Musculoskeletal Physical Assessment (1)

2. Mental Status

• Where are you?
• Why are you here?
• Are you in any pain?
• What time did the class start?
• Who was the last president of the USA?
• Who is the current president?
• Ask for judgment: “Can you walk to the Bahamas?”

🩺 History

📋 Note:

• Patient is awake, alert, calm, cooperative.
• Posture, dress, grooming, and hygiene appropriate.
• Facial expression appropriate.
• No excessive movements. Coordinated, relaxed.
• Thought process logical, answers questions correctly.

📋 Ask about any history of osteoarthritis or joint disease.

🩺 TMJ (Temporomandibular Joint)

📋 ROM: open and close jaw, move side-to-side, protrusion, and retracción. No abnormal masses, swelling, or temperature changes noted.

🩺 Spine/Spinous Processes

📋 Palpate from cervical spine to C7. No tenderness, deformity, or abnormalities.

🩺 Neck ROM & Strength

📋 Flexion (look down), extension (look up), lateral rotation (side to side), lateral flexion (ear to shoulder). Resistance against hand intact.

🩺 Shoulders

“elevation” and “depression” Moving shoulders upward and downward.

📋 ROM: extension, flexion, hyperflexion, internal rotation, external rotation, abduction, and adduction. Strength intact against resistance. Palpation shows no swelling or tenderness.

Circumduction movements

🩺 Wrists & Hands

📋 Extend both arms forward. Perform pronation and supination. Open and close hands. Flex and extend wrists, then flex and extend fingers. Perform ulnar and radial deviation.

📋 Strength testing intact against resistance of fingers and thumb.

📋Palpation of wrists, knuckles, and fingers shows no swelling or abnormalities. (use only two fingers when palpating fingers, use thumb and index)

🩺 Arms/Elbows

📋 Flex and extend elbows.

📋 Strength testing intact against resistance for biceps (flexion) and triceps (extension).

📋 Palpate elbow.

🩺 Hips

(supine)

📋 Palpated lateral hips, no tenderness. ROM: flexion, extension, abduction, adduction, internal rotation, external rotation. Resistance intact.

🩺 Legs

Standing

📋Pt hold to the side of bed: Flex and extend leg. Both legs.

🩺 Spine & Posture (standing)

📋 Spine symmetrical. Shoulders, scapula, and hips aligned. Normal cervical, thoracic, and lumbar curves. Side view shows natural curvatures. 📋On forward bend: no scoliosis; C-curve intact.

🩺 Spinal ROM

📋 Lateral bending, flexion, extension, and rotation performed without limitation.

🩺 Knees (Sitting)

📋 Palpated bilaterally, no swelling or tenderness. ROM: flexion, extension. Strength intact against push/pull resistance.