Pemeriksaan Fisik Muskuloskeletal - dr. Mohammad Shahreza, Sp.OT

Summary

In this video, Dr. Muhammad Syahreza, an orthopedic trauma specialist from the Department of Surgery, FK USU, demonstrates how to perform a thorough musculoskeletal physical examination. The process includes evaluating the upper and lower extremities, as well as the spine, in a systematic approach: 'Look', 'Feel', and 'Movement'. The demonstration covers detailed procedures, including inspection for deformities, palpation for tenderness, neurovascular checks, and assessing range of motion in various joints such as the hip. This comprehensive guide offers valuable insights for clinicians in orthopedic examination techniques.

Takeaways

• 😀 Physical examination of musculoskeletal cases includes checking the upper extremities, lower extremities, and the spine.
• 😀 The examination follows a systematic approach: Look, Feel, and Movement.
• 😀 During the hip joint examination, the 'Look' step involves inspecting the area for differences in color, wounds, or visible deformities.
• 😀 The 'Feel' step involves palpation, where the doctor checks for tenderness, swelling, or irregularities, focusing on bony prominences.
• 😀 Neurovascular examination is crucial for assessing the integrity of the peripheral nervous system and vascularization of the extremity being examined.
• 😀 In the neurovascular examination, sensory and motor components are checked by palpating the fingers and asking the patient to move them.
• 😀 Vascular assessment includes checking the pulse in the dorsalis pedis and posterior tibial arteries to detect any vascular injuries.
• 😀 After neurovascular checks, the range of motion (ROM) is evaluated, which differs for each joint (e.g., hip joint flexion and extension).
• 😀 For the hip joint, normal flexion can reach up to 135-145 degrees, and internal and external rotation is also measured.
• 😀 Deformities or restricted movements in the hip joint may indicate degenerative conditions or joint problems, such as limited internal rotation.
• 😀 The 'Look, Feel, and Movement' approach used for hip joint examination can be applied to other joints in the body as well.

Q & A

What is the primary focus of this physical examination demonstration?

The primary focus is on demonstrating the physical examination of musculoskeletal cases, specifically the hip joint (hip) in this instance.

What are the three main components of musculoskeletal physical examination?

The three main components are: 1) Extremities (upper and lower), 2) Spine, and 3) The physical examination involves looking, feeling, and movement tests.

What are the key steps involved in conducting a physical examination of the hip joint?

The key steps are: 1) Look - to visually inspect the area for deformities or abnormalities, 2) Feel - to palpate for tenderness or bony prominences, 3) Movement - to assess the range of motion in the joint.

Why is it important to perform a neurovascular examination during a musculoskeletal exam?

A neurovascular examination is crucial to assess the integrity of the peripheral nervous system and vascularization in the affected extremity, which helps identify potential nerve or blood vessel injuries.

What does the sensory component of a neurovascular exam assess?

The sensory component involves palpating the fingertips to check for sensation, ensuring that the sensory function is intact.

What does the motor component of a neurovascular exam evaluate?

The motor component evaluates the ability of the patient to move their fingers or toes, indicating whether the motor function is intact.

What are the key components of a vascular examination in the lower extremities?

The vascular examination involves palpating the dorsalis pedis and posterior tibial arteries to check for strong pulse signals, which indicate proper blood flow.

How is the range of motion for the hip joint assessed during the physical exam?

Range of motion for the hip joint is assessed through movements such as flexion, extension, internal rotation, external rotation, adduction, and abduction. These movements are measured by the degree of movement and compared to the contralateral side.

Why is it necessary to examine the hip joint in a side-lying position?

Examining the hip joint in a side-lying position allows for better assessment of hip extension, which may be difficult to assess in a supine position due to interference from the bed.

What can be concluded if a patient cannot perform movements like internal rotation of the hip joint?

If a patient cannot perform movements like internal rotation, it may indicate a degenerative condition in the hip joint, such as femoral head or acetabular dysfunction, which can restrict movement.