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General: Preparation, Inspection, Palpation
- Patient in gown or loosely dressed
- ALWAYS begin each joint exam with inspection for asymmetry, deformity, atrophy
- ALWAYS compare each joint and muscle group bilaterally
- Palpate each joint and muscle group in sequence
- Isolate each axis when testing ROM
- Identify 6 cardinal signs of musculoskeletal disease: pain, redness, swelling, warmth, deformity, loss of function
Neck
- Palpate over each spinous process and paraspinous muscle groups
- Measure ROM in 6 axes
Shoulder
- Palpate: clavicle; A/C joint; corocoid process; scapula; glenohumeral joint; long head of biceps
- Measure ROM in 6 axes (active and passive): abduction, adduction, flexion, extension, internal rotation, external rotation
Special Considerations: Shoulder
- Drop arm test
- Impingement sign
Elbow
- Palpate: medial and lateral epicondyles of the humerus, the olecranon, the grooves between the epicondyles and the olecranon
- Assese range of motion for flexion, extension, supination and pronation
Wrist and Hand
- Palpate interphalangeal joints
- Perform ROM (active and passive) of wrist, thumb, and fingers; isolating each axis of motion
- Thumb abduction and opposition
Special Considerations: Wrist and Hand
- Identify and test for tenderness in anatomical snuffbox
- Profundus and Superficialis Tendon tests
Back
- Palpate over each spinous process and paraspinous muscle group
- Palpate sacroiliac joint
- Measure ROM (active) in 6 axes
Special Considerations: Back
- Straight Leg Raises Bilaterally
Hip
- Palpate: Anterior superior iliac spine, inguinal ligament, pubic tubercle
- Palpate: greater trochanter, ischial tuberosity
- Measure ROM (active) in 6 axes
Special Considerations: Hip
- "FABER" (Flexion, ABduction, External Rotation) Test Bilaterally
Knee
- Palpate: distal femur and muscles; medial and lateral joint lines; patella and tendon; patella with movement; tibial tubercle; head of fibula; popliteal fossa
Special Considerations: Knee
- Collateral Ligament Testing
- Lachman's Test
- Drawer Test
- Major and minor effusion tests
Ankle and Foot
- Inspect all surfaces of the foot
- Palpate: tibiotalar joint, achilles tendon, calcaneus, plantar surface, metatarsophalangeal joints, metatarsal heads
- ROM: Dorsiflex and plantarflex at the the tibiotalar joint, invert and evert proximally, invert and evert distally
Strength Testing Against Resistance
- Abduct shoulder
- Flex and extend elbow
- Spread fingers
- Flex hips
- Flex and extend knee
- Dorsiflex and plantarflex ankle
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