2. TYPES OF BONE
There are 206 bones in the human body, divided into four categories:
Long bones (e.g, femur)
Short bones (e.g., metacarpals)
Flat bones (e.g., sternum)
Irregular bones (e.g., vertebrae)
7. COLLECTING SUBJECTIVE DATA
Current symptoms
Have you had any recent weight gain?
Describe any difficulty chewing you have.
Is it associated with tenderness or pain?
Describe any joint, muscle, or bone pain you have.
8. CON….
Past History
Describe any past problems or injuries you have had to your joints, muscles, or
bones. What treatment was given? Do you have any after effects from the injury
or problem? When were your last tetanus and polio immunizations?
Have you ever been diagnosed with diabetes mellitus, sickle cell anemia,
systemic lupus erythematous(SLE), or osteoporosis?
For middle aged and female clients:
Have you started menopause? Are you receiving estrogen replacement therapy?
9. CON
Family History
Do you have a family history of rheumatoid arthritis, gout, or osteoporosis?
Life-style and health practices
What activities do you engage in to promote the health of your
musculoskeletal system (e.g., exercise, diet, weight reduction)?
Do you smoke tobacco? How much and how often?
Do you drink alcohol or caffeinated beverages? How much and how often?
Describe your typical 24- hours diet. Are you able to consume milk or milk-
containing products? Do you take any calcium supplements?
Describe your activities during a typical day. How much time do you spend in
the sunlight?
10. CON….
Describe any routine exercise in which you engage.
Describe your occupation.
Describe your posture at work and at leisure. What type of shoes do you usually
wear?
Do you have difficulty performing normal activities of daily living? Do you use
assistive devices (e.g., walker, cane, braces) to promote your mobility?
How have your musculoskeletal problems interfered with your ability to interact
or socialize with others? Have they interfered with your usual sexual activity?
How did you view yourself before you had this musculoskeletal problem, and
how do you view yourself now?
Has your musculoskeletal problems added stress to your life? Describe.
12. RATING SCALE
Movement Classification Score
Active motion against full
resistance
Normal 5
Active motion against some
resistance
Slight weakness 4
Active motion against gravity Average weakness 3
Passive range of motion Poor ROM 2
Slighter flicker of contraction Severe weakness 1
No muscular contraction Paralysis 0
13. GAIT
Observe Gait
Observe the client’s gait as the client enters and walks around the room.
Note:
Base of support
Weight bearing stability
Feet position
Stride
Stride length
Cadence
Arm swing
Posture
“nudge test.”
15. STERNOCLAVICULAR JOINT
Inspect and palpate
With client sitting, inspect the sternoclavicular joint for location in
midline, color, swelling, and masses. Then palpate for tenderness or
pain.
19. TEST ROM OF THE CERVICAL SPINE
Test ROM by asking the client to:
Touch chin to chest(flexion).
Look up at ceiling(hyperextension).
Touch each ear to the shoulder on that side (lateral bending).
25. SHOULDERS
INSPECT AND PALPATE
With the client standing or sitting, inspect for symmetry, color,
swelling, and masses.
Palpate for tenderness, swelling, or heat.
27. ELBOWS
INSPECT AND PALPATE
Inspect for size, shape, deformities, redness, or swelling.
With the elbow relaxed and flexed about 70o, use your thumb and
middle fingers to palpate the olecranon process and epicondyles.
49. ANKLES AND FEET
Inspect and palpate
With the client sitting, standing, and walking, inspect position,
alignment, shape, and skin.
Palpate for tenderness, heat, swelling, or nodules.
