UPPER LIMB ASSESSMENT Flashcards
Outline the physical assessment
Look
Feel
Move
- Active
- Passive
- Resisted
Joint above
Affected area
Joint below
RED FLAGS
Colour
Perfusion
Sensation
SWEADES
S - swelling
W - wounds
E - exudate
A - atrophy
D - deformity
E - eretyma
S - scars
Shoulder joint above
neck or spine - reffered pain - rule out
Spine - LOOK
Posture - scoliosis/ kyphosis
Deformities
Spine - FEEL
atrophy/hypertrophy
muscle/bony tenderness
irregular spinous process - tenderness
Spine - MOVE
flexion/extension - nodding
lateral flexion - ear to shoulder
rotation (sitting)
4 joints of the shoulder gurdle
sternoclavicular
acromioclavicular
glenohumeral
scapulothoracic
Sternoclavicular Joint
where the sternum and clavicle join
Acromioclavicular
Acromion process joins onto the clavicle
Glenohumeral joint (shoulder joint)
Glenoid meets the humerus - ball and socket
which joint is the most shallow and susceptible to dislocation?
Glenohumeral
Anterior (front) landmarks
Sternoclavicular joint
Clavicle
AC joint
Coracoid process
Posterior (back) landmarks
spine and borders of the scapula
Humeral landmarks
Head of humerus
tubercule - greater and lesser
Bicipital groove
Deltoid muscle
extension movement
0-60 degrees
external rotation
0-90 degrees
internal rotation
0-70 degrees - body wont allow anymore movement
Regimental badge sign
test for axillary nerve damage
- sensation
light stroke of both sides of shoulder
axillary nerve motor deficit sign
motor - abduction of the deltoid is limited
shoulder dislocation
Anterior - trauma
Posterior - FOOSH
4 stages of subluxation
1 - v shaped widening
2 - moderate subluxation
3 - advanced subluxation
4 - dislocation
4 muscles of the rotator cuff
supraspinatus
subscapularis
infraspinatus
teres minor
tendonitis
tendon swells (becomes inflamed) after an injury.
partial tear
when one or more of the muscles and tendons that make up your rotator cuff tears
full thickness tear
Tear in the muscles or tendons surrounding the shoulder joint.
rotator cuff impingement
condition where the space between the acromion and rotator cuff narrows
other names for rotator cuff impingement
Rotator cuff tendinitis
shoulder bursitis
biceps tendinitis
patient plan for rotator cuff injury
leave at home
self care advice/ worsening advise
gp referral
What can a GP do for a shoulder injury
start non invasive treatment
- physiotherapy
- corticosteroid injections
- surgery referral
with sensation, it is also important to ask about what?
Neurovascular compromise
Elbow landmarks
Radial head
Olecranon
Medial and lateral epicondyles- tennis & golfers elbow
Elbow movements
flexion - bend up towards face
extension - moving down towards feet
pronation - palms down
supination - palms up
what connects the radius to the humerus allowing for pronation and supination?
Annular ligament
where should movements come from with the elbow?
Annular ligament in the elbow not the shoulder
Tennis elbow
Lateral epicondylitis - repetitive strain injury
Golfers elbow
Medial epicondylitis - repetitive strain injury
Pulled elbow is aka
Nursemaids elbow - common in children
what is pulled elbow
radial head subluxtion due to a slip in the annular ligament causing it to trap
Olecranon bursitis is…
inflammation of the Olecranon bursae
Job of the bursae
to reduce bone friction
Main signs of a septic joint
Signs of infection
reduced ability
how many carpals are there?
8
Pneumonic for Carpal bones
Some
Lovers
Try
Positions
That
They
Cant
Handle
Bone structure of the hand
Carpal bones
Metacarpal bones
Proximal phalanges
Middle phalanges
Distal phalanges
movements of the wrist
Palmar/dorsa flexion
Radial/ulnar deviation
Pronation/supination
Smith’s fracture
Flexion fracture of the radius
Colles’ fracture
Extension fracture of the radius
FOOSH pathology
3 radial fractures
greenstick
foosh - colles’
smith’s
anatomical snuffbox test
test for scaphoid fracture
- lightly palpate base of the thumb
