Musculoskeletal Exam

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Musculoskeletal Exam
The basic screening musculoskeletal examination
involves inspection, palpation, and range of
motion. Muscular strength is covered under the
motor exam in the neurological exam. The
musculoskeltal examination may be divided into
spine, upper extremities, and lower
extremities. Besides the basic screening exam
there are many special maneuvers when examining a
patient with musculoskeletal complaints.
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196. Inspection of cervical, thoracic, and
lumbar spine
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197. Percussion of cervical, thoracic, lumbar and
sacral vertebrae
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198. Cervical spine flexion and extension (be
sure full extension is done) may be done from
front or back, /- palpate
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200.Cervical spine
Rotary movement, left and right, palpate
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201. Lumbar spine flexion and extension (be sure
full extension is done), /- palpate
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202. Lumbar spine lateral movement, left and
right, OK from front or back, /- palpate 203.
Lumbar spine rotary movement, left and right,
OK from front or back, /- palpate
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The Shoulder

Areas to palpate in a more thorough exam of the
shoulder. ? Sternoclavicular joint ?
Acromioclavicular joint ? Clavicle ? Scapulae ?
Coracoid process ? Greater trochanter of the
humerus ? Bicepts groove ?The area muscles
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204. Shoulders arms over head207. Note
Shoulders palpation during maneuvers (not over
gown)
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205. Shoulders hands behind head
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206. Shoulders hands behind small of back
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208. Elbows flexion and extension (be sure
full extension is done)
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209. Elbows palpation of elbowsPalpate Medial
and lateral epichondyles Olecranon process
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210. Wrists flexion and extension211. Wrists
radial and ulnar deviation
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212. Wrists--Palpations of Wrist

Palpate - Distal radius and ulna Groove of
joint Anatomic snuff box
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213. Hands bilateral fists/grip,
extend/hyperextend fingers
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214 Hands palpation of metacarpalphalangeal
joints215 Hands palpation of IPJs (PIP and DIP
joints)
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Hip Joint
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Note draping of sheet
216. Hips flexion (be sure full flexion is done
and bilaterally)
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217. Hips internal and external rotation (hip
at 900 and knee at 900 rotate on axis of femur)
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218. Hips abduction (away from the body with hip
and knee at 0 degrees)
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The Knee
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219. Knees flexion and extension (may do with
hip flexion) (be sure full extension is done)
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220. Palpation of Knees
Palpate Patella Patellar tendon Tibial
tuburosisty Medial and lateral joint lines
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221. Ankles
Dorsi and plantar flexion
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222. Ankles
Inversion, eversion of foot (stabilize at ankle
and invert and evert by heel) subtalar joint
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223. Ankles
inversion eversion of foot (stabilize at heel and
invert and evert by forefoot) transverse tarsal
joint
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Ankles palpation of ankle

• Palpate
• Anterior aspect of joint
• Achilles tendon
• Medial and lateral malleoli

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225. Feet
Palpation of metatarsophalangeal joints (may put
pressure across foot from the 1st to the 5th
metatarsals)