Musculoskeletal Exam

For nomenclature regarding direction of movement, see here: Anatomy Nomenclature > Movement

Jaw (temporomandibular joint)

1. Inspect
2. Palpate along TMJ
3. Place fingers on tragus (ridge) in front of each ear and ask patient to open their mouth. Feel for swelling or tenderness
   

Neck (cervical spine)

1. Inspect
2. Palpate along spine and paravertebral muscles
3. Assess range of motion
   1. Ask patient to bend their neck to look at the floor and up to the ceiling
   2. Ask patient rotate head
   3. Ask patient to touch ears to each shoulder

Back (thoracic and lumbar spine)

1. Inspect
2. Palpate along spine
3. Palpate paravertebral muscles (along spine)
4. Assess range of motion
   1. Flexion: Ask patient to touch toes
   2. Extension: Ask patient to bend backwards
   3. Lateral bending: Ask patient to lean left and right
   4. Rotation: Ask patient to turn body to both sides

Shoulders

1. Inspect
2. Palpate shoulders
3. Assess range of motion
   1. Flexion: Ask patient to raise arms above head
   2. Extension: Ask patient to bring arms back as far as comfortable
   3. Abduction: Ask patient to raise their arms laterally
   4. External rotation: Ask patient to place hands behind their neck
   5. Internal rotation: Ask patient to place their hands behind their back and raise them as far as comfortable

Elbows

1. Inspect
2. Support the patients forearm and palpate
3. Assess range of motion
   1. Flexion: Ask patient to bend elbow
   2. Extension: Ask patient to straighten arms
   3. Protonation/supination: Ask patient to flip their palms facing up and then down

Wrists & Hands

1. Inspect
2. Palpate distal radius/ulna, wrist, down fingers
3. Assess wrist range of motion
   1. Flexion: Ask patient to bend wrists up and down
   2. Adduction/abduction: Ask patient to move wrists horizontally left and right
      
4. Assess fingers range of motion
   1. Flexion: Ask patient to close and open their hands
   2. Adduction/abduction: Ask patient to splay out fingers
   3. Ask patient to bring their thumb to their pinky

Hips

1. Have patient lay back
2. Inspect
3. Palpate iliac crest, along hip, and inguinal ligament
4. Assess range of motion
   1. Flexion: Bring knee to chest
   2. Internal/external rotation: Position knee at 90deg and rotate hip towards midline and then away from midline
      
   3. Adduction/abduction: Stabilize at superior hip and pull leg inward and outward
      

Knees

1. Inspect
2. Palpate knee
3. Assess range of motion
   1. Flexion: Ask patient to flex at knee
   2. Extension: Ask patient to extend at knee

Ankles & feet

1. Inspect
2. Palpate anterior ankle, Achilles tendon, heel, tarsals
3. Assess range of motion
   1. Dorsiflexion: Stabilize at ankle and ask patient to point foot towards ceiling
   2. Plantarflexion: Stabilize at ankle and ask patient to point towards floor
   3. Eversion/inversion: Stabilize at ankle and turn foot laterally and medially

Hips (standing)

Assess flexion/extension by asking patient to bring each leg forward and backwards