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    Kuliah Muskulo I

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    SariRahmaYenti
    1. Orthopedics involves the prevention, diagnosis, and treatment of musculoskeletal disorders and injuries through medical, surgical, and physical means as well as the study of related physiology, pathology, and basic sciences. 2. The evaluation of orthopedic patients involves obtaining a history through anamnesis, conducting a physical examination, and ordering imaging and laboratory tests. 3. The physical examination includes inspection, palpation, and evaluating active and passive range of motion to localize areas of tenderness and assess for deformities, abnormalities, or instability. Imaging such as x-rays, CT, MRI, and other modalities can further aid in diagnosis.

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    Kuliah Muskulo I

    Uploaded by

    SariRahmaYenti
    16 views26 pages
    1. Orthopedics involves the prevention, diagnosis, and treatment of musculoskeletal disorders and injuries through medical, surgical, and physical means as well as the study of related physiology, pathology, and basic sciences. 2. The evaluation of orthopedic patients involves obtaining a history through anamnesis, conducting a physical examination, and ordering imaging and laboratory tests. 3. The physical examination includes inspection, palpation, and evaluating active and passive range of motion to localize areas of tenderness and assess for deformities, abnormalities, or instability. Imaging such as x-rays, CT, MRI, and other modalities can further aid in diagnosis.

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    1. Orthopedics involves the prevention, diagnosis, and treatment of musculoskeletal disorders and injuries through medical, surgical, and physical means as well as the study of related physiology, pathology, and basic sciences. 2. The evaluation of orthopedic patients involves obtaining a history through anamnesis, conducting a physical examination, and ordering imaging and laboratory tests. 3. The physical examination includes inspection, palpation, and evaluating active and passive range of motion to localize areas of tenderness and assess for deformities, abnormalities, or instability. Imaging such as x-rays, CT, MRI, and other modalities can further aid in diagnosis.

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    16 views26 pages

    Kuliah Muskulo I

    Uploaded by

    SariRahmaYenti
    1. Orthopedics involves the prevention, diagnosis, and treatment of musculoskeletal disorders and injuries through medical, surgical, and physical means as well as the study of related physiology, pathology, and basic sciences. 2. The evaluation of orthopedic patients involves obtaining a history through anamnesis, conducting a physical examination, and ordering imaging and laboratory tests. 3. The physical examination includes inspection, palpation, and evaluating active and passive range of motion to localize areas of tenderness and assess for deformities, abnormalities, or instability. Imaging such as x-rays, CT, MRI, and other modalities can further aid in diagnosis.

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    Muskulo-skeltal System

    dr. Eko Perdana Putra, Sp.OT, M.kes


    Orthopedia
    •  the art of correcting
    deformities in children
    (Nicolas Andry, 1741)
    • Orthos  straight/free from
    deformity
    • Pais  child
    3 phase of management of muskuloskeletal
    disorder and injuries:
    • I : strap and buckle
    • II : excessive orthopaedic operation
    • III : science replace epiricism
    • Present Scope of orthopaedics: Art and
    science of prevention, diagnosis and
    treatment of disorder and injuries of the
    muskuloskeletal system by medical, surgical
    and physical mean, as well as the study of
    muskuloskeletal physiology, patology, and
    other related basic science.
    Scope of orthopaedics
    1. Congenital and developmental abnormalities.
    2. Infection and inflammation.
    3. Arthritis and rheumatic disorders.
    4. Metabolic and endocrine disorders.
    5. Tumours and lesions that mimic them.
    6. Neurological disorders and muscle weakness.
    7. Injury and mechanical derangement.
    Of bones, joints, muscles, tendons and nerves –
    the skeletal system and all that makes it move.
    How to make a diagnose in
    orthopaedic?

    • Anamnesis
    • Physical Examination
    • Imaging and Laboratory examanition
    Anamnesis
    Symptoms:
    - Pain
    - Stiffness
    - Swelling
    - Deformity
    - Weakness
    - Instability
    - Change in sensibility
    - Loss of function
    Past History

    Patients should be asked specifically about


    childhood disorders, periods of incapacity and old
    injuries.
    • A ‘twisted ankle’ many years ago  unsusual
    osteoarthritis
    • Gastrointestinal disease  ankylosing spondylitis
    or osteoporosis.
    • Previous medication: many drugs, and especially
    cortico – steroids, Alcohol and drug abuse
    Family History
    Should be ask when dealing with:
    - Congenital/hereditary disease
    - Infection

    Social Background
    • level of care and nutrition in children;
    • dietary constraints which may cause specific
    deficiencies;
    • Smoking habits, alcohol consumption and drug abuse
    Physical Examination
    The examination actually begins from the moment we
    set eyes on the patient:
    General appearance, posture and gait.
    distinctive feature: Knock-knees? Spinal curvature? A
    short limb? A paralysed arm? Does he or she appear to
    be in pain? Do their movements look natural? Do they
    walk with a limp, or use a stick? A tell-tale gait may
    suggest a painful hip, an unstable knee or a foot-drop.
    Structural Examination

    LOOK
    FEEL
    MOVE
    • Undressed Patient
    • If one limbs afffeted, expose the normal side
    also
    • Examine the normal limbs first
    LOOK
    Shape and posture
    LOOK
    Skin
    • colour, quality and markings of the skin. Look for
    bruising, wounds and ulceration, Scars
    • Colour reflects vascular status or pigmentation – for
    example the pallor of ischaemia, the blueness of
    cyanosis, the redness of inflammation, or the dusky
    purple of an old bruise.
    • Abnormal creases, unless due to fibrosis, suggest
    underlying deformity which is not always obvious;
    tight, shiny skin with no creases is typical of oedema
    or trophic change.
    FEEL
    • The skin Is it warm or cold; moist or dry; and is
    sensation normal?
    • The soft tissues Can you feel a lump; if so, what are
    its characteristics? Are the pulses normal?
    • The bones and joints Are the outlines normal? Is the
    synovium thickened? Is there excessive joint fluid?
    • Tenderness. Try to localize any tenderness to a
    particular structure; if you know precisely where the
    trouble is, you are halfway to knowing what it is.
    MOVE
    ‘Movement’ covers several different activities: active
    movement, passive mobility, abnormal or unstable
    movement, and provocative movement.

    Range of movement
    Special Examination
    Imaging
    • X Ray
    • CT Scan
    • MRI
    • Radionucleic Imaging
    • BMD
    Other Imaging:
    • Myelography
    • Ultrasound
    • Arthrography
    Other Investigation
    • Blood Inestigation
    • Synovial Fluid
    • Biopsy
    • Diagnostic Arthroscopy
    Thank You

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