GUIDELINES AND CHECKLIST

TUTORIAL OF BASIC CLINICAL SKILLS-1 MODULE

MUSCULOSKELETAL EXAMINATION: UPPER EXTREMITIES
Medical Doctor Undergraduate Program
Faculty of Medicine, Universitas Indonesia

1. Skill Title Musculoskeletal examination: upper extremities

2. Introduction The examination of upper extremities consist of examination of
shoulder joint, elbow joint, wrist and hand. The examination is
based on symptoms. Examination performed by Look, Feel,
Move.
3. Learning objectives After finishing this skill station, students are expected to be able
to:
 Perform physical examination on abnormalities of the
upper extremities musculoskeletal system (shoulder joint,
elbow joint, wrist and hand)
 Perform Special test
 Report results of the examination orally
4. Learning Methods  Students are divided in groups of 8-10 people.
 Tutor leads the discussion
 There is a simulation patient for each group
 Each session will take about 120 minutes, and there will be
2 meetings.
 Examination of upper extremities 1:
- Tutor open and explain the objective of the activity for
5 minutes
- Tutor demonstrate musculoskeletal physical
examination on the shoulder joint, elbow joint, wrist
and hand (inspection, palpation, move and special
test) for 10 minutes.
- Each student practices musculoskeletal physical
examination (inspection, palpation, move and special
test) for 10 minutes.
- Other students act as observers.
- Tutor shows the short comings and mistakes made by
the students and suggests improvements in
performing examination.
- Tutor will conclusion and close the meeting.
 Examination of upper extremities 2:
- Tutor will provide introduction for 10 minutes
- Each student perform musculoskeletal physical
examination (inspection, palpation, move and special
test) for 10 minutes each student.

BCS 1 2017/2018
Musculo skeletal examination : upper extremities
 - Using checklist, the other student and tutor observe
and evaluate the examination
- Tutor signs the students’ log book who are able to
perform physical examination of upper extremities
correctly
- Tutor will give conclusion for 5 minutes
5. Tools and materials Cotton wool
needed
6. References 1. Mc.Rae R. Clinical orthopaedic examination.
London:Elsevier: 2010.
2 Gross J, Fetto J, Rosen E. Musculoskeletal examination. Wiley
Blackwill; 2011
7. Checklist Attached
8. Skill PIC dr. Nora Sutarina, Sp.KO
9. BCS PIC for this skill BCS-1 Module Team

BCS 1 2017/2018
Musculo skeletal examination : upper extremities
 CHECKLIST

Skill Title : MUSCULOSKELETAL EXAMINATION: UPPER EXTREMITIES

Day/Date :

Tuto :

Group :

Checklist* Tutor Assessment/Self Assessment/Peer Assessment

No Skill

1. Greet the patient, introduce yourself and clarify the patient’s identity

2. Ask patient to sit and explaine the examination procedures, ask for informed consent

3. Ask the patient for undressing from the waist up.

4. Perform hand washing according to WHO guideline

Shoulder joint

Inspection (look): the movement of shoulder joint when walking, skin changes (the
5.
color & other disorders), signs of inflamation, muscle contour, bones deformities

6. Palpate (feel): the joint, bones and muscle of the shoulder area

Range of motion (move) of the shoulder joint

7.  flexion - extension
 Abduction-adduction
 internal rotation – external rotation

8. Perform ‘Apley scratch test’

Elbow joint

Inspection: flexion - extension of the elbow, skin changes (the color & other
9.
disorders), signs of inflamation, muscle contour, bones deformities.

Palpate: elbow region include biceps, triceps, 1/3 distal humerus, he lateral and medial
10.
humeral epicodylus, processus and sulcus of olecranii

BCS 1 2017/2018
Musculo skeletal examination : upper extremities
 No Skill

Range of motion (move) of the elbow:

11.  flexion - extension
 pronation-supination

Wrist and hand examination

Inspection: hand position, dorsal and palmar surface, skin changes (the color & other
12.
disorders), signs of inflamation, muscle contour, bones deformities
Palpate: palpation examination on the 1/3 muscle of distal ante brachii, wrist and hand
13.

Range of motion (move) of the wrist:

14.  Dorsiflexion – Palmar flexion
 Ulnar deviation- radial deviation
Range of motion (move) of the hand and thumb
15.  flexion - extension
 Abduction-adduction
 Opposition of the thumb
Perform sensoric test with a cotton wool:
16.  N. Ulnaris
 N. Radialis
 N. Medianus

17. Allow the patient to dress and thank them

18. Perform hand washing according to WHO guideline

19. Explain the examination results to the patient

BCS 1 2017/2018
Musculo skeletal examination : upper extremities