Description
Physical Examination Skills Check List: Musculoskeletal System
Directions for completion:
The following is a Physical Examination Skills Check List intended to guide your independent skills practice on Musculoskeletal System Assessment. Do not start the practice, until after you have read the assigned textbook chapter and completed the Module 9 activities, including watching the Evolve Skills Videos. Here you are asked to practice the examination techniques outlined below on a partner at home*. You should expect to practice the skills multiple times, in order to attain adequate level of proficiency and successfully complete the attestation at the end of the semester. Once you have become proficient with the skills, you must document your findings by filling out the sections below. Do not copy and paste phrases from the textbook. Rather, use your own words to address each of the categories. Once completed, save the file as follows: LastName_FirstName_Musculoskeletal_NSG_200. Submit the completed document onto your Canvas Laboratory (not didactic) course shell titled NV280.NSG.200.0L1H.SP20, under the Musculoskeletal System Lab Assignments module by 11:59 pm on Tuesday, March 24th. Grading is Pass/Fail, whereby Pass equates to 85%. Completion of this assignment is mandatory.
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Student Name: ______________________________
Date: ________
Physical Examination Skills Check List: Musculoskeletal System.
Essential Skills
1. Review appropriate medical history, allergies, contraindications, pain
2. Perform hand hygiene before and after client interactions, before putting on gloves, and after gloves are removed
3. Knock prior to entering client space and introduce self to client (name and NVCC student nurse)
4. Provide client privacy
5. Explain the procedure/purpose to the client using language they will understand
6. Verify client’s identity using 2 identifiers (ask them to state name and assess MR# or DOB)
7. Assist client into the proper position for assessment/procedure
8. Complete assessment as indicated
Examination Techniques
Rationale
Patient
Expected Findings
Unexpected
Instructions/Technique
Findings
Used
To disinfect the hands
Introduce the patient and
No health history of
Perform hand hygiene
before conducting the
Ask patient about
joint disease or
assessment.
musculoskeletal
health
arthritis.
Introduce Self
history, allergies, and pain in
No problems with
Patient Verification
To introduce the examiner joints and muscle.
joints and muscle
and review patients
pain.
Allergies
medical history.
Inspect skeleton and
extremities for alignment and
symmetry
Inspect muscles for
symmetry and size
To evaluate the patients
daily functioning levels.
To determine posture and
alignment
To determine the
musculature symmetry.
To determine the
temperature, pain and
Ask the patient to stand erect;
observe from post-ant-lateral
view
Shoulders have even
contour, scapulae and
iliac crest are level
Ask the patient to perform a
movements (ROM) actively
and with passive help.
Muscles have
symmetry and have
equal sizes
Palpate bones for pain,
temperature, and edema; and
muscles for pain,
temperature, edema, and
tone.
Observe the ROM (ROM) for
major joints and adjacent
muscles, for pain on
movement, joint stability, and
deformity
edema in the bone and
muscle.
To examine presence of
deformity, joint stability,
and pain on muscle
movement.
To test the muscles
movement and bilaterally
strength. Evaluate the
nature of resistance.
Test muscle strength and
compare sides
Observe gait for conformity,
symmetry, and rhythm
To observe the gait and
symmetry when in motion.
Head and neck
To check for facial
symmetry with and
without expression.
Inspect musculature of the
face and neck for symmetry
To examine the joint
tenderness, clicking
The patient should to move
and flex the muscle under
evaluation while you apply an
opposite force to muscle
movement.
The muscle and
bones are firm and
not tender. No
temperature
abnormalities. No
pain during palpation
of bones and muscles.
Skin tone is even
without noticeable
variations.
The ROM is full for
each joint. No pain
on passive and active
movement, deformity
and crepitus.
Ask the patient to walk four
The patient has gait
steps forward towards and
conformity.
away from you; observe the
The patient strides
sway and movement
with a consistent
smooth rhythm with
symmetry of steps
and arm swing.
The patient has
smooth, swaying
movements.
Ask patient to close mouth,
The patient has a
smile and open mouth; check symmetrical face
the symmetry of the face in all with or without facial
actions.
expression. The
Ask the patient to move his
patient’s neck
jaw side by side; notice any
muscles are
clicking sounds.
symmetrical.
Palpate each
temporomandibular joint for
movement, pain, and sounds
Observe jaw for ROM
Open and close
Side to side
Protrude and retract
Palpate the neck for tone
Observe the neck for ROM
Flexion and Hyperextension
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