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11 Cards in this Set

  • Front
  • Back
Big picture components of the MS exam:
-C spine/neck
-Shoulders
-Elbows
-Wrists
-Hands
-Hips
-Knees
-Ankles/feet
-T+L spine + hip extension
Describe the MS exam for C spine:
-Leave pt seated!
-Look at back of neck for symmetry, obvious lesions.

-Press c spine and paraspinous mm, checking for pain.

-ROM: Chin to chest; Look at ceiling; Touch ear to shoulder bilaterally; turn over each shoulder and look behind you.
Describe the MS exam for the shoulders:
-Gotta undo the gown.
-Look for swelling or asymmetry.

-Press SC joint, then out to AC joint, then glenohumeral, then biceps tendon groove.

-ROM: Hands up to ceiling (touchdown), then behind head.
-Hands back (extension), then handcuffs.
-Out to sides like wings (abduction), then back to sides.
Describe the MS exam for the elbows:
-Look at elbow first, both flexed and extended.

-Press on medial/lateral epicondyles for tenderness. Check radiohumeral joint for synovial enlargement.

-Feel for brachial pulse.

-ROM: Keeping elbows tucked in, flex up to shoulders, extend completely, pronate, supinate.
Describe the MS exam for the wrists:
-Look at wrists first.

-Press on wrist joints.

-Feel for radial pulse.

-ROM: go up, go down, go in, go out.

-Tinel (Tap) and Phalen (wrists together).
Describe the MS exam for the hands:
-Look at hands.

-Press all of the joints.

-ROM: Splay fingers, bring together, make a fist, open back out.

-Check capillary refill on tips of fingers.
Describe the MS exam for the hips:
-Lay the table down, pull out the foot support, and drape the pt!

-Inspect the hip.

-Palpate hip joint.

-Do a passive straight leg raise.

-ROM: With knee bent 30˚, bring hip out, bring hip in. With knee straight, hold pt's opposite hip and abduct leg and bring back in, even crossing over past midline.

*Check hip extension with pt standing (usually done during L spine exam)*
Describe the MS exam for the knees:
-Inspect the knee.

-Feel for fluid collection, milking down. Press MCL/LCL.

-Bend knee at 30˚, and test MCL/LCL by torsion.

-Sit on pt's foot and check ACL/PCL.

-Do McMurray's, holding distal femur and the foot. Externally rotate tibia, press medially on knee, and extend knee. Then internally rotate tibia, press laterally on knee, and extend.

-Check the popliteal pulses. They are medial.

-ROM: Flex and extend.
Describe the MS exam for the ankles/feet:
-Inspect ankles and feet, don't forget toenails.

-Press medial/lateral malleolus.

-Check dorsal pulses and medial pulses.

-ROM: hit the gas, flex ankle up, touch together (inversion), eversion.

-Bring pt to a stand and look at arches, etc.
Describe the MS exam for the back and L spine:
-Make sure pt is standing.
-Undo gown if necessary.
-Look for anything swollen or asymmetric.

-Press on spine all the way down to low L spine, then paraspinous muscles.

-ROM: touch your toes, lean all the way back (support them during this one), lean right, lean left, and twist hips to look over right shoulder and left shoulder.

-Finally, make sure to check hip extension with pt supporting themselves on the table!
Give the normal oral presentation for the MS exam:
No midline vertebral TTP of the cervical, thoracic, or lumbar spine. No kyphosis or scoliosis. No paravertebral tenderness or muscle spasm.

FROM of the neck and back without pain. SLR negative. No obvious bony deformities.

Joints (specify which ones) symmetric without warmth, swelling, or tenderness.

Passive ROM in hip abduction, adduction, flexion, internal / external rotation intact. Full active ROM in all other joints.

BONUS: Tinnel and Phalen’s tests do not produce paresthesias. Anterior drawer (or Lachmann), varus and valgus stress tests of the knees demonstrate no laxity. No clicks, catches, or pain on McMurray testing. No knee effusion.