體格檢查是臨床醫(yī)生的基本功,但由于診斷時(shí)間緊迫(尤其在門診),對(duì)于新手而言,要在短時(shí)間內(nèi)完成必要的檢查,實(shí)屬不易。如果檢查操作不正確,必將影響診斷。特別是某些比較少用的檢查方法,更令人感覺生疏,這些都是對(duì)臨床醫(yī)師的挑戰(zhàn)和考驗(yàn)。針對(duì)骨骼、肌肉和周圍神經(jīng)的體格檢查,本書作者收集了重要數(shù)據(jù)、圖表和方法,經(jīng)過精心編排,使林林總總的檢查項(xiàng)目井然有序,令人耳目一新。比如,遇到主訴“肩部疼痛“的患者,醫(yī)生需要快速整理思路:?引起肩痛的原因有哪些?疼痛真的是從肩部發(fā)出的嗎?肩部有哪些重要的結(jié)構(gòu)?哪些體格檢查有助于將部疾病與其他疾病鑒別開?只需要3分鐘內(nèi),本書幫助讀者選擇恰當(dāng)?shù)臋z查方法、掌握檢查要點(diǎn)和手法。特別地,書后附有“臨床速查索引“,幫助讀者快速完成臨床評(píng)估
國(guó)內(nèi)有關(guān)骨骼肌肉和周圍神經(jīng)檢查法圖書中,收錄檢查法最全面面、最直觀的圖書,書后附有“臨床速查索引”幫助讀者快速選擇檢查手法,也是《3分鐘骨骼肌肉和周圍神經(jīng)檢查》的一大特色。<br>只要3分鐘,幫你選擇恰當(dāng)?shù)臋z查方法、掌握檢查要點(diǎn)和手法!
作者:(美國(guó))艾倫·米勒 (美國(guó))金伯利·赫克特 (美國(guó))布賴恩?戴維斯
第1章 關(guān)節(jié)檢查簡(jiǎn)介 (Introduction)肩部檢查 (Shoulder Exam)簡(jiǎn)介(Introduction)頸椎和肩部的活動(dòng)范圍(Range of Motion of the Cervical)肩部觸診(Pal 第1章 關(guān)節(jié)檢查簡(jiǎn)介 (Introduction)肩部檢查 (Shoulder Exam)簡(jiǎn)介(Introduction)頸椎和肩部的活動(dòng)范圍(Range of Motion of the Cervical)肩部觸診(Palpation of the Shoulder)頸椎棘突檢查(Cervical Spinous Process Exam)Spurling 檢查(Spurling’s Test)垂臂檢查(Drop Arm Test)阻抗式外旋檢查(Resisted External Rotation)阻抗式內(nèi)旋檢查(Resisted Internal Rotation)Patte 檢查(Patte’s Test)空罐檢查(Empty Can Tset)背后舉起檢查(Lift-off Test)Hawki 檢查(Hawki’ Test)Neer 檢查(Neer’ Test)研磨操作手法(Scouring Maneuver)上臂交叉/ 內(nèi)收/Apley 繞頸檢查(Crossed Arm/Adductoin/Apley’s Scarf Test)Yergason 檢查(Yergason’s Test)改良Yergason 檢查(Modified Yergason’s Test)Speed 檢查(Speed’s Test)主動(dòng)壓迫檢查 (O’Brien 檢查)[Active Compression(O’Brien’s)Test]恐懼檢查(Appreheion Test)復(fù)位檢查(Relocation Test)驚奇檢查 ( 向前放松檢查)[Surprise(Anterior Release)Test]Adson 操作手法(Adson’s Maneuver)Allen 檢查(Allen’s Test)肋鎖檢查(Costoclavicular Test)Roos 檢查(Roos’s Test)Wright 超外展檢查(Wright’s Hyperabduction Test)肘部檢查 (Elbow Exam)簡(jiǎn)介(Introduction)肘部的活動(dòng)范圍(Range of Motion of the Elbow)肘部觸診(Palpation of the Elbow)Cozen 檢查(Cozen’s Test)腕關(guān)節(jié)屈曲檢查肱骨內(nèi)上髁炎(Wrist Flexion for Medial Epicondylitis)肘部尺神經(jīng)Tinel 征(Tinel’s Sign of Ulnar at Elbow)尺側(cè)副韌帶松弛(Medial Ligamentous Laxity)橈側(cè)副韌帶松弛(Lateral Ligamentous Laxity)腕部/手部/手指檢查(Wrist/Hand/Digit Exam)簡(jiǎn)介(Introduction)腕部和手指的活動(dòng)范圍(Range of Motion of the Wrist and Digits)拇指動(dòng)作 (Thumb Motion)腕部/ 手部/ 手指觸診(Wrist/Hand/Digit Palpation)腕部正中神經(jīng)Tinel 征(Tinel’s Sign of Median nerve at Wrist)改良Phalen 檢查(Modified Phalen’s Test)反向Phalen 檢查(Revee Phalen’s Test)腕部壓迫檢查(Carpal Compression Test)蛤殼檢查 ( 腕部伸。 [Clamshell (Wrist Exteo)]反向蛤殼檢查 ( 腕部屈。Revee Clamshell (Wrist Flexo)]手部?jī)?nèi)部肌肉緊張檢查 (Bunnel-Littler 檢查)[Tight Hand Intriics Test(Bunnel-Littler’s Test)]改良Finkelstein 檢查(Modified Finkelstein’s Test)Froment 征(Froment’s Sign)拇指軸向研磨檢查(Thumb Axial Grind Test)腰骶部和髖部檢查(Lumbosacral Spine and Hip Exam)簡(jiǎn)介(Introduction)髖部和下背部的活動(dòng)范圍(Range of Motion of Hip and Low Back)胸椎- 腰椎- 骶椎屈曲(T-L-S Spine Flexion)胸椎- 腰椎- 骶椎伸展和旋轉(zhuǎn)(T-L-S Spine Exteion and Rotation)胸椎- 腰椎- 骶椎側(cè)向彎曲(T-L-S Spine Lateral Bending)髖關(guān)節(jié)內(nèi)旋(Hip Internal Rotation)髖關(guān)節(jié)外旋(Hip External Rotation)髖關(guān)節(jié)屈曲(Hip Flexion)髖關(guān)節(jié)伸展(Hip Exteion)下背部和髖部觸診(Palpation of the Low Back and Hip)腰椎棘突檢查(Lumbar Spinous Process Exam)腰椎小面關(guān)節(jié)碾磨檢查(Lumbar Facet Gring Test)Yeoman 檢查(Yeoman’s Test)Gaelen 檢查(Gaelen’s Test)Ober 檢查(Ober’s Test)Noble 壓迫檢查(Noble’s Compression Test)直腿抬舉檢查(Straight Leg Raise Test)Ely 檢查(Ely’s Test)松垮檢查(Slump Test)股神經(jīng)牽張檢查(Femoral Nerve Stretch Test)下肢不等長(zhǎng)(Leg Length Discrepancy)股骨前傾(Femoral Anteveion)Hoover 征(Hoover’s Sign)Herbison背部3分鐘檢查法(The Herbison 3-Minute Back Exam)1 胸部旋轉(zhuǎn)(Thoracic Rotation)2 Thomas 檢查(Thomas’s Test)3 改良Gaelen 檢查(Modified Gaelen’s Test)4 改良Ely 檢查(Modified Ely’s Test)5 改良股神經(jīng)牽張檢查(Modified Femoral Nerve Stretch Test)6 改良Ober 檢查(Modified Ober’s Test)7 髖部活動(dòng)范圍檢查(Hip Range of Motion Test)8 直腿抬舉檢查(Straight Leg Raise Test)9 FABERE/Patrick 檢查(FABERE/Patrick’s Test)膝部檢查 (Knee Exam)簡(jiǎn)介(Introduction)膝部的活動(dòng)范圍(Range of motion of the Knee)膝部觸診(Palpation of the Knee)髕骨上方壓迫檢查(Suprapatellar Compression Test)髕骨輕推滑動(dòng)檢查(Patellar Ballotment)向前拖曳檢查(Anterior Drawer Test)軸向移動(dòng)檢查(Pivot Shift Test)向后拖曳檢查(Posterior Drawer Test)Lachman 檢查(Lachman’s Test)McMurray 檢查(McMurray’s Test)外側(cè)穩(wěn)定度檢查(Test for Lateral Stability)關(guān)節(jié)線壓痛檢查(Joint Line Tenderness Test)內(nèi)側(cè)穩(wěn)定度檢查(Test for Medial Stability)Apley 碾磨檢查(Apley’s Grinding Test)Apley 牽引檢查(Apley’s Distraction Test)腓骨頭處腓神經(jīng)的Tinel 征(Tinel’s Sign of Peroneal Nerve at Fibular Head)踝部檢查 (Foot and Ankle Exam)簡(jiǎn)介(Introduction)踝部的活動(dòng)范圍(Range of Motion of the Ankle)踝部觸診(Palpation of the Ankle)跟腱觸診(Achilles Tendon Palpation)緊握擠壓檢查 (Thompson 檢查)[Squeeze Test(Thompson’s Test)]踝部向前拖拽檢查(Ankle Anterior Drawer)外旋檢查(External Rotation Test)距骨傾斜檢查(Talar Tilt Test)足底筋膜炎檢查(Plantar Fasciitis Test)跗管檢查 ( 踝部脛神經(jīng)的Tinel 征)[Taal Tunnel Test (Tinel’s Sign of nerve atAnkle)]第2章 肌肉檢查簡(jiǎn)介 (Introduction)肌力分級(jí)(Grading Muscle Strength)上肢(Upper Extremities)上斜方。║pper Trapezius)中斜方。∕iddle Trapezius)下斜方。↙ower Trapezius)中三角肌(Middle Deltoid)胸大。≒ectoralis Major)菱形。≧homboids)前鋸。⊿erratus Anterior)肩胛下肌(Subscapularis)肩部外旋。⊿houlder External Rotato)肱二頭肌(Biceps Brachii)肱三頭。═riceps)旋前圓肌(Pronator Teres)橈側(cè)腕屈。‵lexor Carpi Radialis)尺側(cè)腕屈。‵lexor Carpi Ulnaris)橈側(cè)腕長(zhǎng)伸肌和橈側(cè)腕短伸肌(Exteor Carpi Radialis Longus and Brevis)指淺屈。‵lexor Digitorum Superficialis)指深屈肌(Flexor Digitorum Superficialis)示指伸。‥xteor Indicis)拇長(zhǎng)屈肌(Flexor Pollicis Longus)拇長(zhǎng)伸肌和拇短伸。‥xteor Pollicis Longus and Brevis)拇短展肌(Abductor Pollicis Brevis)拇收。ˋdductor Pollicis)第一骨間背側(cè)。‵it Doal Interosseous)小指展。ˋbductor Digiti Minimi)骨間掌側(cè)。≒almar Interossei)掌長(zhǎng)肌(Palmaris Longus)下肢(Lower Extremities)髂腰。╥liopsoas)髖部?jī)?nèi)收。℉ip Adducto)髖部外展肌(Hip Adbucto)髖部?jī)?nèi)旋。℉ip Internal Rotato)股四頭。≦uadriceps)腿后群。℉amstrings)脛骨前。═ibialis Anterior)脛骨后肌(Tibialis Posterior)腓骨長(zhǎng)肌和腓骨短。≒eroneus Longus and Brvis)長(zhǎng)屈。‵lexor Hallucis Longus)長(zhǎng)伸。‥xteor Hallucis Longus)腓腸肌和比目魚。℅astrocnemius and Soleus)第3章 反射檢查簡(jiǎn)介 (Introduction)深腱/ 肌肉牽張反射的分級(jí)(Grading Deep Tendon/Muscle Stretch Reflexes)記錄反射的常用方法(Conventional Method of Documenting Reflexes)上肢反射 (Upper Extremity Reflexes)肱二頭肌反射 (C5) (Biceps Reflex)肱橈肌反射 (C6) (Brachioradialis Reflex)橈側(cè)腕伸肌反射 (C6)(Exteor Caepi Radialis Reflex)旋前圓肌反射 (C6) (Pronator Teres Reflex)肱三頭肌反射 (C7) (Triceps Reflex)手屈肌反射 (C8/T1) (Finger Flexo Reflex)下肢反射 (Lower Extremity Reflexes)內(nèi)收肌反射 (L3) (Adductor Reflex)髕反射(L4)(Patellar Reflex)內(nèi)側(cè)腿后肌群反射 (L5) (Medial Hamstring Reflex)踝陣攣反射 (S1)外側(cè)腿后肌群反射 (S1) (Lateral Hamstring Reflex)其他Babiki 征(Babiki’s Sign)Chaddock 征(Chaddock’s Sign)Oppenheim 征(Oppenheim’s Sign)Hoffman 征(Hoffman’s Sign)Wartenberg 征(Wartenberg’s Sign)頜反射(Jaw Jerk)掌頦反射(Palmomental)眉心反射(Glabellar Reflex)鼻口部反射(Snout Reflex)Jendrassik 操作法(Jendrassik’s Maneuver)第4章 周圍神經(jīng)檢查簡(jiǎn)介 (Introductoin)外周神經(jīng)和脊神經(jīng)根 ( 正面分布) [Peripheral Nerves and Spinal Roots (AnteriorDistribution)外周神和脊神經(jīng)根 ( 背面分布) [Peripheral Nerves and Spinal Roots (PosteriorDistribution)]上肢 (Upper Extremities)臂從神經(jīng)(Brachial Plexus)肌皮神經(jīng)(Musculocutaneous Nerve)正中神經(jīng)(Median Nerve)橈神經(jīng)和腋神經(jīng)(Radial and Axillary Nerves)尺神經(jīng)(Ulnar Nerve)神經(jīng)根皮節(jié)分區(qū)檢查的臨床標(biāo)志(Clinical Landmarks for Root-level DermatomalExamination)下肢 (Lower Extremities)腰從、骶叢神經(jīng)(Lumbosacral Plexus)股神經(jīng)(Femoral Nerve)閉孔神經(jīng)(Obturator Nerve)腓神經(jīng)[Peroneal (Fibular) Nerve]脛神經(jīng)(Tibial Nerve)神經(jīng)根皮節(jié)分區(qū)檢查的臨床標(biāo)志(Clinical Landmarks for Root-level DermatomalExamination)其他 (Miscellaneous)輕觸檢查(Light Touch Seatoin)針刺檢查(Pinprick Seation)振動(dòng)檢查(Vibratory Seation)體位覺(Propriception)第5章 步態(tài)和姿勢(shì)簡(jiǎn)介 (Introduction)姿勢(shì)評(píng)估(Posture Evaluation)步態(tài)周期(Gait Cycle)常見的步態(tài)異常(Common Abnormalities of Gait)Trendelenburg 氏步態(tài)(Trendelenburg Gait)腿長(zhǎng)不等(Leg Length Discrepancy)止痛 ( 劇痛) 步態(tài) [Antalgic (Painful) Gait]共濟(jì)失調(diào)步態(tài)(Ataxic Gait)神經(jīng)病變性步態(tài)(Neuropathic Gait)足部拍擊地面(Foot Stap)跨越步態(tài)(Steppage Gait)膝關(guān)節(jié)反屈(Knee Recurvatum)臀大肌跛行(Gluteus Maximus Lurch)痙攣型偏癱步態(tài)(Spastic Hemiplegic Gait)痙攣型雙側(cè)麻痹步態(tài)(Spastic Diplegic Gait)肌營(yíng)養(yǎng)不良步態(tài)(Dystrophic Gait)回轉(zhuǎn)步態(tài)(Circumduction Gait)帕金森病步態(tài)(Parkionian Gait)步態(tài)周期圖解(Gait Cycle Diagram)第6章 脊髓損傷檢查簡(jiǎn)介 (Introduction)美國(guó)脊椎損傷學(xué)會(huì)(American Spinal Injury Association)脊髓綜合征(Spinal Cord Syndrome)感覺檢查(Seory Examination)運(yùn)動(dòng)檢查(Motor Examination)功能損傷評(píng)分(Impairment Scale)分類步驟(Steps in Clasification)標(biāo)準(zhǔn)分類表(Standard Classification Form)第7章 參考表格和資料簡(jiǎn)介 (Introduction)神經(jīng)學(xué)和肌肉骨骼學(xué)參考資料(Neurologic and Musculoskeletal Resources)解剖平面和說明(Anatomic Planes and Descripto)肌力分級(jí)(Grading Muscle Strength)評(píng)估痙攣的改良Ashworth 評(píng)分系統(tǒng)(Modified AshworthScale for Grading Spasticity)深部肌腱/ 肌肉牽張反射分級(jí)(Grading Deep Tendon/Muscle Stretch Reflexes)記錄反射的傳統(tǒng)方法(Conventional Method ofDocumenting Reflexes)上運(yùn)動(dòng)神經(jīng)元與下運(yùn)動(dòng)神經(jīng)元病況之比較(Upper MotorNeuron Veus Lower Motor NeuronFindings)典型上肢神經(jīng)根病變(Classic Upper ExtremityRadiculopathies)典型下肢神經(jīng)根病變(Classic Lower ExtremityRadiculopathies)疼痛類型(Types of Pain)不自主動(dòng)作的定義(Definitio of Involuntary MotorMovements)常見卒中綜合征(Common Stroke Syndrome)美國(guó)風(fēng)濕病學(xué)院1990 年纖維肌痛癥分類標(biāo)準(zhǔn)(AmericanCollege of Rheumatology 1990Criteria for theClassification of Fibromyalgia)非器質(zhì)性下背痛的Waddell 征(Waddell’s Sign ofNonorganic Low Back Pain)對(duì)稱性肌肉無力的診斷(Diagnosis of Symmetric Muscle Weakness)疼痛的視覺類比評(píng)分量表(Visual Analog Scale of Pain)Wong-Baker FACES 小兒疼痛評(píng)估表(Wong-Baker’sFACES Pain Rating Scale)第8章 肌肉骨骼圖譜簡(jiǎn)介 (Introduction)上肢 (Upper Extremities)下肢 (Lower Extremities)第9章 肌肉簡(jiǎn)表簡(jiǎn)介 (Introduction)上肢(Upper Extremities)肌肉動(dòng)作、解剖位置和神經(jīng)支配——肩部與上臂(Muscle Action, Location and Innervation——Shoulder and Arm)肌肉動(dòng)作、解剖位置和神經(jīng)支配——前臂(MuscleAction,Location and Innervation——Forearm)肌肉動(dòng)作、解剖位置和神經(jīng)支配——手部(MuscleAction,Location and Innervation——Hand)下肢 (Lower Extremities)肌肉動(dòng)作、解剖位置和神經(jīng)支配——腹部、髖部、骨盆(Muscle Action,Location and Innervation——Abdomen, Hip, Pelvis)肌肉動(dòng)作、解剖位置和神經(jīng)支配——大腿和小腿(Muscle Action,Location and Innervation——Thigh and Leg)肌肉動(dòng)作、解剖位置和神經(jīng)支配——足部(MuscleAction,Location and Innervation——Foot)筆記