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2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
2010 musculo skeleton assessment
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2010 musculo skeleton assessment

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  • 1. RANGSIMA POOMSAWAT Public Health Nursing, Faculty of Nursing Chiang Mai University http://www.facebook.com/pages/Nursing-Room-By-Rangsima/109937325743807?ref=sgm13 Dec 2010 rangsima@chiangmai.ac.th 1
  • 2. 1.Health History 2.Physical Examination 3.Laboratory 4.Special Investigation13 Dec 2010 rangsima@chiangmai.ac.th 2
  • 3. 13 Dec 2010 3rangsima@chiangmai.ac.th
  • 4. 13 Dec 2010 rangsima@chiangmai.ac.th 4
  • 5. • Sex • Age • Occupational13 Dec 2010 rangsima@chiangmai.ac.th 5
  • 6. • Pain • Deformity • Numbness • Limited Movement • Redness • Inflammation13 Dec 2010 rangsima@chiangmai.ac.th 6
  • 7. • Duration • Onset • Characteristic • Location & Refer or radiation • Severity • Rhythm • Related time • Relation of Symptom • Current Rx.13 Dec 2010 rangsima@chiangmai.ac.th 7
  • 8. 13 Dec 2010 rangsima@chiangmai.ac.th 8
  • 9. Inspection Palpation Manipulation/Move Measurement Muscle Strength13 Dec 2010 rangsima@chiangmai.ac.th 9
  • 10. • Gait • posture • skin • activity deformity • swelling13 Dec 2010 rangsima@chiangmai.ac.th 10
  • 11. • Skin • - Temperature : cold, warm • Joint • - Swelling of synovial membrane. Loose body ; tenderness • Muscle • - Bulk ; Tones : Spasm ; Local ; Tendernesss • Bone • - General contour ; Abnormal prominance. Local Landmarks Tenderness • Mass • - Consistency ; Fluctuation ; Adhesion13 Dec 2010 rangsima@chiangmai.ac.th 11
  • 12. • Abnormal movement • Active and Passive • Crepitus13 Dec 2010 rangsima@chiangmai.ac.th 12
  • 13. Range of motion Abducton/Adduction 13 Dec 2010 rangsima@chiangmai.ac.th 13
  • 14. Range of motion 13 Dec 2010 rangsima@chiangmai.ac.th 14
  • 15. Range of motion 13 Dec 2010 rangsima@chiangmai.ac.th 15
  • 16. Range of motion 13 Dec 2010 rangsima@chiangmai.ac.th 16
  • 17. • Measuring tape • Goniometer13 Dec 2010 rangsima@chiangmai.ac.th 17
  • 18. ขนาดเส้นรอบวง (circumference) ใช้สายวัด 13 Dec 2010 rangsima@chiangmai.ac.th 18
  • 19. Acromion processOlecranon process Lateral le toUlnar styloid13 Dec 2010 rangsima@chiangmai.ac.th 19
  • 20. Anterior superior iliac spine Medial malleolus13 Dec 2010 rangsima@chiangmai.ac.th 20
  • 21. 13 Dec 2010 rangsima@chiangmai.ac.th 21
  • 22. • Grade 0 • Grade 1 • Grade 2 • Grade 3 • Grade 4 • Grade 513 Dec 2010 rangsima@chiangmai.ac.th 22
  • 23. การตรวจกาลังของกล้ ามเนือ ้ Biceps muscle Triceps muscle13 Dec 2010 rangsima@chiangmai.ac.th 23
  • 24. ้ การตรวจกาล ังของกล้ามเนือ Quadriceps muscle Hamstring muscle13 Dec 2010 rangsima@chiangmai.ac.th 24
  • 25. 13 Dec 2010 rangsima@chiangmai.ac.th 25
  • 26. 13 Dec 2010 rangsima@chiangmai.ac.th 26
  • 27. 13 Dec 2010 rangsima@chiangmai.ac.th 27
  • 28. Flexion Hyperextension rotation13 Dec 2010 Lateral bending rangsima@chiangmai.ac.th 28
  • 29. Heberden node13 Dec 2010 rangsima@chiangmai.ac.th 29 Bouchard node
  • 30. 13 Dec 2010 rangsima@chiangmai.ac.th 30
  • 31. Carpal tunnel syndrome• มีอาการชาตาม median nerve 13 Dec 2010 rangsima@chiangmai.ac.th 31
  • 32. extension flexion Abduction13 Dec 2010 Adduction opposition rangsima@chiangmai.ac.th 32
  • 33. hyperextension dorsiflexionextension flexion palmar flexion 13 Dec 2010 rangsima@chiangmai.ac.th 33radial deviation ulnar deviation
  • 34. Lateral Medialepicondyle Epicondyle Olecranon process13 Dec 2010 rangsima@chiangmai.ac.th 34
  • 35. Extensor surface of ulnar Olecranon process และร่ องด้ านข้ าง Medial and lateral epicondyle• Tenderness Lateral epicondyle --> extensor = tennis elbow• Medial epicondyle - - > flexor = Golfer’s elbow• 13 Dec 2010 Olecranon process - - > olecranon bursitis 35 rangsima@chiangmai.ac.th
  • 36. 13 Dec 2010 rangsima@chiangmai.ac.th 36
  • 37. รูปร่างลักษณะ -symmetry, asymmetry บวมShoulder dislocation 13 Dec 2010 rangsima@chiangmai.ac.th 37
  • 38. Acromioclavicular joint Biceps groove Sternoclavicular• Sternoclavicular joint joint• Acromioclavicular joint• Greater tubercle of humerus• Biceps groove Greater tubercle Deltoid muscle13 Dec 2010 rangsima@chiangmai.ac.th 38
  • 39. Acromion process Greater tubercle13 Dec 2010 rangsima@chiangmai.ac.th 39
  • 40. adduction&abduction internal rotation external rotationhyperextension 13 Dec 2010 rangsima@chiangmai.ac.th circumduction 40
  • 41. Biceps muscle Triceps muscle13 Dec 2010 rangsima@chiangmai.ac.th 41
  • 42. Acromion processOlecranon process Lateral le toUlnar styloid13 Dec 2010 rangsima@chiangmai.ac.th 42
  • 43. ลักษณะผิดปกติของนิวเท้ า ้ normal Flat foot 13 Dec 2010 rangsima@chiangmai.ac.th 43
  • 44. 13 Dec 2010 rangsima@chiangmai.ac.th 44
  • 45. Ankle jointMetatarsophalangeal joint 13 Dec 2010 rangsima@chiangmai.ac.th 45
  • 46. Ankle jointdกd dorsiflexion plantarflexion 13 Dec 2010 rangsima@chiangmai.ac.th 46
  • 47. 13 Dec 2010 rangsima@chiangmai.ac.th 47
  • 48. Transverse tarsal joint13 Dec 2010 rangsima@chiangmai.ac.th 48
  • 49. Subtalar joint13 Dec 2010 rangsima@chiangmai.ac.th 49
  • 50. ตรวจการเคลือนไหวของนิวเท ้า ่ ้ Metatarsophalangeal joint13 Dec 2010 rangsima@chiangmai.ac.th 50
  • 51. •รูปร่างลักษณะ พิการผิดรูป •Quadriceps muscle atrophy •ปกติ ควรมีรอยบุมอยูเหนือ และด ้านข ้าง patella ๋ ่ (Suprapatella pouch, Lateral and Medial epicondyle)13 Dec 2010 rangsima@chiangmai.ac.th 51
  • 52. Medial epicondyle Lateral epicondyle13 Dec 2010 rangsima@chiangmai.ac.th 52
  • 53. Suprapatella pouch • Suprapatella pouch, Patella • Lateral and Medial epicondyle • Bulge sign • Ballottement13 Dec 2010 rangsima@chiangmai.ac.th 53
  • 54. Bulge signกดไล่ขึนบน ้ ใช้ นิวมือกดแล้วปล่อย ้ lateral medial medial13 Dec 2010 rangsima@chiangmai.ac.th 54
  • 55. Ballottementกด patella แล้ วปล่ อย กดแรงๆ13 Dec 2010 rangsima@chiangmai.ac.th 55
  • 56. 13 Dec 2010 rangsima@chiangmai.ac.th งอเข่ า /เหยียดเข่ า 56
  • 57. ิ ข ้อตะโพก และกระดูกเชงกราน13 Dec 2010 rangsima@chiangmai.ac.th 57
  • 58. Hip flexion Knee extension Hip flexion deformity “normal”13 Dec 2010 rangsima@chiangmai.ac.th 58
  • 59. extension/hyperextension flexion adduction/abduction external rotationinternal rotation 13 Dec 2010 rangsima@chiangmai.ac.th 59
  • 60. Quadriceps muscleHamstring muscle 13 Dec 2010 rangsima@chiangmai.ac.th 60
  • 61. Anterior superior iliac spine to medial joint knee to13 Dec 2010 Medial malleolus rangsima@chiangmai.ac.th 61
  • 62. ด ้านหน ้า ด ้านข ้าง ด ้านหลัง Kyphosis Scoliosis Lordosis13 Dec 2010 rangsima@chiangmai.ac.th 62
  • 63. Paravertebral muscle palpation Spine palpation Thoracic spinous process Lambar spinous process13 Dec 2010 rangsima@chiangmai.ac.th 63
  • 64. flexion extension/hyperextension lateral bending active range of motion rotation 13 Dec 2010 rangsima@chiangmai.ac.th 64
  • 65. passive range of motion13 Dec 2010 rangsima@chiangmai.ac.th 65
  • 66. • CBC • Hb • WBC • Blood Chemistry • Calcium • Phosphorus • Alkaline Phosphatase • Uric Acid13 Dec 2010 rangsima@chiangmai.ac.th 66
  • 67. 13 Dec 2010 rangsima@chiangmai.ac.th 67
  • 68. 13 Dec 2010 rangsima@chiangmai.ac.th 68
  • 69. 13 Dec 2010 rangsima@chiangmai.ac.th 69
  • 70. 13 Dec 2010 rangsima@chiangmai.ac.th 70
  • 71. 13 Dec 2010 rangsima@chiangmai.ac.th 71
  • 72. 13 Dec 2010 rangsima@chiangmai.ac.th 72
  • 73. 13 Dec 2010 rangsima@chiangmai.ac.th 73
  • 74. Rangsima Poomsawat Public Health Nursing ,Faculty of Nursing, Chiang Mai University E mail : rangsima@chiangmai.ac.th , to_rangsima@hotmail.com http://www.facebook.com/RangsimaPoomsawat http://www.slideshare.net/rpoom http://www.youtube.com/RangsimaPoomsawat http://www.facebook.com/pages/Nursing-Room-By-Rangsima/109937325743807?v=wall13 Dec 2010 rangsima@chiangmai.ac.th 74

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