Draft 1
Draft 1
Draft 1
GENERAL ORTHOPEDIC
EXAMINATION
Primary Survey
Indication of cervical collar
Nexus Criteria
1. Neurological deficits
2. Spinal tenderness
3. Altered sensorium
4. Intoxication
5. Distracting pain
Primary Survey
Circulation
Clinical and radiographic (CXR, pelvic XRay evaluation)
Application of circumferential sheet or binder where indicated
Application of direct pressure to areas of obvious hemorrhage
Initiation of resuscitation
Primary Survey
Disability
Neuro evaluation
DISABILITY
(NEUROLIGICAL 1. GCS
EVALUATION) <8 protect airway and intubte
Þ All patient with altered consciousness
in trauma is considered a result from
CNS injury. Drug/ alcohol intoxication
can accompany traumatic brain injury.
EXPOSURE ABD
ENVIROMENTAL
CONTROL
GENERAL SPINE EXAMINATION
INSPECTION
Café au lait
Lipoma
(neurofibromatosis)
Posture
- Kyphosis
Tuft hair (meningocele)
- Lardosis
- Scoliosis
Palpation
• Carried out in standing, sitting or prone positions
Extension : in standing position, the patient is ask to arch his back while the examiner steadies the
pelvis & a pull is exerted on the shoulder
Lateral flexion : normal range is 30° (thoracic & lumbar segments are equal)
• Local temperature
• Tenderness: try to elicit tenderness
along the following points
Just below the acromion-
supraspinatus tendinitis
Just below acromion when the arm
adducted: Painful arc syndrome
Along coracoid process
All round the joint: in arthritis
PALPATION
2020
MOVEMENT
ELBOW EXAMINATION
INSPECTION
• Local temperature
• Tenderness
• -Start form lateral condyle,
olecranon, radial head, medial
epicondyle , biceps tendon and
ulnar nerve
MOVEMENT
HAND EXAMINATION
With patient lying comfortably on bed, this few component is observe Attitude of the limb
1. check on temperature
Palpation of femoral artery ( feeble or absent is called narath sign )
Tenderness
Bony structure
1. Greater trochanter : palpate the lateral surface of upper thigh feeling the bony resistance from below
upwards. The end of the bony resistance corresponds to the tip of greater trochanter
2. Pubic tubercle : bony prominence felt 2-2.5 cm lateral to the pubic symphysis.
3. ASIS :
RAGE OF MOVEMENT
1. Flexion and extension
2. Adduction and
abduction
5. External and internal rotation
CONCLUSION