PF Ortopedi

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Pemeriksaan Fisik Ortopedi

Text of PF Ortopedi

Musculoskeletal Physical Examination

Musculoskeletal Physical ExaminationTerminologyValgus: describes the position of a joint when the distal segment is angled away from the midline of the bodyVarus: opposite of valgus, the distal segment is angled toward the midline of the bodyAbduction: refers to motion away from the midline of the bodyAdduction: refers to motion toward the midline of the bodyProximal: means closer to any point of reference, opposed to distalDistal: means further from any point of reference, opposed to proximalVolar: the palmar surface of the handDorsal: the posterior surface (back) of the handBasic principalLookSwelling, scar, simetrical, deformity, atrophy of muscle? Always compare side to sideLook from anterior, lateral, posteriorFeelLocate important anatomic landmarksAny tenderness, increase or decrease temperature, mass, muscle spasm?MoveActive and passive, muscle powerSpecial TestPerform essential exam manuevers needed to effectively diagnose problemsBasic PrincipalExamine based on history of:PainLocation, characterStiffnessLocking or poppingInstability

ShoulderLookScapula winging?FeelSternoclavicular joint, clavicula, acromioclavicular joint, anterior and posterior glenoid rim, spina scapula, both supraspinatus and infraspinatus muscleMoveFlexion, Extension, Abduction, Internal & External RotationSpecial TestNeers sign, Hawkin test, Crossover testLift off testLabrum grind testAnterior apprehension test,Inferior apprehension test, Sulcus sign

ElbowLookCubital valgum or cubital varus?FeelEpicondylus medial and lateral, olecranon, head of radius, thickening of ulnar nerve?MoveFlexion, extension, pronation, supinationSpecial testTest for Tennis ElbowTest for Golfer Elbow

HandLookFinger deformity, thenar or hypothenar muscle wastingFeelDistal and proximal interphalang joint, metacarpophalang joint, Radiocarpal JointMoveFinger: flexion, extension, abduction, adductionThumb: extension, abduction, adduction, flexion, oppositionRadiocarpal joint: flexion, extension, radial and ulnar deviationSpecial TestTinel testPhalen testFinkelstein test


HipLookTrendelenburg sign?GaitLeg length discrepancy?FeelTrochanter major tenderness?MoveTest for iliopsoas dysfunction at sitting positionFlexion, extension, adduction, abduction, external and internal rotationSpecial TestThomas testFABERObers test

KneeLookAnterior-> genu valgum or genu varum?Lateral-> genu recurvatum?Posterior-> bakers cyst, aneurysm?Q-lineFeelTibial tuberosity, both tibial and femoral condyle, patella margin, pes anserine, iliotibial tract (knee flexion 90 degrees)MoveFlexion, extensionSpecial TestPatellar tap test, Bulge signPatellar apprehension testAnterior drawer test, Posterior drawer test, Lag signValgus stress test, Varus stress testMcMurray test

AnkleLookFeelBoth malleolus, deltoid ligament, talofibular ant and post ligament, Calcaneofibular ligament, Achilles tendonMoveDorsoflexion, plantarflexion, inversion, eversionSpecial TestThompson testAnterior drawer test

CervicalLookFeelProcessus spinosum (C3-T1), paraspinal muscle, lymphadenopaty?MoveFlexion, Extension, Lateral rotation, Lateral flexionSpecial TestSpurling Test

LumbalLookHair? -> spina bifidaScoliosis, lordosis, kifosis?FeelProcessus spinosum, paraspinal muscleMove Flexion, extension,lateral flexion, rotationSpecial TestLasegue testBowstring sign

ReferenceApleys System of Orthopaedics and Fractures, Ninth ed.Hattam P, Smeatham A. Special tests in Musculoskeletal Examination. Elsevier.