skeletal inspection

Skeletal visual examination is a clinical diagnosis method that doctors use their own vision to systematically observe and examine patients and reveal the normal and abnormal signs of the body. First observe the consciousness, color, nutrition, development, body shape, skin color, skin temperature, degree of sweating, pigmentation, venous engorgement, and observe the granulation, secretions and surrounding tissue of the wound. Then static observation from the front, side, back, standing, sitting, lying position, observe the trunk and limb axis, angle, physiological bending with abnormalities and deformities, whether the sides are symmetrical. Finally, dynamic observation of the upper limbs combing, knotting, unbuttoning and other actions. The posture and gait of the trunk and lower limbs when standing, walking, flexing, rotating, squatting, running and jumping. Basic Information Specialist classification: growth and development check classification: physical examination Applicable gender: whether men and women apply fasting: not fasting Analysis results: Below normal: Normal value: no Above normal: negative: No redness and deformity. Sports barrier-free. Positive: Other abnormalities suggest other diseases and require further examination and diagnosis. Tips: Check your relaxation, you should face it positively and actively cooperate with the inspection. Normal value No redness and deformity. Sports barrier-free. Clinical significance Abnormal results: One limb (1) Form abnormality 1. The spoon-shaped armor is also called the anti-armor. It is characterized by the central depression of the nail, the edge of the nail, the thinning of the nail, the rough surface, and the fringe. It is often a nutritional disorder caused by iron deficiency or certain amino acid metabolism disorders. More common in iron deficiency anemia, high altitude disease, occasionally seen in hyperthyroidism and rheumatic fever. 2. The finger-to-finger (toe) finger or toe end hyperplasia, hypertrophy, and sputum-like enlargement is called clubbing. It is characterized in that the end finger (toe) section is obviously widened and thickened, and the nail is arched from the root to the end, so that the base angle formed by the skin and the nail on the back of the finger end is equal to Or greater than 180° Mechanisms Chronic chlorine deficiency at the end of the limb, metabolic disorders, toxic damage. 3. Acromegaly develops anterior pituitary hyperfunction after puberty (healing of the bone marrow), such as anterior pituitary eosinophilia or anterior pituitary eosinophil proliferation, which increases the secretion of growth hormone. Healing, the body can not become abnormally tall, and the soft tissue such as the end of the bone and its ligaments proliferate, hypertrophy, and the limb ends are abnormally large, called acromegaly. 4. Intra-foot, valgus normal person When the knee joint is fixed, the foot can be turned inward and turned outwards by 35°. If the foot is restricted in activity, it is fixed inversion and adduction deformity, called foot varus. The sole of the foot is a fixed eversion and abduction, called the foot valgus. Foot valgus or varus deformity is more common in congenital malformations and sequelae of polio. 5. Fractures and joint dislocation fractures can shorten or deform the limbs, and local redness and tenderness. Sometimes you can touch the bone rub or hear the bones. After dislocation of the joint, there may be changes in the position of the limb and limited joint activities, such as extensional flexion, varus, abduction or rotation. 6. Muscle Atrophy Part or all of the muscles of a certain limb are reduced in size, relaxed and weak, and are muscle atrophy. Common in sequelae of poliomyelitis, hemiplegia, peripheral nerve injury, partial or total muscle atrophy of both lower extremities are mostly neuritis, polymyositis, transverse myelitis, traumatic paraplegia, progressive muscular atrophy. 7. Lower extremity varicose veins are more common in the lower leg, mainly due to the obstruction of blood flow in the superficial veins of the lower extremities (large and small saphenous veins). Characteristics of the veins such as sputum anger, bending, and long standing are more obvious. Severe cases have swelling of the calf, local skin dark purple, pigmentation, and even ulcers have not healed for a long time. Commonly engaged in standing work or embolic phlebitis. 8. Edema of systemic edema bilateral lower extremity edema is more obvious than the upper limbs, often invasive edema. The lower extremities are low in depression and edema. Unilateral limb edema is often blocked by venous return, such as thrombophlebitis, and lymphatic reflux is blocked, such as filariasis. Joint The joint is an indirect connection to the bone. The joints are often composed of articular surface, articular cartilage, joint capsule, and joint cavity. There is a small amount of synovial fluid in the joint cavity to facilitate the movement between the two bones and various different ranges of running functions. When the lesion is red, swollen, hot, painful, the joint is obviously swollen and deformed, dysfunction, and there is a sense of fluctuation in the touch, suggesting that the joint cavity effusion, the knee joint cavity effusion when checking the floating sputum test is positive. a) abnormal morphology Abnormal wrist shape 1 sacral synovitis is a nodular bulge and tenderness on the back and palm of the wrist. It is found in rheumatoid arthritis and joint tuberculosis. 2 sacral cysts on the back or lateral side of the wrist, which is a garden-shaped painless bulge, which is tough and can be slightly moved in the vertical direction of the tendon. 3 wrist joint stiffness seen in rheumatoid arthritis. 2. Knuckle 1 The proximal interphalangeal joint is swollen and found in rheumatoid arthritis. 2 claw-shaped hand and finger joints are bird-like deformation, seen in ulnar nerve injury, progressive muscular atrophy. 3 distal interphalangeal joints can be found and hard hyperplastic nodules (heberden nodules), seen in osteoarthritis. 3. Knee joint redness, swelling, heat, pain, dysfunction, effusion sign, found in rheumatoid arthritis, osteoarthritis, trauma, tuberculosis. 4. The toe, metatarsophalangeal joints are red, swollen, painful, and tophi, found in gout, more common in middle-aged men. Need to check the crowd: the bones have pain, soreness, tingling, burning pain, numbness, radiation pain, and jumping pain. Positive results may be diseases: knee varus, accessory ear, joint dislocation precautions Taboo before inspection: no special contraindications. Requirements for inspection: Check the feelings of relaxation, should face positively, and actively cooperate with the inspection. Inspection process First observe the consciousness, color, nutrition, development, body shape, skin color, skin temperature, degree of sweating, pigmentation, venous engorgement, and observe the granulation, secretions and surrounding tissue of the wound. Then static observation from the front, side, back, standing, sitting, lying position, observe the trunk and limb axis, angle, physiological bending with abnormalities and deformities, whether the sides are symmetrical. Finally, dynamic observation of the upper limbs combing, knotting, unbuttoning and other actions. The posture and gait of the trunk and lower limbs when standing, walking, flexing, rotating, squatting, running and jumping. Not suitable for the crowd There are no special taboos. Adverse reactions and risks Nothing.