Joints Flashcards
(28 cards)
SHOULDER JOINT
look - front
head and neck posture
symmetry of shoulders
shoulder girdle alignment
deltoid wasting
scars
SHOULDER JOINT
look - side
scars
SHOULDER JOINT
look - back
trapezius wasting
paravertebral muscle wasting
scoliosis
winged scapula
shoulder girdle alignment
deltoid wasting
scars
SHOULDER JOINT
what happens after looking at front, side, and back?
inspect for winged scapula - long thoracic nerve injury
SHOULDER JOINT
what to feel on the front?
joint temperature bilaterally
shoulder girdle:
sternoclavicular joint
acromioclavicular joint
acromion
coracoid process
clavicle
head of humerus
greater tuberosity of humerus
repeat on other shoulder
SHOULDER JOINT
what to feel on the back?
borders and spine of scapula
SHOULDER JOINT
movements?
compound:
- shoulder abd and ext rotation with elbow flexion
- shoulder int rotation
active:
- shoulder flexion/extension
- shoulder abduction/adduction
- shoulder int/ext rotation
- degree and smoothness of scapular movement
passive: same as active (feel for crepitus)
SHOULDER JOINT
normal angle: shoulder flexion?
150-180
SHOULDER JOINT
normal angle: shoulder extension?
~40
SHOULDER JOINT
normal angle: shoulder abduction
up to 180
SHOULDER JOINT
normal angle: shoudler adduction
30-40
SHOULDER JOINT
normal angle: ext rotation
80-90
SHOULDER JOINT
normal angle: int rotation
80-90
SHOULDER JOINT
normal angle: int rotation
80-90
SHOULDER JOINT
special tests?
empty can - weakness/impingment of supraspinatus
painful arc - impingement of supraspinatus
ext rotation against resistance - tendonitis or tear of infraspinatus
int rotation against resistance - tendonitis or tear of subscapularis
SHOULDER JOINT
how to complete exam?
examine joint above - cspine
examine joint below - elbow
assess nv status of both upper limbs
look at any available xrays
HAND AND WRIST JOINT
what are you looking for?
scars/swelling
deformities
skin and nail changes
muscle wasting
palmar:
dupuytren’s
thenar/hypothenar wasting
elbow:
psoriatic plaques
rheumatoid nodules
HAND AND WRIST JOINT
feeling?
temp
pulse - radial and ulnar
hypothenar and thenar + palmar fascia
sensation - median and ulnar
turn over hands
sensation - radius
temperature
squeeze MCP joints
bimanually palpate each joint
anatomical snuffbox
medial border of upper arm
HAND AND WRIST JOINT
what to do when doing the MCP joint squeeze?
observe any signs of pain or discomfort
HAND AND WRIST JOINT
what to do when bimanually palpating each joint?
check for tenderness or asymmetry
HAND AND WRIST JOINT
order of bimanual joint palpation?
MCP
PIP
DIP
thumb
wrist
HAND AND WRIST JOINT
movements?
passive hand flexion/extension
passive wrist hyperextension/hyeprflexion
active extension and flexion
resisted:
- resisted finger adduction/extension
- resisted thumb abduction
HAND AND WRIST JOINT
special tests?
power grip
pincher
pick up small item
tinel’s
phalen’s
SHOULDER JOINT
what does intact ext rotation suggest?
infrapinsatus and teres minor are intact
