骨科查体英文课件.ppt

1、examnation of examnation of orthopedicsorthopedicsvideovFull exposureFull exposurevBilateral contrastBilateral contrastvuninjured side uninjured side first,first,uninjured side uninjured side secondsecondvActive Active first,first,passive passive secondsecondvcomprehensivecomprehensive、repeatedlyrep

2、eatedly、softsoftv gait and gesturegait and gesturev There is no skin redness,cyanosis,pigmentation There is no skin redness,cyanosis,pigmentation or venous engorgementor venous engorgementv Soft tissue swelling and massSoft tissue swelling and massv Muscle contraction or muscle fiber fibrillationMus

3、cle contraction or muscle fiber fibrillationv Scar,wound,sinus secretions,and its propertiesScar,wound,sinus secretions,and its propertiesv Wound shape and depth,there is no foreign body Wound shape and depth,there is no foreign body residual and active bleedingresidual and active bleedingv abnormal

4、ities,such as scoliosis,limb shortening abnormalities,such as scoliosis,limb shortening and so on.and so on.v tenderness tenderness：position、depth、scope、level and qualityv abnormal activity and bone rub feeling,play ringvLocal temperature and sensation,bilateral contrastvpercussion painpercussion pa

5、invpercussion pain of Limb axial vIndirect spinal painvTinelvCheck the range of motion of the joint and Check the range of motion of the joint and the contraction of the muscle.the contraction of the muscle.vactive movementactive movementvpassive exercisepassive exercisevLimb length measurementLimb

6、length measurementvMeasurement of limb circumferenceMeasurement of limb circumferencevactive movement;free exerciseactive movement;free exercise Related nervous system Related nervous system examinationexamination Muscle volume,muscle tension,muscle Muscle volume,muscle tension,muscle strength,ataxi

7、astrength,ataxiav Muscle strength rating criteria 0：Muscle strength completely disappeared,no muscle contraction I：Mild muscle contraction,joints can not be active II：Muscle contraction,joint movement,but not against the gravity of the body III：Can resist the gravity of the body to make joint activi

8、ties,but can not resist the resistance IV：Resistance to external resistance,but weak muscle strength V：Normal muscle strength upper limb joint upper limb joint v Shoulder joint Shoulder joint examinationexaminationvElbow joint inspectionvWrist and handShoulder joint examinationVisual examinationVisu

9、al examination winged scapula：costoscapularis paralysation Square shoulder deformityShoulder joint examinationpalpationpalpation Emptiness of the shoulderDugas征 Special inspection Special inspection 杜加斯杜加斯(Dugas)(Dugas)征征:When a When a ormal ormal personperson put hisput his/her/her hands on hands o

10、n the side of the the side of the shouldershoulder，his/her his/her e elbow can be attached lbow can be attached to the chestto the chest,with the,with the shoulder has anterior shoulder has anterior dislocation,when we dislocation,when we put the hand of put the hand of injured side to the injured s

11、ide to the oppsite shoulder,the oppsite shoulder,the elbow can not be elbow can not be attached to the attached to the chestchest.This is a.This is a positive sign of positive sign of DuDugasgas.video Elbow joint inspection Elbow joint inspectionVisual Visual examinationexaminationposterior cubital

12、triangleposterior cubital triangle肘关节检查肘关节检查视视 诊诊肘关节检查肘关节检查网球肘网球肘肱骨外上髁炎肱骨外上髁炎肘关节检查肘关节检查Mills sign:Mills sign:when extent the elbow，flex the wrist,pronate the forearm，if there is pain on the external condyle of humerus,there is positive sign of positive sign of Millsvideo Wrist and hand Wrist and han

13、dvwrist drop wrist drop vape handvClaw hand杵状指杵状指(acropachy)vrespiratory disease vheart diseasevNutritional disordersv匙状甲匙状甲(koilonych)iron-deficiency anemia;High altitude disease rheumatic fever wrist and handcrushing test of wrist crushing test of wrist triangular cartilagetriangular cartilagev Wr

14、ist joint in neutral Wrist joint in neutral positionposition,And then make And then make the wrist joint the wrist joint passive to the ulnar passive to the ulnar deviation and deviation and longitudinal longitudinal extrusionextrusion,If there is If there is pain in the lower pain in the lower ulna

15、r jointulnar joint,it shows,it shows the the positive signpositive signv injury of triangular injury of triangular fibrocartilaginous fibrocartilaginous discdisc、fracture of fracture of processus styloideus processus styloideus ulnaeulnaevideoJoint of lower Joint of lower extremityextremityvJoint of

16、 lower Joint of lower extremityextremityvKnee joint examinationvExamination of ankle joint and foot Anatomy of hip joint Anatomy of hip jointvMaximum Maximum weight weight bearing bearing joint of joint of human bodyhuman bodyvideo Joint motion degree examination Joint motion degree examination髋关节正常

17、活动度髋关节正常活动度髋关节正常活动度髋关节正常活动度 Anatomy of knee joint Anatomy of knee joint前交叉韧带后交叉韧带半月板韧带半月板胫骨髌骨股骨膝关节正常活动度膝关节正常活动度 Knee joint force line Knee joint force line examnationv Under normal Under normal circumstances the knee circumstances the knee can be togethercan be togetherv Normal double ankle distance

18、v The knee can not be togetherv The ankle joint distance is too largebow legbow legcross-kneecross-knee4-6cm4-6cm Knee joint force line Knee joint force linev In the knee with medial pain,the knee is In the knee with medial pain,the knee is accompanied by lateral pain,suggesting that the accompanied

19、 by lateral pain,suggesting that the medial or lateral tibial femoral joint is medial or lateral tibial femoral joint is osteoarthritis of the knee.osteoarthritis of the knee.v The pain of the knee joint outside the knee joint is often indicated by the injury of the lateral meniscus of the knee join

20、t and vice versa.v Severe knee joint force line abnormalities under arthroscopic debridement and cartilage treatment can relieve pain,but the main treatment is high tibial osteotomy Patella related examination Patella related examination浮髌试验浮髌试验(floating patella test)v Check the joint effusion,generally moderate effusion(50ml),floating patella test was positive。videovideoExamination of ankle Examination of ankle joint and footjoint and footExamination of ankle Examination of ankle joint and footjoint and footvideovideo1video2video2vsummary