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
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