Advanced Assessment Shoulder Anatomy Shoulder Shoulder ...
Advanced Assessment of the Musculoskeletal System By André J. Roy RN, MSNMSN-FNP ONC
Shoulder Anatomy
Advanced Assessment History of Present illness O: Onset L: Location D: Duration C: Character A: Aggravating and associated factors R: Relieving Factors T: Temporal factors S: Severity of symptoms
Shoulder ROM ( see A1) Apley “Scratch” test Quick assessment for ROM. Degenerative Tendonitis
Yergason test To establish the stability of the biceps tendon.
Drop Arm Test Detects rotator cuff injury.
Apprehension test Assessment for anterior/posterior dislocation.
Speed test Indicates Biceps tendinitis
Shoulder… Shoulder …
Elbow Anatomy
Impingement sign (Neer) Assessment for Overuse injury to the Supraspinatus or Biceps Tendon
Empty can test Rotator cuff injury, impingement
Mazion’s shoulder maneuver Adhesive capsulitis, dislocation, and rotator cuff injury
Dawbarn’s sign Subacromial bursitis
1
Elbow
Hip Anatomy
Test For Ligamentous stability To test for medial/lateral collateral ligaments
Tinel sign Can be used to test for a neuroma. neuroma. Ulnar nerve entrapment.
Tennis elbow test To determine lateral epicondylitis. epicondylitis.
Golfer’s elbow To determine medial epicondylitis. epicondylitis.
Pinch sign (OK) To determine Anterior Interosseous Nerve entrapment
Hip Thomas Test Specific for hip flexion contracture
Ober Test Test for contracture of the iliotibial band
Trendelenburg Test Test is designed to evaluate the strength of the gluteus medius muscle
True leg length discrepancy
Hip Gauvain’s Sign Assessment for Tuberculous Arthritis or AdultAdultOnset Osteonecrosis of the Femoral Head
Patrick’s Test Assessment for Intracapsular Coxa Pathologic Conditions
To determine the true leg length
Knee
Knee Anatomy McMurray Test
To assess for a probable Meniscal tear
Apley’s compression and distraction Tests To aid in the detection of a Meniscal tear
Bounce Home Test Assessment for Meniscal tear
Childress Duck Waddle Test Assessment for Medial or Lateral Meniscus tear
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Knee Distraction Test To aid in distinguishing between meniscal and ligamentous problems
Patella Apprehension (Fairbank test) To detect subluxation or Medial retinaculum injury
Patella Grind Assessment for Patellofemoral pathology
Patella Ballottement Test Assessment for Joint Effusion
Knee Ligament Stability Tests ж Valgus Stress: MCL/PCL/posterior capsule injury ж Varus Stress: LCL/PCL? Posterior capsule injury ж Lachman: ACL injury ж anterior drawer: ACL injury ж Posterior drawer: PCL injury ж Posterior sag: PCL injury ж Pivot shift: AnteroLateral Rotary Instability (ALRI) ж Reverse Pivot shift: PosterioLateral Rotary Instability (PLRI) ж Slocum: a)ER: AnteroMedial Rotary Instability b)IR: AnteroLateral Rotary Instability, ACL injury ж Posterior LateralDrawer: PLRI, PCL ж Posterior Medial drawer: PMRI, PCL
References Conklin, K., Watrous, J. (Ed.). (2002). Instant access to orthopedic physical assessment. St. Louis, Missouri: Mosby, Inc. Hoppenfeld, S. (Ed.). (1976). Physical examination of the spine & extremities. Norwalk, Connecticut: Appleton & Lange. Seidel, H. M., Ball, J. W., Dains, J. E., & Benedict, W. G. (Eds.). (2003). Mosby's guide to physical examination (5th ed.). St. Louis, Missouri: Mosby. Thompson, J. C. (Ed.). (2004). Netter's concise atlas of orthopaedic anatomy (1st ed.). Teterboro, N.J.: Icon Learning Systems LLC.
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Shoulder Anatomy
Advanced Assessment History of Present illness O: Onset L: Location D: Duration C: Character A: Aggravating and associated factors R: Relieving Factors T: Temporal factors S: Severity of symptoms
Shoulder ROM ( see A1) Apley “Scratch” test Quick assessment for ROM. Degenerative Tendonitis
Yergason test To establish the stability of the biceps tendon.
Drop Arm Test Detects rotator cuff injury.
Apprehension test Assessment for anterior/posterior dislocation.
Speed test Indicates Biceps tendinitis
Shoulder… Shoulder …
Elbow Anatomy
Impingement sign (Neer) Assessment for Overuse injury to the Supraspinatus or Biceps Tendon
Empty can test Rotator cuff injury, impingement
Mazion’s shoulder maneuver Adhesive capsulitis, dislocation, and rotator cuff injury
Dawbarn’s sign Subacromial bursitis
1
Elbow
Hip Anatomy
Test For Ligamentous stability To test for medial/lateral collateral ligaments
Tinel sign Can be used to test for a neuroma. neuroma. Ulnar nerve entrapment.
Tennis elbow test To determine lateral epicondylitis. epicondylitis.
Golfer’s elbow To determine medial epicondylitis. epicondylitis.
Pinch sign (OK) To determine Anterior Interosseous Nerve entrapment
Hip Thomas Test Specific for hip flexion contracture
Ober Test Test for contracture of the iliotibial band
Trendelenburg Test Test is designed to evaluate the strength of the gluteus medius muscle
True leg length discrepancy
Hip Gauvain’s Sign Assessment for Tuberculous Arthritis or AdultAdultOnset Osteonecrosis of the Femoral Head
Patrick’s Test Assessment for Intracapsular Coxa Pathologic Conditions
To determine the true leg length
Knee
Knee Anatomy McMurray Test
To assess for a probable Meniscal tear
Apley’s compression and distraction Tests To aid in the detection of a Meniscal tear
Bounce Home Test Assessment for Meniscal tear
Childress Duck Waddle Test Assessment for Medial or Lateral Meniscus tear
2
Knee Distraction Test To aid in distinguishing between meniscal and ligamentous problems
Patella Apprehension (Fairbank test) To detect subluxation or Medial retinaculum injury
Patella Grind Assessment for Patellofemoral pathology
Patella Ballottement Test Assessment for Joint Effusion
Knee Ligament Stability Tests ж Valgus Stress: MCL/PCL/posterior capsule injury ж Varus Stress: LCL/PCL? Posterior capsule injury ж Lachman: ACL injury ж anterior drawer: ACL injury ж Posterior drawer: PCL injury ж Posterior sag: PCL injury ж Pivot shift: AnteroLateral Rotary Instability (ALRI) ж Reverse Pivot shift: PosterioLateral Rotary Instability (PLRI) ж Slocum: a)ER: AnteroMedial Rotary Instability b)IR: AnteroLateral Rotary Instability, ACL injury ж Posterior LateralDrawer: PLRI, PCL ж Posterior Medial drawer: PMRI, PCL
References Conklin, K., Watrous, J. (Ed.). (2002). Instant access to orthopedic physical assessment. St. Louis, Missouri: Mosby, Inc. Hoppenfeld, S. (Ed.). (1976). Physical examination of the spine & extremities. Norwalk, Connecticut: Appleton & Lange. Seidel, H. M., Ball, J. W., Dains, J. E., & Benedict, W. G. (Eds.). (2003). Mosby's guide to physical examination (5th ed.). St. Louis, Missouri: Mosby. Thompson, J. C. (Ed.). (2004). Netter's concise atlas of orthopaedic anatomy (1st ed.). Teterboro, N.J.: Icon Learning Systems LLC.
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