PROCEDURES RELATED TO

NEUROMUSKULOSKELETAL
SYSTEMS
ARTHROSCOPIC
EXAMINATION
Direct visualization of a joint with a fiber-optic scope
inserted through a small skin incision

PURPOSES:
 Evaluate joint changes
 Removal of torn cartilage and repair of torn ligaments
 Reduces period required for rehabilitation
 NURSING CARE

Explain procedure and obtain consent

Maintain sterile technique when changing
postoperative dressing
Maintain limb position as ordered
Assist client during ambulation as ordered
COMPUTERIZED
TOMOGRAPHY

CT SCAN
Cross section visualization of the brain determined
by computer analysis of relative tissue density as an
X-ray beam passes through
Provides valuable information regarding infarcts,
tumors, atrophy and vascular lesions
 NURSING CARE

Explain procedure
Evaluate allergy to iodine (if + dye)
Withhold foods 4 hours prior to testing
Remove wigs, clips, and pins prior to the test
Assess claustrophobia
CEREBRAL ANGIOGRAPHY
Visualization of cerebral vasculature with contrast
dye and x-ray projection

NURSING CARE:
 Informed consent
 Allow time for verbalization of fears
 NPO 6-8 hours before procedure
 Allergies: iodine
 Administer sedatives as orders
After procedure:
 Monitor V/S
 Assess puncture site for bleeding, sand bags or ice packs are
used if the femoral artery is used
 Assess involved extremity for ischemia
 Maintain bed rest for a prescribed number of hours
ELECTROENCEPHALOGRAP
HY
Measurement of the electrical activity of the brain in
the form of waves
Provides information regarding tumors, infections,
and chemical toxicity
Client may be asked to hyperventilate or flashing
lights may be used to trigger abnormal wave pattern
 NURSING CARE

Explain procedure to the client

Provide client a normal meal to avoid hypoglycemia
Withhold stimulants
Shampoo hair after the procedure to remove
conducting jelly
ELECTROMYOGRAPHY
Measurement and recording of the electrical activity
of specific muscles into which needle electrodes have
been inserted

NURSING CARE:
 Explain procedure to the client
MAGNETIC RESONANCE
IMAGING
Utilizes magnetism and radio waves to produce
images of cross sections of the body
Can produce accurate images of blood vessels, bone
marrow, gray and white matter, the spinal cord, the
globe of the eye, the heart
 NURSING CARE

Assess for claustrophobia

Instruct client to toilet before procedure
Advise client to remove jewelry, clothing with metal
fasteners, dentures, hearing aids, glasses prior to
entering the scanner
Assess for:
 Metal prostheses, orthopedic screws
 Pacemaker
 Dysrhythmias
 Unstable medical conditions
POSITRON EMISSION
TOMOGRAPHY
Registers glucose metabolism in a cross section of
the brain, glucose metabolism increases in areas of
the brain that are active
Utilized to diagnose Alzheimer’s disease, depression,
dementia, brain tumors
 NURSING CARE

Instruct client to abstain from alcohol, tobacco, and

caffeine prior to the test
Allow client to eat a meal 3 hours before the
procedure
Provide a safe and quiet environment
Instruct client what to expect:
 2 IV lines will be utilized
 Blindfold and cotton plugs may be utilized
 Mental activities are done prior to the procedure
 Scan will take 60 to 90 minutes and patient must remain still
Following test, encourage client to void to clear
radioactive isotope from the body
LUMBAR PUNCTURE
MOBILITY
 MOBILITY

BRACES/SPLINTS
CANE
CRUTCHES
TRANSFER
WALKER
NEUROLOGIC ASSESSMENT
CRANIAL NERVES
MOTOR FUNCTION
 Balance: gait, Romberg’s test
 Coordination
 Muscle strength
SENSORY FUNCTION
MENTAL STATUS
MENTAL STATUS
 LOC (alert-comatose)
 Orientation
 Judgment
 Appropriateness of mood and behavior

REFLEXES
 Deep tendon reflexes
 Plantar (babinski)
GLASSGOW COMA SCALE
EYE Score:
 Spontaneous opening: 4
 Opens to voice 3
 Opens to pain 2
 None 1
VERBAL RESPONSE
 Oriented 5
 Confused 4
 Incomprehensible 3
 Incoherent 2
 None 1
MOTOR RESPONSE:
 Obeys command 6
 Localizes pain 5
 Withraws the pain 4
 Flexion 3
 Extension 2
 None 1
 NURSING CARE

7 and below is considered comatose

3 is the less responsive, 15 is the most responsive
Assess other indicators like VS, pupillary reaction,
movement of extremities, strength
Document findings
 QUIZ!

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