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 Objective Data
History of Present Concern MUSCULOSKELETAL
Have you noticed any weight gain? Inspection (size/shape/symmetry) of
Do you have any difficulty chewing? muscles and joints
Do you have any joint/muscle or bone Palpation (smoothness of movement/
pain? muscle tone/crepitation or tenderness)
Do you experience numbness in any Range of motion (ROM) movements
extremity? How often? ROM – grading muscle strength against
resistance where appropriate (0–5 rating)
Past Health History
Have you had any problems or UPPER MUSCULOSKELETAL
received treatment to Range of Motion
muscle/joint/bones? Describe the
treatment you received. Cervical/Thoracic/Lumbar
What surgeries have you had? Cervical
When was your last tetanus/polio o Flexion (against resistance)
immunization? o Extension (against resistance)
What medical conditions do you o Hyperextension (against resistance)
have? o Lateral flexion (against resistance)
Are you menopausal? o Rotation
Family History Thoracic/Lumbar
Does anyone in your family have o Flexion
diabetes/arthritis/gout/osteoporosis/ o Extension
lupus? o Lateral flexion
Lifestyle and Health Practices o
What medications are you taking? Hyperextension o
Prescribed/over the counter/herbal? Rotation
Do you smoke? How much? How Shoulders/Arms/Elbows
long? Shoulders/Arms
How much alcohol and/or o Flexion (against resistance)
caffeinated/diet beverages do you
o Extension
drink per day?
o Hyperextension (against resistance)
Describe a typical 24-hour food/fluid
intake. o Abduction (against resistance)
Do you exercise? How often? Type of o Adduction (against
exercise? How long? Consistency? resistance) o Circumduction
What do you do for a living? o External rotation (against resistance)
What type of shoes do you wear most Elbows
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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