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NRSG 2220 Module 5- Mobility & Musculoskeletal Assessment- Conducting MS Assessment

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John Marsh
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Module 5- Mobility & Musculoskeletal Assessment- Conducting MS Assessment

Northeastern University

Nursing Interventions Assessment And Community Care (NRSG 2220)

NRSG 2220
Module 5: Mobility & Musculoskeletal Assessment: Conducting MS Assessment
September 20
Musculoskeletal Assessment
● Normal level of function
○ Acute mobility problems
○ Chronic mobility problems
● The cardinal signs of MS disease are:
○ Pain
○ Redness (erythema)
○ Swelling (edema)
○ Increased warmth
○ Deformity
○ Loss of function
● Implication for neurological exam
○ If pt has pain in elbow, is it caused by injury to joint itself or is it coming from
nerves that innervating the movement of the elbow?
● MS Inspection:
○ Note position and alignment of the body
○ Ability to stand erect; posture
○ Symmetry of body parts; compare contralateral side
○ Note discolorations, swelling, masses
○ Note the appearance for muscularity
■ Hypertrophy vs. atrophy
○ Note fasciculations, spasms
■ Fasciculation→ small and minor spasms, usually in face
● Palpation
○ Feel the tone of the muscle; flaccid, spastic, good
○ Note tenderness, heat, swelling, crepitus (crunching under fingers→ indicates air
build-up)
○ Assess ROM
■ Compare contralateral joints
○ Test the strength of the muscle group
Active ROM
● Ask the pt to move each joint through a full ROM following your prompts
● Note the degree and type of any limitations: pain, weakness, tremors
● Note any increased or decreased ROM or instability
● Compare with the other side
Passive ROM
● Support the major joints of extremity
● Gently move the joint through its full range of motion
● Note the degree and type of any limitation: pain or mechanical
● Compare with the other side
Muscle Strength Grading Scale:
● 0/5 No muscle contraction is detected
● ⅕ A trace concentration is noted in the muscle by palpating the muscle while the pt
attempts to contract it
● ⅖ The pt is able to actively move the muscle with help
● ⅗ The pt can move muscle but not against resistance
● ⅘ The pt may move the muscle group against some resistance, but weak
● 5/5 The pt moves the muscle group and overcomes resistance (THIS IS NORMAL
MUSCLE STRENGTH)

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NRSG 2220 Module 5- Mobility & Musculoskeletal Assessment- Conducting MS Assessment

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