Application of Patient History and Examation Flashcards
What should you look at when taking a patient history?
current complaint
B/W/S since onset
NPRS
Nature of Pain
PMH
PSH
aggravating factors
Easing Factors
Medications
Other
what are the 5 parts of a screen exam?
- Posture
2 ROM - Force Production
- Sensation
- Reflexes
what are you looking at in a posture during screen exam?
-performed sitting or standin
-cervical and thoracic alignment
-upper extremity symmetry
-muscular/soft tissue imbalances
-iliac crest height
-nose over sternum
-tragus aligned with acromion
-umbilicus centered
what some places you can test AROM & overpressure?
-cervical spine
-shoulder
-elbow
-wrist/hand
when testing ROM in a screening exam what are you looking for?
-reproducing of symptoms
-changing symptoms
-limited ROM
-then response to over pressure
what are all the ROM to test on cervical spine?
-flexion
-extension
-lateral side bend
-rotation
What are the motions that can be tested when looking at shoulder ROM?
-extention (back)
-flexion (up and side)
-scaption (arms out at angle then up)
-function internal & external rotation
-abduction
when testing ROM of shoulder what motions do you not apply over pressure?
-FIR & FER
what is 2 point insufficiency?
when two joint muscles does not flex enough limiting ROM in antagonist direction
when testing ROM of the elbow what are the motions that can be tested?
-flexion
-extension
-forearm supination & pronation
When testing ROM in the wrist what motions can be tested?
–wrist flexion
-wrist extension
-finger abduction/adduction/opposition
what is a myotome?
single nerve root that provides innervation to specific muscle
what is the grading of myotomes and what does it mean?
-strong and pain free = healthy
-strong & painful = little problem (prob with muscle at local point)
-weak & painful = larger problem that will take more time
-weak & no pain = huge problem b/c contractile tissue is not intact
what is an isometric break test?
used to examine bilateral strength
-5 second hold requires
- patient has to give best effort to meet resistance
when doing an isometric break test what might paresis indicate?
nerve root lesion
when doing an isometric break test what might flaccidity or paralysis indicate?
peripheral nerve issue
When doing isometric break test what can be tested?
-cervical spine (flexion, extension, sidebending)
-shoulder elevation
-shoulder abduction (also shoulder IR & ER)
-elbow flexion & extension
-wrist extension
-thumb extension
-finger abduction
what is the myotome for cervical spine?
C1-3
what is the myotome for shoulder elevation?
C4
what is myotome shoulder abduction?
C5
what is the myotome for elbow flexion?
C6
what is the myotome for elbow extension?
C7
what is the myotome for wrist flexion?
C7
what is the myotome for wrist extension?
C6
