Nursing Assessment of the

Musculoskeletal System
Part 1
 Subjective Data
Health History
• Trauma, arthritis, neurological disorder
• H/O pain, swelling in muscles or joints
• Frequency & type of exercise
• Mobility alterations
• Intake of calcium, alcohol
• History of smoking Taylor, p. 643 & 1281.

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 Musculoskeletal Assessment
Techniques
• The musculoskeletal system is assessed with
inspection and palpation.
• Inspection allows the nurse to observe the
patient’s range of motion, gait, endurance,
symmetry and alignment.
• Palpation allows the nurse to assess muscular
strength, pain, swelling, nodules, crepitation
and range of motion.
 Skeletal Function = the ability of bones to
support the body and facilitate movement.
Indicators:
• Bone Integrity- No fractures
• Bone Density- No osteoporosis
• Joint Movement- No arthritis
• Joint stability
• Weight bearing
• Skeletal alignment

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Mobility = the ability to move purposefully
& independently with or without an
assistive device.
Indicators:
• Balance, coordination, gait, joint & muscle
movement
• Body positioning performance,
transfer performance
• Ease of movement

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 Joint structure & Function
• Range of Motion of
Joints: know terms in
table 39-2 pg 1264
• Normally each joint has
full range of motion, is
not tender and moves
smoothly
• Palpate for pain,
swelling, nodules or
crepitus
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Hip Rotation Hip Flexion

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Supinate
=
palms up

Pronate
=
palms down

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 Common Joint Problems
Osteoarthritis Rheumatoid Arthritis

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Distal Joints = further away from the
point of insertion

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Proximal joint = close to the insertion site

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 Proximal & Distal are terms that refer to
direction in relation to where a structure is
to a point of insertion.

The wrist is distal to the elbow.

The distal end of the radius is by the wrist.
The shoulder is proximal to the elbow.
The knee is proximal to the ankle.

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Terms used to describe ROM

Full ROM
Fixed in flexion
Limited flexion
Fixed in extension

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 Where do you go from here?
• Continue on to Musculoskeletal System
Assessment Part 2.
• Review the Fall Risk Assessment tool.