Health Assessment: Musculoskeletal System- Nursing Skills

Summary

This video covers a detailed guide on conducting a musculoskeletal assessment, which includes evaluating muscles, bones, and joints in three main areas: the spine, upper extremities, and lower extremities. The process involves inspection, palpation, and assessing the range of motion. Key techniques include active and passive movements, checking for abnormalities like scoliosis or crepitus, and evaluating muscle strength on a scale from 0 to 5. The video emphasizes thoroughness and provides guidance for adapting the assessment based on patient abilities, offering insights for healthcare professionals to ensure effective patient care.

Takeaways

• 💪 Musculoskeletal assessment involves evaluating muscles, bones, and joints for both structure and function.
• 🛏️ If the patient can't stand, perform active range of motion in bed or use passive movements to assist them.
• 🧍‍♂️ Three main areas to assess: spine, upper extremities, and lower extremities through inspection, palpation, and range of motion.
• 🔎 Inspect the spine for alignment, abnormal curvature (scoliosis), and exaggerated curves (kyphosis or lordosis).
• 🤕 Assess the cervical spine by checking chin up/down, side-to-side head turns, and ear-to-shoulder motions.
• 👨‍⚕️ For the upper extremities, inspect muscles, palpate for heat or abnormalities, and test strength through resistance exercises.
• 🦶 Lower extremity assessment starts at the hips, moving down to knees, ankles, and toes, checking range of motion and strength.
• ⚖️ If the patient has trouble balancing, assist with stability and perform movements in bed.
• 🏋️ Strength is graded on a 0-5 scale, with 5 representing full strength and range of motion.
• 🚶 You can assess gait and include reflex testing if desired during the musculoskeletal assessment.

Q & A

What are the key areas assessed in a musculoskeletal assessment?

The key areas assessed in a musculoskeletal assessment are the spine, upper extremities, and lower extremities. For each area, inspection, palpation, and range of motion are performed.

What should you do if the patient cannot perform active range of motion exercises?

If the patient cannot perform active range of motion exercises, you can help them through passive movements to complete the range of motion.

How is the spine assessed during a musculoskeletal assessment?

The spine is assessed by inspecting and palpating the spinous processes for alignment, checking for abnormal lateral curvatures like scoliosis, and assessing kyphosis or lordosis by observing the patient's side profile.

What range of motion exercises are performed for the cervical spine?

For the cervical spine, the patient should perform chin-up and down movements, turn their head left and right, and tilt each ear toward the shoulder on the same side.

What should you inspect and palpate for in the upper extremities during a musculoskeletal assessment?

You should inspect for muscle size, shape, skin color, redness, swelling, masses, and deformities in the upper extremities. Palpation should be used to assess for heat, crepitus, and pain in the joints.

How is shoulder range of motion tested?

Shoulder range of motion is tested through abduction, adduction, forward motion, backward motion, rotation, and shrugging.

What are the range of motion movements for the hips?

The range of motion movements for the hips include flexion, extension, abduction, adduction, and internal and external rotation.

What specific aspects should you assess in the lower extremities during a musculoskeletal assessment?

In the lower extremities, you should inspect and palpate each joint, check for heat, deformities, pain, and swelling, and assess range of motion and strength in the hips, knees, ankles, and toes.

How do you assess the strength of the upper extremities?

Strength in the upper extremities is assessed by having the patient push and pull against resistance and lift and lower their arms, with a grading scale from 0 to 5 used to evaluate strength.

When can gait and reflexes be included in a musculoskeletal assessment?

Gait can be assessed during the musculoskeletal assessment if the patient can stand and balance, and reflexes can be included if desired, though they are typically part of a neurological assessment.