诊断学 6、运动系统检查.pptVIP

很多以发明者名字命名 数量惊人 特殊检查有一定特异性和敏感性 选择自己熟悉的 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 * 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 fossa (Panel B). The patient received a diagnosis of bilateral anterior shoulder dislocation. After the patient received morphine for pain relief, the shoulder dislocations were reduced individually with the use of gentle external rotation. Anterior shoulder dislocation accounts for the majority of joint dislocations seen in the emergency department. The diagnosis of dislocation is based on a number of factors, including pain and range of movement of the afflicted joint. Asymmetry of the joint typically heralds a dislocation. When bilateral dislocation occurs, this clinical asymmetry is absent, so attention must be paid to the clinical history and physical f