NURS 295 Final Review, Nursing 295 Final Exam, Nursing
Fundamentals Final
musculoskeletal system - Bony skeletal has no inherent movement
- Supplied by muscles, tendons, ligaments
muscles/motor activity - innervated by nervous system, if innervation is interrupted, no
movement
tendons connect muscle to bone
ligaments Connect bone to bone
musculoskeletal problems causes:
- Trauma
- Inflammation/ Rheumatoid arthritis/ Gout
- Degeneration / osteoarthritis
- Congenital
- Overuse . repetitive use
- Age / osteoporosis
- Tumor metastasis
- Mechanical stress / ergonomics (obesity/poor posture)
- musculoskeletal diseases
musculoskeletal diseases - Muscular dystrophy
- ALS, MS
- Myasthenia gravis
musculoskeletal exam - Cephalocaudal: start at the head
- Inspect : symmetry, deformities, erythema, edema, ecchymosis, muscle mass
- Palpate : warmth, tenderness, crepitus with ROM.
- Range of motion: each joint
TMJ - Articulation of the mandible and the temporal bone
- Hinge joint - Limited movement
TMJ exam Inspection
- jaw symmetry
Palpation
- Fingertips in front of tragus, ask pt to open mouth, should feel the joint space
ROM
- Open & close (opening should allow 3 fingers positioned vertically)
- move jaw side-to-side
- Thrust jaw forward
cervical spine - Vertebrae in neck
- 7 cervical vertebrae
- Inspect for deformities
,- Palpate for tenderness, muscle spasm.
ROM:
- Flexion
- Extension
- Lateral bending
- Lateral rotation
muscles of neck - Sternocleidomastoid and trapezius
flexion Decreases the angle of a joint
extension increases the angle of a joint
shoulder joint - Ball and socket joint
- Humerus articulates in the shoulder socket, the upper outer end of the scapula
- Supported by rotator cuff - 4 muscles
- Together called the shoulder girdle
- Allows for wide range of motion
shoulder joint exam Inspect for
- symmetry of scapulae
- shoulder height
- muscle atrophy.
Palpate
- Sternoclavicular joint
- Acromioclavicular joint
- Bicipital groove
- Glenohumeral joint
- Rotator cuff area
ROM
- Flexion/Extension
- Abduction/Adduction
External rotation/Internal rotation
abduction Movement away from the midline of the body
adduction Movement toward the midline of the body
external rotation rotation of the hip or shoulder away from the midline
internal rotation rotation of the hip or shoulder toward the midline
Elbow -Humerus
- Medial and lateral epicondyles of humerus
- Ulna
- Olecranon process of ulna
Elbow exam Inspect
- erythema, swelling, deformity.
Palpate
- olecranon, humeral epicondyles, bursa.
ROM
- Flexion
- Extension
- Supination
- Pronation
pronation turning the palm downward
,supination
Wrist exam - Inspect fo erythema, swelling deformity
- Palpate carpal joints for warmth, tenderness, swelling
ROM
- Flexion
- Extension
- Radial deviation
- Ulnar deviation
MCP - Metacarpal phalanges
- hand
PIP - Proximal interphalanges
- hand
DIP - Distal interphalanges
- hand
hand/finger exam - Inspect for erythema, swelling, deformity
- Palpate metacarpals, MCP, PIP, DIP
- Test for CSM
- Cap refill
- Sensation
- Movement
ROM
- Flexion/Extension
- Abduction/Adduction
hand deformities Osteoarthritis
Rheumatoid arthritis
hip - Ball and socket
- Allows for wide range of motion
- Femur articulates in acetabulum
Hip exam Inspect
- Gait for symmetry
- Gluteal muscle mass
- Palpate greater trochanters for tenderness
ROM
- Flexion with knee straight
- Flexion with knee flexed
- Extension
- Internal rotation/External rotation
- Abduction/Adduction
Knee - Hinge joint = limited ROM
- Lifelong weight bearing
- Cruciate (crossed) ligaments hold femur on top of tibia
- Medial and lateral meniscus cushion on the joint
Knee exam Inspection
- swelling, erythema, deformity.
Palpation:
- patella, tendon,
, - Lateral joint spaces
- Posterior space
ROM: Hinge joint
- Flexion/Extension
Knee problems - Valgus
- Genu varum "bowed legs"
- Genu valgum "knock knees"
- Genu recurvatum "back knee"
Ankle - Tibia
- Fibula
- Talus
- Talar joint
Ankle exam Inspect:
- swelling, redness, bruising
Palpate:
- swelling, warmth, tenderness
ROM:
- plantar flexion, dorsiflexion, inversion, eversion
MTP metatarsal phalangeal joints
foot exam Inspect
- swelling, erythema, deformities.
- Flat feet
- Corns, bunions, calluses.
- Extremely important for diabetes to inspect their feet daily
Palpate
- tenderness
ROM
- Inversion/eversion of forefoot
- Flexion, extension, abduction, adduction of toes
inversion Turning the sole of the foot inward
eversion turning the sole of the foot outward
spine Cervical
Thoracic
Lumbar
Sacrum
Coccyx
spine exam Inspection:
- symmetry of muscle mass
- contour of vertebral column
Palpation:
- Spine tenderness
- Paravertebral muscles, tenderness, spasm
ROM
- Flexion, extension
- Lateral bending
- Rotation
Fundamentals Final
musculoskeletal system - Bony skeletal has no inherent movement
- Supplied by muscles, tendons, ligaments
muscles/motor activity - innervated by nervous system, if innervation is interrupted, no
movement
tendons connect muscle to bone
ligaments Connect bone to bone
musculoskeletal problems causes:
- Trauma
- Inflammation/ Rheumatoid arthritis/ Gout
- Degeneration / osteoarthritis
- Congenital
- Overuse . repetitive use
- Age / osteoporosis
- Tumor metastasis
- Mechanical stress / ergonomics (obesity/poor posture)
- musculoskeletal diseases
musculoskeletal diseases - Muscular dystrophy
- ALS, MS
- Myasthenia gravis
musculoskeletal exam - Cephalocaudal: start at the head
- Inspect : symmetry, deformities, erythema, edema, ecchymosis, muscle mass
- Palpate : warmth, tenderness, crepitus with ROM.
- Range of motion: each joint
TMJ - Articulation of the mandible and the temporal bone
- Hinge joint - Limited movement
TMJ exam Inspection
- jaw symmetry
Palpation
- Fingertips in front of tragus, ask pt to open mouth, should feel the joint space
ROM
- Open & close (opening should allow 3 fingers positioned vertically)
- move jaw side-to-side
- Thrust jaw forward
cervical spine - Vertebrae in neck
- 7 cervical vertebrae
- Inspect for deformities
,- Palpate for tenderness, muscle spasm.
ROM:
- Flexion
- Extension
- Lateral bending
- Lateral rotation
muscles of neck - Sternocleidomastoid and trapezius
flexion Decreases the angle of a joint
extension increases the angle of a joint
shoulder joint - Ball and socket joint
- Humerus articulates in the shoulder socket, the upper outer end of the scapula
- Supported by rotator cuff - 4 muscles
- Together called the shoulder girdle
- Allows for wide range of motion
shoulder joint exam Inspect for
- symmetry of scapulae
- shoulder height
- muscle atrophy.
Palpate
- Sternoclavicular joint
- Acromioclavicular joint
- Bicipital groove
- Glenohumeral joint
- Rotator cuff area
ROM
- Flexion/Extension
- Abduction/Adduction
External rotation/Internal rotation
abduction Movement away from the midline of the body
adduction Movement toward the midline of the body
external rotation rotation of the hip or shoulder away from the midline
internal rotation rotation of the hip or shoulder toward the midline
Elbow -Humerus
- Medial and lateral epicondyles of humerus
- Ulna
- Olecranon process of ulna
Elbow exam Inspect
- erythema, swelling, deformity.
Palpate
- olecranon, humeral epicondyles, bursa.
ROM
- Flexion
- Extension
- Supination
- Pronation
pronation turning the palm downward
,supination
Wrist exam - Inspect fo erythema, swelling deformity
- Palpate carpal joints for warmth, tenderness, swelling
ROM
- Flexion
- Extension
- Radial deviation
- Ulnar deviation
MCP - Metacarpal phalanges
- hand
PIP - Proximal interphalanges
- hand
DIP - Distal interphalanges
- hand
hand/finger exam - Inspect for erythema, swelling, deformity
- Palpate metacarpals, MCP, PIP, DIP
- Test for CSM
- Cap refill
- Sensation
- Movement
ROM
- Flexion/Extension
- Abduction/Adduction
hand deformities Osteoarthritis
Rheumatoid arthritis
hip - Ball and socket
- Allows for wide range of motion
- Femur articulates in acetabulum
Hip exam Inspect
- Gait for symmetry
- Gluteal muscle mass
- Palpate greater trochanters for tenderness
ROM
- Flexion with knee straight
- Flexion with knee flexed
- Extension
- Internal rotation/External rotation
- Abduction/Adduction
Knee - Hinge joint = limited ROM
- Lifelong weight bearing
- Cruciate (crossed) ligaments hold femur on top of tibia
- Medial and lateral meniscus cushion on the joint
Knee exam Inspection
- swelling, erythema, deformity.
Palpation:
- patella, tendon,
, - Lateral joint spaces
- Posterior space
ROM: Hinge joint
- Flexion/Extension
Knee problems - Valgus
- Genu varum "bowed legs"
- Genu valgum "knock knees"
- Genu recurvatum "back knee"
Ankle - Tibia
- Fibula
- Talus
- Talar joint
Ankle exam Inspect:
- swelling, redness, bruising
Palpate:
- swelling, warmth, tenderness
ROM:
- plantar flexion, dorsiflexion, inversion, eversion
MTP metatarsal phalangeal joints
foot exam Inspect
- swelling, erythema, deformities.
- Flat feet
- Corns, bunions, calluses.
- Extremely important for diabetes to inspect their feet daily
Palpate
- tenderness
ROM
- Inversion/eversion of forefoot
- Flexion, extension, abduction, adduction of toes
inversion Turning the sole of the foot inward
eversion turning the sole of the foot outward
spine Cervical
Thoracic
Lumbar
Sacrum
Coccyx
spine exam Inspection:
- symmetry of muscle mass
- contour of vertebral column
Palpation:
- Spine tenderness
- Paravertebral muscles, tenderness, spasm
ROM
- Flexion, extension
- Lateral bending
- Rotation
