{"id":1152,"date":"2022-09-19T09:26:41","date_gmt":"2022-09-19T13:26:41","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/brief-scan-msk-system\/"},"modified":"2026-02-02T13:06:02","modified_gmt":"2026-02-02T18:06:02","slug":"brief-scan-msk-system","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/brief-scan-msk-system\/","title":{"raw":"Brief Scan: MSK System","rendered":"Brief Scan: MSK System"},"content":{"raw":"<span style=\"color: #000000\">A brief scan provides a <strong>quick overview<\/strong> of the MSK system. It can be performed when the client enters the room. Your observations provide insight into how the client may need to be supported during the assessment, ways you may need to modify the assessment, and cues that require further investigation.<\/span>\r\n\r\n<span style=\"color: #000000\"><strong>Steps involved in the brief scan<\/strong> are:<\/span>\r\n<ol>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Assess the type of <strong>footwear<\/strong> and the presence of <strong>[pb_glossary id=\"1508\"]prosthetics[\/pb_glossary]<\/strong> and <strong>mobility aids<\/strong> such as canes, walkers, braces, splints, or wheelchairs.<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">If aids are present, you should ask further questions. You need to understand the need for the aid and should assess whether it is being used properly.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Assess the client\u2019s <strong>posture<\/strong> and <strong>balance<\/strong> when they enter the room and their ability to sit or stand upright and maintain this position.\u00a0\u00a0<\/span>\r\n<ul>\r\n \t<li><span style=\"color: #000000\">Normal findings may include an upright posture and no issues with balance.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings may include hunched over, unequal weight bearing, and lateral lean.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Assess for the presence of <strong>[pb_glossary id=\"1510\"]tremors[\/pb_glossary] or obvious deformities<\/strong>.\u00a0<\/span>\r\n<ul>\r\n \t<li><span style=\"color: #000000\">Normal findings include no tremors or deformities.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings may include deformities, which could include fractures, or unilateral or bilateral tremors in head\/neck region, upper or lower limbs.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Assess the client\u2019s <strong>symmetry of limbs<\/strong> in terms of length and [pb_glossary id=\"1266\"]gait[\/pb_glossary]. This can be done informally when the client walks in the room from the waiting room. Otherwise, you can ask them to walk about 10 feet. This may not be required if a client is in a wheelchair, particularly if they are unable to stand up.<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normally, limbs are symmetrical, and gait is balanced. <\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings include asymmetrical limbs and difficulties with balance. Cues of asymmetry and a gait that is not balanced should be probed further.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Note the<strong> findings<\/strong>.<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normal findings might be documented as: \u201cClient\u2019s body is symmetrical, no deformities, posture straight, steady gait and balance. No mobility aids used.\u201d<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings might be documented as: \u201cClient has a slow and unsteady gait. Left arm hangs lower than the right arm.\u201d<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>\r\n<div class=\"textbox shaded\">\r\n<h2 style=\"text-align: center\"><span style=\"color: #000000\"><strong>Contextualizing Inclusivity<\/strong><\/span><\/h2>\r\n<span style=\"color: #000000\">Use a <strong>person-centred<\/strong> and <strong>systematic approach<\/strong> to assessment. The initial MSK brief scan will help guide your questioning and facilitate a <strong>non-discriminatory<\/strong>,<strong> anti-ableist<\/strong> assessment. For example, if a client uses a mobility aid, always ask for permission\/consent to touch or handle the equipment.<\/span>\r\n\r\n<\/div>\r\n<div align=\"left\">\r\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<h2 class=\"textbox__title\" style=\"text-align: center\"><strong>Priorities of Care<\/strong><\/h2>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\n<span style=\"color: #000000\">During the brief scan, any <strong>fractures <\/strong>or <strong>suspected fractures<\/strong> should take priority. The fracture may have caused internal damage that is not visible upon inspection, such as a punctured lung, severed cranial nerve, perforated organ, bone fragments, or vascular or peripheral nerve damage. <\/span>\r\n\r\n<span style=\"color: #000000\">A <strong>primary survey<\/strong> approach should be performed before beginning a focused MSK assessment. If there are no life-threatening injuries, you can begin the MSK assessment. <strong>Safety<\/strong> should be prioritized, including prevention of falls when assessing a client\u2019s movement, balance, strength, and gait.<\/span>\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>","rendered":"<p><span style=\"color: #000000\">A brief scan provides a <strong>quick overview<\/strong> of the MSK system. It can be performed when the client enters the room. Your observations provide insight into how the client may need to be supported during the assessment, ways you may need to modify the assessment, and cues that require further investigation.<\/span><\/p>\n<p><span style=\"color: #000000\"><strong>Steps involved in the brief scan<\/strong> are:<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Assess the type of <strong>footwear<\/strong> and the presence of <strong><button class=\"glossary-term\" aria-describedby=\"1152-1508\">prosthetics<\/button><\/strong> and <strong>mobility aids<\/strong> such as canes, walkers, braces, splints, or wheelchairs.<\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">If aids are present, you should ask further questions. You need to understand the need for the aid and should assess whether it is being used properly.<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Assess the client\u2019s <strong>posture<\/strong> and <strong>balance<\/strong> when they enter the room and their ability to sit or stand upright and maintain this position.\u00a0\u00a0<\/span>\n<ul>\n<li><span style=\"color: #000000\">Normal findings may include an upright posture and no issues with balance.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings may include hunched over, unequal weight bearing, and lateral lean.<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Assess for the presence of <strong><button class=\"glossary-term\" aria-describedby=\"1152-1510\">tremors<\/button> or obvious deformities<\/strong>.\u00a0<\/span>\n<ul>\n<li><span style=\"color: #000000\">Normal findings include no tremors or deformities.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings may include deformities, which could include fractures, or unilateral or bilateral tremors in head\/neck region, upper or lower limbs.<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Assess the client\u2019s <strong>symmetry of limbs<\/strong> in terms of length and <button class=\"glossary-term\" aria-describedby=\"1152-1266\">gait<\/button>. This can be done informally when the client walks in the room from the waiting room. Otherwise, you can ask them to walk about 10 feet. This may not be required if a client is in a wheelchair, particularly if they are unable to stand up.<\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normally, limbs are symmetrical, and gait is balanced. <\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings include asymmetrical limbs and difficulties with balance. Cues of asymmetry and a gait that is not balanced should be probed further.<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Note the<strong> findings<\/strong>.<\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normal findings might be documented as: \u201cClient\u2019s body is symmetrical, no deformities, posture straight, steady gait and balance. No mobility aids used.\u201d<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings might be documented as: \u201cClient has a slow and unsteady gait. Left arm hangs lower than the right arm.\u201d<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<div class=\"textbox shaded\">\n<h2 style=\"text-align: center\"><span style=\"color: #000000\"><strong>Contextualizing Inclusivity<\/strong><\/span><\/h2>\n<p><span style=\"color: #000000\">Use a <strong>person-centred<\/strong> and <strong>systematic approach<\/strong> to assessment. The initial MSK brief scan will help guide your questioning and facilitate a <strong>non-discriminatory<\/strong>,<strong> anti-ableist<\/strong> assessment. For example, if a client uses a mobility aid, always ask for permission\/consent to touch or handle the equipment.<\/span><\/p>\n<\/div>\n<div style=\"text-align: left;\">\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h2 class=\"textbox__title\" style=\"text-align: center\"><strong>Priorities of Care<\/strong><\/h2>\n<\/header>\n<div class=\"textbox__content\">\n<p><span style=\"color: #000000\">During the brief scan, any <strong>fractures <\/strong>or <strong>suspected fractures<\/strong> should take priority. The fracture may have caused internal damage that is not visible upon inspection, such as a punctured lung, severed cranial nerve, perforated organ, bone fragments, or vascular or peripheral nerve damage. <\/span><\/p>\n<p><span style=\"color: #000000\">A <strong>primary survey<\/strong> approach should be performed before beginning a focused MSK assessment. If there are no life-threatening injuries, you can begin the MSK assessment. <strong>Safety<\/strong> should be prioritized, including prevention of falls when assessing a client\u2019s movement, balance, strength, and gait.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"glossary\"><div class=\"glossary__tooltip\" id=\"1152-1508\" hidden><p>are artificial devices that replace a missing body part such as an artificial limb<\/p>\n<\/div><div class=\"glossary__tooltip\" id=\"1152-1510\" hidden><p>are involuntary rhythmic twitching-like movements.<\/p>\n<\/div><div class=\"glossary__tooltip\" id=\"1152-1266\" hidden><p>refers to balance and movement of limbs while walking.<\/p>\n<\/div><\/div>","protected":false},"author":34,"menu_order":4,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by-nc"},"chapter-type":[],"contributor":[85],"license":[56],"class_list":["post-1152","chapter","type-chapter","status-publish","hentry","contributor-january-2023","license-cc-by-nc"],"part":1139,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/1152","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/users\/34"}],"version-history":[{"count":3,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/1152\/revisions"}],"predecessor-version":[{"id":4008,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/1152\/revisions\/4008"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/parts\/1139"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/1152\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/media?parent=1152"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapter-type?post=1152"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/contributor?post=1152"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/license?post=1152"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}