Assess for tenderness or palpable masses—no tenderness or masses present34) Palpate liver: - place hand under patient w/ palm up (costovertebral angle), look @ midclavicular line and press down and upward while instructing patient to take a deep breath in—feeling for lower edge of liver35) Palpate spleen:- Have patient turn onto right side- Place hand under patient w/ palm up (costovertebral angle)- Press down and upward while instructing patient to take a deep breath in—do not feel edge of spleen = normal finding36) Test Bloomberg sign:Hand at 90° - press down on RLQ—rebound tenderness = positive Bloomberg sign* Repeat on LLQ37) Inspect lower extremities—no edema or lesions noted 38) Range of motion—HIPFlex knee & push up to flex hipAbduction (away)Adduction (cross midline over other leg)Internal rotation (knee in, ankle out)External rotation )knee out, ankle in)* Good range of motion* Rest leg—will not be testing extension.39) Range of motion—KNEEPerform flexion and extensionTest strength of knees (bilaterally @ same time)- Flex knee, place hands on patient’s shins.- Ask pt. to push up against hands- Place hands on calves, ask pt. to push down against hands* Good strength, 5/5 and equal bilaterally40) Range of motion—ANKLESupport ankle to check for flexion, extension, & rotation- Check dorsiflexion (toward head)- Check plantarflexion (toward ground) - Check rotation (move ankle in a circle)
* Good range of motionTest strength of ankles (bilaterally @ same time)- Dorsiflex w/ resistance- Plantarflex w/ resistance* Good strength, 5/5 and equal bilaterally41) Palpate dorsalis pedis pulses—2+ and equal bilaterally 42) Spine exam (have patient stand up)Inspect and palpate along each side of spine—assess for any curvatures, malalignmentor tendernessROM—spine: - Bend over and touch toes, then stand up straight- Bend backward, then straighten back up- Lateral flexion to each side- Rotation to each side* Good active ROM43)Romberg’s test:Stand w/ arms down to side.Close eyes for ~ 20 seconds.-Assess for any swaying—Romberg’s test is NEGATIVE if no swaying is seen44) Gait:Have patient take a few steps away from you and then walk back- Note any abnormalities in gait.* Patient has normal gait
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- Fall '15
- Motor, Palpate pinnae