Musculoskeletal Examination E-Book

Jeffrey M. Gross

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Veröffentlichungsjahr: 2015

Beschreibung

MUSCULOSKELETAL EXAMINATION Musculoskeletal Examination is a user-friendly textbook on the techniques of physical examination. Written by a physiatrist, orthopedic surgeon, and physical therapist, it has a uniquely multidisciplinary approach. Musculoskeletal Examination covers the complete basic examination and basic principles of normal and abnormal musculoskeletal function are fully explained, leading you to the correct differential diagnosis. The new fourth edition is now in full colour throughout and includes over 750 detailed illustrations, X-rays and MRIs, and more than 100 photographs showing examination techniques. It also includes a companion website at www.wiley.com/go/musculoskeletalexam featuring 107 MCQs and videos demonstrating key examination methods. Musculoskeletal Examination is perfect as a quick reference guide, while the detailed descriptions and clinically relevant examples of frequently encountered conditions will help even the most novice practitioner gain the understanding necessary to make a correct diagnosis and determine a successful treatment plan. It is ideal for physical therapists, physiatrists, orthopedists, medical students, practitioners, and all those involved in sports medicine and clinical massage. All content reviewed by students for students Wiley Medical Education books are designed exactly for their intended audience. All of our books are developed in collaboration with students. This means that our books are always published with you, the student, in mind.

Leseprobe

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Musculoskeletal Examination

Fourth Edition

Jeffrey M. Gross, MD

Clinical Assistant Professor of Rehabilitation MedicineWeill-Cornell Medical CollegeAdjunct Clinical Associate Professor of Rehabilitation MedicineNew York University School of MedicineMedical DirectorUnion Square Rehabilitation and Sports MedicineNew York

Joseph Fetto, MD

Associate Professor of Orthopedic SurgeryNew York University School of MedicineAssociate Professor and ConsultantManhattan V.A. Medical CenterNew York

Elaine Rosen, PT, DHSc, OCS

Professor of Physical TherapyHunter CollegeCity University of New YorkPartnerQueens Physical Therapy AssociatesForest Hills, New York

This edition first published 2016 © 2016 by John Wiley & Sons, Ltd Previous editions: 1996, 2009 by Jeffrey Gross, Joseph Fetto, Elaine Rosen

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Library of Congress Cataloging-in-Publication Data

Gross, Jeffrey M., 1957–, author.   Musculoskeletal examination / Jeffrey M. Gross, Joseph Fetto, Elaine Rosen. – 4th edition.       p. ; cm.   Includes bibliographical references and index.   ISBN 978-1-118-96276-3 (pbk.)   I. Fetto, Joseph, author.  II. Rosen, Elaine, author.  III. Title.   [DNLM: 1. Musculoskeletal Diseases–diagnosis.  2. Musculoskeletal Physiological Phenomena.  3. Musculoskeletal System–anatomy & histology.  4. Physical Examination–methods. WE 141]   RC925.7   616.70076–dc23

2015000697

A catalogue record for this book is available from the British Library.

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Cover image: istock (photo/muscles-of-the-arm-34748034) 02-09-14 (c) Eraxion

Contents

How to Use This Book

Acknowledgments

About the Companion Website

Chapter 1 Introduction

What Is a Physical Examination?

What Is the Purpose of the Physical Examination?

How Is the Physical Examination Useful?

How Does the Musculoskeletal System Work?

What Are Paradigms?

What Are the Components of the Musculoskeletal System?

Bone

Cartilage

Ligaments

Muscle

Tendons

Synovium and Bursae

Fascia

The Interaction of Connective Tissues

Chapter 2 Basic Concepts of Physical Examination

Introduction

Observation

Subjective Examination (History)

Objective Examination

Anterior View

Correlation

Chapter 3 Overview of the Spine and Pelvis

Chapter 4 The Cervical Spine and Thoracic Spine

Observation

Subjective Examination

Gentle Palpation

Trigger Points of the Cervical Spine

Active Movement Testing

Passive Movement Testing

Resistive Testing

Neurological Examination of the Cervical Spine and Upper Extremity

Special Tests

Upper Cervical Instability Testing

Alar Ligament Stress Tests

Referred Pain Patterns

Radiological Views

Chapter 5 The Temporomandibular Joint

Functional Anatomy of the Temporomandibular Joint

Observation

Subjective Examination

Special Questions

Gentle Palpation

Trigger Points of the TMJ Region

Active Movement Testing

Passive Movement Testing

Resistive Testing

Reflex Testing

Chapter 6 The Lumbosacral Spine

Observation

Subjective Examination

Gentle Palpation

Trigger Points of the Lumbosacral Region

Active Movement Testing

Forward Bending

Passive Movement Testing

Resistive Testing

Neurological Testing

Special Tests

Radiological Views

Chapter 7 Overview of the Upper Extremity

Chapter 8 The Shoulder

Functional Anatomy

Observation

Subjective Examination

Gentle Palpation

Trigger Points of the Shoulder Region

Active Movement Testing

Passive Movement Testing

Resistive Testing

Neurological Examination

Special Tests

Referred Pain Patterns

Radiological Views

Chapter 9 The Elbow

Functional Anatomy

Observation

Subjective Examination

Gentle Palpation

Resistive Testing

Elbow Flexion

Elbow Extension

Forearm Pronation

Forearm Supination

Neurological Examination

Special Tests

Referred Pain Patterns

Radiological Views

Chapter 10 The Wrist and Hand

Functional Anatomy

Observation

Subjective Examination

Gentle Palpation

Active Movement Testing

Passive Movement Testing

Resistive Testing

Neurological Examination

Special Tests

Referred Pain Patterns

Radiological Views

Chapter 11 The Hip

Functional Anatomy

Observation

Subjective Examination

Gentle Palpation

Anterior Aspect—The Patient Is Positioned in Supine

Posterior Aspect—The Patient Is Positioned in Prone

Side-Lying Position

Trigger Points

Active Movement Testing

Flexion

Extension

Abduction

Adduction

Medial (Internal) Rotation

Lateral (External) Rotation

Passive Movement Testing

Physiological Movements

Resistive Testing

Neurological Examination

Special Tests

Tests for Integrity of the Hip Joint for Degenerative Joint Disease (DJD) or Labral Tear

Radiological Views

Chapter 12 The Knee

Functional Anatomy

Observation

Subjective Examination

Gentle Palpation

Trigger Points

Active Movement Testing

Passive Movement Testing

Resistive Testing

Neurological Examination

Special Tests

Radiological Views

Chapter 13 The Ankle and Foot

Functional Anatomy

Observation

Subjective Examination

Gentle Palpation

Active Movement Testing

Passive Movement Testing

Resistive Testing

Neurological Examination

Referred Pain Patterns

Special Tests

Tests for Alignment

Radiological Views

Chapter 14 Gait

The Lower Extremity

What Is Gait?

What Is Normal Gait?

The Examination of Abnormal Gait

Appendices

Bibliography

Index

EULA

List of Tables

Chapter 1

Table 1.1

Table 1.2

Chapter 6

Table 6.1

Chapter 8

Table 8.1

Chapter 9

Table 9.1

Chapter 10

Table 10.1

Table 10.2

Chapter 11

Table 11.1

Chapter 12

Table 12.1

Chapter 13

Table 13.1

Chapter 14

Table 14.1

Appendices

Appendix A

Appendix B

List of Illustrations

Chapter 1

Figure 1.1

Biological systems, like inorganic systems, can fail under one of two modes: an acute single supramaximal stress or repetitive submaximal chronic loading.

Figure 1.2

The “vicious cycle of injury” results from the reinjury of a vulnerable, recently traumatized system. This increased vulnerability occurs due to a diminishing of a system's tolerance limit as a result of adaptation to a lower level of demand during the period of rest necessitated by pain.

Figure 1.3

Conditioning is the adaptation of a biological system to the controlled application of increasing stress at a frequency, intensity, and duration within the system's tolerance limit, with a resultant increase in the system's tolerance limit.

Figure 1.4

(a) Collagen is a linear protein made of α chains that wind into a triple-helix. (b) Collagen fibrils are formed by the cross-linking of collagen monomer proteins. (c) The different types of collagen are determined by the number of α1 and α2 collagen monomers that join to form a triple-helix collagen molecule. For example, two α1 chains and one α2 chain that join to form a triple-helix make type I collagen, which is found in bone, tendon, ligament, fascia, skin, arteries, and the uterus. Type II collagen, which is found in articular cartilage, contains three α1 chains. There are at least 12 different collagen types.

Figure 1.5

The proteoglycan aggregate is formed on a backbone of hyaluronic acid and has the appearance of a bristle brush.

Figure 1.6

The structure of a typical long bone.

Figure 1.7

The composition and structure of articular hyaline cartilage. Water moves in and out of the cartilage due to the pressure of the joint surfaces on one another and attraction of the water by the ground substance. Note the orientation of the collagen fibers.

Figure 1.8

The ligaments of the knee. Because of the inherent instability of the joint, ligaments are necessary to prevent motion in all planes. They act as the primary stabilizers of the joint and are assisted by the muscles and other connective tissues.

Figure 1.9

The mechanical response of stress and strain on the anterior longitudinal ligament and the ligamentum flavum. The anterior cruciate ligament, having more collagen than elastin, can handle a larger load but will only stretch a short amount before breaking. The ligamentum flava, having more elastin than collagen, cannot tolerate a very large load but can stretch a lot before breaking.

Figure 1.10

A microscopic view of muscle shows the repeated patterns of the sarcomeres and the fibrils.

Figure 1.11

The organization of skeletal muscle tissue.

Figure 1.12

Different types of muscle–fascicle arrangements.

Figure 1.13

A tendon.

Figure 1.14

The olecranon bursa is between the skin and the olecranon process at the elbow.

Chapter 2

Figure 2.1

Body chart.

Figure 2.2

Normal posterior view.

Figure 2.3

Calcaneal valgus deformity.

Figure 2.4

Genu varum (a) and valgum (b) deformities.

Figure 2.5

Scoliosis.

Figure 2.6

Rounded thoracic kyphosis.

Figure 2.7

Abducted scapula.

Figure 2.8

Winged scapula.

Figure 2.9

Sprengel's deformity.

Figure 2.10

Normal anterior view.

Figure 2.11

Pes planus deformity.

Figure 2.12

Hammertoe deformity.

Figure 2.13

Hallux valgus deformity.

Figure 2.14

Squinting patellae. The patellae face each other.

Figure 2.15

Genu varum (a) and valgum (b) deformities.

Figure 2.16

Barrel chest deformity.

Figure 2.17

Torticollis.

Figure 2.18

Normal lateral view.

Figure 2.19

Normal medial longitudinal arch.

Figure 2.20

Genu recurvatum deformity.

Figure 2.21

Flat back deformity.

Figure 2.22

Sway back deformity.

Figure 2.23

Dowager's hump deformity.

Figure 2.24

Rounded shoulders.

Figure 2.25

Forward head posture.