Lab Guide

Musculoskeletal Assessment
This lab introduces the assessment of the musculoskeletal system and indicators of health
status.

Student Learning Outcomes

At the conclusion of this lab, the student will be able to:

1. Identify key questions to elicit additional information pertaining to the upper

and lower musculoskeletal system.

2. Describe normal assessment findings of the musculoskeletal system for an adult.

3. Demonstrate a complete, accurate assessment of the musculoskeletal system.

4. Demonstrate reflective practice.

Preparation for Lab

Prior to the guided practice lab session, students should complete the following:

 Jarvis textbook, Chapter 22 – “Subjective Data” and “Objective Data” sections

 Jarvis Student Lab Manual, Chapter 22

 Health Assessment DVD: Musculoskeletal Assessment

 Complete Lab Exercise D – Musculoskeletal Assessment, and hand in to your lab

instructor at the beginning of this lab.

Student to Bring to Lab

No equipment required
Guided Lab Practice
The lab will provide you with the opportunity to practise both subjective and objective
assessments. The major focus of the guided practice will be on the practice and
demonstration of objective data collection for the musculoskeletal system.
Subjective Data – Sample Questions
History of Present Concern
 Have you noticed any weight gain?
 Do you have any difficulty chewing?
 Do you have any joint/muscle or bone
pain?
 Do you experience numbness in any
extremity? How often?
Past Health History
 Have you had any problems or
received treatment to
muscle/joint/bones? Describe the
treatment you received.
 What surgeries have you had?
 When was your last tetanus/polio
immunization?
 What medical conditions do you
have?
 Are you menopausal?
Family History
 Does anyone in your family have
diabetes/arthritis/gout/osteoporosis/
lupus?
Lifestyle and Health Practices
 What medications are you taking?
Prescribed/over the counter/herbal?
 Do you smoke? How much? How
long?
 How much alcohol and/or
caffeinated/diet beverages do you
drink per day?
 Describe a typical 24-hour food/fluid
intake.
 Do you exercise? How often? Type of
exercise? How long? Consistency?
 What do you do for a living?
 What type of shoes do you wear most  Elbows
Objective Data
MUSCULOSKELETAL
 Inspection (size/shape/symmetry) of
muscles and joints
 Palpation (smoothness of movement/
muscle tone/crepitation or tenderness)
 Range of motion (ROM) movements
 ROM – grading muscle strength against
resistance where appropriate (0–5 rating)
UPPER MUSCULOSKELETAL
Range of Motion
Cervical/Thoracic/Lumbar
 Cervical
o Flexion (against resistance)
o Extension (against resistance)
o Hyperextension (against resistance)
o Lateral flexion (against resistance)
o Rotation
 Thoracic/Lumbar
o Flexion
o Extension
o Lateral flexion
o
Hyperextension o
Rotation
Shoulders/Arms/Elbows
 Shoulders/Arms
o Flexion (against resistance)
o Extension
o Hyperextension (against resistance)
o Abduction (against resistance)
o Adduction (against
resistance) o Circumduction
o External rotation (against resistance)
Subjective Data – Sample Questions Objective Data
of the day? o Flexion (against resistance)
 Do you have difficulty completing o Extension (against resistance)
ADLs independently? o Pronation
 Have you recently travelled outside of o Supination
Canada? Where? When?
Wrists
 Have you been camping recently?
 Flexion (against resistance)
 Extension
 Hyperextension (against resistance)
 Ulnar deviation (against resistance)
 Radial deviation (against resistance)
Hands/Fingers
 Abduction (against resistance)
 Adduction (against resistance)
 Flexion (against resistance)
 Extension (against resistance)
 Hyperextension (against resistance)
 Opposition (thumb touching base of
small finger)
 Circumduction (rotation of thumb only)

LOWER MUSCULOSKELETAL
Range of Motion
Hips
 Flexion (against resistance)
o Knee bent
o Knee straight
 Extension (against resistance)
 Abduction (against resistance)
 Adduction (against resistance)
 Internal rotation (against resistance)
 External rotation (against resistance)
 Hyperextension
Knees
 Flexion (against resistance)
 Extension (against resistance)
Subjective Data – Sample Questions Objective Data
Toes
 Abduction (against resistance)
 Adduction (against resistance)
 Flexion
 Extension

Suggested Lab Activities

 Complete an objective assessment of the musculoskeletal system. Remember to
always assess range-of-motion against resistance as well.

 “Simon Says” range-of-motion game

 Perform reflective practice using the form provided at end of this lab.
 Name:

Lab Exercise – Musculoskeletal Assessment

1. You are conducting a musculoskeletal assessment on a healthy adult. When
performing ROM of the shoulder the client states “There, it starts to hurt there.”
What would be your next step?

a. Continue with the current ROM on the shoulder.

b. Stop and let the client rest.
c. Stop and measure where the ROM is limited.

2. What is the name of the tool used to measure ROM?

3. You are conducting ROM on a healthy adult. You document that the muscle strength
is “average weakness.” In terms of muscle strength what does this mean?

a. Active motion against full resistance with a rating of 5

b. Active motion against gravity with a rating of 3
c. Active motion against some resistance with a rating of 4

4. When observing a client’s gait, identify three things you would want to note.

5. Describe how you would measure “true leg length.”

6. Snuffbox tenderness may indicate a fracture of which bone?

a. Metacarpal
b. Phalanx
c. Capitate
d. Scaphoid
Musculoskeletal Assessment Documentation of Findings
Sample:

T 37.3, P 76/minute, R 14/minute, BP 128/76, O2 Sats 97% on RA. Gait smooth with
equal stride. Full range of motion (ROM) of spine. Able to perform movements
against full resistance. Full ROM of shoulders with limited abduction of right
shoulder. Able to perform all movements against full resistance except abduction –
grade 3. Full range of ROM of elbows and wrists. Able to perform movements
against full resistance. Full range of ROM of hands and fingers . Able to perform
movements against full resistance. Full range of ROM of hips. Able to perform
movements against full resistance. Full range of ROM of knees with exception of
flexion. Stated pain 6/10 when left knee flexed. Able to perform extension against full
resistance. Flexion of left knee grade 3 against resistance. Right knee grade 5. Full
range of ROM of ankles and feet. Able to perform movements against full resistance.
Full range of ROM of toes. Able to perform movements against full resistance.

Documentation of your findings

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