This document summarizes an examination of the upper limbs, including assessment of the pulse, skin temperature, anatomy, presence of any arteriovenous fistula, skin changes, lymph nodes, needle tracks, and nail changes. Specific conditions mentioned include Dubuytren's contracture, polydactyly, syndactyly, scleroderma, tetany, rheumatoid arthritis, osteoarthritis, psoriatic arthritis, gouty arthritis, and dactylitis. Clubbing of the nails and its causes are also discussed.

1. Upper limb examination

2. Anatomy

3. Pulse

4. Skin temperature

5. AV fistula

6. SKIN

7. Pallor

9. BLEEDING tendency

10. hemoarthrosis

11. LNs

12. Needle tracks

13. Acanthosis Nigricans

14. Xanthomatosis

15. PULM ERYTH VITELLIGO

17. Tylosis

18. Raynaud’s phenomena

19. Shape

20. Spade shaped hand

22. Arachnodactyly

27. Down Syndrome

28. PSEUDOHYPOPARA

30. Dubuytren contracture
Thickening and fibrotic contracture of the palmar fascia
results in puckering of skin, and flexion deformity of
the fingers, especially of the inner two or three fingers
. The thumb is characteristically spared.
- The condition may be unilateral, or bilateral.

31. Polydactyly
Syndactyly

32. Scleroderma

34. TETANY

37. Look
• Rheumatoid arthritis

41. Osteoarthritis

42. Osteoartheritis

43. Psoriatic arthritis

45. Gouty arthritis

46. DACTYLITIS

47. Nail examination

48. Clubbing

52. Clubbing

55. ??

56. Thyroid acropachy in Grave’s

57. Pseudo-clubbing
in Scleroderma

60. HAND

67. Wasting of small muscles of the hand

68. Tremors

69. Thank you