临床诊断学课件：运动系统体格检查.ppt

C 1-7 – cervical spine 颈椎 T 1-12– thoracic spine 胸椎 L1-5 – lumbar spine 腰椎 S 1-5 – sacrum spine 骶椎 Cervical spine- 7 Thoracic spine- 12 Lumbar spine - 5 Sacrum spine- 5 Coccyx spine- 4 There are four curves of the spine. 7th cervical spine procecc第7颈椎棘突：突起明显 3th thoracic 胸椎棘突：肩胛冈平面 7th 胸椎棘突：肩胛骨下角平面 第4、5腰椎棘突间：两髂嵴平面 望 触 动 量 Scoliosis侧弯 1.5% to 3% 筛查试验 弯？ 直？ kyphosis Lordosis 前曲 Lindner test (supine w/ passive neck flexion)?Passive flex of neck stretches dural sac?Pain reproduction may indicate disc lesion at level of pain?-Sharp, diffuse pain or involuntary hip move may indicate meningeal irritation /article/2092651-technique The test was first described in 1937 by Dr Paul Schober (1865 – 1943), a German physician Acropachy 杵状指 Hippocratic fingers Clubbing nail 上肢 肩关节脱位 Thomas sign Ely test 试述脊柱的常用检查方法 简述髋关节和膝关节的特殊检查方法。 NEJM Images in Clinical : /multimedia/images-in-clinical-medicine Google Bilateral Anterior Shoulder Dislocation Moughty AM, O'Connor G. N Engl J Med 2012;367:e12. McRae, Ronald. ?Clinical orthopaedic examination /. 6th ed. Edinburgh ; New York : Churchill Livingstone/Elsevier, c2010. Cleland, Joshua A. ?Netter's orthopaedic clinical examination : an evidence-based approach /. 2nd ed. Philadelphia, PA. : Saunders/Elsevier, c2011. Hattam, Paul. ?Special tests in musculoskeletal examination : an evidence-based guide for clinicians /. Edinburgh ; New York : Churchill Livingstone, 2010. caihongxin.zju@ * A 34-year-old man with a history of recurrent dislocations of both shoulders presented with sudden excruciating pain in both arms and an inability to move either of them, after attempting to lift a weight equal to his body weight above his head in the gym. On physical examination, the patient was unable to move either shoulder, and squaring of the normal shoulder contour was observed bilaterally (Panel A). Radiographs showed the anterior and inferior positions of the humeral head relative to the glenoid fo