Saturday 25 December 2010

objective neuromuscular exam - structure


1. Working Hypothesis

2. Plan & Consent

3. Look :

3.1. General Obs
3.2. Acute Obs

4. Neurological screen

5. Feel - Palpation

6. Move :

6.1. A.P.R

6.2. specialised tests

6.3. functional tests

7. Review


detail

1. working hypothesis - based on subjective exam....
2. advice and consent - given and obtained
3. look
1. general obs watch patient walk in and sit down
2. acute obs s.s.d.a.b.s
symmetry/posture swelling discolouration
atrophy/muscle bulk bone defects/deformity
scars

5. feel - palpation
everything from s.s.d.a.b.s plus
temperature
tenderness ( indurated or weak areas )
crepitus

6. move
active
passive
resisted

background to a.p.r. compare - be aware of fixed joints - be aware of paralysis

specialised tests
functional tests

review - have i got all info - have i made comparisons - have i got divergent measurements - can i report findings