Introduce, identify patient, consent Ask: pain in neck? Any lumps? Difficulty swallowing or breathing? Inspection: from front and side Scars Lesions Distended neck veins Goitre

  Inspection Gait – limp, restriction of movement Pt standing: Posture: alignment of shoulder, hips, patella Skin: colour, sinuses, (arthroscopic) scars Joint: popliteal fossa:

Shoulder joint consists of glenohumeral joint and acromioclavicular joint; movement also occurs between scapula and posterior chest wall. Shoulder pain frequently referred to upper arm. Meanwhile, p

  Common musculoskeletal symptoms: pain (arthralgia / myalgia / other soft tissue); stiffness; inflammation; swelling; weakness; locking and triggering; deformity; extra-articular manifestations

  General inspection: Abnormal or asymmetrical pupils: II, III Ptosis, strabismus (squint), abnormal eye position: III Poor articulation of words: V, VII, X, XII General asymmetry, muscle

  1. Ask: pain? Gait Stand on tip toes: distal muscle weakness diagnosed Heel-toe walking: cerebellar function Shuffling: Parkinsonism Stamping: loss of sensation Stand feet together,

  Ask: pain? Inspection   Scars Asymmetry and atrophy Fasciculations: flick muscles Tone Wrist, elbow, shoulder Cogwheel movements at wrist? Power: shoulder, elbow, wri

  General inspection Well / sick Jaundice Pruritus (itching): scratch marks Liver disease (bile salts) Chronic renal failure Iron deficiency Drug reactions Old age Hands C

  General inspection Well / sick RR Accessory muscles of ventilation? Cheyne-Stokes respiration Barrel chest Cyanosis? Asthma paraphernalia Sputum, + colour Hands Clubbing