Assessment of Musculoskeletal System

Common Symptoms
• Pain
- Bone Pain
- Fracture Pain
- Sharp Pain
• Tenderness
• Tightness
• Abnormal Sensations
Interview Assessment
• Past Health
• Social
• Family History
Physical Assessment
• Posture
Common Deformities of the
spine:
- Kyphosis
Lordosis
Scoliosis
• Gait
• Bone Integrity
• Joint Function
- Limited range of motion may be the result of skeletal deformity, joint
pathology, or contracture of the surrounding muscles, tendons and
joint capsule.
Goniometer
Joint Motion
• Effusion
Joint Deformity
Test for detecting fluid in the knee
• Muscle Strength and Size

- The muscular system is assessed by noting muscular strength

and coordination, the size of individual muscles, and the patient’s
ability to change position.
- Weakness of a group of muscles might indicate a variety
conditions, such as polyneuropathy, electrolyte disturbances
(particularly potassium and calcium), myasthenia gravis,
poliomyelitis, and muscular dystrophy.
- By palpating the muscle while passively moving the relaxed
extremity, the nurse can determine the muscle tone.
Skin
• The nurse inspects the skin for edema, temperature, and color.

• Palpation of the skin can reveal whether any areas are warmer,
suggesting increased perfusion or inflammation, or cooler,
suggesting decreased perfusion or inflammation, and whether
edema is present.
Neurovascular Status
• It is important for the nurse to perform frequent neurovascular
assessments of patient with musculoskeletal disorders (especially
of those with fractures) because of the risk for tissue and nerve
damage.
• One complication that the nurse needs to be alert for when as-
sessing the patient is compartment syndrome. This major
neurovascular problem is caused by pressure within a muscle
compartment that increases to such an extent that
microcirculation di-minishes, leading to nerve and muscle anoxia
and necrosis.
Assessing for Peripheral Nerve Function
Musculoskeletal Impairments influenced
by Genetic Factors
Achondroplasia
Congenital Talipes equinovarus (clubfoot)
Developmental dysplasia of the hip (DDH)
Ehlers-Danlos syndrome
Marfan syndrome
Stickler syndrome
Osteogenesis imperfecta
Osteoporosis