Standard Upper Extremety Exam

Question 0

Skin appears

Answer 0

“no lesions, discolorations, texture is normal”

Question 1

Begin exam by inspecting and saying:

Answer 1

“Shoulders, elbows, wrists, and fingers are symmetrical without atrophy, deformities, fasiculations (twitch) or tremors; there is no swelling or discoloration”

Question 2

Palpate shoulder saying

Answer 2

“I am palpating the following areas: clavicles, acromioclavicular joint (AC joint), coracoid process and bicipital groove, as well as triceps and biceps”

Question 3

Palpate elbow saying

Answer 3

“I am palpating epitrochlear lymph nodes, brachial pulse, lateral and medial epicondyles, olecranon process, radial and ulnar styloids, ANTECUBITAL fossa”

Question 4

Palpate the wrist saying

Answer 4

” I am doing a general inspection of carpal bones, MCP jnts, PIP and DIP jnts, radial and ulnar styloids, RADIAL PULSE”
Ask pt if MCP PIP and DIP jnt are tender.
“There is no swelling or tenderness of PIP and DIP joints”

Question 5

Palpate the hand sayingZ

Answer 5

“I am checking the nails for capillary refill.
Palpating metacarpophalangeal joints, proximal and distal interphalangeal jts. (Ask pt if tender) There is no swelling or tenderness of PIP or DIP joints.”

Question 6

fasiculations mean

Answer 6

twitch

Question 7

When testing ROM of upper extremeties, say

Answer 7

“Muscle tone and strength are normal and symmetrical. There is no rigidity or cog-wheeling”

Question 8

cog-wheeling is

Answer 8

???

Question 9

To test flexion and extension, say

Answer 9

“Put your hands in front, bring the all the way up above your head, Extention: swing arms back down and behind you.

Question 10

To test strength resistance for abduction

Answer 10

Raise your arms bilaterally above your head, now hold your arms straight out to your sides at shoulder level and don’t let me push them down.”

Question 11

To test for adduction and strength resistance

Answer 11

• swing your arms across your body

- hold your arms straight out to your sides at shoulder lever and don’t let me push them up.

Question 12

To test external rotation

Answer 12

bring your hands behind your head.

Internal rotation: put your hands behind your back

Question 13

ROM at elbow

Answer 13

Bring your fists to your shoulder and down.

Question 14

Check flexion and extension of elbow and against resistance

Answer 14

Flexion: flex your elbow and don’t let me pull your arms down
Extension: extend your arms. Now flex the arms and push them against my resistance.

Question 15

Check pronation, supination, radial and ulnar deviation

Answer 15

Pronation: turn your palms down
Supination: turn your palms up

Question 16

Check wrist flexion and extention

Answer 16

“Bring your wrists up, don’t let me push them down”

“Bring your wrists down, don’t let me pull them up”

Question 17

Radial and Ulnar deviation of wrists is checked with palms up or down?

Answer 17

Arms bent at elbows, hands out straight with PALMS DOWN:
“Keep you forearms still and move your hands to the sides - ULNAR deviation. Then move your hands toward each other - RADIAL deviation”

Question 18

Test GRIP STRENGTH and finger strength by

Answer 18

Asking pt to grasp your index finger “Squeeze my finger as hard as you can”
“Spread fingers and don’t let me bring them together