Musculoskeletal System
What are the components of the Muscoskeletal System?
Bones, Cartilage, Ligaments, Muscle (skeletal), Joints (fibrous, cartilaginous, synovial)
What might the aging adult experience?
-atrophy of neuron structures in brain/spinal cord
-thinning of cerebral cortex
-reduced subcortical brain structures
-expansion of ventricles
-decrease in cerebral blood flow & oxygen consumption
Questions to ask when assessing the thorax N' lungs...
-cough? -environmental exposure
-SOA (shortness of air) -patient-centered care
-chest pain w/breathing
-prior resp. infections
-smoking history
How to assess the carotid artery?
-inspect for pulsations
-palpate one at a time
-auscultate
-higher risk for undernutrition
-medication interaction
-physical changes
flexion, extension, abduction, adduction, pronation, supination, circumduction, inversion, eversion, rotation, protraction, retraction, elevation, & depression
Questions to ask during a neurological assessment...
-headache? -numbness/tingling?
-head injury? -difficulty swallowing?
-dizziness/vertigo? -difficulty speaking?
-seizures? -patient centered care
-tremors? -environmental/occupational hazards?
-weakness? -incoordination?
What are the steps of the assessment of posterior chest?
-inspection
-palpation
-percussion
-auscultate
What are the components of the CV system?
-obtain pulse n' B/P
-assess extremtities
-assess neck vessels
-assess precordium
How do you define nutritional status?
-optimal nutritional status
-undernutrition
-overnutrition
-obesity
Size, contour, color, swelling, masses/deformity/contracture
How do you assess cerebellar function?
-rapid alternating movements
-finger-nose-finger test
-heel-to-shin test
-balance test (gait, romberg test)
What are the breath sounds?
-bronchial
-bronchialvascular
-vesicular
-adventitious sounds (crackles/rales, wheeze/rhonchi, atelectatic crackles, pleural friction rub, stridor)
How to assess the precordium?
-inspect anterior chest
-palpate the apical pulse
-palpate across the percordium
what are the anthropometric measures?
-body mass index
-waist to hip ratio
-arm span
-serial assessment
What are you looking for when palpating the Muscoskeletal system?
Temperature/Heat, Bone articulation mobility, tenderness/painful, ROM (range of motion) (active, passive, crepitation, muscle strength, TMJ)
How do you assess the sensory system?
-anterolateral tract (pain, light touch)
-posterior colum tract (vibration, position (kinesthesia), tactile discrimination (fine touch) (stereognosis, graphesthesia, extinction, point location)
Abnormal physical findings of the throax and lung area are...
-barrel chest, pectus excavatum, pectus carinatum, scoliosis, kyphosis
where to auscultate the heart and neck
-valve areas (aortic valve) (pulmonic valve) (tricuspid valve) (mitral valve)
-systematic Z pattern
-rate & rhythm
-pulse deficit
-abnormal sounds
questions to ask during nutritional assessment...
-eating patterns, usual weight, changes in appetite smell or taste, changes in chewing or swallowing, recent surgery, trauma, burns, infections, chronic illness, nausea/vomiting/diarrhea/constipation, food allergies/intolerance, medications/supplements, patient centered care, ETOH/illegal drug use, exercise/activity pattern, family history
What areas do you assess when assessing the MS system?
Cervical spine (spinous process, sternomastoid, trapezius, paravertebral muscles), Upper Extremities (bilateral shoulders, shrug shoulders, wrist, hand, elbow), Lower Extremities (hip, knee, ankle, foot)
What is the neurological recheck?
-level of consciousness (LOC)
-motor function
-pupillary response
-vital signs
-glascow coma scale
What are the abnormal respiratory patterns?
-bradypnea/tachypnea
-hypoventilation/hyperventilation
-Cheyne-stokes
-biot
-chest pain -dyspnea -orthopnea
-cough -fatigue -cyanosis/pallor
-edema -nocturia -past cardiac history
-family cardiac history -medications -environmental concerns
Types of nutritional assessment
-nutritional screening, mini-nutritional assessment, comprehensive nutritional assessment, 24 hour recall, food frequency questionnaire, food diary, direct observation, calorie count