Summary NR 509 Week 3: The Musculoskeletal System

NR 509 Week 3: The Musculoskeletal System Table of Contents Note For learning purposes in this course, the weekly lessons are divided by body systems and focused on specific objective physical examination techniques. The lessons are adjunct to the assigned reading and by no means a substitution. Therefore, it is incumbent upon you to fully comprehend the associated subjective health history, health promotion, and anatomy and physiology as outlined in each textbook chapter. By the end of the course, you will be proficient with conducting a complete physical examination. Advanced Practice Assessment Techniques Assessment of the musculoskeletal system involves evaluating for issues of the bones, joints, skeletal muscles, ligaments and tendons, and cartilage throughout the body. As a clinician, you need to be aware of the expected anatomy and physiology of each structure within the musculoskeletal system, including the expected range of motion (ROM) of each joint. When abnormalities or limitations are discovered on assessment, diagnostic reasoning skills must be applied to determine how to best utilize the data.  Your examination should be systematic. Include inspection, palpation of bony structures and related joint and soft tissue structures, assessment of range of motion, and special maneuvers to test specific movements. Recall that the anatomical shape of each joint determines its range of motion. There are two phases to range of motion: active (by the patient) and passive (by the examiner). There are specific differences in approach to assessment, as well as expected findings, across the lifespan. As you review the required readings this week, be alert for special considerations that relate to special patient populations.  Review the videos below which demonstrate examination of the entire musculoskeletal systems and then practice your assessment skills. Continue to practice your skills until you can comfortably repeat a return demonstration of the entire assessment. The Hip Examination The hip joint is deeply embedded in the pelvis and is notable for its strength, stability, and wide range of motion. The stability of the hip joint, essential for weight bearing, arises from the deep fit of the head of the femur into the acetabulum, its strong fibrous articular capsule, and the powerful muscles crossing the joint and inserting below the femoral head, providing leverage for movement of the femur. Often, the examiner must assist the patient with movements of the hip, so further detail is provided below for flexion, abduction, addu