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CONTENTS PREFACE iv ACKNOWLEDGMENTS v INTRODUCTION TO EVIDENCEBASED VALIDITY AND RELIABILITY OF PHYSICAL EXAMINATION PROCEDURES vii 1 PROTOCOL CLINICAL ASSESSMENT1 Patient History 2 Observation/Inspection 4 Palpation 4 Range of Motion Evaluation 5 Special Physical, Orthopaedic, and Neurological Testing 8 Diagnostic Imaging and other Specialized Structural Testing 9 Functional Testing 13 2 POSTURAL ASSESSMENT 15 by Steven P.Weiniger, DC Why Posture Is Important 16 Architectural versus Adaptive Postural Changes: Body Types, Injury, and Habit 16 Posture Evaluation: Methods and Observations 19 Posture Types 25 Postural Syndromes 26 Other Postural Distortions, Adaptations, and Pathologies 28 3 TESTS CERVICAL ORTHOPAEDIC39 Cervical Orthopaedic Examination Flow Chart 40 Cervical Palpation 41 Cervical Range of Motion 47 Cervical Resistive Isometric Muscle Testing 52 Vertebrobasilar Circulation Assessment 56 Subclavian Artery Compromise 68 Differential Diagnosis: Strain versus Sprain 70 Cervical Fractures 72 Cervical Instability 76 Space-Occupying Lesions 80 Cervical Neurological Compression and Irritation 82 4 LESIONS CERVICAL NERVE ROOT92 C5 96 C6 98 C7 100 C8 102 T1 104 5 TESTS SHOULDER ORTHOPAEDIC106 Shoulder Orthopaedic Examination Flow Chart 107 Shoulder Palpation 108 Shoulder Range of Motion 116 Impingement Syndrome (Supraspinatus) 122 Tendinitis (Bicipital) 125 Bursitis 129 Anterior Glenohumeral Instability 132 Posterior Glenohumeral Instability 139 Multidirectional Shoulder Instability 142 Labral Tears (Slap Lesions) 145 Rotator Cuff Instability 149 Biceps Tendon Instability 151 Thoracic Outlet Syndrome 156 Brachial Plexus Irritation 162 6 TESTS ELBOW ORTHOPAEDIC168 Elbow Orthopaedic Examination Flow Chart 169 Elbow Palpation 170 Elbow Range of Motion 178 Lateral Epicondylitis (Tennis Elbow) 181 Medial Epicondylitis (Golfer's Elbow) 185 Ligamentous Instability 186 Neuropathy/Compression Syndromes 189 7 TESTS WRIST ORTHOPAEDIC195 Wrist Orthopaedic Examination Flow Chart 196 Wrist Palpation 197 Carpal Tunnel Syndrome 207 Ulnar Tunnel Syndrome 212 Stenosing Tenosynovitis 213 Carpal Instability 214 8 HAND ORTHOPAEDIC TESTS 217 Hand Palpation 218 Joint Instability 222 Joint Capsule Tests 224 Tendon Instability 226 9 TESTS THORACIC ORTHOPAEDIC230 Thoracic Orthopaedic Examination Flow Chart 231 Palpation 232 Thoracic Range of Motion 239 Scoliosis/Kyphosis Screening 242 Thoracic Fractures 245 Nerve Root Lesions 247 Costovertebral Joint Ankylosis 250 10 TESTS LUMBAR ORTHOPAEDIC252 Lumbar Orthopaedic Examination Flow Chart 253 Palpation 254 Lumbar Range of Motion 260 Joint Dysfunction Tests 263 Lumbar Fractures 267 Lumbar Nerve Root and Sciatic Nerve Irritation/Compression Tests 268 Space-Occupying Lesions 289 Differential Diagnosis: Lumbar versus Sacroiliac Involvement 292 11 LESIONS LUMBAR NERVE ROOT298 T12, L1, L2, L3 299 L2, L3, L4 305 L4 307 L5 309 S1 313 12 TESTS SACROILIAC ORTHOPAEDIC316 Sacroiliac Orthopaedic Examination Flow Chart 317 Palpation 318 Sacroiliac Sprain 320 Piriformis Syndrome 325 General Sacroiliac Joint Lesions 328 13 TESTS HIP JOINT ORTHOPAEDIC333 Hip Joint Orthopaedic Examination Flow Chart 334 Palpation 335 Hip Range of Motion 341 Congenital Hip Dysplasia 347 Hip Fractures 350 Hip Contracture Tests 352 General Hip Joint Lesions 357 14 TESTS KNEE ORTHOPAEDIC362 Knee Orthopaedic Examination Flow Chart 363 Palpation 364 Knee Range of Motion 375 Meniscus Instability 377 Plica Tests 388 Ligamentous Instability 391 Patellofemoral Dysfunction 401 Knee Joint Effusion 405 15 TESTS ANKLE ORTHOPAEDIC408 Ankle Orthopaedic Examination Flow Chart 409 Palpation 410 Ankle Range of Motion 420 Ligamentous Instability 424 Tarsal Tunnel Syndrome 428 Achilles Tendon Rupture 430 16 TESTS MISCELLANEOUS ORTHOPAEDIC434 Peripheral Arterial Insufficiency 435 Deep Vein Thrombosis 437 Somatosensory Amplification Assessment 438 Meningeal Irritation and Inflammation 446 Leg Measurements 449 17 CRANIAL NERVES 451 Olfactory Nerve (I) 453 Optic Nerve (II) 454 Ophthalmoscopic Examination 457 Oculomotor, Trochlear, and Abducens Nerves (III, IV, VI) 459 Trigeminal Nerve (V) 462 Facial Nerve (VII) 465 Auditory Nerve (VIII) 468 Glossopharyngeal and Vagus Nerves (IX, X) 474 Spinal Accessory Nerve (XI) 477 Hypoglossal Nerve (XII) 478 18 REFLEXES 480 Pathological Upper Extremity Reflexes 481 Pathological Lower Extremity Reflexes 485 Superficial Cutaneous Reflexes 490 19 TESTS CEREBELLAR FUNCTION493 Upper Extremity 494 Lower Extremity 499 INDEX 503 /B>/B>

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