1、examnation of orthopedicsvideo23vFull exposureFull exposurevBilateral contrastBilateral contrastvuninjured side uninjured side first,first,uninjured side uninjured side secondsecondvActive Active first,first,passive passive secondsecondvcomprehensivecomprehensive、repeatedlyrepeatedly、softsoft4v gait
2、 and gesturegait and gesturev There is no skin redness,cyanosis,pigmentation There is no skin redness,cyanosis,pigmentation or venous engorgementor venous engorgementv Soft tissue swelling and massSoft tissue swelling and massv Muscle contraction or muscle fiber fibrillationMuscle contraction or mus
3、cle fiber fibrillationv Scar,wound,sinus secretions,and its propertiesScar,wound,sinus secretions,and its propertiesv Wound shape and depth,there is no foreign body Wound shape and depth,there is no foreign body residual and active bleedingresidual and active bleedingv abnormalities,such as scoliosi
4、s,limb shortening abnormalities,such as scoliosis,limb shortening and so on.and so on.567v tenderness：position、depth、scope、level and qualityv abnormal activity and bone rub feeling,play ringvLocal temperature and sensation,bilateral contrast8vpercussion painvpercussion pain of Limb axial vIndirect s
5、pinal painvTinel9vCheck the range of motion of the joint and Check the range of motion of the joint and the contraction of the muscle.the contraction of the muscle.vactive movementactive movementvpassive exercisepassive exercise10vLimb length measurementLimb length measurementvMeasurement of limb ci
6、rcumferenceMeasurement of limb circumferencevactive movement;free exerciseactive movement;free exercise111213 Related nervous system examination Muscle volume,muscle tension,muscle strength,ataxiav Muscle strength rating criteria 0：Muscle strength completely disappeared,no muscle contraction I：Mild
7、muscle contraction,joints can not be active II：Muscle contraction,joint movement,but not against the gravity of the body III：Can resist the gravity of the body to make joint activities,but can not resist the resistance IV：Resistance to external resistance,but weak muscle strength V：Normal muscle str
8、ength14 upper limb joint v Shoulder joint examinationvElbow joint inspectionvWrist and hand15Shoulder joint examinationVisual examination winged scapula：costoscapularis paralysation Square shoulder deformity16Shoulder joint examinationpalpation Emptiness of the shoulderDugas征17 Special inspection 杜加
9、斯杜加斯(Dugas)(Dugas)征征:When a When a ormal ormal personperson put hisput his/her/her hands on hands on the side of the the side of the shouldershoulder，his/her his/her e elbow can be attached lbow can be attached to the chestto the chest,with the,with the shoulder has anterior shoulder has anterior di
10、slocation,when we dislocation,when we put the hand of put the hand of injured side to the injured side to the oppsite shoulder,the oppsite shoulder,the elbow can not be elbow can not be attached to the attached to the chestchest.This is a.This is a positive sign of Dupositive sign of Dugasgas.video1
11、8 Elbow joint inspectionVisual examinationposterior cubital triangle19肘关节检查肘关节检查视视 诊诊20肘关节检查肘关节检查网球肘网球肘肱骨外上髁炎肱骨外上髁炎21肘关节检查肘关节检查Mills sign:when extent the elbow，flex the wrist,pronate the forearm，if there is pain on the external condyle of humerus,there is positive sign of positive sign of Millsvideo
12、22 Wrist and handvwrist drop vape handvClaw hand23杵状指杵状指(acropachy)vrespiratory disease vheart diseasevNutritional disorders24v匙状甲匙状甲(koilonych)iron-deficiency anemia;High altitude disease rheumatic fever 25wrist and hand26crushing test of wrist crushing test of wrist triangular cartilagetriangular
13、cartilagev Wrist joint in neutral Wrist joint in neutral positionposition,And then make And then make the wrist joint the wrist joint passive to the ulnar passive to the ulnar deviation and deviation and longitudinal longitudinal extrusionextrusion,If there is If there is pain in the lower pain in t
14、he lower ulnar jointulnar joint,it shows,it shows the the positive signpositive signv injury of triangular injury of triangular fibrocartilaginous fibrocartilaginous discdisc、fracture of fracture of processus styloideus processus styloideus ulnaeulnaevideo27Joint of lower extremityvJoint of lower ex
15、tremityvKnee joint examinationvExamination of ankle joint and foot 28 Anatomy of hip jointvMaximum weight bearing joint of human bodyvideo29 Joint motion degree examination30髋关节正常活动度髋关节正常活动度31髋关节正常活动度髋关节正常活动度32 Anatomy of knee joint前交叉韧带后交叉韧带半月板韧带半月板胫骨髌骨股骨33膝关节正常活动度膝关节正常活动度34 Knee joint force line e
16、xamnationv Under normal circumstances the knee can be togetherv Normal double ankle distancev The knee can not be togetherv The ankle joint distance is too largebow legcross-knee4-6cm35 Knee joint force linev In the knee with medial pain,the knee is accompanied by lateral pain,suggesting that the me
17、dial or lateral tibial femoral joint is osteoarthritis of the knee.v The pain of the knee joint outside the knee joint is often indicated by the injury of the lateral meniscus of the knee joint and vice versa.v Severe knee joint force line abnormalities under arthroscopic debridement and cartilage t
18、reatment can relieve pain,but the main treatment is high tibial osteotomy36 Patella related examination浮髌试验浮髌试验(floating patella test)v Check the joint effusion,generally moderate effusion(50ml),floating patella test was positive。video37Examination of ankle joint and foot38Examination of ankle joint and footvideo1video239vsummary
