees quality teaching and schooling for students and the public” (Sergiovanni & Starratt, p. 236). An excellent system for teacher evaluation would include elements of both summative and formative assessment. I believe that, as an administrator, I will attempt to implement (if allowed by union agreement) a colleague evaluation as one of the formal assessments after being at the school for a few years. This process will only work when teachers are able to see that my focus is to ensure that they reach their professional goals and not to “get rid of them.” By establishing a trust with my staff, it will be possible for the teachers to evaluate each other honestly without fear of the information being used against them. The summative evaluations, which will always be necessary to ensure that teachers are meeting expectations, will include the information gathered during colleague evaluations, but will also, include other elements which will encompass the climate and visions of the district. By...

Words: 316 - Pages: 2

Premium Essay

Implementing Chage

...place, come up with a strategy to implement a change, implement the change, and examine the change in a suitable manner. To have a productive implementation of a new system it is essential for the manager to be included in every step. The manager should include the employees and keep them abreast so that they may understand why the change is taking place and how it will impact the work environment. The manager encounters many demands such as dealing with employees who might resist to change, and meeting the company’s goals. This paper will point out the manager’s responsibility and position on implementing change, the way a manager should handle employees who are resistant to change, and define the steps of the change system such as assessment, planning, implementation, and evaluation. When implementing change in the work environment within the department, the manager’s position and responsibility is to make certain it is a smooth transition with the help of the employees. Management should be able to offer support to their employees if they are reluctant to change, communicate honestly and openly, stress positive outcomes from implementing change, find resolutions to problems that are barriers to change, and accept the agreement of change. It is necessary for the manager to be able to recognize the change, analyze and collect information, create a plan, help the employees gear up for the change, prepare to deal with resistance, give feedback, and examine...

Words: 563 - Pages: 3

Free Essay

Reflective Practise

...Reflective report on 3 aspects of training assessment performed with student I asked Leanne (student) to provide three reflective reports on random training she had received in-house from myself. Each one is dated 9th, 17th and 26th January 2012 respectively. The three were quite interesting for Leanne, as one was her first ever fitting of a hearing aid, the second was observational on a unique type of specialist hearing aid, and the third was assessing of a patient for hearing aid suitability. It was agreed that these three sessions encompassed all aspects in Audiology she may come across in her future career. For example, she can fit a hearing aid, she can assess a patient and she has learnt that not all fittings are straight forward, for those presenting with a unique problem(s). The end product is patient satisfaction, provide a solution for the patient and to support that in practise. Leanne has come on in leaps and bounds since her early days in the department. She is confident, but finds it difficult to ask questions. However, she does manage talk about things in the appointment through her reflective reporting. This is something I may need to talk with her about when I have the final meeting with her. But I am not overly concerned at this moment in time. The 3 reflective reports that Leanne produces is of good quality, informative and reasonably accurate. It also highlights aspects of training she mentions that we both have undertaken together in the appointment...

Words: 309 - Pages: 2

Premium Essay

Eilsa Assesment Layout

...NCFE Level 2 Award in Reflective Practice (600/4643/0) | Learner’s Evidence Tracking Log (LETL) ------------------------------------------------- ------------------------------------------------- Candidate name: Louise Erica Pierce ------------------------------------------------- Centre number: ------------------------------------------------- Centre name: ------------------------------------------------- ------------------------------------------------- ------------------------------------------------- ------------------------------------------------- ------------------------------------------------- Signatures ------------------------------------------------- ------------------------------------------------- Candidate: Date: ------------------------------------------------- Tutor/Assessor: Date: ------------------------------------------------- Internal Moderator*: Date: ------------------------------------------------- External Moderator*: Date: ------------------------------------------------- ------------------------------------------------- * For completion if part, or all, of the evidence has been sampled by the Internal and/or External Moderator ------------------------------------------------- Unit 01 Evaluate learning F/503/6824 You will: Evaluate own learning to date | You can: | What you’ve done to show this | Location/Portfolio page number | IM/EM signature (if sampled) |...

Words: 2844 - Pages: 12