Assessment of the

Musculoskeletal
System

The Musculoskeletal System

The
musculoskeletal
system is
composed of
bones, joints,
muscles,
cartilage,
ligaments, and
tendons.

The Musculoskeletal System

The skeleton provides a structural
framework for the body and, because
bones are rigid, provides support and
protection for vital organs and softer
tissues.
Skeletal muscles and bones work together
to make body movement possible.

Physical Assessment
Management of orthopedic
patients begins with an
accurate assessment of the
patient's specific problems.
Important information can be
obtained from the patient's
history and the physical assessment.

PA: Preparation
Assemble
equipment:
Goniometer
an instrument for
the precise
measurement of
angles, especially
one used to
measure the angles.

PA: Preparation
Introduce yourself and verify the clients
identity. Explain to the client what you are
going to do, why it is necessary, and how
the client can cooperate.
Perform hand hygiene and observe other
appropriate infection control procedures
and provide for client privacy.

PA: Assessment of Muscles

Inspect the muscles for
size.
Compare each muscle on one
side of the body to the same
muscle on the other side. For any
apparent discrepancies, measure
the muscles with a tape.
Inspect face for symmetry.
Palpate the muscles for
mastication (masseters, temporal
muscles and pterygoid muscles)

PA: Assessment of Muscles

Inspect the muscles and
tendons for contractures.
Inspect the muscles for
tremors.
Inspect any tremors of the
hands and arms by having the
client hold arms out in front of
body.

PA: Assessment of Muscles

Palpate muscles at rest to
determine muscle tonicity.
Palpate muscles while the client is
active and passive for flaccidity,
spasticity, and smoothness of
movement.

PA: Assessment of Muscles

Flaccidity complete
loss of muscle tone
Spasticity increased
muscle tone with
exaggeration of tendon
reflexes

PA: Assessment of Muscles

Test muscle strength. Compare
the right side with left side.

Sternocleidomastoid
Trapezius
Deltoid
Biceps
Triceps
Wrist and finger muscles

PA: Assessment of Muscles

Test muscle strength. Compare the
right side with left side.

Grip strength
Hip muscle
Hip abduction
Hip adduction

Hamstring
Quadriceps
Muscles of the ankles and
feet.

PA: Assessment of Bones

Inspect the
skeleton for normal
structure and
deformities.
Palpate the bones
to locate any areas
of edema or
tenderness.

PA: Assessment of Joints

Inspect the joint for swelling.
Palpate each joint for tenderness,
smoothness of movement, swelling,
crepitation, and presence of nodules.

Assess joint range of motion.

Ask the client to move selected body parts. If
available, use a goniometer to measure the
angle of the joint in degrees.

PA: Assessment of Joints

Documentation
Document findings in the client
record.