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Shoulder Exam
I think that the most daunting aspect of the shoulder exam is appreciating the functional anatomy of this incredibly mobile joint. The primary benefit of the ball and socket arrangement is that it allows the hand to be positioned precisely in space, maximizing our ability to function. In terms of functionality, the shoulder might be best described as having a golf ball-on-a-tee design.
Location Of The Muscle Groups Is Approximated In The Pictures Above.
Start by looking at the normal (or more normal) side. Note any scars, obvious asymmetry, discoloration, swelling, or muscle asymmetry.
Palpation
Gently palpate around the shoulder, touching each of the landmarks noted above. Make note of pain.
A hemangioma (he-man-jee-O-muh) is a birthmark that most commonly appears as a rubbery, bright red nodule of extra blood vessels in the skin. A hemangioma grows during the first year of life, and then recedes over time. A child who had a hemangioma during infancy usually has little visible trace of the growth by age 10.
Polycystic liver disease (PLD or PCLD) is a rare condition that causes cysts -- fluid-filled sacs -- to grow throughout the liver. A normal liver has a smooth, uniform appearance. A polycystic liver can look like a cluster of very large grapes.
Cellulitis (sel-u-LIE-tis) is a common, potentially serious bacterial skin infection. Cellulitis appears as a swollen, red area of skin that feels hot and tender. It can spread rapidly to other parts of the body. Cellulitis isn't usually spread from person to person. Skin on lower legs is most commonly affected, though cellulitis can occur anywhere on your body or face. Cellulitis might affect only your skin's surface. Or it might also affect tissues underlying your skin and can spread to your lymph nodes and bloodstream. Left untreated, the spreading infection can rapidly turn life-threatening. It's important to seek immediate medical attention if cellulitis symptoms occur.
Blood type (or blood group) is determined, in part, by the ABO blood group antigens present on red blood cells. A blood type (also called a blood group) is a classification of blood based on the presence or absence of inherited antigenic substances on the surface of red blood cells (RBCs).
Ehlers-Danlos syndrome is a group of disorders that affect the connective tissues that support the skin, bones, blood vessels, and many other organs and tissues. Defects in connective tissues cause the signs and symptoms of Ehlers-Danlos syndrome, which vary from mildly loose joints to life-threatening complications. Previously, there were more than 10 recognized types of Ehlers-Danlos syndrome, differentiated by Roman numerals. In 1997, researchers proposed a simpler classification that reduced the number of major types to six and gave them descriptive names: the classical type (formerly types I and II), the hypermobility type (formerly type III), the vascular type (formerly type IV), the kyphoscoliosis type (formerly type VIA), the arthrochalasia type (formerly types VIIA and VIIB), and the dermatosparaxis type (formerly type VIIC). This six-type classification, known as the Villefranche nomenclature, is still commonly used. The types are distinguished by their signs and symptoms, their underlying genetic causes, and their patterns of inheritance. Since 1997, several additional forms of the condition have been described. These additional forms appear to be rare, affecting a small number of families, and most have not been well characterized.
An ICD is a battery-powered device placed under the skin that keeps track of your heart rate. Thin wires connect the ICD to your heart. If an abnormal heart rhythm is detected the device will deliver an electric shock to restore a normal heartbeat if your heart is beating chaotically and much too fast.
Nelson syndrome refers to a spectrum of symptoms and signs arising from an adrenocorticotropin (ACTH)–secreting pituitary macroadenoma after a therapeutic bilateral adrenalectomy. The spectrum of clinical features observed relates to the local effects of the tumor on surrounding structures, the secondary loss of other pituitary hormones, and the effects of the high serum concentrations of ACTH on the skin. [1] The first case was reported by Nelson et al in 1958. [2]