RN Nursing · Musculoskeletal and Neurologic Systems · Practice question
A nurse in a provider's office is preparing to assess a young adult client's musculoskeletal system as part of a comprehensive physical examination. Which of the following findings should the nurse expect? (Select all that apply)
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Concave thoracic spine posteriorly
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Exaggerated thoracic curvature
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Exaggerated lumbar curvature
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Concave lumbar spine posteriorly
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Muscles slightly larger on the dominant side
Answer & explanation
Correct: Concave thoracic spine posteriorly · Concave lumbar spine posteriorly · Muscles slightly larger on the dominant side
In a healthy young adult, the normal spinal curvatures include a concave thoracic spine when viewed from the posterior (the thoracic region curves inward relative to the back, creating a kyphotic arc that is concave posteriorly), a concave lumbar spine posteriorly (the lumbar region has a lordotic curve that is concave when viewed from behind), and muscles that are slightly larger on the dominant side due to greater use and muscle development. These three findings represent expected normal variants in the young adult musculoskeletal assessment. An exaggerated thoracic curvature describes kyphosis, which is an abnormal finding associated with aging, osteoporosis, or postural dysfunction — not expected in a healthy young adult. An exaggerated lumbar curvature describes lordosis, which is also an abnormal finding that can result from obesity, pregnancy, or structural abnormalities. Students often confuse the normal concave posterior curvatures with pathological exaggerations; the key distinction is that normal curvatures are gentle and balanced, while exaggerated curves indicate musculoskeletal pathology. Muscle asymmetry with slight dominance-side enlargement is a normal, expected finding and does not indicate pathology unless the asymmetry is pronounced or accompanied by other signs.
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