Musculoskeletal exam

Сентябрь 16, 2022

Главная
Медицина
Musculoskeletal exam

Содержание

2. Things you must Do Is the pain worse on weight bearing? Is the worst pain and
3. Make the patient focus!
4. How not to write your history
5. RECORDING THE EXAM In the real world-”BJM are normal”or “all joints:ROM intact” Can use either a
6. BONDING “Our hands are central to our psychology as they continually switch between executive, exploratory and
7. UPPER BODY Nails
11. UPPER BODY Nails Palms, Hands…….. Grip strength and “ knuckle sign” are very helpful.
12. Depression
13. More or less susceptible to myocardial infarction?
14. Heberden’s Nodes
15. Bouchard’s Nodes
16. Clue to an infectious arthritis
18. Palmar Erythema
19. telangiectasia
20. Double Jointed
21. This Patient should stop what?
22. What are the yellow nodules?
23. What drug should this patient have been on?
24. Synovitis
25. Rheumatoid arthritis
27. UPPER BODY Nails Palms, Hands…….. Grip strength and “ knuckle sign” are very helpful. Do a
28. What is this?
29. UPPER BODY Nails Palms, Hands…….. Grip strength and “ knuckle sign” are very helpful. Do a
32. UPPER BODY Cervical Spine and ……..don’t forget the TMJ! Shoulders
33. Quick Assessment of Shoulder Function If the pt can abduct, elevate the arm above the head
34. WHAT MEDI- CATION IS SHE TAKING?
35. A SLIGHTLY HIGHER YIELD THAN SPINAL PERCUSSION
36. DOES THIS MAN HAVE HEART DISEASE?
37. LOWER BODY Skin
38. ERYTHEMA MIGRANS
39. ERYTHEMA NODOSUM
40. LOWER BODY Skin Feet- MTPs are sentinel joints for inflammatory arthritis Ankle
41. Podagra
42. Psoriasis
43. LOWER BODY Knee flexion extension patello/femoral clicking don’t forget the anserine bursa
44. WHAT IS THE ANSERINE BURSA? VERY COMMONLY MISSED SOURCE OF “KNEE” PAIN Worst at night and
45. LOWER BODY Skin Feet Ankle Knee Hip internal/external ROM while knee flexed
46. TERMS/SYNDROMES Arthralgia/arthritis Myalgia Baker’s cyst Ganglion cyst Medial and lateral epicondylitis Patello-femoral syndrome Hypermobility syndrome
47. The End
49. Скачать презентацию

Слайд 2

Things you must Do
Is the pain worse on weight bearing?
Is the

worst pain and stiffness present upon arising?
What drugs have you tried, what dose and what happened?
Always do bilateral assessments of joints

Слайд 3

Make the patient focus!

Слайд 4

How not to write your history

Слайд 5

RECORDING THE EXAM
In the real world-”BJM are normal”or “all joints:ROM intact”
Can

use either a table format or Stick diagram/template
STL system is 0-4 with 4 being the worst possible and 0 is normal
Worst is maximal swelling, severe tenderness and complete loss of motion
Simply state whether fluid is present or not

Слайд 6

BONDING
“Our hands are central to our psychology as they continually switch

between executive, exploratory and expressive activity”

Слайд 7

UPPER BODY
Nails

Слайд 8

Слайд 9

Слайд 10

Слайд 11

UPPER BODY
Nails
Palms, Hands…….. Grip strength and “ knuckle sign” are very

helpful.

Слайд 12

Depression

Слайд 13

More or less susceptible to myocardial infarction?

Слайд 14

Heberden’s Nodes

Слайд 15

Bouchard’s Nodes

Слайд 16

Clue to an infectious arthritis

Слайд 17

Слайд 18

Palmar Erythema

Слайд 19

telangiectasia

Слайд 20

Double Jointed

Слайд 21

This Patient should stop what?

Слайд 22

What are the yellow nodules?

Слайд 23

What drug should this patient have been on?

Слайд 24

Synovitis

Слайд 25

Rheumatoid arthritis

Слайд 26

Слайд 27

UPPER BODY
Nails
Palms, Hands…….. Grip strength and “ knuckle sign” are very

helpful.
Do a Tinel’s sign while you are there
Arms- slide hand along ulna for nodules

Слайд 28

What is this?

Слайд 29

UPPER BODY
Nails
Palms, Hands…….. Grip strength and “ knuckle sign” are very

helpful.
Do a Tinel’s sign while you are there
Arms- slide hand along ulna for nodules
Elbow-synovial thickening at ulnar groove and epitroclear nodes are the “S4s” of the rheumatology consult!
Olecranon bursal effusions are likely when elbow has full ROM

Слайд 30

Слайд 31

Слайд 32

UPPER BODY
Cervical Spine and ……..don’t forget the TMJ!
Shoulders

Слайд 33

Quick Assessment of Shoulder Function
If the pt can abduct, elevate the

arm above the head and touch the contralateral shoulder-then re-elevate and by reverse motion to touch the L-S spine..it is highly unlikely there is significant pathology present.
Rotator Cuff assessment: by history there will be inability/pain on abducting arm >90o and by PX pain on internal /external rotation at 90o
Pt may also have + beer can sign
If there is abnormal and/or pain upon motion of the humerus in the A-P dimension, pathology is in the G-H joint

Слайд 34