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Chapter 62 Chapter 62 Nursing Assessment Nursing Assessment Musculoskeletal System Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

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Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved. Fig. 62-1

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Page 1: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Chapter 62Chapter 62

Nursing AssessmentNursing AssessmentMusculoskeletal SystemMusculoskeletal System

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Page 2: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Structures and Functions of the Structures and Functions of the Musculoskeletal SystemMusculoskeletal System

BoneBone FunctionFunction 1. Support1. Support 2. Protection of internal organs2. Protection of internal organs 3. Blood cell production3. Blood cell production 4. Mineral storage4. Mineral storage

Page 3: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Fig. 62-1

Page 4: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Structures and Functions of the Structures and Functions of the Musculoskeletal System (cont’d)Musculoskeletal System (cont’d)

JointsJoints

CartilageCartilage

Page 5: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Fig. 62-2

Page 6: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Fig. 62-5

Page 7: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Structures and Functions of the Structures and Functions of the Musculoskeletal System (cont’d)Musculoskeletal System (cont’d)

Skeletal MuscleSkeletal Muscle

Ligaments and tendonsLigaments and tendons

FasciaFascia

BursaeBursae

Page 8: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Gerontologic ConsiderationsGerontologic ConsiderationsEffects of Aging on the Musculoskeletal Effects of Aging on the Musculoskeletal

SystemSystem Decreased number of muscle cellsDecreased number of muscle cells Loss of elasticity in ligaments and cartilageLoss of elasticity in ligaments and cartilage Increased risk to cartilage erosionIncreased risk to cartilage erosion Narrowing of intervertebral spacesNarrowing of intervertebral spaces Decrease in bone densityDecrease in bone density

Page 9: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Assessment of the Musculoskeletal Assessment of the Musculoskeletal SystemSystem

Subjective dataSubjective data Important health informationImportant health information

• Past health historyPast health history

• MedicationsMedications

• Surgery or other treatmentsSurgery or other treatments

Page 10: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Assessment of the Musculoskeletal Assessment of the Musculoskeletal System (cont’d)System (cont’d)

Functional health patternsFunctional health patterns• Health Perception–Health Management PatternHealth Perception–Health Management Pattern

• Nutritional-Metabolic PatternNutritional-Metabolic Pattern

• Elimination PatternElimination Pattern

• Activity-Exercise PatternActivity-Exercise Pattern

• Sleep-Rest PatternSleep-Rest Pattern

Page 11: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Assessment of the Musculoskeletal Assessment of the Musculoskeletal System (cont’d)System (cont’d)

Functional health patternsFunctional health patterns

• Cognitive-Perceptual PatternCognitive-Perceptual Pattern

• Self-Perception–Self-Concept PatternSelf-Perception–Self-Concept Pattern

• Role-Relationship PatternRole-Relationship Pattern

• Sexuality-Reproductive PatternSexuality-Reproductive Pattern

• Coping–Stress Tolerance PatternCoping–Stress Tolerance Pattern

• Value-Belief PatternValue-Belief Pattern

Page 12: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Assessment of the Musculoskeletal Assessment of the Musculoskeletal System (cont’d)System (cont’d)

Objective dataObjective data Physical examinationPhysical examination

• InspectionInspection

• PalpationPalpation

• MotionMotion Passive ROMPassive ROM

Active ROMActive ROM

Page 13: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Assessment of the Musculoskeletal Assessment of the Musculoskeletal System (cont’d)System (cont’d)

Objective dataObjective data Physical examinationPhysical examination

• Muscle-strength testingMuscle-strength testing

• MeasurementMeasurement

• OtherOther

Page 14: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Fig. 62-7

Page 15: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Diagnostic Studies of the Diagnostic Studies of the Musculoskeletal SystemMusculoskeletal System

Page 16: Chapter 62 Nursing Assessment Musculoskeletal System Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved

Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.

Diagnostic StudiesDiagnostic Studies

X-rayX-ray CT scanCT scan MyelogramMyelogram MRIMRI Bone mineral density measurementBone mineral density measurement Laboratory Laboratory Invasive studiesInvasive studies