A.

Musculoskeletal System
1. Physical Assessment

Special Considerations:

- Be sure that the room is at comfortable temperature, provide rest period if

necessary, provide adequate draping to avoid exposure of client yet
adequate visualization of the part being examined, explain the frequent
changes in position and various movements of body parts.

- Demonstrate to client how to move various body parts and provide verbal
direction.
Sequence: INSPECTION AND PALPATION
INSPECT: a. Posture
N: erect and comfortable for age
AbN: slumped shoulders (esp. when seated) , (abnormal curvatures of spine) lordosis,
Scoliosis, kyphosis

Slumped Good
shoulder posture
 INSPECT: b. Gait
N: evenly distribute weight, stand on heels & toes,
Toes point straight ahead, movements coordinated, arms swing in opposition, stride length
appropriate
AbN: uneven weight bearing, cannot stand in heels or toes, toes point in or out, limps,
shuffle, propels forward, wide-based gait.

Weight distribution Wide-based gait Propels forward

INSPECT: a. risk of falling backward in older or handicapped client by
performing “nudge test”
N: does not fall backward
AbN: falling backward easily

Client with Parkinson

disease
INSPECT & PALPATE: a. Temporomandibular
Joint (TMJ)
N: snapping and clicking may be felt and heard,
mouth opens 1-2 in, mouth opens and closes
smoothly, jaw moves laterally 1-2 cm, jaw
protrudes and retracts easily
AbN: swelling, tenderness or
crepitus, decreased muscle
strength w/ muscle joint
disease, decreased ROM,
clicking, popping or grating
sound may be noted w/ TMJ
dysfunction

Temporomandibular joint ankylosis Oval-shaped swelling at left side

Septic Arthritis of the Temporomandibular Joint 
in a child temporomandibular joint
 INSPECT & PALPATE: a. Test ROM

N: jaw has full ROM against AbN: Lack of full contraction w/ cranial nerve V
resistance, contraction palpated lesion. Pain or spasms w/ myofascial syndrome
with no pain or spasms

cranial nerve V lesion

myofascial syndrome
INSPECT & PALPATE: a. Sternoclavicular joint
N: No visible bony overgrowth, swelling or redness, non-
tender joint
AbN: swollen, redness or enlarged joint or tender, painful
joint is seen w/ inflammation of the joint Visible bony overgrowth

Septic Arthritis of the Sternoclavicular Join

t