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DeGowin's Diagnostic Examination, 9e
Physical Examination of the Spine and Extremities
Sections: Examination of the Axial Skeleton: Spine and Pelvis, Examination of the Cervical Spine, General Examination of the Thoracolumbar Spine and Pelvis, Schober test for lumbar flexion, Additional exams for herniated disk, Testing the SI joint, Low back pain—Magnuson pointing test for malingering, Examination of the Appendicular Skeleton Including Joints, Ligaments, Tendons, and Soft Tissues, General Examination of Joints, The Upper Limb, Examination of the Hand, Functional tests of fingers, Examination of the Wrist, Examination of the Forearm, Examination of the Elbow, Examination of the Shoulder, Inspection and palpation of the shoulder joint, Measurements of shoulder motion, Testing mobility of the shoulder, Auscultation of bony conduction through the shoulder, The Lower Limb, Examination of the Hip and Thigh, Sites of pain, Begin the examination with the patient standing, Lateral tilting of the pelvis, Test for rotation with extension, Test for rotation with flexion, Test for abduction, Test for adduction, Test for hip flexion contracture, The anvil test, Direction palpation of the hip joint, Patrick (FABER) test, Test for extension, Measurement of the lower limbs, Examination of the Knee, General examination of the knee, Examination for knee effusion, Examination of the knee ligaments, Examination of the Injured Knee, Testing for meniscus injury, Examination of the Ankle Joint, Examination of the Foot, Examination for flatfoot, Muscle Examination, Brief Examination for Skeletal Injuries.
Topics Discussed: achilles tendon rupture; adduction test; ankle joint; apley test response; arm; carpal bones; cervical spine; clavicle fractures; elbow region; examination of hand; examination of knee joint; facial fracture; fingers; flatfoot; foot; foot fractures; forearm; forearm fractures; hand; hand fractures; herniated disc; hip examination; hip joint; hip region; humeral fractures; joints; knee injuries; knee instability; knee joint; knee joint effusion; knee ligament; knee region; lachman's test; leg; leg bones; leg length inequality; limb; limb fractures, lower; malingering; mcmurray test response; modified schober test; musculoskeletal injuries; musculoskeletal system; neck injuries; passive range of hip abduction; patrick's test; pelvis; pelvis fractures; rib fractures; sacroiliac joint; scapula; scoliosis; shoulder joint; shoulder region; skeletal injury; skull fractures; spinal fractures; spine; supraspinatus tear; thigh; thoracolumbar spine; thumb; upper extremity bones; wrist.
Excerpt:"Because the examination must integrate the observations of bones, joints, and muscles, most clinicians examine anatomic regions in a sequence dictated by convenience for the doctor and patient, rather than examining each component sequentially. This also requires constant cross-referencing to the nervous and peripheral vascular systems.In the absence of acute trauma, examine the patient in the seated position viewing the neck from the front, sides, and back for deformities and unusual posture. Have the patient point to the site of pain. Test active motions of the neck with the instructions: "chin to chest," "chin to right and left shoulder," "ear to right and left shoulder," and "head back." With the flat of the hand, palpate the paravertebral muscles for muscle spasm, tender points or trigger points. Palpate and percuss the spinous processes for tenderness.With patient standing erect, heels together, place a mark on the spine at the lumbosacral junction (the L5 spinous process or the point where a horizontal line between the posterior superior iliac spines intersects the spine). Have the patient bend forward maximally, trying to touch the fingers to the toes. Normally, the distance between the marks increases..."
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