Musculoskeletal

• Tremor is an involuntary trembling of a limb or

  body part. Tremors may involve large groups of

  muscle fibers or small bundles of muscle fibers
• Intention tremor becomes more apparent when

  an individual attempts a voluntary movement, such

  as holding a cup of coffee.
• Resting tremor is more apparent when the client is

  at rest and diminishes with activity.
• Fasciculation is an abnormal contraction of a

  bundle of muscle fibers that appears as a twitch.
• The musculoskeletal system encompasses the

  muscles, bones, and joints.
• Bones are assessed for normal form
• Joints are assessed for tenderness, swelling,

  thickening, crepitation (a crackling, grating sound),

  and range of motion.
• Body posture is assessed for normal standing and

  sitting positions.
• The axial skeleton is shown in yellow. The appendicular skeleton is shown in blue.

  
• Abduction: Moving away from midline of the body
• Adduction: Moving toward midline of the body
• Circumduction: Circular motion
• Inversion: Moving inward
• Eversion: Moving outward
• Extension: Straightening the extremity at the joint and increasing the angle of the joint
• Hyperextension: Joint bends greater than 180 degrees
• Flexion: Bending the extremity at the joint and decreasing the angle of the joint
• Dorsiflexion: Toes draw upward towards the ankle
• Plantar flexion: Toes point away from the ankle
• Pronation: Turning or facing downward
• Supination: Turning or facing upward
• Protraction: Moving forward
• Retraction: Moving backward
• Rotation: Turning of a bone on its own long axis
• Internal rotation: Turning of a bone toward the center of the body
• External rotation: Turning of a bone away from the center of the body
• Atrophy is a decrease in size
• Hypertrophy is an increase in size
• Atomic is muscles lacking tone
• Flaccidity is the weakness or laxness in muscles
• Spasticity is a sudden involuntary muscle contraction
• Sternocleidomastoid:

  • Client turns the head to one side against the resistance of your hand. Repeat with the other side
• Trapezius:

  • Client shrugs the shoulders against the resistance of your hands
• Deltoid:

  • Client holds arm up and resists while you try to push it down
• Biceps:

  • Client fully extends each arm and tries to flex it while you attempt to hold arm in extension
• Triceps:

  • Client flexes each arm and then tries to extend it against your attempt to keep in flexion
• Wrist and Finger Muscles:

  • Client spreads the fingers and resists as you attempt to push the fingers together
• Grip strength:

  • Client grasps your index finger and middle fingers while you try to pull the fingers out
• Hip Muscles:

  • Client is supine, both legs extended; client raises one leg at a time while you attempt to hold it down
• Hip abduction:

  • Client is supine, both legs extended. Place your hands on the lateral surface of each knee; client spreads the legs apart against your resistance