Joint Examination

Question 1

Define a dislocation

Answer 1

Complete lack of contact between the 2 articular surfaces

Question 2

Define subluxation

Answer 2

Residual contact between 2 articular surfaces

Question 3

Define valgus deformity

Answer 3

Distal part of limb directed away from midline

genu valgus= “knock knees”

Question 4

Define varus deformity

Answer 4

Distal part of the limb direct toward the midline

genu varus= “bow legs”

Question 5

Describe the overall process of a joint examination

Answer 5

1. inspection: what do you see? (bilaterally)
2. Palpation: are there temperature differences, tenderness, effusion?
3. Range of motion: are they the same bilaterally? Is there tenderness?
4. Speciality testing based on the area of the body that you are in

Question 6

What are the differences between the joint and extremity examinations?

Answer 6

The extremity examination includes neuromuscular statuses including pulses distal to the injury

Question 7

What are the values/scales that the following measurements are recorded in?

1. Pulses
2. Reflexes
3. Muscle strength

Answer 7

1. Pulses: out of 4; 2/4 is normal
2. Out of 4, 2/4 is expected
3. 5/5 is the highest

Question 8

Describe the ratings of muscle strength in detail 
0
1
2
3
4
5

Answer 8

0: no muscular contraction
1: Barely any contraction
2: Active movement without gravity
3: Active movement against gravity and some resistance
4: Active movement against gravity and some resistance
5. Active movement against full resistance without evident fatigue. This is normal strength

Question 9

Describe a Colles fracture

Answer 9

Usually the results of a FOOSH

Dinner fork deformity

Fracture to the distal radius with an avulsion typically to the styloid process of the ulna

Question 10

Describe the presentation of a septic arthritis

Answer 10

Will NOT bear weight or allow ROM testing to be performed

Joint is erythematous, swollen, warm, and painful to the touch

Question 11

Describe the deep tendon reflex ratings in detail 
0
1
2
3
4

Answer 11

0: no response
1: low normal
2: Average, normal
3: Brisker than average
4: hyperactive with clonus (rhythmic oscillation between flexion and extension

Question 12

Describe the major landmarks involving the dermatomes

Answer 12

C4: top of the shoulder 
C6: radial aspect of the forearm 
C8: 5th digit 
T4: nipple 
T10: umbilicus 
L5: great toe 
S1: posterior calf and the little toe

Question 13

Describe the pulse ratings in detail 
0
1
2
3
4

Answer 13

0: Absent
1: Diminished, barely palpable
2: Average intensity
3: Strong, full, increased
4: Bounding

Question 14

Describe the edema ratings in detail 
0
1
2
3
4

Answer 14

0: Absent
1+: Barely detectable, slight pitting (2mm); disappears rapidly
2+: Slight indentation (4mm); 10-15 sec
3+: Deeper indentation (6mm); >1 min
4+: Very marked indentation (8mm); 2-5 min