Musculoskeletal Assessment肌肉骨骼评估.pptVIP

Musculoskeletal Assessment NUR123 Spring 2009 K. Burger, MSEd, MSN, RN, CNE PPP by: Victoria Siegel RN, CNS, MSN Sharon Niggemeier RN MSN Revised by: Kathleen Burger Musculoskeletal: ReviewAnatomy Physiology Skeleton: 206 bones Long: femur, humerus, radius Short: carpals, tarsals Irregular: vertebrae Bones protect, support, allow for locomotion and mineral storage (Ca,Mg) Musculoskeletal Joints: Range from joints that don’t move to joints that freely move. Ligaments and tendons: stabilize joints Ligaments: attached from bone to bone Tendons: attached from muscle to bone Cartilage: ends on bones Musculoskeletal Muscles: controlled by nervous system Fascia: surrounds muscles, divides muscles, main blood vessels and nerves. Bursae: cushions moving parts Muscle tone: ability to resist force; graded 0-5 Atrophy: decrease size Assessing: Subjective Data Joint pain: SLIDA: Severity, Location, Intensity, Duration, Aggravating factors (alleviating factors, associated symptoms) Stiffness Limited movement Assessing: Subjective Data Rheumatoid Arthritis (RA) chronic systemic inflammatory disease involves symmetric joints. Other MS disorders involve isolated or unilateral joints. Rheumatoid arthritis Stiffness Swelling Limited ROM Movement decreases pain Assessing: Subjective Data Osteoarthritis: chronic degeneration of joint cartilage caused by aging or trauma Stiffness Swelling Limited ROM Heberden’s and Bouchard’s nodules May be unilateral Assessing: Subjective Data Muscle Pain: SLIDA Aching/cramps Weakness Resistance 0-5 Atrophy Assessing: Subjective Data Bone pain: SLIDA Hx Deformity Trauma- limitations as a result of trauma Assessing: Subjective Data Functional Assessment: ADL’s- does MS problem create limits: Bathing- getting in and out of tub, turning faucets Toileting- getting on/off toilet, wiping self Dressing- buttons, zippers, tying shoes Grooming- shaving, brushing teeth, putting on makeup Eating- cutting food, preparing meals etc… Assessi