For palpation, function test: need to ask if patient feels pain

HIP:

Gait Side and posterior (mencangkung) view.

Findings: normal gait
Inspection Anterior view: swelling, scaring, redness, muscle wasting
(standing) Lat: swelling, scaring, redness
Post: swelling, scaring, redness, quadriceps wasting
Feel and palpate 1. See whether both ASIS in same level or not
(lying) 2. Feel for temperature from ASIS down to area above knee
3. Palpate: ASIS down to area above knee
4. Measure the length
Movement Flexion and extension (patient lying laterally)
(lying) Abduction, adduction
Internal and external rotation
Special function 1. Thomas test (lying down): our one hand on the patient spine to support,
test: patient flexed passively and hold, see whether the opposite leg got raise 🡪
test for fixed flexion deformities
2. Trendelenburg test (standing): support patient posteriorly, ask patient to
stand with one leg for 30s, see whether he can 🡪 test for contralateral hip
abductor(gluteus medius and minimus)

KNEE:

Gait Side and posterior (mencangkung) view.

Findings: normal gait
Inspection Anterior view: swelling, scaring, redness
(standing) Lat: swelling, scaring, redness
Post: swelling, scaring, redness
Feel and palpate 1. Feel the temperature around knee area (anterior. Medial and lateral
(lying) surface)
2. Palpate (in leg straight position): medial and lateral collateral ligaments,
patella (below patella) and quadriceps (above patella) tendons
3. Palpate (in leg bend position): tibial tuberosity, palpate along knee line
from below to top
Movement 1. Flexion
(lying) 2. Extension
 Special function 1. Patella tap test (leg in straight position) Findings: patella not floating
test: 2. Meniscus tear test/ McMurray test: tests for medial and lateral meniscus.
When test for medial, toes of foot face outward and vice versa.
3. Anterior drawer test. (both legs flexed, sit on patient feet and pull at knee
joint)

Shoulder:

Inspection Anterior view: swelling, scaring, redness, muscle wasting, symmetrical shoulder
(standing) Lat: swelling, scaring, redness, deltoid wasting
Post: swelling, scaring, redness, spinal curvature, trapezius wasting, winging of
scapula (push against the wall)
Feel and palpate Feel for temperature and palpate: From sternoclavicular joint 🡪 along clavicle
(standing) 🡪 acromioclavicular joint 🡪 coracoid 🡪 head of humerus 🡪 scapula border 🡪
paraspinal muscle
Movement Flexion, extension
(standing) Abduction and adduction
Internal and external rotation
circumduction
Special function 1. Supraspinatous: drop or empty can test (Support pt elbow) Findings:
test: (standing) Intact
2. Infraspinatous test; flex hand 90 degree, abduct a bit, push patient hand
inward, ask them to resist (Support pt elbow) Findings: Intact
3. Subscapularis test: flex hand 90 degree posteriorly, push patient hand
upward and ask them to resist (Support pt elbow) Findings: Intact

Elbow

Inspection Anterior view: swelling, scaring, redness

(standing) Lat: swelling, scaring, redness
Post: swelling, scaring, redness, rheumatoid nodules, psoriasis plaque
Feel and palpate Temperature around the elbow joint: antecubital fossa to olecranon
(standing) Palpate (hand flexed 90 degree): olecranon, medial and lateral epicondyle,
biceps tendon, biceps and triceps wasting
Movement 1. Flexion and extension
(standing) 2. Supine and pronation
Special function 1. Tennis elbow: press on lateral epicondyle, pronate elbow, extend fist, push
test (standing): their hand and ask patient to resist
 2. Golfer test: press on medial epicondyle, supine elbow, extend wrist, push
their hand and ask patient to resist

Wrist (sit): Hands on pillow

Inspect: Dorsum and palm: scar, swelling, redness, deformities, skin and nail changes
(dorsum), muscle wasting (palm for hypothenar and thenar)
Feel: 1. Dorsum, palm and joint: Temperature
2. Check for Radial and ulnar pulse: present
3. Feel for bulk on the palm (hypothenar and thenar)
4. Sensation:
5. MCP compression: press the MCP and see got pain mah
6. Bimanual palpitation: press all the joints in the hand, including wrist joint
and ask whether got pain
7. Press anatomical snuffbox
Sensation: 1. Median and ulnar nerves on palm (centre for median nerve and medial for
ulnar nerves- patient close eye, u touch these area, ask if they feel or not)
Findings: these nerves are intact
2. Radial nerve on dorsum at the thumb (same procedure, close eyes, touch
them and ask whether they feel) Findings: radial nerve is intact.
Movement: 1. Flexion and extension of wrist
2. Move the fingers
3. Resistance tests:
A. Finger flexion
B. Finger extension
C. Finger abduction
D. Thumb abduction

Function test 1. Finger grip: ask patient to hold tightly ur hand. Findings: normal
2. Pincer grip: use thumb and index to press ur finger. Findings: normal
3. Ask patient to pick up object (both hands)
4. Tinel test: tap on the wrist joint and ask whether got tingling or pain.
Findings: negative tinel test, no pain
5. Phalen test: bring two flexed wrist together , where the dorsum of hand
touch each other. Findings: negative, no pain