Assessments Ch 22 – Musculoskeletal System

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moving a body part away from an axis or the medial line.


moving a body part toward the center or toward the medial line.


immobility, consolidation, and fixation of a joint because of disease, injury, or surgery; most often due to chronic rheumatoid arthritis.


inability to perform coordinated movements.


enclosed sac filled with viscous fluid located in joint areas of potential friction.


moving the arm in a circle around the shoulder.


dry cracking sound or sensation due to grating of the ends of damaged bone.


directed toward or located on the surface

dupuytren contracture

flexion contracture of the fingers due to chronic hyperplasia of the palmar fascia.


moving the sole of the foot outward at the ankle.


bending a limb at a joint


round, cystic, non-tender nodule overlying a tendon sheath or joint capsule, usually on dorsum of wrist.

hallux valgus

lateral or outward deviation of the great toe.


moving the sole of the foot inward at the ankle.


outward or convex curve of the thoracic spine; hunchback


fibrous band running directly from one bone to another bone that strengthens the joint.


inward or concave curve of the lumbar spine

nucleus pulposus

center of the intervertebral disc.

olecranon process

bony projection of the ulna at the elbow




refers to the surface of the sole of the foot


turning the forearm so that the palm is down


moving a body part forward and parallel to the ground

range of motion, ROM

extent of movement of a joint


moving a body part backward and parallel to the ground

rheumatoid arthritis

chronic systemic inflammatory disease of joints and surrounding connective tissue.


nerve pain along the course of the sciatic nerve that travels down from the back or thigh through the leg and into the foot.


S-Shaped curvature of the thoracic spine


turning the forearm so that the palm is up

talipes equinovarus

clubfoot, congenital deformity of the foot where it is plantar flexed and inverted.


strong fibrous cord that attaches a skeletal muscle to a bone.


wryneck; contraction of the cervical neck muscles, producing torsion of the neck.

1. Differentiate synovial from non-synovial joints.

Synovial joints allow sliding of opposing surfaces, cartilage covers the surface of opposing bones. Nonsynovial joints are united by fibrous tissue or cartilage and are immovable like the sutures in the skull or slightly movable like the vertebrae.

3. Differentiate the following:

dislocation -Displacement of a body part, especially the temporary displacement of a bone from its normal position. subluxation-Incomplete or partial dislocation of a bone in a joint. Contracture -abnormal shortening of muscle tissue, rendering the muscle highly resistant to passive stretching. Ankylosis – immobility, consolidation, and fixation of a joint because of disease, injury, or surgery; most often due to chronic rheumatoid arthritis.

4. Differentiate testing of active range of motion versus passive range of motion.

Active range of motion is done entirely by the patient. Passive range of motion is where you help the patient or solely manipulate the body to make the movements.

5. Explain the method for measuring leg length.

To determine if one leg is shorter than the other; Normally these measurements are equal or within 1 cm, indicating no true bone discrepancy. True leg lengths are equal, but apparent leg lengths unequal – this condition occurs with pelvic obliquity or adduction or flexion deformity in the hip.

6. Describe the Ortolani maneuver for checking an infants hips.

The infant lays supine, flex the knees holding your thumbs on the inner mid thighs and your fingers outside on the hips touching the greater trochanters. Adduct the legs until your thumbs touch. Then gently lift abduct, moving the knees apart and down so their lateral aspects touch the table.

7. When performing a functional assessment for an older adult, state the common adaptations that the aging person makes when attempting these maneuvers:

• Walking: shuffling pattern and swaying • Climbing up stairs: person holds on to handrail • Walking down stairs: person holds on to handrail with both hands • Picking up object from floor: often bends at waist instead of knees • Rising up from sitting in chair: uses arms to push off chair arms • Rising up from lying in bed: may roll to one side, push arm to lift up torso

8. Draw and describe swan neck deformity and boutonniere deformity in rheumatoid arthritis.

Swan-Neck: Flexion contracture of meta-carpophalangeal joint. Boutonniere deformity: the knuckle looks like being pushed through a button-hole.

9. Contrast Bouchard’s nodes with Heberden’s nodes in osteoarthritis.

Bouchard’s nodes are hard, bony outgrowths or gelatinous cysts on the proximal inter-phalangeal joints, the middle joints of fingers or toes. They are a sign of either osteoarthritis or Rheumatoid arthritis. Herberden’s nodes are hard or bony swellings that can develop in the distal inter-phalangeal joints, DIP, the joints closest to the end of the fingers and toes. Heberden’s are at the end of fingers and the Bouchard and are in the middle.

9a. Fill in the labels indicated on the following illustrations (foot anatomy).

Tendo calcaneous, Achilles tendon Talus bursae Flexor muscles flexor tendon extensor tendon Synovial joint- -Capsular ligament -synovial cavity -synovial membrane -cartilage -Tibia

9b. Fill in the labels indicated on the following illustrations (knee).

Lateral epicondyle of femur Lateral collateral ligament Lateral meniscus Lateral condyle of tibia fibula Tibial tuberosity Anterior cruciate ligament, joint opened to show detail Medial condyle of tibia Patella ligament Patella Quadriceps muscle

1. During the assessment of the spine, the patient would be asked to:

D. Flex, extend, abduct, and rotate.

2. Pronation and supination of the hand and forearm are the result of the articulation of the:

B. Radius and ulna

3. Anterior and posterior stability are provided to the knee joint by the:

D. Anterior and posterior cruciate ligaments

4. A 70-year old woman has come for a health examination. Which of the following is a common age-related change in the curvature of the spinal column.

C. Kyphosis

5. Examination of the shoulder includes 4 motions. These are:

A. Forward flexion, internal rotation, abduction, and external rotation.

6. The bulge sign is a test for:

A. Swelling in the supra-patellar punch

7. The examiner measures a patients legs for length discrepancy. Which is a normal finding.

C. Within 1 cm of each other

8. A 2-year-old child comes to the clinic for a health examination. A common finding for this age group is:

B. lordosis

9. A positive Phalen test and Tinel sign are found in a patient with:

C. Carpal tunnel syndrome

10. When assessing an infant, the examiner completes the Ortolani maneuver by:

B. Gently lifting and abducting the infant’s flexed knees while palpating the greater trochanter with the fingers.

11. Hematopoiesis takes place in which of the following?

D. Bone marrow

12. Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions are known as:

D. Ligaments

13. Flexion:

B. Bending a limb at a joint.

14. Extension:

E. Straightening a limb at a joint.

15. Abduction:

G. Moving a limb away from the midline of the body.

16. Adduction:

I. Moving a limb toward the midline of the body.

17. Pronation:

D. Turning the forearm so that the palm is down.

18. Supination:

A. Turning the forearm so that the palm is up.

19. Circumduction:

J. Moving the arm in a circle around the shoulder.

20. Inversion:

M. Moving the sole of the foot inward at the ankle.

21. Eversion:

K. Moving the sole of the foot outward at the ankle.

22. Rotation:

N. Moving the head around a central axis.

23. Protraction:

L. Moving a body part forward and parallel to the ground

24. Retraction:

H. Moving a body part backward and parallel to the ground

25. Elevation:

F. rising a body part

26. Depression:

C. lowering a body part

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