Musculo skeletal assessment Nursing 101

BONES! Long, short, irregular, flat Joints allow movement where two bones meet Tendons join bone to muscle Ligaments join bone to bone

Muscles! Limp, without tone ____________________________ Greater than normal tone__________________________ Decreased size of muscle_____________________________ Increased size of muscle_________________________________

Health history Pain Fractures Personal and family history Achondroplasia Marfan syndrome Osteoporosis Scoliosis

Assess posture Stand behind patient, view back, buttocks, and legs Look for shoulder and hip symmetry, prominent scapula Kyphosis Lordosis Scoliosis

Assessing gait Have patient walk away from you Look for smoothness and rhythm Observe for limp Observe for shuffling Knee should be flexed in normal gait

Assessing bone alignment Inspect for bone deformities and misalignment Inspect for shortening of limb Palpate for crepitus Palpate for motion at points other than joints

Assessing neurovascular status Circulation, motion, sensation (“CMS”) Compartment Syndrome Pain Pallor Pulselessness Paresthesia Paralysis Poikilothermia

Assessing joints Inspect and palpate for effusion Range of motion Passive Active Contracture Crepitus Dislocation/subluxation

Diagnostic studies of the musculoskeletal system Xray nursing implications: MRI CT DEXA Description: Nursing implications Arthrogram Description Bone Scan