Abdomen and Musculoskeletal Discussion

Abdomen and Musculoskeletal Discussion. Obtain the following information on an adult volunteer. For the history, ask about the items indicated. For the physical
exam items; read the assigned chapters, review the course presentations/videos, and gather needed equipment before
performing the exam. Use this guide when documenting the findings. Be sure to address all items in your documentation.
Volunteer Information
Gender, age, birthplace, race/ethnicity
Health History Findings (address each item and list specific denials)
Abdomen, musculoskeletal
• Past medical history – Personal history of acute/chronic disease, surgery, injury, infection, pain
• Review of systems
o Abdomen – Appetite, intolerance to any food, heartburn, nausea, vomiting, constipation, diarrhea, change
in stool, incontinence, bleeding, hemorrhoids, laxatives, endoscopic tests and results
o Musculoskeletal – Pain, stiffness, swelling of joints, limited movement, cramps, weakness, problem with
gait, deformities, assistive devices
• Family history of illnesses in these systems
Physical Exam Findings (address findings for each item)
Abdomen
• Inspect – skin, umbilicus, peristalsis, symmetry, aortic impulse, etc.
• Auscultate – bowel sounds
• Percuss – general
• Palpate – light, aortic pulse, deep, liver, kidneys
• Costovertebral angle (CVA) tenderness – can do here if not already done with posterior chest
Musculoskeletal
• Inspect – muscularity, symmetry, alignment, deformities, edema, redness, etc.
• Neck
o ROM – flexion, hyperextension, rotation, lateral bending
o Strength
• Shoulders
o ROM – abduction, adduction, internal rotation, external rotation
o Strength
• Elbows
o ROM – flexion, extension, pronation, supination
o Strength
• Wrists/Hands
o ROM – wrist flexion, wrist hyperextension, finger flexion, finger extension
o Strength
• Hips
o ROM – abduction, adduction, internal rotation, external rotation, hyperextension
o Strength
• Knees
o ROM – flexion, extension
o Strength
• Ankles
o ROM – flexion, extension
o Strength
• Feet (ROM only) – inversion, eversion
• Vertebral column (ROM only) – flexion, hyperextension, rotation, lateral bending
Analysis: Abnormalities and/or Health Risks
Provide your analysis of actual/potential risks based on the information from the history and physical exam

What do nurses use to assess the musculoskeletal system?

Abdomen and Musculoskeletal Discussion.

This guide provides specific help with details about skills in each system. As you practice these portions of the exam, use
the guide to help you perform them correctly. In addition, use the textbook descriptions and course videos to help you
learn and perform the exam skills.
Equipment: stethoscope
Abdomen (supine, pillow under head, empty bladder)
Inspect and verbalize skin, umbilicus, peristalsis, symmetry, aortic impulse, etc.
Auscultate (stethoscope) all quadrants
Percuss general, all quadrants
Palpate aortic pulse (just to left of umbilicus)
light (all quadrants)
deep (all quadrants)
liver (both hands, instruct to take deep breath)
kidneys (both hands, instruct to take deep breath)
CVA tenderness (can do here if not done already with posterior chest) indirect percussion, both sides
Musculoskeletal

Abdomen and Musculoskeletal Discussion: What are the major steps of a musculoskeletal examination?

Inspect and verbalize muscularity, symmetry, alignment, deformities, edema, redness, etc.
Neck ROM – flexion, hyperextension, rotation, lateral bending
Strength – patient resists pushing on forehead and back of head
Shoulders ROM – abduction, adduction, internal rotation, external rotation
Strength – patient extends arms to sides and resists pushing down and up on arms
Elbows ROM – flexion, extension, pronation, supination
Strength – patient resists flexion and extension
Wrist/hands ROM – wrist flexion, wrist hyperextension, finger flexion, finger extension
Strength – patient resists flexion and hyperextension or hand grasps
Hips ROM – (supine) flexion (knee to chest), abduction, adduction, internal rotation, external rotation
Strength – (supine) patient raises each leg against resistance
ROM – (standing) hyperextension
Knees ROM – flexion, extension
Strength – patient resists flexion and extension
Ankles ROM – flexion, extension
Strength – patient resists flexion and extension
Feet ROM only – inversion, eversion
Vertebral column ROM only (standing) – flexion, hyperextension, rotation, lateral bending