MUSCULOSKELETAL SYSTEM

 Observe gait. Observe the client’s gait as the

client enters and walks around the room.
Note: • Base of support • Weight-bearing
stability • Foot position • Stride and length and
cadence of stride • Arm swing • Posture
 NORMAL: Evenly distributed weight.
Client able to stand on heels and toes.
Toes point straight ahead. Equal on both
sides. Posture erect, movements
coordinated and rhythmic, arms swing in
opposition, stride length appropriate.
 ABNORMAL: Uneven weight bearing
is evident. Client cannot stand on heels
or toes. Toes point in or out. Client
limps, shuffles, propels forward, or has
wide-based gait.
 Observe posture
 Normal: posture is erect and
comfortable for age
 Abnormal: slumped shoulders may
result from poor posture or from
depression. Abnormal curvatures of
spine. Include in lordosis (excessive
curvature of spine), kyphosis
(rounded thoracic convexity)
 Inspect and palpate the TMJ. Have the client
sit; put your index and middle fingers just
anterior to the external ear opening
 NORMAL: Snapping and clicking
may be felt and heard in the normal
client. Mouth opens 1–2 inches
(distance between upper and lower
teeth). The client’s mouth opens and
closes smoothly. Jaw moves laterally
1–2 cm. Jaw protrudes and retracts
easily.
 ABNORMAL: Decreased ROM,
swelling, tenderness, or crepitus may be
seen in arthritis. Decreased muscle
strength with muscle and joint disease.
Decreased ROM, and a clicking,
popping, or grating sound may be noted
with TMJ dysfunction
 Test ROM.
 NORMAL: Jaw has full ROM against
resistance. Contraction palpated with no
pain or spasms.
 ABNORMAL: Lack of full contraction
with cranial nerve V lesion. Pain or
spasms occur with myofascial pain
syndrome.