1- 1b] Dx. Tx, Joint Mobs, Sensory Flashcards
Constant, nocturnal
Disturbs sleep
AM stiffness > 2 hours
Unaffected by rest
Systemic pain
Intermittent
AM stiffness less than few min
Eased by rest
No sleep disturbance
Mechanical pain
Radicular (radiating) pain is secondary to ? And typically ?
Spinal segment/nerve
Dermatomal
Throbbing pain with systolic increase
Vascular headache
Arteritis
Arterial pain
Neoplasms
Compressive neuropathies
Tendon tears (rotator cuff)
Burning or acute throb
Pain at rest
P’s for PVD
Pallor
Pulsenessness
Paraesthesia
Paralysis
Ischemic pain: sharp or dull
Vascular claudication
Angina- visceral lesion
Typically 5-10 min after activity
Angina- MSK problem
Pain during activity
Goals of movement assessment exam
To reproduce symptoms and to determine impairments
3 types of selective tissue tensions exam
Contractile vs non contractile
Contractile
Non contractile
What is contractile vs non contractile
Active ROM
Passive ROM
Isometric testing
Contractile tissue
Muscles
Tendons
Tenoperiosteal insertion
Non contractile tissue
Ligaments/capsules
Bursa
Fascia
How to develop a differential diagnosis list
Begin broad, then focus.
Rule in, rule out.
Types of normal end feels
Bony
Capsular
Soft tissue approximation
Elastic/muscular
Bony end feel example
Elbow extension
Soft tissue approx example end feel
Elbow flexion
Knee flexion
Elastic end feel example
Wrist flex with finger flex
SLR
Ankle DF with knee extension
Capsular end feel examples
Soft wrist flexion
Medium supination elbow flexion
Hard knee extension
Springy end feel example
Knee flex/ext with displaced meniscus
Boggy end feel example
Hemarthrosis at knee
Spasm end feel example
Arthritis
Hypermobility
Grade II muscle tears
Empty end feel examples
Acute bursitis
Sign of buttock
Capsular pattern is limited ROM in?
Fixed proportion
Non capsular pattern is?
Any other pattern
Capsular pattern for shoulder
ER > ABD > IR
Capsular patterns go in order of ?
whichever motion they have the least of first
Non capsular pattern for shoulder
Flex > ER
Contractile tissue pain with?
AROM in same
A/PROM in opposite
Non-contractile tissue pain? No pain?
NO pain with AROM same
Pain with A/PROM in opposite
Spinal vs peripheral.
Spinal has?
Motion, contraction, position impacts CC.
Dermatomal pattern of pain.
Myotomal pattern of weakness.
Spinal vs peripheral.
Peripheral?
NO impact on CC
NON dermatomal pattern
NON myotomal pattern
Joint mob indications (7)
Increase ROM and strength Decrease pain Muscle relax Joint nutrition Correct position Eliminate meniscoid impingement Physio, psycho, placebo effects
Contraindications for joint mobs (8)
Unhealed Fx Hypermobile Ankylosis Acute inflammation Hemarthrosis Acute arthritis Osteomyelitis Spinal cord compression
Grade 1 joint mob
Small amp osc at beginning of range
Grade 2 joint mob
Large amp osc from beg to mid range
Grade 3 joint mob
Large amp osc from mid to end range
Grade 4 joint mob
Small amp osc at end range
Grade 5 joint mob
high velocity, small amp thrust at end range
Grade 1 distraction
Loosening
Grade 2 distraction
Tightening
First stop at tissue resistance/end feel
Grade 3 distraction
Stretching
After slack is taken up
Process of transmission of the stimulus event from receptors to the cortex
Sensation
Interpretation of and meaning attached to a stimulus
Perception
Sensory loss of entire distal segment (foot or hand) is?
Stocking or glove sensory loss
Abnormal responses to sensation testing (5)
Decreased sensation Exaggerated response (hyperaesthesia) Absence Incorrectly identify Inconsistent response to stimulus
What type of sensation is examined first?
Superficial sensation
Stereognosis
Object recognition
What is myotome for heel walking?
L4 - L5
What is myotome for toe walking?
S1
What do myotomes start at for UE and LE?
UE is C3 cervical lateral flexion
LE is L2 hip flexion
