MSK

• Activity # 1, What Do We Remember?

  1. In a group of 4-5, Discuss the following question that you will be handed

  2. Each group will present one question to the class
• POP Quiz
• Joints


  • Nonsynovial or synovial
  • Cartilage
  • Ligament
  • Bursa
• Muscles


  • Fasciculi
  • Tendon
  • Skeletal muscle movements
• Class Activity # 2, Structure and Function


  Please match the correct words and the proper definition in your team
• Subjective Data: Health History

  • Joints: Pain, Stiffness, Swelling, heat, and redness, Limitation of movement
  • Muscles: Pain (cramps), Weakness
  • Bones: Pain, Deformity, Trauma (fractures, sprains, dislocations)
  • Functional assessment (activities of daily living)
  • Self-care behaviours
• Additional Health History Questions

  • For infants and children: Birth trauma, Anoxia, Milestones, Bone injuries, Bone deformities
  • For adolescents: Athletics, Sports equipment, Warming up, Injury, Time management
  • For older adults: Weakness, Injury, Mobility
• Class Activity #3


  Please match the correct words and the proper definition in your team
• Objective Data: Physical Exam

  • Preparation
  • Screening musculoskeletal examination
  • Complete musculoskeletal examination
  • Equipment needed: Tape measure, Skin marking pen
  • Order of examination: Inspection, Palpation, Range of motion, Muscle testing
• Temporomandibular joint


  1. Inspect joint area

  2. Palpate as person opens mouth

  3. Motion and expected range: Open mouth maximally, Protrude lower jaw and move side to side, Stick out lower jaw

  4. Palpate muscles of mastication
• Cervical spine


  1. Inspect alignment of head and neck

  2. Palpate spinous processes and muscles

  3. Motion and expected range: Touch chin to chest, Lift chin, Move each ear to shoulder, Turn chin to each shoulder
• Shoulders


  1. Inspect joint

  2. Palpate shoulders and axilla

  3. Motion and expected range: Move arms forward and up, Move arms behind back and hands up, Move arms to sides and up over head, Touch hands behind head
• Cervical Spine ROM

  Flexion of 45 degrees, Hyperextension of 55 degrees, Lateral bending of 40 degrees, Rotation of 70 degrees
• Shoulder ROM


  Forward Flexion, Internal Rotation, Abduction, External Rotation
• Wrist and hand

  1. Inspect joints on dorsal and palmar sides

  2. Palpate each joint

  3. Motion and expected range: Bend hand up, down, Bend fingers up, down, Turn hands out, in, Spread fingers, make fist, Touch thumb to each finger

  4. Phalen test

  5. Tinel's sign
• Wrist and Hand ROM

  Bend the hand up at the wrist, Bend the hand down at the wrist, Bend the fingers up and down at metacarpophalangeal joints, Turn palms outward and in, Spread fingers apart; then, make a fist, Touch the thumb to each finger and to the base of the little finger
• Wrist and Hand Phalen Test

  Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand, Positive Phalen test: numbness and burning sensation occurs with carpal tunnel syndrome
• Wrist and Hand Tinel's Sign


  Direct percussion of the location of the median nerve at the wrist produces no symptoms in the normal hand, Positive Tinel's sign: burning and tingling sensations along its distribution occurs with carpal tunnel syndrome
• Elbow


  1. Inspect joint in flexed and extended positions

  2. Palpate joint and bony prominences

  3. Motion and expected range: Bend and straighten elbow, Pronate and supinate hand

  4. Test muscle strength
• Elbow ROM


  Bend and then straighten the elbow, Hold the hand midway; then touch the front and back sides of the hand to the table
• Elbow Muscle Strength Test

  Stabilize the patient's arm with one hand, Apply resistance just proximal to the wrist and instruct the patient to flex the elbow against your resistance and then extend the elbow against your resistance
• Wrist and Hand


  1. Inspect the hands and wrists on the dorsal and palmar sides, noting position, contour, and shape

  2. Palpate each joint in the wrist and hands
• Hip


  1. Inspect as person stands

  2. Palpate with person supine

  3. Motion and expected range: Raise leg, Bend knee to chest, Flex knee and hip; swing foot out, in, Swing leg laterally, medially, Stand and swing leg back
• Hip ROM


  Hip flexion of 90 degrees, Hip flexion of 120 degrees, Internal rotation of 40 degrees, External rotation of 45 degrees, Abduction of 40 to 45 degrees, Adduction of 20 to 30 degrees
• Knee


  1. Inspect joint and muscle

  2. Palpate

  3. Motion and expected range: Bend patient's knee, Extend the knee, Check the knee during ambulation
• Knee Inspection


  The skin normally looks smooth, with even coloring and no lesions, Inspect lower leg alignment, Inspect the knee's shape and contour
• Knee Palpation


  The muscles and soft tissues should feel solid, and the joint should feel smooth, with no warmth, tenderness, thickening, or nodularity
• Knee ROM


  Bend each knee (Flexion), Extend each knee (Extension and hyperextension), Ambulate (Examiner checks knee ROM during ambulation)
• Ankle and foot


  Inspect with person sitting, standing
• Gait


  • Reflects equal leg lengths and functional hip motion
• Palpation


  1. Help the patient into the supine position and palpate the hip joints

  2. The joints should look symmetrical, with no tenderness or crepitation
• Hip flexion


  90 degrees
• Hip flexion


  120 degrees; the opposite thigh should remain on the table
• Hip internal rotation


  40 degrees
• Hip external rotation


  45 degrees
• Hip abduction


  40 to 45 degrees
• Hip adduction


  20 to 30 degrees
• Knee inspection


  • The skin normally looks smooth, with even coloring and no lesions
  • Inspect lower leg alignment. The lower leg should extend in the same axis as the thigh
  • Inspect the knee's shape and contour
• Knee palpation


  Palpate the patient's knee in the supine position. The muscles and soft tissues should feel solid, and the joint should feel smooth, with no warmth, tenderness, thickening, or nodularity
• Knee ROM


  1. Bend each knee (Flexion)

  2. Extend each knee (Extension and hyperextension)

  3. Ambulate (Examiner checks knee ROM during ambulation)