Upper Extremities Examination
63
Nadhilla Nurayu Lathifa Medical Faculty Trisakti University RSUD Bekasi [email protected] UPPER EXTREMITIES EXAMINATION
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Transcript of Upper Extremities Examination
Nadhilla Nurayu LathifaMedical Faculty Trisakti UniversityRSUD [email protected]
UPPER EXTREMITIES EXAMINATION
05/03/2023 [email protected] 2
History InspectionPalpationRange of Motion (ROM)Muscular and Neurological Assessment
GENERAL APPROACH
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An accurate history is essentialHow symptomp started? (mechanism of injury)Duration of onset?Locaton, nature of pain, and symptomps?Alleviate or aggregavate maneuveres?
HISTORY
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Observe how the patient moves as they go into the room or move from chair to table
General AppearanceBody Proportions
GENERAL INSPECTION
05/03/2023 [email protected] 5
Look for assymetry between sidesSwellingDeformitiesAtrophyErythema
INSPECTION OF SPECIFIC AREA
05/03/2023 [email protected] 8
Know the anatomy of the structure before palpatingWarmth, skin temperatureSoft tissue Swelling or joint effussionBones Evaluating location of tenderness, abnormalities
compared to other side
PALPATION
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Range the JointsDecreased / increased movement?Watch for swelling, pain, stiffness, weakness in
movementListen for crepitus or “popping”Watch for abnormal movementNote: quality of movement, crepitus, painful range,
looseness or excessive range
RANGE OF MOTION (ACTIVE)
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Range the joint passively, compare to the active points
Note any decreased / increased movementPain with the movementAny crepitus or popping?
RANGE OF MOTION (PASSIVE)
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Neer's sign (forward flexion/internal rotation) for subacromial impingement
SPECIAL TEST - SHOULDER
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Hawkin's sign (90° abduction and 45° of horizontal adduction, then humeral internal rotation) for sub- acromial impingement.
SPECIAL TEST - SHOULDER
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Swelling or deformitiesFlexion, extensionUlnar & radial deviation of the wrist?
INSPECTION
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Determine stability of joint by examining for abnormal mobility
Testing integrity of ligaments and articular surface
Mild : minimal fibres torn, stability OKModerate : partial tear, some loss of stabilitySevere : complete rupture, unstable joint
LIGAMENT STRESS TESTING
