Locomotor history

Question 1

Associated locomotor symptoms

Answer 1

Stiffness
Grinding
Instability
Weakness
Paraesthesia

Question 2

How do you assess loss of function?

Answer 2

Dressing
Brushing hair
Toilet
Lifting
Hanging washing
Work 
Leisure (sport, gardening)

Question 3

What PMH, DH, SH is important

Answer 3

Previous trauma and surgery
Previous treatment (analgesia, physio, injections, surgery)
Able to walk up stairs, cook and dress self, clean

Question 4

Shoulder examination special tests

Answer 4

Impingement: passively abduct then let go. painful arc if pain between 60-120º
Acromioclavicular pathology: Flex shoulder & elbow at 90º and put hand on opposite shoulder. Apply force posteriorly on elbow
Rotator cuff: abduction against resistance (supraspinatus)
External rotation against resistance (infraspinatus, teres minor)
Internal rotation against resistance, lift hands off back (subscapularis)
Winged scapula (serratus anterior)

Question 5

How do you assess hip extension?

Answer 5

Ask patient to roll onto side

Question 6

Special tests for hip examination

Answer 6

Thomas’ test: hand under lower back, flex non-test hip and other leg should stay on couch
Trendelenburg: pt stand on one leg, assess superior iliac spine movement, if dips on unsupported side then weak hip abductors on supported side
Gait

Question 7

Special tests for knee examination

Answer 7

Anterior and posterior draw test
Posterior sag test
Collateral ligaments test
McMurray’s test: flex knee to 90º press on medial joint line, externally rotate foot and extend knee
press on lateral joint line and internally rotate foot and extend knee

Question 8

What do you feel for in a knee examination

Answer 8

Tenderness/swelling
Temperature
Baker's cyst
Patella tap
Sweep test: medial distal->proximal, lateral Proximal-> distal