Musculoskeletal and Neurological Systems Flashcards

Flashcards for review of musculoskeletal and neurological systems.

What is circumduction?

Moving a limb in a circular motion.

What movements describe pronation and supination?

Pronation: palms down; Supination: palms up.

What is the difference between flexion and extension?

: bending; straightening

What is the difference between abduction and adduction?

Abduction: moving away from midline; Adduction: moving toward midline.

What is the difference between internal and external rotation?

Internal/medial rotation: rotating toward midline; External/lateral rotation: rotating away from midline.

What movements describe dorsiflexion and plantar flexion?

ankle/toes up; point toes down.

What movements are inversion and eversion

Foot inward at ankle;: Foot outward at ankle.

What movements describe protraction and retraction?

Forward and parallel to ground; Backward and parallel to ground.

What is arthroplasty?

Joint replacement.

What are some musculoskeletal ROS symptoms?

Myalgia (muscle pain), Ostealgia (bone pain), Arthralgia (joint pain)

What are important aspects of a musculoskeletal health history?

Previous conditions, injuries, surgeries, medications, smoking, and calcium/vitamin D intake.

What ADLs are assessed in a functional assessment?

Bathing, toileting, dressing, grooming, eating, mobility, communicating.

When is a complete musculoskeletal exam appropriate?

For persons with current disease or changes in functional ability.

What are the key components of a Musculoskeletal Exam Overview?

Overall Inspection, Joints (Inspect/Palpate), Range of Motion, and Muscle Strength

What is assessed during the overall inspection of the musculoskeletal system?

Posture, extremity alignment, symmetry, size, gross deformities, and musculature symmetry.

What is assessed during the inspection & palpation of the cervical spine and TMJ?

ROM: lateral bending; rotation; flex/extend. Muscle Strength: turn head against resistance (CN XI).

How is the spinal column assessed?

Inspect profile, posteriorly (bend at waist). Assess ROM: flex/extend; rotation; lateral bend.

Scoliosis

Lateral curvature of the spine.

Kyphosis

Excessive outward curvature of the thoracic spine.

Lordosis

Excessive inward curvature of the lumbar spine.

How are the shoulders assessed in a musculoskeletal exam?

Inspect & palpate joints for abnormalities. Assess ROM: adduct/abduct; external/internal rotation; flex/extend. Test muscle strength: abduct against resistance.

How are the elbows assessed in a musculoskeletal exam?

Inspect & Palpate joint for abnormalities. Assess ROM: flex/extend; supinate/pronate. Test Muscle Strength: biceps (flexion) and triceps (extension).

How are the wrists and hands assessed in a musculoskeletal exam?

Inspect & Palpate joints. Assess ROM: Flexion and extension of wrists and fingers. Test Muscle Strength: Hand grips (offer two fingers).

How are the hips assessed in a musculoskeletal exam?

Client supine. Inspect & Palpate joint. Assess ROM: flexion/extension; internal/external rotation; abduction/adduction. Test Muscle strength.

How are the legs and knees assessed in a musculoskeletal exam?

Inspect & Palpate knee joints for abnormalities, including fluid accumulation. Assess ROM: Flexion, extension. Muscle strength: Hamstrings (flexion) & Quads (extension).

How to preform a true leg length assessment

Anterior iliac spine to medial malleolus.

How to preform an apparent leg length assessment

Umbilicus to medial malleolus.

How are the ankles and feet assessed in a musculoskeletal exam?

Inspect & Palpate ankle and toe joints. Assess ROM: dorsiflexion & plantar flexion; eversion and inversion; equal bilateral flexion and extension of toes. Test Muscle strength: foot pushes & pulls.

What are some developmental competence considerations for musculoskeletal assessment?

Longer arms than the trunk, kyphosis & accommodating backward head tilt, and more pronounced bony prominences.

What is the significance of falls in elderly patients?

Higher risk of falls and greater morbidity and mortality associated with falls.

What are examples of Tests for Balance & Fall Risk?

Timed Get Up and Go (TUG) test, Tinetti Balance and Gait Assessment, and Morse fall scale

What is the difference between subluxation and dislocation?

loss of contact between two bones in a joint; misalignment of two bones in a joint (partial dislocation).

What is a contracture?

Shortening of a muscle leading to limited ROM.

What are some common findings for fractures?

Pain with movement, deformity, decreased ROM, localized edema.

What does CMS stand for in neurovascular assessments?

Circulation, Motor, Sensation.

What are the key neurovascular assessments?

Pulses, Color, Motor Function, Sensation, Pain, Temperature, Cap Refill.

Which demographic is at the highest risk for osteoporosis?

Thin, white postmenopausal females.

What preventative measures can be taken for Osteoporosis?

Calcium & Vitamin D, impact exercises and Bone density screenings (DEXA).

Describe the features of Rheumatoid Arthritis (RA)

Bilateral involvement: pain, edema, stiffness, crepitus. Chronic morning stiffness lasts hours, gets better with warmth, movement

Describe the features of Osteoarthritis (OA)

Noninflammatory; can be unilateral. Affected joints: brief morning stiffness, bony protuberances, limited ROM, crepitus

What are Heberden's and Bouchard's nodes?

Hard, nontender nodules of interphalangeal (IP) joints in the hand, seen in osteoarthritis.

What is gout?

A type of arthritis caused by an increase in serum uric acid.

What are some characteristics of Carpal Tunnel Syndrome?

Burning, numbness, and tingling in hands; will occur with Phalen’s sign or Tinel’s sign.

Frontal lobe

Personality.

Temporal lobe

Senses.

Occipital lobe

Vision.

Parietal lobe

Tactile.

What are the components of the Peripheral Nervous System (PNS)?

Cranial nerves (12 pairs) and Spinal nerves (31 pairs).

Where are the Upper motor neurons (UMN) located?

CNS.

Where are the Lower motor neurons (LMN) located?

PNS.

What subjective data is collected for a neurological assessment?

Headache, Memory Changes, Head Injury, Dizziness, Vertigo, Syncope, Weakness, Incoordination, Paresthesia, Tremors, Sensory changes

What is the difference between intention and restor tremors?

Occurs when relaxed & supported. Worse with voluntary movement

Describe a Screening Neuro Exam vs Complete (Comprehensive) Neurologic Exam vs Neuro Rechecks

Shorter neuro exam to perform on those who appear well and have no significant findings. …. those with abnormal S/S or existing neuro disease. Neuro Rechecks: quick check for decreasing neuro function/increasing ICP

What is included in a neurological exam?

Mental Status, Cranial nerve (CN) function, Motor function: strength, tone, cerebellum, Sensation, Reflexes

What are components of a Mental Status Exam?

Orientation, recall.

What does EOM's stand for?

Extraocular movements

What is assessed during Motor Function evaluation?

Size (abnormal: atrophy), Strength (abnormal: paresis, paralysis), Tone (abnormal: flaccidity, spasticity, rigidity), Range of Motion (abnormal: pain, limited ROM), Tremor

Flaccidity

Decreased muscle tone (hypotonia). Weak & easily fatigued.

Spasticity

Increased tone (hypertonia). Increased resistance than sudden movement.

Rigidity

Constant resistance (dystonia) against Passive ROM.

Dysdiadochokinesia

Slow, clumsy, sloppy movements.

Dysmetria

Clumsy & overshoot movements.

Romberg Test

Test to assess balance; + Romberg= loss of balance.

Algesia

Sensitivity to pain.

Esthesia

Sensitivity to touch.

Kinesthesia/Proprioception

Detect joint motion and limb position when their eyes are closed.

Graphesthesia

Draw number on palm.

Stereognosis

Familiar object in hand.

Clonus

Rapid, rhythmic contractions of a muscle.

Babinski

Dorsiflexion and fanning of toes (Abnormal response in adults)

What are some considerations in Older adult assessments?

Slower verbal and motor responses, Some loss of muscle tone, Gait may be slower and more intentional

Cushing’s triad

Late sign of increased ICP: increased BP/widening PP, decreased HR, decreased/irregular respirations.

Describe some of the Signs and Symptoms for Meningitis

Fever, severe headache, stiff neck, photosensitivity, rash

Often preceded by aura (auditory, visual, or motor)

Epilepsy

Quadriplegia

Upper extremity are affected

Paraplegia

Lower extremity are affected

Autonomic Dysreflexia

Injuries at T6 or higher

Aphasia, hemiparesis, h/a, balance

Cerebrovascular Accident (CVA)

Autoimmune progressive demyelination of nerve fibers of brain and spinal cord (UMN)

Multiple Sclerosis (MS)

*Resting “pill-rolling” tremor; Rigidity; *Bradykinesia; *Impaired balance/coordination

Parkinson’s Disease

Ascending flaccid paralysis

Guillain-Barré Syndrome