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Nadhi l l a Nurayu Lathi fa

Medi cal Facul ty Tri sakti Uni versi ty


RSUD Bekasi
Thi fa_qq@yahoo. com
UPPER EXTREMITIES
EXAMINATION
Hi story
Inspection
Pal pation
Range of Moti on (ROM)
Muscular and Neurol ogical Assessment
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GENERAL APPROACH
An accurate hi story i s essential
How symptomp started? (mechani sm of i nj ury)
Durati on of onset?
Locaton, nature of pai n, and symptomps?
Al l eviate or aggregavate maneuveres?

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HISTORY
Observe how the pati ent moves as they go i nto the room or
move from chai r to tabl e
General Appearance
Body Proporti ons
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GENERAL INSPECTION
Look for assymetry between si des
Swel ling
Deformi ties
Atrophy
Erythema
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INSPECTION OF SPECIFIC AREA
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INSPECTION
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INSPECTION
Know the anatomy of the structure before pal pating
Warmth, ski n temperature
Sof t ti ssue Swel ling or j oi nt ef fussi on
Bones
Eval uating l ocati on of tenderness, abnormalities compared to
other si de
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PALPATION
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PALPATION
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PALPATION
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MOVEMENT
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MOVEMENT
Range the Joi nts
Decreased / i ncreased movement?
Watch for swel ling, pai n, sti f fness, weakness i n movement
Li sten for crepi tus or popping
Watch for abnormal movement
Note: qual ity of movement, crepi tus, pai nful range, l ooseness
or excessive range
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RANGE OF MOTION (ACTIVE)
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MOVEMENT
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MOVEMENT
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MOVEMENT
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MOVEMENT
Range the j oi nt passi vely, compare to the acti ve poi nts
Note any decreased / i ncreased movement
Pai n wi th the movement
Any crepi tus or poppi ng?
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RANGE OF MOTION (PASSIVE)
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SPECIAL TEST
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SPECIAL TEST
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SPECIAL TEST
Neer' s si gn (forward fl exion/internal rotati on) for subacromial
i mpi ngement
SPECIAL TEST - SHOULDER
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Hawkin' s si gn (90 abduction and 45 of hori zontal
adduction, then humeral i nternal rotati on) for sub- acromi al
i mpi ngement.
SPECIAL TEST - SHOULDER
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ELBOW
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INSPECTION
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INSPECTION
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PALPATION
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PALPATION
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MOVEMENT
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MOVEMENT
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MOVEMENT
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SPECIAL TEST - ELBOW
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WRIST
Swel ling or deformities
Fl exi on, extensi on
Ul nar & radi al deviation of the wri st?
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INSPECTION
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INSPECTION
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INSPECTION
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NSPECTION
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PALPATION
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PALPATION
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PALPATION
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MOVEMENT
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MOVEMENT
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MOVEMENT
Determine stability of j oi nt by examining for abnormal
mobi l ity
Testing i ntegri ty of l i gaments and arti cular surface

Mi l d : mi ni mal fi bres torn, stabili ty OK
Moderate : parti al tear, some l oss of stabi lity
Severe : compl ete rupture, unstable j oi nt
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LIGAMENT STRESS TESTING
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MOVEMENT
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MOVEMENT
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MOVEMENT
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SPECIAL TEST FOR WRIST
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SPECIAL TEST FOR THE WRIST
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SPECIAL TEST FOR WRIST
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THE HAND
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INSPECTION
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INSPECTION
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INSPECTION
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INSPECTION
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INSPECTION
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INSPECTION
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INSPECTION
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PALPATION
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MOVEMENT
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MOVEMENT
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MOVEMENT
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