Curriculum Block

Objectives

• Assess a patient's feet with them standing.
• Palpate for tenderness over the epicondyles of the elbow.
• Palpate for tenderness over the greater trochanter of the hip.
• Perform internal and external rotation of the hip with it flexed to 90 degrees.
• Perform Trendelenberg's test.
• Perform Thomas' test.
• Detect an effusion at the knee.
• Perform a patellar tap.
• Demonstrate cross fluctuation or the bulge sign when looking for a knee effusion.
• Test for collateral ligament stability in the knee.
• Use the anterior draw test to assess anterior cruciate ligament stability in the knee.
• Examine the sole of a patient's feet.
• Recognise hallux valgus, claw and hammer toes.
• Assess the acromio-clavicular joint (by palpation alone).
• Assess for flat feet (including the patient standing on tip toes).
• Recognize hind foot/heel pathologies.
• Assess plantar and dorsi-flexion of the ankle.
• Assess movements of inversion and eversion of the foot.
• Assess the sub-talar joint.
• Perform a lateral squeeze across the metatarsophalangeal joints.
• Assess flexion/extension of the big toe.
• Examine a patient's footwear.
• Palpate the spinous processes.
• Assess lateral and forward flexion of the lumbar spine (using fingers not tape measure).
• Assess thoracic rotation with the patient sitting.
• Make qualitative assessment of movement (not joint end feel but features such as cog-wheeling).
• Elicit tenderness around a joint.
• Elicit temperature around a joint.
• Detect synovitis.
• Have an awareness of the difference between active and passive movements.
• Perform passive and active movements at all relevant joints.
• Detect a loss of full extension and a loss of full flexion.
• Assess gait.
• Correctly use the terms varus and valgus.
• Assess limb reflexes routinely when examining the spine and in other relevant circumstances.
• Have an understanding of the term subluxation.
• Where appropriate examine neurological and vascular systems when assessing a problematic joint (check for intact sensation and peripheral pulses).
• Assess leg length with a tape measure when assessing for a real leg length discrepancy.
• Detect the difference between bony and soft tissue swelling.
• Assess the median and ulnar nerves.
• Be able to localize tenderness within the joints of the hand (palpate each small joint of the hand if necessary).
• Assess power grip.
• Assess pincer grip in the hand.
• Make a functional assessment of the hand such as holding a cup.
• Correctly use the term "Heberden's nodes".
• Perform Phalen's test.
• Detect a painful arc* and frozen shoulder*
• Make a functional assessment of the shoulder (can they put their hands behind their head and back?).
• Perform external/internal rotation of the shoulder with the elbow flexed to 90 degrees and held in against the patient's side.
• Examine a patient's shoulder from behind for scapular movement.

Activities

• Hip and Knee Pain
• Shoulder and Elbow Pain
• Wrist, Hand and Ankle, Foot Pain
• Back Pain, GALS Exam

Tags

Medical Foundation 4 Musculoskeletal Medicine Part 4 Part 4 Orthopedics Ataxia (Gait) Movement Disorders, Involuntary / Tic Disorders Weakness (not caused by Cerebrovascular Accident) Clinical Skills 1.1 Gather essential and accurate information about patients and their health through history-taking, physical examination, and the use of laboratory data, imaging, and other tests. 1.3 Interpret laboratory data, imaging studies, and other tests required for the area of practice 2.3 Apply principles of clinical sciences to diagnostic and therapeutic decision-making, clinical problem-solving, and other aspects of evidence-based healthcare 3.1 Solicit and respond to feedback from peers, teachers, supervisors, patients, families, and members of health care teams regarding one’s knowledge, skills, attitudes and professional behaviours 3.2 Integrate feedback, external measures of performance and reflective practices to identify strengths, deficiencies, and limits in one’s knowledge, skills, attitudes and professional behaviours 3.3 Set learning and improvement goals 3.4 Identify and perform learning activities that address one’s gaps in knowledge, skills, and/or attitudes 8.1 Demonstrate healthy coping mechanisms to respond to stress 8.3 Develop the ability to use self-awareness of knowledge, skills, and emotional limitation to seek help appropriately Clinical Competence [I02.399.630.210] Gait [E01.370.600.250] Musculoskeletal Physiological Processes [G11.427.590] Physical Examination [E01.370.600]