Joints - General Exam Flashcards
Valgus vs Varus
What are some 1) causes 2) symptoms and 3) signs of joint inflammation?
Causes:
trauma, infection, systemic
Symptoms:
pain, stiffness
Signs:
redness, swelling, warmth
Approach to Joint vs Extremity Steps
Joint
- Inspection
- Palpation
- ROM
- Specialty Test
Extremity
- Inspection
- Palpation
- ROM
- Specialty Test
- Reflexes
- Neuro exams (strength, sensory)
- Vascular exam (pulse, capillary refill, edema)
Deep Tendon Reflexes
4+Very brisk, hyperreflexive, with clonus
3+Brisker or more reflexive than normally.
2+Normal
1+Low normal, diminished
0No response
Biceps = C5
Brachioradialis = C6
Triceps = C7
Patella = L2-L4 (Femoral)
Achilles = S1-S2
Muscle Strength
Recorded 0-5
0 = no contraction
1 = barely muscle contraction
2 = active movement with no gravity
3 = active movement with gravity
4 = active movement against gravity and some resistence
5 = active movement against full resistence without evidence of fatigue
Sensory/Dermatome landmarks (Upper)
C4 = top of shoulder
C6 = lateral arm/forearm
C8 = 5th digit
T4 = Nipple line
T10 = Ubilicus
L5 = Great toe
S1 = Posterolateral calf
Capillary Refill
compress patient digit to cause blanching, release pressure and note time it takes for color to return (2 sec or less is normal)
Pulses (area and scale)
- Neck (carotid)
- Wrist (radial)
- underarm and cubital fossa (brachial)
- Back of knee (popliteal)
- Top of foot (dorsalis pedis)
ALWAYS CHECK PULSE IN AREAS DISTAL TO THE INJURY
Scale
0 = no pulse
1 = weak, barely palpable
2 = average
3 = strong
4 = very intense, bounding
Edema Testing
KEY = do on bony area since edema will be more apparent
Areas:
Medial malleolus (behind), dorsum of foot, anterior tibia
Scale:
0 = none
1 = barely pitting (2mm), quickly disappears
2 = slight indentation (4mm); 10-15 seconds
3 = mild indentation (6mm); >1min
4 = deep indentation (8mm); 2-5min
Sensory Dermatomes (Lower)
