Health assessment - MSK

MSK system

skeletal + muscular + connective tissue. includes joints

joints

provide articulation. classified by cartilage type (fibrous, cartilaginous, synovial). provide MOBILITY

cartilage

allows bones to slide over one another, reduces friction, absorbs shock

tendons

connect muscles to bones

ligaments

connect bone to bone to stabilize joints, limits movement

bursae

fluid filled sacs, cushions bones that might rub against each other

meniscus

cartilage disc between bones, absorbs shock

fascia

sheets that line and protect muscles, attach muscle to bone and provide structure

flexion

decreases angle

extension

increases angle

abduction

moves away from center of body

adduction

moves toward center of body

rotation

turning of the joint

circumduction

circular motion (combines flexion, extension, abduction and adduction)

inversion

turn sole of foot inward

eversion

turn sole of foot outward

inspection of MSK

compare sides. posture, gait, mobility, balance, coordination.

extermities - swelling, deformity, injury?

symmetry, tone, strength, ROM

palpation of MSK

each joint, muscle bulk and tone, bumps, swelling, pain, deformity?

active ROM

like assessment of peripheral vision, use own expected range as a guide, doesn't require assistance to perform movement

passive ROM

with assistance. don't push past motion with pain, for limited range consult physio.

ROM assessment

TMJ, C T and L spine, shoulder, elbow, wrist and hand, hip, knee, foot

scoliosis

characterized by an abnormal, sideways curvature of the spine, often forming an "S" or "C" shape rather than a straight line.

kyphosis

characterized by an excessive outward curve of the thoracic spine (upper back), resulting in an abnormally rounded, hunched, or "humpback" appearance

lordosis

excessive inward curvature of the spine.

herniated disc

occurs when the soft, jelly-like center of a spinal disc pushes through a crack in its tougher exterior, often irritating nearby nerves

hip ROM

flexion (lift knee)

extension (lay on stomach lift leg up)

abduction (leg away)

Adduction (leg toward while on side)

external rotation (leg goes INWARD)

internal rotation (leg goes OUTWARD)

pronation

inward roll of the foot, or turning palms down

supination

outward roll of the foot, turning palms up

MSK red flags

redness of swelling of a joint

fractures, dislocations, severe strains or sprains

spine or soft tissue injury (loss of bowel bladder function)

cauda equina syndrome

severe medical emergency caused by compression of nerve roots at the lower end of the spinal cord. Key symptoms include severe low back pain, saddle anesthesia (numbness in buttocks/genitals), and rapid bowel/bladder dysfunction

CSMT (neurovascular assessment)

Circulation, Sensation, Movement, Temperature/Touch.

risk factors for neurovascular compromise

trauma, burn, injury, infection, cast, traction, tight dressing, thrombosis risk

circulation

arterial and venous insufficiency

arterial insufficiency

cool, thin, shiny, pain with cold, decreased pulse and hair, thick nails. ischemic ulcers (toes heel, ankle). capillary refill longer than 3 secs

venous insufficiency

skin thick and hardened, edema, varicose veins, capillary refill is less than 3 secs. often lower leg (gaiter area)

sensation

numbness, tingling, pain, absence of pain

movement

wiggle fingers, thumb opposition, wiggle toes

CSMT red flags

pain edema, warmth of extremity = DVT

dyspnea, chest pain, diaphoresis and anxiety = pulmonary embolism

pain in an extremity beyond what is expected = compartment syndrome

onset of paresthesia or loss of sensation after orthopedic neurosurgery.