Sean P. Flanagan, PhD, ATC, CSCS Department of Kinesiology California State University, Northridge

Transcription

1 Sean P. Flanagan, PhD, ATC, CSCS Department of Kinesiology California State University, Northridge 2006 Sean P. Flanagan

2

3 Muscle Organs Tendon Bone Body Structures Bursae Joint Nerve Vascular

4 Exostosis Apophysitis Contusion Bone Avulsion Fracture Stress Classification Location Severity Shape

5 FRACTURE CLASSIFICATIONS A. By Location 1) 2) 3) B. Severity 1) 2) 3) 4) C. Shape 1) 2) 3) 4) 5) 6) 7)

6 Arthritis Osteochondritis Dissecans Osteochondral Defects Ligament Joint Synovitis 1 st Degree Sprain 2 nd Degree 3 rd Degree Subluxation Cartilage Tear Dislocation

7 Strain Muscle Contusion 1 st Degree 2 nd Degree 3 rd Degree Myositis Ossificans

8 Calcific Tendinitis Tendinosis Tenosynovitis Tendinitis Tendon 1 st Degree 2 nd Degree 3 rd Degree Peritendinitis

9 Bursa Bursitis

10 Complex Regional Pain Syndrome Stretch Nerve Entrapment Neurapraxia Axonotmesis Neurotmesis

11 COMPARING TISSUE INJURIES Structure Nomenclature Description Ligament Muscle Tendon Nerve

12 Vascular

13

14 Evaluations Clinical On-Field Ambulatory Athlete Down

15 Injury Evaluation Process

16 Description Related to Opposite Side Changes in Symptoms Previous History Mechanism History General Medical Health Sounds & Sensations Location Onset & Duration

17 COMMON DESCRIPTIONS OF PAIN A. BONE B. FRACTURE C. JOINT D. MUSCLE / TENDON E. BURSAE F. NERVE G. VASCULAR

18 Posture Gross Deformity Gait Shoes Observation Functional Movement Patterns Injured Area Signs of Infection Swelling Discoloration Bilateral Symmetry

19 SIGNS OF INFECTION A. Pain B. Redness C. Swelling D. Pus E. Foul Odor Drainage F. Heat to Site G. Fever H. Swollen Lymph Nodes

20 Changes in Tissue Density Point Tenderness Palpation Crepitus Trigger Points

21 PALPATION GUIDELINES A. Practice Self Palpation B. Less is More C. Movement vs. Stillness D. Develop a Sequence 1) Structures 2) Areas E. Begin on Opposite Side / Away from Pain

22 Stress Tests

23 Long Bone Compression Bone Percussion

24 Passive R.O.M. End Feel Special Tests Joint Joint Play

25 END FEELS A. Normal 1) 2) 3) B. Abnormal 1) 2) 3) 4) 5)

26 GONIOMETRY SFTR METHOD Plane 1 st Number 2 nd Number 3 rd Number Sagittal (S) Frontal (F) Transverse (T) Rotation (R) Hypomobility Fixed Joint Ankylosis

27 Resisted R.O.M. Isometric Break Tests Active R.O.M. Muscle / Tendon Passive R.O.M.

28 MUSCLE TEST GRADING GRADE VALUE MOVEMENT

29 Deep Tendon Reflexes Myotomes Motor Sensory Dermatomes Nerve Pathological Reflexes Brain Cerebrum Cerebellum Cranial Nerve

30 DEEP TENDON REFLEX GRADING GRADE VALUE PATHOLOGY

31 Vascular Distal Pulses

32 Computed Tomography X-Ray Imaging Magnetic Resonance Imaging Bone Scan Ultrasound

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34 Cerebrum Diencephalon Cerebellum Brain Stem

35 BRAIN NERVE CRANIAL NERVES

36 BONE Blood Vessels EPIDURAL SPACE Fat DURA MATER ARACHNOID MATER CSF CSF SUBARCHNOID SPACE? PIA MATER GREY MATTER WHITE MATTER

37 12 CRANIAL NERVES NERVE NAME I OLFACTORY FUNCTION II III IV V VI VII VIII IX X XI XII OPTIC OCULOMOTOR TROCHLEAR TRIGEMINAL ABDUCENS FACIAL VESTIBULOCOCHLEAR (ACOUSTIC) GLOSSOPHARYNGEAL VAGUS ACCESSORY HYPOGLOSSAL

38 THE BRACHIAL PLEXUS

39 ARTERIES VASCULAR VEINS epidural subdural

40 Important Parts of the Vertebrae Vertebral Body End Plate Foramen Vertebral Intervertebral Neural Arch Pedicle, Lamina, Pars Interarcticularis Intervertebral Disc Annulus Fibrosus Nucleus Pulposus

41 Acceleration / Deceleration ROTATIONAL LINEAR BOTH MECHANISMS COUP IMPACT CONTRE- COUP

42 Epidural Hematoma Intracerebral Hemorrhage Subdural Hematoma FOCAL Cerebral Contusion TRAUMATIC BRAIN INJURY DIFFUSE Cerebral Concussion Simple Complex Second Impact Syndrome Post Concussion Syndrome

43 Occiput C-0 Atlas C-1 BONE Lower Cervical Transverse Foramen Cervical Arteries Axis C-2

44 Anterior Longitudinal Ligament Spine Ligaments Body Posterior Longitudinal Ligament Inter- Transverse Ligament Ligamentum Flavum Spinous Process Inter- Spinous Ligament Supra- Spinous Ligament

45 Capital MUSCLES Cervical

46 Cervical Arteries VASCULAR Brachial Artery

47 Spine Ligaments Ligament Connects Restrains ALL PLL Ligamentum Flavum Ligamentum Nuchae Interspinous Ligament Intertransverse Ligament

48 Spine Muscle Joint Interaction Motion Prime Mover(s) Flexion Extension Rotation Lateral Flexion

49 Burst Fx Jefferson Fx Atlas C-1 Bone Spurs Skull Fx Occiput C-0 BONE Lower Cervical Spinal Stenosis Axis C-2 Spinous Process Fx Pars Fx Hangman s Fx

50 Herniated Disc JOINT Intervertebral Sprains Instability Facet Syndrome

51 Strains MUSCLE / TENDON

52 Nerve Root Compression NERVE Disc Herniation Brachial Plexus Injury

53 VASCULAR Thoracic Outlet Syndrome

54 Loss of Consciousness Anterograde Amnesia History Previous Hx Of Concussion Retrograde Self-Reported Symptoms Headache Tinnitus Nausea Vision

55 Less complete recovery From lighter impacts Multiple Concussion Patterns Lengthier recovery Closer together in time

56 Ears: Blood/CSF Athlete Behavior Racoon Eyes Position of Head & Neck Observation Skull & Scalp Battle s Sign Posture PEARL Forward Head Rounded Shoulders

57 HEAD AND C-SPIN PALPATION GUIDE Warning: Rule out Skull and C-Spine Fractures!!! Anterior Posterior Hyoid Bone Thyroid Cartilage Cricoid Cartilage SCM Scalenes Carotid Artery Lymph Nodes Occiput Superior Nuchal Line Transverse Processes Spinous Processes Trapezius

58 Cognitive Functioning B.E.S.S. Memory BRAIN Balance & Coordination Tandem Walking Vital Signs Romberg

59 CRANIAL NERVE ASSESSMENT NERVE NAME I OLFACTORY ASSESSMENT II III IV V VI VII VIII IX X XI XII OPTIC OCULOMOTOR TROCHLEAR TRIGEMINAL ABDUCENS FACIAL VESTIBULOCOCHLEAR (ACOUSTIC) GLOSSOPHARYNGEAL VAGUS ACCESSORY HYPOGLOSSAL

60 Distraction Shoulder Abduction Spurling Test Compression Nerve Root Compression Cranial Nerves NERVE Brachial Plexus Brachial Plexus Traction Test Babinski Oppenheim Pathological Reflexes Upper & Lower Motor Neurons Upper & Lower Quadrant Screen

61 Valsalva Herniated Disc PROM JOINT Intervertebral Sprains Spring Test Facet Syndrome

62 AROM PROM MUSCLE / TENDON RROM

63 Head and Neck Checklist HISTORY General History Loss of consciousness Amnesia Self-reported symptoms Previous history INSPECTION General Inspection Position of head Position of neck Skull and scalp Athlete behavior Pupils - PEARL Battle's Sign Racoon Eyes Ears and Nose Posture PALPATION Anterior Hyoid Bone Thyroid Cartilage Cricoid Cartilage SCM

64 Scalenes Carotid Artery Lymph Nodes Posterior Occiput Superior Nuchal Line Transverse Processes Spinous Processes Trapezius STRESS Brain Memory Cognitive Balance and Coordination Vital Signs Cranial Nerves I II III IV V VI VII VIII

65 IX; X XI XII Upper Motor Neurons Babinski Test Oppenheim Test Lower Motor Neurons Upper Quarter Screen Lower Quarter Screen Nerve Root/Plexus Brachial Plexus Traction Test Shoulder Abduction Test Cervical Compression Test Spurling Test Cervical Distraction Test Vascular Vertebral Artery Test Joint Spring Test Passive ROM Muscle / Tendon Active ROM Resisted ROM

66 Vascular Vertebral Artery Test

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68 A*C Joint Scapulo- Thoracic Articulation Thorax Sternum Clavicle Scapula Humerus S*C Joint G*H Joint Labrum

69 AC Ligaments SC Ligaments SC JOINT AC Coracoacromial GH GH Ligament Complex Coracoclavicular Ligaments Trapezoid Conoid

70 Shoulder Joint Abduct Lateral ER IR No consistent pattern Flex Anterior X Posterior Extend Medial Adduct

71 Humeral Positioners Deltoids GH Protectors MUSCLE Propellors Pecs Lats Rotator Cuff Scapular Pivoters Serratus Anterior Traps Rhomboids Pec Minor Levator Scapulae

72 The Rotator Cuff

73 Shoulder Muscle Joint Interaction Motion Prime Mover(s) Flexion Extension IR ER Abduction Adduction

74 Scapula Muscle Joint Interaction Motion Prime Mover(s) Upward Rotation Downward Rotation Protraction Retraction

75 BURSA Subacromial

76 Fracture Humerus Fracture BONE Clavicle Shoulder Pointer

77 Dyskinesis Sprain Dislocation ST Sprain SC JOINT GH Labral Tear AC Adhesive Capsulitis Sprain

78 Impingement Syndrome Strains MUSCLE / TENDON Biceps Contusion Tendinitis Myositis Ossificans

79 Impingement Syndrome BURSA

80 Peripheral Nerves Nerve / Vascular Thoracic Outlet Syndrome

81 Palpation Guide for the Shoulder Anterior Structures Posterior Structures Sternal end of clavicle Shaft of clavicle Coracoid process Acromion process Head of Humerus Greater Tuberosity Bicipital Groove Lesser Tuberosity Humeral shaft Spine of Scapula Superior Angle Medial Border Inferior Angle SC Joint Deltoid Muscle Group Pectoralis Major Pectoralis Minor Biceps brachii - short head Coracobrachialis AC Joint Biceps brachii - long head Serratus Anterior Rotator Cuff Trapezius Levator scapulae Teres Major Latissimus Dorsi Triceps brachii

82 Palpation Strategies for the Shoulder Starkey and Ryan: Anterior Structures Humerus Scapula Posterior Structures Hoppenfeld: Bony Palpation Soft Tissue Palpation Zone I Rotator Cuff Zone II Subacromial and Subdeltoid Bursa Zone III Axilla Zone IV Prominent Muscles of the Shoulder Girdle

83 See Muscle GH Glide Apprehension Relocation ST Dyskinesis Sulcus Sign Sprain / Dislocation Posterior Apprehension SC Glide SC Sprain JOINT GH AC Sprain Labral Tear O Brien AC Glide AC Traction AC Compression

84 Goniometry - Shoulder Motion Normal ROM Stationary Arm Axis of Rotation Moving Arm Flexion Extension IR ER Abduction Adduction

85 Scapular Mobility Winging Dyskinesis Subscapularis Neer Gerber Lift Off Impingement Syndrome MUSCLE / TENDON Rotator Cuff Hawkins Empty/Full Can Yergason s Biceps Tendinitis Speed s Supraspinatus Ludington s

86 Peripheral Nerves Nerve / Vascular Adson s Thoracic Outlet Syndrome Military Brace Allen

87 Peripheral Nerve Injuries NERVE Suprascapular Inferior Subscapular Medial Pectoral Axillary Long Thoracic Musculocutaneous Median Ulnar MUSCLE WEAKNESS Subscapularis Latissimus Dorsi Pectoralis Major Rhomboids; Levator Trapezius Triceps; Forearm;Hand

88 SHOULDER COMPLEX CHECKLIST HISTORY General History INSPECTION General Inspection Position of Head Position of Arm Shoulder posture Anterior Level of shoulders Contour of clavicles Symmetry of deltoids Humerus and biceps Lateral Deltoid muscle group Acromion process Position of humerus Posterior Alignment of vertebrae Position of scapulae Muscle tone Position of humerus PALPATION Anterior Structures

89 Sternal end of clavicle SC Joint Shaft of clavicle Deltoid Muscle Group Pectoralis Major Coracoid process Pectoralis Minor Biceps brachii - short head Coracobrachialis Acromion process AC Joint Head of Humerus Greater Tuberosity Bicipital Groove Biceps brachii - long head Lesser Tuberosity Humeral shaft Serratus Anterior Posterior Structures Spine of Scapula Rotator Cuff Superior Angle Medial Border Trapezius

90 Levator scapulae Inferior Angle Teres Major Latissimus Dorsi Triceps brachii STRESS Joint Sternoclavicular Glide Test Acromioclavicular Glide Test Traction Test Compression Test Glenohumeral Glide Test Apprehension Test Relocation Test Posterior Apprehension Sulcus Sign O'Brien Apley's Scratch Passive ROM

91 Muscle / Tendon Glenohumeral Active ROM Resisted ROM Scapular Active ROM Resisted ROM Scapular Winging Impingement Neer Hawkins Rotator Cuff Empty Can / Full Can Gerber Lift-Off Biceps Yergason's Speed's Ludington's Nerve Dermatomes C4 Dermatomes C5 Dermatomes T1 Dermatomes T2 Dermatomes T3

92 Dermatomes T4 Dermatomes T5 Vascular Brachial Pulse Radial Pulse Thoracic Outlet Adson's Allen Military Brace Position

93

94 Humerus Humero- Ulnar Jt Humero- Radial Jt Ulna Radius Proximal Radioulnar Jt

95 Ulnar Collateral Humerus Radial Collateral Ulna Radius Annular

96 P Extensors Triceps Anconeus MUSCLE L Supinators Pronators M Supinator Pronator Teres Pronator Quadratus Biceps Brachialis Brachioradialis Flexors A

97 P Lateral Epicondyle MUSCLE Medial Epicondyle L M Anconeus Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis Extensor Digitorum Extensor Carpi Ulnaris Pronator Teres Flexor Carpi Radialis Flexor Digitorum Superficialis Flexor Digitorum Profundus Palmaris Longus Flexor Carpi Ulnaris A

98 Elbow / Forearm Muscle Joint Interaction Motion Prime Mover(s) Flexion Extension Pronation Supination

99 BURSA Olecranon

100 Radial Nerve Ulnar Anterior Interosseus Median

101 Brachial Vascular Radial Ulnar

102 Fracture Humerus Little League Elbow Fracture BONE Ulna Radius Contusion Fracture

103 Sprain Radial Collateral Sprain Annular JOINT Dislocation Ulnar Collateral Sprain

104 Lateral Epicondylitis Strains MUSCLE / TENDON Medial Epicondylitis

105 BURSA Olecranon Bursitis

106 Cubital Tunnel Syndrome Radial Nerve Ulnar Anterior Interosseus Median Pronator Teres Syndrome

107 Brachial Volkmann s Contracture Vascular Radial Ulnar

108 Alignment of Wrist & Forearm Cubital Recurvatum Bony Alignment Olecranon Process & Bursa Posterior Lateral OBSERVATION Medial Extensor Muscle Mass Anterior Flexor Muscle Mass Carrying Angle Cubital Fossa Swelling

109 Elbow and Forearm Palpation Guide Medial Structures Posterior Structures Lateral Structures Anterior Structures Medial Epicondlye Olecranon Process Lateral Epicondle Cubital Fossa Ulnar Nerve Pronator Teres Flexor Carpi Radialis Palmaris Longus Flexor Carpi Ulnaris Olecranon Bursa Triceps Anconeus Brachioradialis Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis Extensor Carpi Ulnaris Biceps Tendon Brahial Artery Median Nerve

110 Sprain Annular Posterolateral Rotary Instability Sprain Radial Collateral JOINT Ulnar Collateral Sprain Varus Dislocation Valgus

111 Goniometry Elbow/Forearm Motion Normal ROM Stationary Arm Axis of Rotation Moving Arm Flexion Extension Pronation Supination

112 Lateral Epicondylitis Lateral Epicondylitis Test Strains MUSCLE / TENDON Medial Epicondylitis Medial Epicondylitis Test

113 Tinel s Sign Cubital Tunnel Syndrome Radial Nerve Ulnar Anterior Interosseus Median Pronator Teres Syndrome Pinch Test Pronator Teres Test

114 Peripheral Nerve Injuries NERVE Musculocutaneous Median Ulnar MUSCLE WEAKNESS Triceps; Forearm;Hand

115 Nerve Root Dermatomes Myotomes DTRs C6 C7 C8 T1

116 Brachial Volkmann s Contracture Vascular Radial Ulnar DISTAL PULSE!!!

117 ELBOW & FOREARM CHECKLIST HISTORY General History INSPECTION General Inspection Carrying Angle Bony Alignment Cubital Recurvatum PALPATION Medial Structures Medial Epicondlye Ulnar Nerve Pronator Teres Flexor Carpi Radialis Palmaris Longus Flexor Carpi Ulnaris Posterior Structures Olecranon Process Olecranon Bursa Triceps Anconeus

118 Lateral Structures Lateral Epicondle Brachioradialis Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis Triceps brachii Anterior Structures Cubital Fossa Biceps Tendon Brahial Artery Median Nerve STRESS Joint Valgus Stress Test Varus Stress Test Posterolateral Rotary Instability Passive ROM Muscle / Tendon Active ROM Resisted ROM Tennis Elbow Test

119 Golfer's Elbow Test Nerve Tinel's Sign Pronator Teres Test Pinch Test Dermatomes C6 Dermatomes C7 Dermatomes C8 Dermatomes T1 Biceps DTR Brachioradialis DTR Triceps DTR Vascular Radial Pulse

120

121 Intercarpal Jt Radiocarpal Jt Distal Middle Proximal DIP PIP Interphalangeal Jts Metacarpalphalangeal (MCP) Jt Metacarpal Carpometacarpal (CMC) Jt Trapezium Scaphoid Lunate Triquetral TFCC Radius Ulna

122 Volar Plate IP Collateral Ligaments Volar Plate MCP Collateral Ligaments CMC Deep Transverse Metacarpal Radial Collateral Dorsal Radiocarpal Radioscaphoid Intercarpal Jts. Radiocarpal Named for 2 bones Radiotriquetral Ulnar Collateral Ulna Ulnolunate Ulnotriquetral

123 P ECU EDC ECRL ECRB M L FCU FDP FCR FDS PL A

124 EXTRINSIC FINGERS Flexors Flexor Digitorum Superficialis Flexor Digitorum Profundus Extensors Extensor Digitorum Communis Extensor Indicis Extensor Digiti Minimi EXTRINSIC THUMB Flexors Flexor Pollicis Longus Extensors /Abductors Extensor Pollicis Longus Abductor Pollicis Longus Extensor Pollicis Brevis

125 INTRINSIC MUSCLES Thenar Eminence Opponens Pollicis Abductor Pollicis Brevis Flexor Pollicis Brevis Hypothenar Eminence Opponens Digiti Minimi Abductor Digiti Minimi Flexor Digiti Minimi Other Intrinsics Lumbricals Dorsal Interosseii Palmar Interosseii Adductor Pollicis Pads & Dabs 4 Door

126 Wrist Muscle Joint Interaction Motion Prime Mover(s) Flexion Extension Radial Deviation Ulnar Deviation

127 Finger Muscle Joint Interaction Motion Prime Mover(s) Flexion Extension Abduction Adduction

128 Radial Nerve Ulnar Median

129 Brachial Vascular Radial Ulnar Deep Palmar Arch Superficial Palmar Arch

130 Scaphoid Fracture Colles Fracture BONE Hamate Fracture Boxer s Fracture

131 Ganglion Gamekeeper s (Skier s) Thumb Wrist JOINT Fingers Sprains Hand Lunate Dislocation Dislocation

132 Finger Tendinitis Boutonniere Deformity Mallet Finger Jersey Finger Wrist MUSCLE / TENDON Tenosynovitis Thumb De Quervain s (Hoffman s) Disease

133 NERVE Median Carpal Tunnel Syndrome

134 Ape Hand Dupuytren s Contracture Bishop s Deformity Claw Hand OBSERVATION HAND Swan Neck Deformity Volkmann s Contracture

135 Subungual Hematoma Felon OBSERVATION FINGERS Deformities Alignment Paronychia

136 WRIST, HAND, FINGER, PALPATION GUIDE Medial Structures Lateral Structures Carpal Bones Medial Epicondlye Lateral Epicondle Ulnar Styloid Process Pisiform Lister's Tubercle Flexors Extensors Triquetrum Hook of Hamate Hypothenar Eminence 3rd Metacarpal Capitate Lunate Metacarpals Phalanges Radial Styloid Process Metacarpals 1-5 MCP Joints Phalanges 1-5 IP Joints Scaphoid/ Navicular Trapezium 1st Metacarpal Thenar Eminence Thenar Web Space Central Compartment

137 Valgus / Varus ROM JOINT Glides

138 Goniometry Wrist Motion Normal ROM Stationary Arm Axis of Rotation Flexion Extension Radial Deviation Ulnar Deviation Moving Arm

139 Goniometry Fingers Motion Normal ROM Stationary Arm Axis of Rotation Moving Arm Flexion Extension Abduction Adduction

140 Finkelstein s Test MUSCLE / TENDON A/RROM

141 Phalen s Test NERVE Tinel s Sign

142 WRIST & HAND CHECKLIST HISTORY General History INSPECTION General Inspection Wrist Hand Thumb and Fingers PALPATION Medial Structures Medial Epicondlye Flexors Lateral Structures Lateral Epicondle Extensors Carpal Bones Ulnar Styloid Process Triquetrum Pisiform Hook of Hamate Hypothenar Eminence Lister's Tubercle 3rd Metacarpal

143 Capitate Lunate Radial Styloid Process Navicular Trapezium 1st Metacarpal Thenar Eminence Thenar Web Space Metacarpals Metacarpals 1-5 Central Compartment MCP Joints Phalanges Phalanges 1-5 IP Joints STRESS Bone Compression Test Joint Wrist Valgus / Varus Wrist Glides MCP Valgus / Varus IP Valgus / Varus

144 Passive ROM Muscle / Tendon Active ROM Resisted ROM Finkelstein's Test Nerve Tinel's Sign Phalen's Test Dermatomes C6 Dermatomes C7 Dermatomes C8 Vascular Radial Pulse

145

146

147 External Ear Auricle External Acoustic Meatus EAR Middle Ear Inner Ear Tympanic Membrane Eustachian Tubes Cochlea Semi- Circular Canals

148 FACE Mandible Zygoma Orbit Maxillary

149 PARTS OF THE EYE OPTIC NERVE SCLERA IRIS PUPIL CONJUNCTIVA CORNEA LENS RETINA

150 MUSCLES OF THE EYE Superior Rectus Inferior Rectus Lateral Rectus Medial Rectus Superior Oblique Inferior Oblique

151 Temporal Bone Synovial Membrane TMJ Articular Disk Mandibular Condylar Process

152 PARTS OF THE TOOTH Root Neck Crown Enamel Dentin Pulp Cavity Root Canal Periodontal Ligament

153 Nasal Cavity Mouth Pharynx Larynx Epiglottis Esophagus Trachea

154 Diaphragm Muscles Ribs Negative Pressure Lungs Intercostals

155 ABDOMINAL CONTENTS Liver Gall Bladder Pancreas Kidneys Spleen Appendix

156 External Ear Auricle External Acoustic Meatus Auricular Hematoma Otitis Externa Eustachian Tubes EAR Middle Ear Tympanic Membrane Tympanic Membrane Rupture Otitis Media Cochlea Inner Ear Semi- Circular Canals

157 FACE Mandible Zygoma Maxillary Fx I LeFort II III Blow Up Orbit Blow Out

158 EYE INJURIES Cornea Cornea Iris Retina Conjunctiva Globe Foreign Bodies

159 Deviated Septum Nose Fracture

160 Dislocations Sprains TMJ Subluxations Cartilage Tears

161 Costochondral Injury Rib Fx Thorax Pneumothorax Flail Chest Hemothorax

162 TOOTH INJURIES Grade Fracture Dislocation I II III IV

163

164 Outer Ear Ear Tympanic Membrane Periauricular Area

165 Muscle Tone Bleeding Face & Jaw Symmetry Ecchymosis

166 Pupil Size & Shape General Appearance Iris Eye Sclera Eyelids Cornea Conjunctiva

167 Septum & Mucosa Alignment Nose Eyes & Face Epistaxis

168 Lips Teeth Gums Mouth Tounge Lingual Frenulum

169 Speech Throat Respiration Thyroid & Cricoid Cartilage

170 Throat Vomiting Hematuria Nail Beds Thorax & Abdomen Muscle Tone Normal & Abnormal Sounds Discoloration Of Skin Breathing

171 MISC STRUCTURES PALPATION GUIDE Face and Related Structures Nasal Bone Nasal Cartilage Zygoma Maxilla TMJ Periauricular Area External Ear Teeth Mandible Hyoid Bone Cartilages Thorax and Abdomen Manubrium Sternal Body Xiphoid Process Ribs Spleen Kidneys McBurney's Point Abdominal Quadrants

172 Rigidity Areas of Pain Rebound Tenderness Abdominal Palpation Quadrant Analysis Tissue Density

173 LIVER GALL BLADDER S SPLEEN HEART STOMACH PANCREAS KIDNEY LUNG KIDNEY LUNG R L APPENDIX URETER BLADDER COLON GONADS I URETER BLADDER COLON GONADS

174

175 Balance Ears Hearing

176 Face Tongue Blade Test

177 Motility PEARL Eyes Visual Acuity Flourescein Dye Test

178 Nose Smell

179 TMJ ROM

180 FACE AND RELATED STRUCTURES CHECKLIST HISTORY Location of the pain Onset Activity Injury Mechanism Other symptoms INSPECTION Face and Jaw Bleeding Ecchymosis Symmetry Muscle Tone Ear Auricle Tympanic Membrane Periauricular Area Eye General Appearance Eyelids Cornea Conjuctiva Sclera Iris

181 Pupils Nose Alignment Epistaxis Septum Mucosa Deformity Mouth Lips Teeth Tongue Lingual Frenulum Gums Throat Respiration Speech Cartilages PALPATION Nasal Bone Nasal Cartilage Zygoma Maxilla TMJ

182 Periauricular Area External Ear Teeth Mandible Hyoid Bone Cartilages STRESS Face Tongue Blade Test Ear Hearing Balance Eye Visual Acuity PEARL Tracking Nose Smell TMJ ROM

183 THORAX AND ABDOMEN CHECKLIST HISTORY Location of Pain Activity / Mechanism Symptoms General Medical Health INSPECTION Guarding Breathing Nail Beds Muscle Tone Discoloration Vomiting Hematuria Auscultation PALPATION Manubrium Sternal Body Xiphoid Process Ribs Spleen Kidneys McBurney's Point

184 Abdominal Quadrants STRESS Nerve Referred Pain Abdominal Percussion Ribs Compression