Skill Performance Evaluation: Musculoskeletal Examination; Upper Extremities

Directions: You will have 15 minutes to complete the skill*. All critical (C) steps and 80% of the noncritical steps
must be performed or verbalized. Special tests (S) will be performed if requested by the examiner.

*These skills are performed bilaterally. Start: End:

Performed Verbalized
Washes hands and dons appropriate personal protective equipment. C

Introduces self to patient using first and last names. Y/N

Notes general appearance and vital signs. Y/N

Inspection
1. Inspect upper extremities (UE) for symmetry, swelling, deformity, contours, and
Y/N Y/N
abnormal positioning: shoulder, elbow, wrist, and hand
Palpation
1. Palpate bony landmarks, muscles, tendons, and ligaments for swelling, tenderness,
Y/N
bogginess, or bony enlargement
2. Shoulder (Sternoclavicular joint, acromion, acromioclavicular joint, coracoid process,
greater tubercle, biceps tendon, subacromial and subdeltoid bursae, supraspinatus, Y/N Y/N
infraspinatus, and teres minor.)
3. Elbow (Lateral and medial epicondyles, olecranon process, ulnar nerve.) Y/N Y/N
4. Wrist and hand (Distal radius, ulna, radial styloid bone, anatomical snuffbox, carpal
Y/N Y/N
bones, metacarpals, metacarpophalangeal proximal and distal interphalangeal joints.)
Assess Range of Motion (ROM); note symmetry and rhythm of movement Y/N

1. Shoulders: flexion, extension, abduction, adduction, external rotation, internal rotation Y/N Y/N

2. Elbows: extension, flexion, supination, pronation Y/N Y/N

3. Wrists: flexion, extension, ulnar and radial deviation Y/N Y/N

4. Hands (thumb): flexion, extension, abduction, adduction, opposition Y/N Y/N

5. Hand (fingers): flexion, extension, abduction, adduction Y/N Y/N

Special Tests
1. Shoulder (Neer and Hawkin impingement signs, drop-arm sign, “empty-can test,”
S Y/N
infraspinatus strength, forearm supination.)
2. Wrist/hand (Tinel and Phalen signs.) S Y/N

All exams were performed with bilateral comparison. C

Adequate exposure was obtained for all inspection steps. C

Adequate draping was maintained for all steps. C

Evaluation: #Y = #C =
min. = 19/24 min. = 4
Comments on quality of performance: Needs remediation?

Y/N

Student: Evaluator: Date:

Developed by Albany Medical College, Center for Physician Assistant Studies | Bickley: Bates’ Guide to Physical Examination
and History Taking, Twelfth Edition. Copyright © 2017 Wolters Kluwer Health