2. Assess this system while bathing or
positioning
Focus on range of joint motion, muscle
strength, tone, joint & muscle condition
Muscular disorders may result from
neurological disease
Simultaneous muscular & neurological
examination
3. Visualize : Bone anatomy, muscle
placement & joint structure
Assess the degree of mobility
Provide proper position while
examination
4. Nursing History
Determine involvement in competitive
sports
H/o alcohol or caffeine use, cigarette
smoking, constant dieting
Menopause before age 45, estrogen
deficiency
Family H/o osteoporosis
Chronic diseases
5. Cont…
History of problems in bone, muscle or
joint function
Nature and extent of pain
Normal activity pattern
Height loss in women over age 50
6. Inspection
Observe client’s gait
Note: how client walks, sits & rises from a
sitting position
Note foot dragging, limping, shuffling &
position of legs in relation to trunk
Observe client in standing position
Note common postural abnormalities
7. Cont…
Check for kyphosis, lordosis & scoliosis
Assess for signs of osteoporosis
Extremities: overall size, gross deformity,
bony enlargement, alignment &
symmetry
8. Palpation
Gentle palpation : bones, joints,
surrounding muscles
Note heat, tenderness, edema or
resistance to pressure
During palpation: no discomfort to client
Muscles should be firm
10. Range of motion
Includes both active & passive ROM
Put each major joint through active and
passive full ROM
Demonstrate and instruct the client
13. Muscle tone and strength
Check for hypertonicity & hypotonicity
In case of pain: support the extremity
Slight resistance can be there
Compare symmetrical muscle pairs
14. Maneuvers to assess muscle
strength
Neck (sternocleidomastoid muscle)
Place hand firmly against client’s upper jaw
& ask the client to turn the head laterally
against resistance
15. Cont..
Shoulder (trapezius)
Place hand over midline of client’s shoulder
exerting firm pressure. Have the client to
raise shoulder against resistance
16. Cont…
Elbow
◦ Biceps : pull down on forearm as client
attempts to flex arm
◦ Triceps : as you flex client’s arm, apply
pressure against forearm. Ask client to
straighten the arm
17. Cont..
Hip
◦ Quadriceps : when client is sitting, apply
downward pressure to thigh.Ask client to
raise leg up from table
◦ Gastrocnemius : client sits, while examiner
holds shin of flexed leg.Ask client to
straighten leg against resistance
18. Muscle strength
Muscle function
level
Grade % Normal Lovett scale
No evidence of
contractility
0 0 0(zero)
Slight contractility, no
movement
1 10 T(trace)
Full range of motion,
gravity eliminated
2 25 P(poor)
Full range of motion
with gravity
3 50 F(fair)
Full range of motion
against gravity, some
resistance
4 75 G(good)
Full range of motion
against gravity, full
resistance
5 100 N(normal)