한방 골상과 정리 TCM Traumatology and Orthopedic

적색골수(in 해면골) ; 적혈구, 백혈구, 혈소판
황색골수(in 골수강) ; 일부의 백혈구

Compound fracture : open and comlete

Hinge joint : Elbow cf)Partial hinge:knee joint
Saddle joint : Thumb

Static(정적) - Isometric(등척성)
                      - Isotonic(등장성) - concentric(단축성) & Eccentric(신장성)
Dynamic(동적) - Isokinetic(등속성)

Deltoid C5 - Bicep reflex
Biceps C6 - Branchioradial reflex
Triceps C7 - Triceps refle
Interossei C8 : Finger abd, add

Supraspinatus 극상근
Infraspinatus 극하근
Teres minor 소원근
Subscapularis 견갑하근

Apley's test : active range of motion (AROM)
Drop arm test : tear in rotator cuff
Y(G)erason test : Biceps tendon
Apprehension test : shoulder dislocation / "Duga's sign

De Quervain's disease (양계 부위)
     - Finkelsten test (baby fist) and deviation ulnar side
Guyon Tunnel = Pisiform + hook of Hamate
Capal Tunnel : Tinel sign, Phalen test

태양경근 : 손이 뒤로 안돌 때, 손을 등 뒤로 돌릴 때 이상
대장경근 : 손바닥 위로해서 올릴때
삼초경근 : 손등을 위로해서 올릴때
소장경근 : 손을 목 뒤로 반대쪽 귀 잡을때, 손을 등위로 돌릴 때 이상 

Shoulder impingement syndrome
     pain arc 60`~120`
     => Supraspinatus tendinitis or Bursitis
Mills manipulation : for tennis elbow, wrist extension and rotate inside 

Thoracic outlet syndrome
          Adson test: head ipsilateral side, hold and deep breath, shoulder passive abduct
          Halstead test: hyper-extension
          Allen test: head turn opposite, arm abduct&elevate

Carrying angle : Men 5`  Women 10-15`
Q(quadriceps) angle : Men 12`  Women 16`

대능형골      소능형골     유두골     유구골
Trapezium Trapezoid Capitate Hamate

주상골       월상골      삼각골           두상골
Scaphoid Lunate    Triquetrum Pisiform


Muscle evaluation
5 100% Normal    full resistance
4 75%  Good        some resistance
3 50%  Fair            no resistance
2 25%  Poor          gravity omitted
1 10%  Trace        no joint motion
0 0%    Zero          no muscle contractility

Pronators회내근 Syndrome : pain and numbness in forearm
Dupuytren's contracture : palmar aponeurosis
Trigger Finger : nodule trapped behind sheath

Heberden's node : DIP
Bouchard's node : PIP

Hyoid bone: C3
Thyroid cartilage : C4
Frist cricoid ring : C6 = tracheostomy
C5-6 : most often involved facet joint ploblem

Torticollis (=wryneck) : Sternocledomastoid muscle
Whiplash injury : Traffic accident

Brachial plexus : C5-T1
Lumbar plexus : L2-S3
Jaw reflex test : Trigeminal cranial nerve(5th)
Chvostek test : Facial cranial nerve(7th) 

Iliac crests : between L4-L5
PSIS : S2 spinous process
Umbilicus : between L3-L4

Sciatic : L4-S3 , Tibial L4-S3, Common peroneal L4-S2

Piriformis syndrome : piriformis, obturator internus, sciatic nerve
Iliopsoas tendon(main flexor of hip) + lesser trochanter : T12 - L3
Quadriceps (hip adductor ) : L2 - L4

Patellar reflex : L4
Achilles refles : S1

Hoover test : 한쪽 다리 올릴때 다른쪽 아래로 향하는 힘이 느껴짐
Kernig test : meningeal sign, with hip flexed and knee flexed-cannot extend knee

Intrathecal pressure test
   1. Migram test : 누운자세로 다리를 5cm 정도 올리고 30초 유지
   2. Naphziger test : jugular vein 10 sec
   3. Valsalba maneuber : 허리 구부리고 숨을 참음

Rock the Sacroiliac joint
   1. Pelvic rock test
   2. Gaenslen's test : Iliopsoas M. & SI joint : 침대 끝에 누워 양다리 가슴으로 모으고 한쪽 떨어트림
   3. Patrick of Fabere test : 4자 검사, AVN 또는 내전근의 경직

Ober's test : 측와로 슬관절 90`, 고관절을 가능한 외전 자세유지, Fascia lata 염증 또는 구축
Ortolani click :Hip dysplasia (Women>Men)

SLR (Straight leg raising test)
   35` : sciatic root
   70` 이전 : SI joint
   70` 이후 : Lumbar spine

Gait 
Stance phase : Heel strike - Foot flat - Mid stance - Push off  
Swing phase : Accelration - Mid swing - Deceleration

Trendelenburg gait sign : Glutues medius
Propulsive gait : 평발
Steppage gait : 까지발
Waddling(duck) gait : 양발

Spastic gait : 다리가 원을 그리며 전진
Scissors gait (adductor) 가위 모양

Pelvic girdle : hip joint, SI joint, pubic symphsis
Inguinal Triangle : Femoral vein-artery-nerve (VAN)
Sartorius : 가장 길다 ASIS - Knee(tibial tuberosity)

Snapping hip (gluteal tendinitis) : 
     External : Gluteus medius - Iliotibial band
     Internal : Iliopsoas tendon catches on femoral head

Supertrochanteric plane : staring point of sciatic nerve

Pre-patellar bursitis
Pes anserine bursitis : medial aspect of the tibial tubercle

valgus : knock knee
varus : bow leg
lax ligament : genu recurvatum

Osgood-Schlatter's syndrome 
: patellar tendon palpable to its insertion into the tibial tubercle

Medial meniscus : attached to upper edge of the plateau (more common damage)
ITB(iliotibial tract band) 
Baker's cyst : gastrocnemius-semimembranosus bursa)

Unhappy triad syndrome = ACL+median meniscus+median collateral ligament

Bounce home test : bounce after knee drop
Lachmen test : ACL 20~30` 
Anterior draw: ACL 90`
McMurray test : Meniscus ( median, lateral )
Apley's compression and distraction test : compression or grinding
Patella femoral grinding test