1. Musculoskeletal Exam The basic screening musculoskeletal examination involves inspection, palpation, and range of motion. Muscular strength is covered under the motor exam in the neurological exam. The musculoskeltal examination may be divided into spine, upper extremities, and lower extremities. Besides the basic screening exam there are many special maneuvers when examining a patient with musculoskeletal complaints.

2. 196. Inspection of cervical, thoracic, and lumbar spine

3. 197. Percussion of cervical, thoracic, lumbar and sacral vertebrae

4. 198. Cervical spine: flexion and extension (be sure full extension is done) may be done from front or back, +/- palpate

6. 200.Cervical spine Rotary movement, left and right, palpate

7. 201. Lumbar spine: flexion and extension (be sure full extension is done), +/- palpate

8. 202. Lumbar spine: lateral movement, left and right, OK from front or back, +/- palpate 203. Lumbar spine: rotary movement, left and right, OK from front or back, +/- palpate

9. The Shoulder Areas to palpate in a more thorough exam of the shoulder. Sternoclavicular joint Acromioclavicular joint Clavicle Scapulae Coracoid process Greater trochanter of the humerus Bicepts groove The area muscles

10. 204. Shoulders: arms over head 207. Note: Shoulders: palpation during maneuvers (not over gown)

11. 205. Shoulders: hands behind head

12. 206. Shoulders: hands behind small of back

13. 208. Elbows: flexion and extension (be sure full extension is done)

14. 209. Elbows: palpation of elbows Palpate: Medial and lateral epichondyles; Olecranon process

15. 210. Wrists: flexion and extension 211. Wrists: radial and ulnar deviation

16. Palpate - Distal radius and ulna Groove of joint Anatomic snuff box 212. Wrists--Palpations of Wrist

18. 213. Hands: bilateral fists/grip, extend/hyperextend fingers

19. 214: Hands: palpation of metacarpalphalangeal joints 215: Hands: palpation of IPJs (PIP and DIP joints)

20. Hip Joint

21. 216. Hips: flexion (be sure full flexion is done and bilaterally) Note draping of sheet

22. 217. Hips: internal and external rotation (hip at 90 0 and knee at 90 0 rotate on axis of femur)

23. 218. Hips: abduction (away from the body with hip and knee at 0 degrees)

24. The Knee

26. 219. Knees: flexion and extension (may do with hip flexion) (be sure full extension is done)

27. 220. Palpation of Knees Palpate Patella Patellar tendon Tibial tuburosisty Medial and lateral joint lines

28. 221. Ankles: Dorsi and plantar flexion

29. 222. Ankles: Inversion, eversion of foot (stabilize at ankle and invert and evert by heel) subtalar joint

30. 223. Ankles inversion eversion of foot (stabilize at heel and invert and evert by forefoot) transverse tarsal joint

31. Ankles: palpation of ankle Palpate: Anterior aspect of joint Achilles tendon Medial and lateral malleoli

32. 225. Feet Palpation of metatarsophalangeal joints (may put pressure across foot from the 1 st to the 5 th metatarsals)