Musculoskelatal discussion questions
Choose any joint/musculoskeletal injury (there are numerous ones so no duplication is allowed!!), describe the joint injury, and then describe ONE (and only one) particular assessment test that would help with diagnosis of that injury and the rationale behind it.
The fractured clavicle in the newborn is “the most frequently fractured bone during birth” (Jarvis, 2012). At times, these fractures can be difficult to diagnose because it is often asymptomatic. One assessment test used is palpation over the clavicular area. While palpating, the nurse is comparing both sides of the clavicle length and feeling for localized edema and crepitus. These findings are the easiest to palpate due to the subcutaneous location of the clavicle and because of rapid callus formation. Palpation may also reveal “tenting of the skin due to bone fragments or overlapping bone fragments” (Shannon, Hart and Grattkou, 2009). Thankfully, neonatal clavicle fractures generally heal rapidly and have no long term affects.
Jarvis, C. (2012). Musculoskeletal System. In Physical examination and health assessment (6th ed., p. 600). St. Louis, MO: Elesevier Saunders
Shannon, E., Hart, E., & Grottkau, B. (2009). Clavicle Fractures in Children: The Essentials. Orthopaedic Nursing, 28(5), 210-214. The Apley scratch test is another assessment tool in rotator cuff injury. Have the patient attempt to touch the opposite scapula. Simply ask the patient to “scratch your neck”. This tests abduction and external rotation. Next ask the patient to “reach down you and try to touch your opposite scapula”, this checks for adduction and internal rotation. Note if there is pain with range of motion during this part of the exam.
Reference
The Painful Shoulder: Part I. Clinical Evaluation. http://www.aafp.org/afp/2000/0515/p3079.html Another range of motion test for torn meniscus is called the Thessaly test. During this exam, have the patient stand flat footed (while the nurse provides hands for
The fractured clavicle in the newborn is “the most frequently fractured bone during birth” (Jarvis, 2012). At times, these fractures can be difficult to diagnose because it is often asymptomatic. One assessment test used is palpation over the clavicular area. While palpating, the nurse is comparing both sides of the clavicle length and feeling for localized edema and crepitus. These findings are the easiest to palpate due to the subcutaneous location of the clavicle and because of rapid callus formation. Palpation may also reveal “tenting of the skin due to bone fragments or overlapping bone fragments” (Shannon, Hart and Grattkou, 2009). Thankfully, neonatal clavicle fractures generally heal rapidly and have no long term affects.
Jarvis, C. (2012). Musculoskeletal System. In Physical examination and health assessment (6th ed., p. 600). St. Louis, MO: Elesevier Saunders
Shannon, E., Hart, E., & Grottkau, B. (2009). Clavicle Fractures in Children: The Essentials. Orthopaedic Nursing, 28(5), 210-214. The Apley scratch test is another assessment tool in rotator cuff injury. Have the patient attempt to touch the opposite scapula. Simply ask the patient to “scratch your neck”. This tests abduction and external rotation. Next ask the patient to “reach down you and try to touch your opposite scapula”, this checks for adduction and internal rotation. Note if there is pain with range of motion during this part of the exam.
Reference
The Painful Shoulder: Part I. Clinical Evaluation. http://www.aafp.org/afp/2000/0515/p3079.html Another range of motion test for torn meniscus is called the Thessaly test. During this exam, have the patient stand flat footed (while the nurse provides hands for