14 Focused Assessment- Musculoskeletal System/Mobility
Ching-Chuen Feng
Learning Objectives
At the end of the chapter, the learner will:
- Obtain a health history related to the musculoskeletal system.
- Perform physical examination of the musculoskeletal system using correct examination techniques.
- Assess the ability to perform activities of daily living.
- Discuss screening tools for falls risk assessment.
- Document the findings from the musculoskeletal assessment.
I. Overview: Focused Musculoskeletal System Assessment
A focused musculoskeletal assessment includes collecting subjective data about the patient’s mobility and exercise level, as well as the patient’s and family’s history of musculoskeletal conditions. The nurse should ask the patient about any signs and symptoms of musculoskeletal injury or conditions. Objective data will include assessing the patient’s range of motion and muscle strength. Additionally, the patient should be evaluated for fall risk.
II. Anatomy and Physiology Review:
III. Medical Terminology
Important Terms to know:
| Ankylosis | fixation of a joint, usually resulting from destruction of articular cartilage |
| Ataxia | inability to coordinate muscular movement |
| Bradykinesia | abnormal slowness of movement |
| Crepitus | a grating, creaking, or cracking sound or sensation heard or felt when moving a join |
| Dyskinesia | uncontrolled, involuntary movements |
| Erythema | redness of the skin |
| Kyphosis | abnormal outward curvature of the spine |
| Lordosis | abnormal inward curvature of the lumbar spine |
| Muscle strength | the muscle’s ability to contract and create force in response to resistance |
| Muscle tone | the tension in a muscle at rest |
| Scoliosis | lateral curvature of the spine |
| Sprain | traumatic injury to the ligament |
| Strain | traumatic injury to the muscle or the tendon |
| Tendinitis |
inflammation of a tendon |
Illustrations of normal and abnormal spinal curvatures
The normal spine should be straight with expected curvatures, and the body should be symmetrical when comparing one side to the other.
Range of Motion (ROM) Terms:
| Abduction | movement of a limb away from the body |
| Adduction | movement of a limb toward the body |
| Circumduction | circular movement of a limb |
| Dorsiflexion | backward or upward motion of a body part |
| Eversion | turning the sole of the foot away from the midline |
| Extension | movement of bringing a joint into a straight position |
| External Rotation | or lateral rotation, turning a limb outward from the mid line of the body |
| Flexion | movement that brings a joint into a bent position |
| Hyperextension | extension of a body part beyond normal limits of extension |
| Internal Rotation | inward turning of a limb |
| Inversion | turning the sole of the foot inwards towards the midline |
| Supination | turning the forearm to keep palm facing up |
| Plantar Flexion | bending of the foot or toes toward the sole of the foot |
| Pronation | turni