Discuss the musculoskeletal assessment

Paper instructions

Discuss the musculoskeletal assessment of the following ages. Be sure to address all three patients. Include history questions to ask and at least 3 pertinent physical exam findings you would assess for each patient. What maneuvers would you perform? What are normal and abnormal findings?


Musculoskeletal Assessment

The musculoskeletal system comprises bones, cartilage, muscles, ligaments, tendons, and joints. It provides body support and stability, and allows locomotion. Musculoskeletal assessment involves various clinical tests depending on the patient’s complaints. However, the assessment tends to vary with age.

A 2 day old infant

Musculoskeletal assessment of a two-day old infant begins with the evaluation of perinatal history. This can be in form of questions pertaining to family history of hereditary abnormalities, mother’s age and gravidity, problems during pregnancy, number of alive and dead siblings, labor and delivery problems, birth weight, HIV status, blood groups, and signs of any clinical problems (Lewis, 2014).

Physical examination involves general inspection (appearance, skin color, and state of nutrition), regional inspection (from head to feet), hip examination, placenta examination, and examination of neurological status (Consolini, 2019). The physical examination can be accompanied by measurements of birth weight, head circumference, gestation age, and skin temperature.

It is important for both normal and abnormal findings of the physical examination measurements to be recorded. For instance, while normal birth weight can range between 2500 and 4000 g, weight that is below 2500 g is abnormal. Normal abdominal wall temperature ranges between 36-36.5 °C. However, if the temperature is below 36 °C, the infant has hypothermia.

7-year-old child

The assessment of a seven-year-old child is different from that of a child. It requires the examination of the child’s history of present illnesses, medical history, family history, and personal and social history (Chiocca, 2019). On present illnesses, it is necessary to ask questions on onset, chronology, frequency, symptoms, and relieving factors. Medical history questions may involve ones asking on recent infections, immunizations received, previous trauma, and medications given. Family history questions include those that generate information on conditions such as diabetes. Personal and social history questions may include those touching on eating habits, physical activities, risk behaviors, and school attendance.

Physical examination of the child entails inspection of the apparent heath state, condition of distress, and status of nutrition (Chiocca, 2019; Gawlik et al., 2021). The inspection can be followed by the observation of posture, gait and mobility, and signs of fever, redness and swellings. Palpation may be conducted to determine tenderness, tendon function, and stability of ligaments (Gawlik et al., 2021). Just like in the case of infants, there is need to separate abnormal findings of the physical examination from the normal findings.  For example, high fever, swellings, redness, bone tenderness, and reduced mobility are all signs of abnormal musculoskeletal system. In contrast, good posture, absence of swellings, and good locomotion are signs of normal health of the system.

65-year-old patient

The musculoskeletal assessment of a 65-year-old patient also involves both history and physical examinations. Evaluating the history of such a patient may take time due to cognitive impairment associate with old age. In getting details about patient history, it is vital to emphasize on questions based on functional status, medications given, review of systems (cardiovascular illnesses, weight change, sleep patterns, falls, dizziness, sensory impairment, and depression), social history (lifestyles, values, and cultural factors), and nutritional history (Chandrashekara, 2015; Minetto et al., 2020).

On its part, the physical examination of the elderly patient involves making general observations (appearance, hygiene, and weight), checking for vital signs (blood pressure, pulse rate, and nutritional status), HEENT examination (scalp, pupils, tympanic membrane, nostrils, and oral cavity membrane), neck examination, abdomen examination, pelvic assessment, and neurological assessment (Minetto et al., 2020). In carrying out the examinations, it is necessary to look for deformities, swellings and rashes, feel for temperature and tenderness, and carry out functional assessment of the joints to determine muscle stability.

During physical examination, normal and abnormal clinical findings need to be recorded as well. For instance, abnormal musculoskeletal system is characterized by overweight, high blood pressure, malnutrition, deformed scalp, ruptured tympanic membrane, discharge from nose, stiff neck, rashes, and swellings. On the other hand, normal musculoskeletal system is associated with normal weight, healthy nutritional habits, round and equal pupils, normal tympanic membrane, and flexible neck.


Chandrashekara, S. (2015). Managing Elderly Patients with Musculoskeletal Disorders Warrants a Different Approach. IJRCI., 3(1): E1. Retrieved from https://www.chanrejournals.com/index.php/rheumatology/article/view/167/html

Chiocca, E. M. (2019). Advanced Pediatric Assessment. New York: Springer Publishing.

Consolini, D. M. (2019). Physical Examination of the Newborn. Retrieved from https://www.merckmanuals.com/home/children-s-health-issues/care-of-newborns-and-infants/physical-examination-of-the-newborn

Gawlik, K., Melnyk, B. M., & Teall, A. M. (2021). Evidence-Based Physical Examination: Best Practices for Health and Well-Being Assessment. New York, NY: Springer Publishing Company.

Lewis, M. L. (2014). A Comprehensive Newborn Examination: Part II. Skin, Trunk, Extremities, Neurologic. Am Fam Physician., 90 (5): 297-302. Retrieved from https://www.aafp.org/afp/2014/0901/p289.html

Minetto, M. A., Giannini, A., McConnell, R., Buso, C., Torre, G. & Massazza, G. (2020). Common Musculoskeletal Disorders in the Elderly: The Star Triad.  J. Clin. Med., 9 (4): 1216 https://doi.org/10.3390/jcm9041216

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