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Al al-Bayt University
School of Nursing
Nursing Practicum
Musculoskeletal assessment Checklist
Student’s Name:
Grade :
Instructor
COMMENTS
PERFORMANCE RATING
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STEPS
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History taking
Gather equipments
Wash hands.
Explain procedure to patient.
Make sure patient wears a gown
Provide privacy & drape appropriately
Provide comfortable environment.
Vital signs
General examination for each joint
Inspection: for symmetry, deformities, skin changes,
nodules, fasciculations, swelling.
2. Palpation: muscle atrophy, tenderness, crepitus
3. Test range of motion
4. Test muscle strength
5. Special maneuvers for each joint
TMJ
Inspection
Palpation when pt opens mouth
– Palpate muscles of mastication
(masseters,temporal,petrygoid)
Range of motion ( open ,close ,protrusion, retraction)
Shoulder
Inspection
Palpation :
Palpate medially from sternoclavicular joint to lateral
From behind with index palpate Acromion (summit of shoulder)
and palpate acromioclavicular joint
With thumb palpate coracoid process.
Great tubercle
Biceps tendon
Muscles :
Supraspinatus-under the Acromion
Infraspinatus-posterior to supraspinatus
Teres minor- posterior & inferior to the supraspinatus
Range of motion :
Flexion Extension Abduction Adduction .Internal rotation
External rotation
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Al al-Bayt University
School of Nursing
Nursing Practicum
Musculoskeletal assessment Checklist
Student’s Name:
Grade :
Special maneuvers for shoulder joint
Instructor
Al al-Bayt University
School of Nursing
Nursing Practicum
Musculoskeletal assessment Checklist
Student’s Name:
Grade :
Instructor
Elbow joint
Inspection
Palpation
Support pt’s forearm with elbow flexed 70 ◦ ,identify medial &
lateral epicondyles ,olecranon process .
Range of motion
Flexion,extention,supination,pronation
The wrist & Hands
Inspection
Al al-Bayt University
School of Nursing
Nursing Practicum
Musculoskeletal assessment Checklist
Student’s Name:
Grade :
Instructor
Palpation :
Palpate distal radius &ulna
Carpal bones
Metacarpals
Proximal ,middle & distal phalanges
Metacarpophalangeal joints (MCP)
Proximal interphalangeal joints (PIP)
Distal interphalangeal joints (DIP)
Range of motion :
Flexion,extension,adduction,abduction
Maneuvers :
Hand Grip
Thumb movement
Carpal tunnel :
Thumb abduction
Tinel’s sign
Phalen’s sign
Fingers & thumbs range of motion (flexion ,extension
adduction .abduction) & thumb opposition
Spine
Inspection from side & behind for :
Lumbar curve
Posture
Spinous process
Iliac crest
Iliac spines
Palpate the inspected areas
Test range of motion
Neck (flexion,extension,rotation,lateral bending)
Spine ( flexion,extension,rotation,lateral bending)
Hip
Al al-Bayt University
School of Nursing
Nursing Practicum
Musculoskeletal assessment Checklist
Student’s Name:
Grade :
Instructor
Inspection :Observe phases of gait
– Stance :when foot is on the ground
– Swing :foot move forward
Width of base 2-4 inches from heal to heal
Palpation :
Bony land marks /
– Anterior aspect: iliac crest, iliac tubercle, anterior
superior iliac spine, greater trochanter, pubic
symphysis
– Posterior aspect: posterior superior iliac spine, greater
trochanter, ischial tuberosity, sacroiliac joint
Inguinal ligament
Range of motion :
Flexion ,extension ,adduction ,abduction , internal rotation,
external rotation
Knee
Inspection
Contours and alignment of knees for swelling
Atrophy of quadriceps muscle
Knee action during swing and stance phases of gait
Palpation(pt sitting)
Infrapatellar spaces adjacent to patella
Medial and lateral femoral epicondyles and condyles
Medial and lateral margins of tibial plateau
Insertion of patellar tendon at the tibial tubercle
Palpate, with the knee flexed, and note any tenderness:
Along the joint line, including menisci and bursae
Along the medial and lateral collateral ligaments (MCL and
LCL)
Over the patellar tendon. If tender, compress the patella
against the femur and check knee extension
Palpate:
Over the suprapatellar bursa above the knee
Prepatellar bursa over the patella
Pes anserine bursa on posteromedial knee
• If swelling, palpate for bulge sign or balloon sign, or
“balotte” the patella
Range of motion :
Flexion, extension, internal rotation , external rotation
Ankle and foot
Al al-Bayt University
School of Nursing
Nursing Practicum
Musculoskeletal assessment Checklist
Student’s Name:
Grade :
Inspect the surfaces of the ankles and feet for any deformities,
nodules, swellings, calluses, or corns
Palpate
Anterior aspect of each ankle joint for bogginess, swelling,
tenderness
Achilles tendon for nodules or tenderness
Heel for tenderness
Medial and lateral malleolus for tenderness
Metatarsophalangeal joints for tenderness
Heads of the 5 metatarsals by compressing between your
thumb and index finger
Range of motion
Ankle flexion (plantar flexion)
– Point foot toward the floor
Ankle extension (dorsiflexion)
– Point foot toward the ceiling
Inversion
– Bend heel inward
Eversion
– Bend heel outward
Maneuvers :
Assess range of motion
Tibiotalar joint (ankle)
Dorsiflex- and plantar-flex the foot at the ankle
Subtalar (talocalcaneal) joint
Stabilize the ankle and grasp the heel; invert and evert the heel
Transverse tarsal joint
Stabilize the heel; invert and evert the forefoot
Metatarsophalangeal joints
o Flex toes in relation to the feet
Record
Instructor