Assessment of Skeletal

System
Presented by: Faqiha Andleeb
Course Title: Health Assessment
Presented to: Mam Fatima
Assessing the Bones and Joints
• The assessment of bones and joints is a vital part of
musculoskeletal evaluation, helping identify
abnormalities, injuries, or diseases affecting mobility
and overall health.
• By examining their structure, function, and range of
motion, we can detect conditions such as fractures,
arthritis, or joint deformities.
• This assessment is crucial in diagnosing issues, planning
treatments, and monitoring recovery for improved
patient outcomes.
1. Assessing the Head
Observation:
• Look for the size, shape, and symmetry of the head.
• Check for any visible swelling, bruises, or deformities.
Palpation:
• Feel for tenderness, bumps, or abnormal textures on the
scalp.
• Check for any signs of injury or irregularities in the skull.
Function:
• Assess head movements (e.g., ability to turn or tilt smoothly).
• Look for signs of pain or restricted motion.
2. Assessing the Jaw
Observation:
• Check the jawline for symmetry.
• Look for swelling or abnormal alignment.
Palpation:
• Gently press around the jaw and temporomandibular joint (TMJ).
• Feel for tenderness, stiffness, or unusual movement.
Function:
• Ask the individual to open and close their mouth.
• Observe if the motion is smooth or if there is clicking, popping,
or pain.
Assessing the Neck
Observation:
• Inspect the neck for symmetry, swelling, or visible abnormalities.
• Look for lumps, scars, or unusual skin changes.
Palpation:
• Feel for lymph nodes in the neck area (e.g., under the jaw, along the
sides of the neck).
• Check for tenderness, swelling, or masses.
Range of Motion (ROM):
• Ask the individual to move their neck (forward, backward, sideways,
and rotate).
• Note any stiffness, pain, or limited movement.
Continue..
Thyroid Examination:
• Observe for visible thyroid enlargement.
• Gently palpate the thyroid gland to detect swelling or nodules.
Vascular Assessment:
• Feel for carotid pulses on both sides of the neck.
• Check for any abnormal pulsations or bruit sounds using a
stethoscope.
Trachea Position:
• Check if the trachea is midline or deviated (could indicate
underlying issues).
Assessing the SPine
Observation:
• Inspect posture and spinal alignment.
• Look for deformities (e.g., scoliosis, kyphosis, lordosis).
• Observe gait and balance.
Palpation:
• Feel for tenderness, swelling, or abnormal masses.
• Identify spinous processes and surrounding muscles.
Range of Motion:
• Flexion, extension, lateral bending, and rotation.
• Note any restrictions or discomfort.
Special Tests:
• Perform tests like the Straight Leg Raise (SLR) or Spurling's Test.
• Assess neurological function: reflexes, muscle strength, and sensation.
Assessing the Shoulder and Elbow
Observation:
• Look for asymmetry, swelling, or deformities.
• Assess for atrophy of muscles (deltoid, supraspinatus).
Palpation:
• Feel for tenderness in the clavicle, acromion, and scapula.
• Check the rotator cuff and bicipital groove.
Range of Motion (ROM):
• Assess active and passive motions: flexion, extension, abduction,
adduction, and rotation.
Strength Testing:
• Evaluate muscles: deltoid, supraspinatus, infraspinatus, and
subscapularis.
 Assessing the Wrist, Hand and
Fingers
1. Wrist Assessment
• Observation:
• Inspect for swelling, deformities, or scars.
• Note any asymmetry or redness.
• Palpation:
• Feel for tenderness over the carpal bones, radial, and ulnar aspects.
• Check for swelling or warmth in the joints.
• Range of Motion (ROM):
• Flexion, extension, radial deviation, and ulnar deviation.
• Compare bilaterally for symmetry.
• Strength Testing:
• Test grip strength and wrist extension/flexion resistance.
• Special Tests:
• Phalen’s Test for carpal tunnel syndrome.
• Finkelstein’s Test for de Quervain’s tenosynovitis.
Continue..
2. Hand and Fingers Assessment:
• Observation:
• Inspect for atrophy (thenar and hypothenar muscles), deformities, or nodules.
• Note finger alignment and presence of contractures (e.g., Dupuytren's contracture).
• Palpation:
• Palpate each joint (DIP, PIP, MCP) for tenderness and swelling.
• Assess tendon integrity, especially flexor and extensor tendons.
• Range of Motion (ROM):
• Evaluate individual finger flexion, extension, abduction, and adduction.
• Assess thumb opposition and circumduction.
• Strength Testing:
• Test pinching strength and individual finger resistance.
• Special Tests:
• Allen’s Test for blood flow.
• Trigger finger test by palpating the flexor tendons during movement.
Assessing the Hips and Knee
1. Assessing the Hips
Observation:
• Inspect for symmetry, swelling, or deformity in the hips.
• Look at posture and alignment, especially while standing or walking.
Palpation:
• Feel for tenderness, swelling, or warmth around the hip joint.
• Palpate the bony structures to detect abnormalities.
Range of Motion (ROM):
• Test hip movements: flexion, extension, abduction, adduction, and rotation.
• Note any pain, stiffness, or limited mobility.
Gait Assessment:
• Observe how the individual walks to identify limping or uneven strides.
Continue..
2. Assessing the Knees
Observation:
• Check for swelling, redness, or deformities in the knees.
• Note the alignment of the legs (e.g., bowlegs or knock-knees).
Palpation:
• Feel for warmth, swelling, or tenderness around the knee joint.
• Check for crepitus (grinding sensation) during movement.
Range of Motion (ROM):
• Test knee movements: flexion and extension.
• Assess for pain, stiffness, or restricted motion.
• Stability Tests:
• Perform tests like the anterior drawer or Lachman test to evaluate ligament stability
(e.g., ACL).
Functional Assessment:
• Ask the individual to squat or climb stairs to check functional capacity.
 Assessing the Ankle and Foot
1. Ankle Assessment
Inspection:
• Alignment, swelling, discoloration.
• Deformities (e.g., valgus/varus).
Palpation:
• Bony structures: Malleoli, talus, calcaneus.
• Soft tissues: Achilles tendon, ligaments.
Range of Motion (ROM):
• Dorsiflexion, plantarflexion, inversion, eversion.
Special Tests:
• Anterior Drawer: Ankle instability.
• Talar Tilt: Lateral ligament injury.
• Thompson Test: Achilles tendon rupture.
Continue..
2. Foot Assessment
Inspection:
• Arch height, alignment, ulcers, calluses.
• Deformities: Bunions, hammertoes, claw toes.
Palpation:
• Bony structures: Metatarsals, phalanges, calcaneus.
• Soft tissues: Plantar fascia, tendons.
Range of Motion (ROM):
• Toe flexion, extension, abduction.
Special Tests:
• Morton’s Test: Assess neuroma.
• Windlass Test: Plantar fasciitis.