Question

Critical Thinking Exercises:

1. How do you inspect the Spine of the adult client? Please discuss your answer.

2. How do you inspect the Joints of the adult client? Please discuss your answer.

3. Indicate and discuss the how do you grade the Muscle Strength?

Answer 1

1. Examination of Spine:

Spine refers to the series of bones situated at the back from the head to the pelvis of a person . It is also called a vertebral column or back bone.

Examination of spine is done mainly through inspection and palpation.

Inspection or observation of spinal column:

* Provide privacy and expose the needed area, do the inspection of entire spine.

* Check for any abnormal curvatures like

Kyphosis: An abnormal convex curvature of the spine in the cervical or lumbar regions of the spine.

Scoliosis : A condition in which there is abnormal lateral curvature of the spine.

lordosis : An excessive backward curvature of the spine , causing a hollow in the back.

* Look for any swellings or scars

* Check for any pelvic tilt or shoulder assymetry

Palpation : Check for any tenderness over bones and on soft tissues also any crepitation. Check the area of tenderness, eg: Cervical or lumbar.

2. Inspection of joints:

Joint refers to any part of the body, where two bones join, most cases allowing that part of the body to be bent or straightened .

* Inspect the joints at rest, for colour, size , scar.

* Check the joints for any swelling, sign of inflammation or swelling, check any signs of arthritis ( inflammation of joints).

* Move the joint by active motion ( patient) and by passive motion ( examiner) and check for any pain.

* Check the Range of Motion by the joint to check the direction and distance with which a joint can move and to check the potentiality of the joints.

3. Muscle strength: muscle strength indicate one person's ability to move , pull , push or lift the objects. It is assessed on 5/5 scale.

0/5-  Muscle Contraction absent

1/ 5- No movement, but muscle flickers

2/ 5 - Simple movement is present, but can't move against gravitational force.

3/5 - Simple movements and also movement against gravity is also present, but the movement against Examiner's resistance is not possible.

4/5 - Examiner's resistance can be overcome with the muscle movement.

5/5 : normal movements , with adequate strength against gravity as well as Examiner's resistance.