Standard Limb Exam Templates

Examination templates, written in the negative, for boring bog standard limb exams. They are written to be as concise and clinically relevant as possible. These are commonly used exams in context - it's filed under Orthopaedics as they are typically performed in the setting of an orthopaedics presentation.

Knee

– On gross examination, there is no obvious swelling, varus/valgus deformity, or bogginess.
– Patient is able to ambulate with some pain on weight bearing. ROM is about __
– There is tenderness _, otherwise, there is no significant tenderness elsewhere (laterally / medially / posteriorly / over the joint line.
– Varus/Valgus force applied, no laxity or significant pain to suggest a lateral collateral ligament injury.
– Anterior/Posterior drawer tests demonstrate no laxity to suggest a severe ACL/PCL injury.
– Flexing and extending the knee with internal/external rotation of the tibia demonstrates no significant pain or audible click to suggest a lateral/medial meniscus injury. However it is noted this test is only about 50% sensitive/specific.

Quick Radial / Median (+AIN) / Ulnar Screener

Fractures of the upper limb are unbelievably common. The radial nerve tends to be injured in humeral shaft fractures, while the others tend to be injured in radius/ulna fractures and the odd ~5% of supracondylar elbow fractures. The following standard neurology assessment for patients with forearm/wrist fractures is quick and easy to perform

“make a fist” “make an O with your thumb and pointer finger” “make a scissors and cut my finger”

– The Median nerve is intact. Patient is able to make a fist easily, with sensation intact to the palmar aspect of the thumb and index finger. In addition to that, the median anterior interosseous nerve is unaffected evidenced by preserved thumb flexion at the IPJ and index finger flexion at the DIPJ.
– The Radial nerve is intact. Flexion of the fingers is unaffected, with sensation intact to the dorsal aspect of the thumb and index finger.
– The Ulnar nerve is intact. Finger abduction and adduction are unaffected, with sensation intact to the medial hand.

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