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Musculoskeletal Exam

Musculoskeletal Exam. The basic screening musculoskeletal examination involves inspection, palpation, and range of motion. Muscular strength is covered under the motor exam in the neurological exam.

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Musculoskeletal Exam

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  1. Musculoskeletal Exam The basic screening musculoskeletal examination involves inspection, palpation, and range of motion. Muscular strength is covered under the motor exam in the neurological exam. The musculoskeltal examination may be divided into spine, upper extremities, and lower extremities. Besides the basic screening exam there are many special maneuvers when examining a patient with musculoskeletal complaints.

  2. 196. Inspection of cervical, thoracic, and lumbar spine

  3. 197. Percussion of cervical, thoracic, lumbar and sacral vertebrae

  4. 198. Cervical spine: flexion and extension (be sure full extension is done) may be done from front or back, +/- palpate

  5. 200.Cervical spine Rotary movement, left and right, palpate

  6. 201. Lumbar spine: flexion and extension (be sure full extension is done), +/- palpate

  7. 202. Lumbar spine: lateral movement, left and right, OK from front or back, +/- palpate 203. Lumbar spine: rotary movement, left and right, OK from front or back, +/- palpate

  8. The Shoulder Areas to palpate in a more thorough exam of the shoulder.  Sternoclavicular joint  Acromioclavicular joint  Clavicle  Scapulae  Coracoid process  Greater trochanter of the humerus  Bicepts groove The area muscles

  9. 204. Shoulders: arms over head207. Note: Shoulders: palpation during maneuvers (not over gown)

  10. 205. Shoulders: hands behind head

  11. 206. Shoulders: hands behind small of back

  12. 208. Elbows: flexion and extension (be sure full extension is done)

  13. 209. Elbows: palpation of elbowsPalpate: Medial and lateral epichondyles; Olecranon process

  14. 210. Wrists: flexion and extension211. Wrists: radial and ulnar deviation

  15. 212. Wrists--Palpations of Wrist Palpate - •Distal radius and ulna • Groove of joint • Anatomic snuff box

  16. 213. Hands: bilateral fists/grip, extend/hyperextend fingers

  17. 214: Hands: palpation of metacarpalphalangeal joints215: Hands: palpation of IPJs (PIP and DIP joints)

  18. Hip Joint

  19. Note draping of sheet 216. Hips: flexion (be sure full flexion is done and bilaterally)

  20. 217. Hips: internal and external rotation (hip at 900 and knee at 900 rotate on axis of femur)

  21. 218. Hips: abduction (away from the body with hip and knee at 0 degrees)

  22. The Knee

  23. 219. Knees: flexion and extension (may do with hip flexion) (be sure full extension is done)

  24. 220. Palpation of Knees Palpate •Patella • Patellar tendon • Tibial tuburosisty • Medial and lateral joint lines

  25. 221. Ankles: Dorsi and plantar flexion

  26. 222. Ankles: Inversion, eversion of foot (stabilize at ankle and invert and evert by heel) subtalar joint

  27. 223. Ankles inversion eversion of foot (stabilize at heel and invert and evert by forefoot) transverse tarsal joint

  28. Palpate: Anterior aspect of joint Achilles tendon Medial and lateral malleoli Ankles: palpation of ankle

  29. 225. Feet Palpation of metatarsophalangeal joints (may put pressure across foot from the 1st to the 5th metatarsals)

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