Mobility Terminology
A grating, crackling or popping sound/sensation felt over a joint due to bone rubbing on bone or air in the subcutaneous tissue
What is crepitus
A patient with knee osteoarthritis reports a crackling sound when bending their knee
An example of crepitus
fluid-filled sac found in connective tissue, usually in the area of joints
What is bursa
caused by damage to upper motor neurons ie stroke, multiple sclerosis, spinal
cord injury, cerebral palsy, and brain tumors
Common causes of clonus
Symptoms- pain, when bearing weight especially, stiffness and limited ROM, sometimes swelling
Can affect any bone in the body but most common in hip,knee,shoulder,and ankle.
Risk increases with age/ Certain medical conditions such as lupus
Symptoms, and risk factors of avascular necrosis
Increased with passive movement (may indicate compartment syndrome)
Pain
What are the things you observe during assessment
Balance
coordination
stride length
posture
Check for tingling, numbness, or burning sensations
Assess bilateral extremities for comparison●
Use sharp vs. dull test to evaluate sensory deficits
Assessment of paresthesia
An abnormal sensation such as tingling, numbness or burying often due to nerve damage or compression
What is Paresthesia?
A patient with carpal tunnel syndrome complains of "pins and needles" in their
fingers.
An example of paresthesia
inflammation of a fluid-filled sac in a joint
What is bursitis
Injury (e.g., burns, trauma), immobilization (e.g., casts, braces), Nerve damage,Muscle disease (e.g., cerebral palsy, muscular dystrophy), Scar formation, Lack of use
Common causes of contracture
Risk factors Aging, Being overweight, Having weak core muscles, Smoking, and Jobs that involve sitting or driving for long periods
Risk factors for sciatica
Pale skin color, a sign of poor circulation
Pallor
Symmetrical stride, good balance
Normal Gait
Neurovascular status (6 P’s: Pain, Pallor, Pulses, Paresthesia, Paralysis, Poikilothermia)
Pain level
Mobility and gait assessment
Swelling, deformities, or bruising
Assessment for a patient with musculoskeletal disorder
restoration of fracture fragments into anatomic alignment
What is fracture reduction
a fracture that persists for a minimum of nine months without signs of healing
for three months.
An example of nonunion
involuntary, rhythmic contractions of a muscle
What is known as Clonus
Caused by trauma, steroids, alcoholism, some medications, blood disorders and autoimmune diseases
Common causes of Avascular necrosis
Immobilization (bedrest, casting, paralysis)
Aging
Poor nutrition
Neuromuscular disorders(e.g., stroke, ALS)
Chronic illnesses (e.g., stroke, COPD)
Risk factors for muscle atrophy
Diminished or absent pulses require immediate intervention
Pulses
cerebellar disorder
Ataxic
Elevate extremity above heart level
Apply compression (if not contraindicated)
Encourage movement to improve circulation
Monitor for skin integrity breakdown, Diuretics (if due to fluid retention)
Management of edema
healing of a fractured bone in a malaligned position
A 13-year-old boy presents with a 6-day history of fever and increasing pain in his left ankle. There is swelling around the ankle and warm to the touch.
An example of osteomyelitis
abnormal shortening of muscle, joint, or both; fibrosis
What is contracture
Fractures (hip, spine, wrist)
Kyphosis ("dowager’s hump")
Complications of osteoporosis
Postmenopausal women
Low calcium and vitamin D intake
Sedentary lifestyle
Smoking and alcohol use
Long-term corticosteroid use
Risk facators for osteoporosis
Numbness or tingling indicates nerve involvement
Paresthesia
Shuffling gait
Parkinson's disease
Monitor for DVT, infection, and dislocation
Early mobilization (usually with PT)
Avoid hip flexion >90° after total hip replacement
Arthroplasty Post-operative Care
Failure of fractured bones to heal together
What is nonunion
A fracture is redacted incorrectly causing bones to align wrong, the fractured
bone then heals in an incorrect position resulting in improper alignment.
An example of malunion
death of tissue due to insufficient blood supply
Avascular necrosis
Pathological fractures
Kyphosis
Chronic pain
Decreased height
Complications of osteoporosis
Aging
Joint overuse/repetitive stress
Obesity
Previous joint injury
Risk factors for osteoarthritis
The inability to move a limb suggests nerve damage
Lower motor neuron disease
Steppage gait
R-est
I-ce
C-ompression
E-levation
Treatment for sprains and strains
Infection of the bone
What is osteomyelitis
A four-year-old is diagnosed with “nursemaid elbow” after his arm was pulled
a little too hard. This is common in children under 5.
What is an example of subluxation
inflammation of the sciatic nerve, resulting in pain and tenderness along the nerve through the thigh and leg. It can feel like shooting, burning, tingling, or numbness
Sciatica
Infection (osteomyelitis)
Nonunion or delayed healing
Compartment syndrome
Complications of open fracture
Unilateral leg swelling
Redness, warmth
Pain or tenderness in the calf
Positive Homan’s sign (controversial)
Symptoms of DVT
Used to assess what
Neurovascular status
Stroke
Hemiparesis gait
Reposition every 2 hours
Use pressure-relieving devices
Maintain dry, clean skin
Ensure adequate nutrition
prevention of pressure ulcer in post op patients
partial separation of joint surfaces
What is subluxation
Located in hips, knees, elbows, and shoulders. Can become inflamed and cause bursitis
What is the Bursa
Excessive thoracic curvature (hunchback)
Kyphosis
Dizziness
Lightheadedness
Syncope (fainting)
Drop in BP (>20 mmHg systolic or >10 mmHg diastolic)
Symptoms of Orthostatic hypotension
Pulse: Strong, equal bilaterally
Capillary refill: < 3 seconds
Sensation: No numbness or tingling
Movement: Full range of motion without pain
Skin temperature: Warm, consistent with body temperature
Expected findings of the 5 P's
A patient post-hip replacement may have a Trendelenburg gait due to hip
muscle weakness.
An example of of gait assessment
Anticoagulants (e.g., heparin, enoxaparin, warfarin)
Used to prevent blood clots
Lateral curvature of the spine
Scoliosis
A patient with a cast on their leg for six weeks may experience muscle
shrinkage due to disuse.
An example of of muscle atrophy
Excessive lumbar curvature (swayback)
lordosis
Poikilothermia
Size, depth, color
Drainage, odor
Signs of infection
How to assess a wound