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Introduction to Clinical Skills  Limbs Examination Universidad Iberoamericana UNIBE
Introduction to Clinical Skills <ul><li>Teaching Staff  </li></ul><ul><ul><li>Dra Elizabeth Peralta </li></ul></ul><ul><ul...
Introduction to Clinical Skills <ul><li>Objectives </li></ul><ul><ul><li>Skin and Appendages </li></ul></ul><ul><ul><li>Pe...
Introduction to Clinical Skills  Lower Extremities Universidad Iberoamericana UNIBE
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy-Histology-Physiology ...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology -Anatomy-Histology-Physiology...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology- Anatomy -Histology-Physiolog...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy- Histology -Physiolog...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy-Histology- Physiology...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>The Health History </li></ul></ul><ul><u...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Forefoot Types </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Anatomy </li></ul></ul><ul><ul><li>...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Anatomy </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>The Health History </li></ul></ul><...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Health Promotion and Counseling </l...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Risk factors for Lower-Extremity ar...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Recording your findings </li></ul><...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory evaluation  (sensory pa...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory evaluation (sensory pat...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory evaluation (sensory pat...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor exam (motor pathways) </l...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor exam (motor pathways) </l...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (spinal reflexes: the ...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (spinal reflexes: the ...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (spinal reflexes: the ...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (spinal reflexes: the ...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (Cutaneous stimulation...
Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Joint structure and function </li></ul><...
Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Joint structure and function </li></ul><...
Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>The Health History </li></ul></ul><ul><u...
Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Health Promotion and Counseling. Importa...
Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Examination of specific joints </li></ul...
Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Joint structure and function </li></ul><...
Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Joint structure and function </li></ul><...
Introduction to Clinical Skills
Introduction to Clinical Skills  Upper Extremities Universidad Iberoamericana UNIBE
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul>
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology -Anatomy-Histology-Physiology...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology- Anatomy -Histology-Physiolog...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy- Histology -Physiolog...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy-Histology- Physiology...
Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>The Health History </li></ul></ul><ul><u...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>The Health History </li></ul></ul><...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Arterial </li></ul></ul><ul><ul><li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Allen´s Test </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Allen´s Test </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Allen´s Test </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Allen´s Test </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Arterial </li></ul></ul><ul><ul><li...
Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Arterial </li></ul></ul><ul><ul><li...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory  </li></ul></ul><ul><ul...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory  </li></ul></ul><ul><ul...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory  </li></ul></ul><ul><ul...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Motor </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Flexion </li></ul></ul><ul><u...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Ulnar deviation </li></ul></u...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Fingers flexion </li></ul></u...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Motor </li></ul></ul><ul><ul>...
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Motor </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Motor </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Motor </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Motor </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral neurological exam   </li></ul><ul><ul><li>Motor </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes </li></ul></ul>
Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes </li></ul></ul>
Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Muscles </li></ul></ul><ul><ul><li>Bones...
Introduction to Clinical Skills
Introduction to Clinical Skills
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Transcript of "Limbs examination"

  1. 1. Introduction to Clinical Skills Limbs Examination Universidad Iberoamericana UNIBE
  2. 2. Introduction to Clinical Skills <ul><li>Teaching Staff </li></ul><ul><ul><li>Dra Elizabeth Peralta </li></ul></ul><ul><ul><li>Dr Marcos Núñez </li></ul></ul><ul><ul><li>Dra Cristina Páez C </li></ul></ul><ul><ul><li>Dr Juan Carlos Mariñez </li></ul></ul><ul><ul><li>Dra Wayna Greo </li></ul></ul><ul><ul><li>Dra Yun Pey Lee </li></ul></ul>
  3. 3. Introduction to Clinical Skills <ul><li>Objectives </li></ul><ul><ul><li>Skin and Appendages </li></ul></ul><ul><ul><li>Peripheral Vascular </li></ul></ul><ul><ul><li>Neurological (Peripheral) </li></ul></ul><ul><ul><ul><li>Sensory, Motor, Reflexes </li></ul></ul></ul><ul><ul><li>Muscle-skeletal </li></ul></ul><ul><ul><ul><li>Muscle tone, Muscle strength </li></ul></ul></ul>
  4. 4. Introduction to Clinical Skills Lower Extremities Universidad Iberoamericana UNIBE
  5. 5. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy-Histology-Physiology </li></ul></ul><ul><ul><li>The Health History </li></ul></ul><ul><ul><li>Health Promotion and Counseling </li></ul></ul>
  6. 6. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology -Anatomy-Histology-Physiology </li></ul></ul><ul><ul><ul><li>11 weeks </li></ul></ul></ul>1.Periderm 2. Basal layer 3. Intermediate layer 4. Migrating melanoblast 5. Mesenchyme
  7. 7. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology- Anatomy -Histology-Physiology </li></ul></ul>
  8. 8. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy- Histology -Physiology </li></ul></ul>
  9. 9. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy-Histology- Physiology </li></ul></ul>
  10. 10. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>The Health History </li></ul></ul><ul><ul><ul><li>Rash </li></ul></ul></ul><ul><ul><ul><li>Moles (Nevus) </li></ul></ul></ul><ul><ul><li>Health Promotion and Counseling </li></ul></ul><ul><ul><ul><li>Risk factors for skin cancers </li></ul></ul></ul><ul><ul><ul><li>Avoidance of excessive sun exposrure </li></ul></ul></ul><ul><ul><ul><li>Avoid skin dryness </li></ul></ul></ul><ul><ul><ul><li>Nail cutting (pedicure) </li></ul></ul></ul><ul><ul><ul><li>Shoes </li></ul></ul></ul>
  11. 11. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Forefoot Types </li></ul></ul>
  12. 12. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Anatomy </li></ul></ul><ul><ul><li>The Health History </li></ul></ul><ul><ul><li>Health Promotion and Conseling </li></ul></ul>
  13. 13. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Anatomy </li></ul></ul>
  14. 14. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>The Health History </li></ul></ul><ul><ul><ul><li>Pain in the legs </li></ul></ul></ul><ul><ul><ul><li>Intermittent claudication </li></ul></ul></ul><ul><ul><ul><li>Cold, numbness, pallor in the legs, hair loss </li></ul></ul></ul><ul><ul><ul><li>Swelling in calves, legs or feet </li></ul></ul></ul><ul><ul><ul><li>Color change in toes in cold weather </li></ul></ul></ul><ul><ul><ul><li>Swelling with redness or tenderness </li></ul></ul></ul>
  15. 15. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Health Promotion and Counseling </li></ul></ul><ul><ul><ul><li>Screening for peripheral arterial disease </li></ul></ul></ul><ul><ul><ul><li>Screening for renal artery disease </li></ul></ul></ul><ul><ul><ul><li>Screening for abdominal aortic aneurysm </li></ul></ul></ul>
  16. 16. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Risk factors for Lower-Extremity arterial peripheral disease </li></ul></ul><ul><ul><ul><li>Age younger than 50 years with diabetes or atherosclerosis risk factor of smoking, dyslipidemia, hypertension, or hyperhomocysteinemia </li></ul></ul></ul><ul><ul><ul><li>Age 50 to 60 years and history of smoking or diabetes </li></ul></ul></ul><ul><ul><ul><li>Age 70 years or older </li></ul></ul></ul><ul><ul><ul><li>Leg symptoms with exertion or ischemic rest pain </li></ul></ul></ul><ul><ul><ul><li>Abnormal lower extremity pulses </li></ul></ul></ul><ul><ul><ul><li>Known atherosclerotic coronary, carotid, or renal disease </li></ul></ul></ul>
  17. 17. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li></ul></ul><ul><ul><ul><li>The Legs </li></ul></ul></ul><ul><ul><ul><ul><li>Size, symmetry, skin color </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Femoral pulse and inguinal lymph nodes </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Popliteal, posterior tibialis and dorsalis pedis pulses </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Peripheral edema </li></ul></ul></ul></ul>
  18. 18. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li></ul></ul><ul><ul><ul><li>Arterial system exam </li></ul></ul></ul><ul><ul><ul><ul><li>Anatomy </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Pallor, cyanosis </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Color and capillary refill </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Postural changes </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Extremity pulses ( 0 to 2+) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Ankle Brachial Index </li></ul></ul></ul></ul>
  19. 19. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li></ul></ul><ul><ul><ul><li>Arterial system exam </li></ul></ul></ul>
  20. 20. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li></ul></ul><ul><ul><ul><li>Arterial system exam </li></ul></ul></ul>
  21. 21. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li></ul></ul><ul><ul><ul><li>Venous system exam </li></ul></ul></ul><ul><ul><ul><ul><li>Anatomy </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Skin color, pigmentattion, ulcers </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Postural changes </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Venous pattern </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Competency of venous valves </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Soft edema </li></ul></ul></ul></ul>
  22. 22. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li></ul></ul><ul><ul><ul><li>Venous system exam </li></ul></ul></ul>
  23. 23. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li></ul></ul><ul><ul><ul><li>Venous system exam </li></ul></ul></ul>
  24. 24. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Important Areas of Examination </li></ul></ul><ul><ul><ul><li>Lymphatic system exam </li></ul></ul></ul><ul><ul><ul><ul><li>Anatomy </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Skin color </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Postural changes </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Edema (soft vs brawny) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Palpable lymph nodes </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Painful lymh nodes </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Red striking tracts </li></ul></ul></ul></ul>
  25. 25. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Recording your findings </li></ul></ul><ul><ul><ul><li>“ Extremities are warm and without edema. No varicosities or stasis changes. Calves are supple and nontender. No femoral or abdominal bruits. Femoral, popliteal, posterior tibialis and dorsalis pedis pulses are 2+ and symmetric” </li></ul></ul></ul>
  26. 26. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory evaluation (sensory pathways) </li></ul></ul><ul><ul><li>Motor exam (motor pathways) </li></ul></ul><ul><ul><li>Reflexes (spinal reflexes: the deep tendon response) </li></ul></ul>
  27. 27. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory evaluation (sensory pathways) </li></ul></ul><ul><ul><ul><li>Dermatomes </li></ul></ul></ul><ul><ul><ul><ul><li>Pinwheel </li></ul></ul></ul></ul><ul><ul><ul><li>Digital nerves </li></ul></ul></ul><ul><ul><ul><ul><li>2PD static </li></ul></ul></ul></ul>
  28. 28. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory evaluation (sensory pathways) </li></ul></ul>
  29. 29. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor exam (motor pathways) </li></ul></ul><ul><ul><ul><li>Body position </li></ul></ul></ul><ul><ul><ul><li>Involuntary movements </li></ul></ul></ul><ul><ul><ul><li>Muscle bulk </li></ul></ul></ul><ul><ul><ul><li>Muscle tone </li></ul></ul></ul><ul><ul><ul><li>Muscle strength </li></ul></ul></ul>
  30. 30. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor exam (motor pathways) </li></ul></ul>
  31. 31. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (spinal reflexes: the deep tendon response) </li></ul></ul><ul><ul><ul><li>Patella </li></ul></ul></ul><ul><ul><ul><li>Achilles tendon </li></ul></ul></ul>
  32. 32. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (spinal reflexes: the deep tendon response) </li></ul></ul>
  33. 33. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (spinal reflexes: the deep tendon response) </li></ul></ul><ul><ul><ul><li>Reinforcement of Knee Reflex </li></ul></ul></ul>
  34. 34. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (spinal reflexes: the deep tendon response) </li></ul></ul>
  35. 35. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes (Cutaneous stimulation reflex) </li></ul></ul>
  36. 36. Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Joint structure and function </li></ul></ul><ul><ul><li>The Health History </li></ul></ul><ul><ul><li>Health Promotion and Counseling </li></ul></ul><ul><ul><li>Examination of specific joints </li></ul></ul><ul><ul><ul><li>Spine and Hip </li></ul></ul></ul><ul><ul><ul><li>Joints of lower extremities </li></ul></ul></ul>
  37. 37. Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Joint structure and function </li></ul></ul>
  38. 38. Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>The Health History </li></ul></ul><ul><ul><li>Common or concerning Symptoms </li></ul></ul><ul><ul><ul><li>Low back pain </li></ul></ul></ul><ul><ul><ul><li>Monoarticular or polyarticular joint pain </li></ul></ul></ul><ul><ul><ul><li>Inflammatory or infectious joint pain </li></ul></ul></ul><ul><ul><ul><li>Joint pain with systemic features such fever, chills, rash, anorexia, weight loss, weakness </li></ul></ul></ul><ul><ul><ul><li>Joint pain with symptoms from other organ system </li></ul></ul></ul>
  39. 39. Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Health Promotion and Counseling. Important Topics </li></ul></ul><ul><ul><ul><li>Nutrition </li></ul></ul></ul><ul><ul><ul><li>Low back: lifting biomechanics </li></ul></ul></ul><ul><ul><ul><li>Prevneting falls </li></ul></ul></ul><ul><ul><ul><li>Osteoporosis: screening and prevention </li></ul></ul></ul>
  40. 40. Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Examination of specific joints </li></ul></ul>
  41. 41. Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Joint structure and function </li></ul></ul>
  42. 42. Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Joint structure and function </li></ul></ul>
  43. 43. Introduction to Clinical Skills
  44. 44. Introduction to Clinical Skills Upper Extremities Universidad Iberoamericana UNIBE
  45. 45. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul>
  46. 46. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology -Anatomy-Histology-Physiology </li></ul></ul>
  47. 47. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology- Anatomy -Histology-Physiology </li></ul></ul>
  48. 48. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy- Histology -Physiology </li></ul></ul>
  49. 49. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>Embriology-Anatomy-Histology- Physiology </li></ul></ul>
  50. 50. Introduction to Clinical Skills <ul><li>Skin and Appendages </li></ul><ul><ul><li>The Health History </li></ul></ul><ul><ul><ul><li>Rash </li></ul></ul></ul><ul><ul><ul><li>Moles (Nevus) </li></ul></ul></ul><ul><ul><li>Health Promotion and Counseling </li></ul></ul><ul><ul><ul><li>Risk factors for skin cancers </li></ul></ul></ul><ul><ul><ul><li>Avoidance of excessive sun exposrure </li></ul></ul></ul><ul><ul><ul><li>Avoid skin dryness </li></ul></ul></ul>
  51. 51. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>The Health History </li></ul></ul><ul><ul><ul><li>Pain in the hands </li></ul></ul></ul><ul><ul><ul><li>Intermittent claudication </li></ul></ul></ul><ul><ul><ul><li>Cold, numbness, pallor in the hands, hair loss </li></ul></ul></ul><ul><ul><ul><li>Swelling in arm, forearm and hand </li></ul></ul></ul><ul><ul><ul><li>Color change in fingers in cold weather </li></ul></ul></ul><ul><ul><ul><li>Swelling with redness or tenderness </li></ul></ul></ul>
  52. 52. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Arterial </li></ul></ul><ul><ul><li>Venous </li></ul></ul><ul><ul><li>Lymphatics </li></ul></ul>
  53. 53. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Allen´s Test </li></ul></ul>
  54. 54. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Allen´s Test </li></ul></ul>
  55. 55. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Allen´s Test </li></ul></ul>
  56. 56. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Allen´s Test </li></ul></ul>
  57. 57. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Arterial </li></ul></ul><ul><ul><li>Venous </li></ul></ul><ul><ul><li>Lymphatics </li></ul></ul>
  58. 58. Introduction to Clinical Skills <ul><li>Peripheral vascular exam </li></ul><ul><ul><li>Arterial </li></ul></ul><ul><ul><li>Venous </li></ul></ul><ul><ul><li>Lymphatics </li></ul></ul>
  59. 59. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory </li></ul></ul><ul><ul><ul><li>Pinwheel exam </li></ul></ul></ul>
  60. 60. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory </li></ul></ul><ul><ul><ul><li>2PD static or moving </li></ul></ul></ul>
  61. 61. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Sensory </li></ul></ul><ul><ul><ul><li>Tinel´s sign </li></ul></ul></ul>
  62. 62. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor </li></ul></ul>
  63. 63. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Flexion </li></ul></ul><ul><ul><li>Extension </li></ul></ul><ul><ul><li>Pronation </li></ul></ul><ul><ul><li>Supination </li></ul></ul>
  64. 64. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Ulnar deviation </li></ul></ul><ul><ul><li>Radial deviation </li></ul></ul>
  65. 65. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Fingers flexion </li></ul></ul><ul><ul><li>Fingers extension </li></ul></ul>
  66. 66. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor </li></ul></ul><ul><ul><ul><li>Muscle Bulk </li></ul></ul></ul><ul><ul><ul><li>Muscle Tone </li></ul></ul></ul><ul><ul><ul><li>Muscle Strength </li></ul></ul></ul><ul><ul><ul><ul><li>M0 –M5 </li></ul></ul></ul></ul><ul><ul><ul><li>Grip strength </li></ul></ul></ul><ul><ul><ul><ul><li>Dynamometer </li></ul></ul></ul></ul>
  67. 67. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor </li></ul></ul>
  68. 68. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor </li></ul></ul>
  69. 69. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor </li></ul></ul>
  70. 70. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor </li></ul></ul>
  71. 71. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Motor </li></ul></ul>
  72. 72. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes </li></ul></ul>
  73. 73. Introduction to Clinical Skills <ul><li>Peripheral neurological exam </li></ul><ul><ul><li>Reflexes </li></ul></ul>
  74. 74. Introduction to Clinical Skills <ul><li>Muscleskeletal exam </li></ul><ul><ul><li>Muscles </li></ul></ul><ul><ul><li>Bones </li></ul></ul><ul><ul><li>Joints an ligaments </li></ul></ul>
  75. 75. Introduction to Clinical Skills
  76. 76. Introduction to Clinical Skills
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