Assesement Flashcards
name a method to quantify pain in order to document and track it
numeric pain rating scale(NPRS), visual analog scale (VAS); McGill pain questionaire (MPQ); Oswestry disability index (ODI); Wong-baker FACES scale
what should a massage therapist do with the health history form once the client completes it
go over it with the client
characteristics of client-reported pain that a therapist should find out
onset, quality(sharp , dull ,throbbing), radiation or referral patterns, what relieves or aggravates the pain
unilateral decreased foot arch typically results in what positioning of the ipsilateral leg?
internal (medial ) rotation
internal rotation of the upper extremities can result in the dorsal surface of the hand facing which direction during relaxed standing posture ?
anterior
what are two characteristics of skin included in a thorough visual assessment
color and discoloration, presence of hair
weakness of the dorsiflexors can result in what gait abnormality observed during gait assessment
foot drop
The T8 spinous processes is approximately level with what boney landmark observed during posture assessment?
the inferior angel of the scapula
what is a symptom of upper cross posture that can be observed from the side view?
forward head posture
what general qualities of soft tissue are determined during a palpation assesment
temperature, texture, tone, soft tissue movements or restrictions
a massage therapist has palpated a tight band of muscle that causes pain at another area when pushed. what has the therapist likely found?
a trigger point
what bony landmarks of the pelvis can be palpated during a physical assessment?
anterior superior lilac spine (ASIS) ; posterior superior iliac spine (PSIS); iliac crest; sacroiliac joint
a massage therapist palpates a trigger point at the supraspinatus. where would the client likely feel pain based on normal referral patterns
lateral deltoid region
what is normal flexion PROM of the shoulder complex?
180 degrees ( includes glenohumeral and scapulothoracic movement)
this type of range of motion assessment is not affected by the clients strength
Passive range of motion (PROM)
how is a bony block end feel described when documenting ROM assessment findings?
hard end feel
what is normal ROM of wrist supination and pronation
80 degrees supination, 80 degrees pronation
If correcting ROM restrictions is a primary treatment goal, when should measurments be taken
before and after treatment
how should you document assessing ROM at a joint when the client stops you before reaching end range due to pain?
empty end feel/ stopped d/t pain
what kind of special test attempt to reproduce the clients pain to identify the source?
provocation test
when is the best time for the client to provide feedback?
at anytime; before, during, or after the massage
what should the massage therapist do if a client reports pain that keeps them up at night and is not affected by movement or position?
this a red flag, refer them to a physician prior to treatment.
a client presents with unidentified/undiagnosed signs and symptoms of fatigue, left leg swelling, warmth, redness, and pain at the thigh. what is the best action for the massage therapist to take?
refer client to physician before providing any treatment that may affect circulation ( there is a posibiliy of DVT)
General observations include
- Skin : dry patches, blotches or red spots, acne unusual marks or moles, rashes, bruises wounds, scars
- Movement quality: slow , stiff, fluid, controlled, unstable, guarded
- Facial expression: smile, frown, nervous habit, furrowed brow, blank, serene
- Level of communication: nonstop talking, talkative, quiet, non responsive, silent
- Voice quality: loud, soft, weak, raspy, high pitched , low pitched-
- Breathing : relaxed , diaphragmatic, chest breathing, labored, rapid, sighing, congested, wheezing, coughing–
- Mental clarity: sharp, alert, fuzzy, vacant, distracted, forgetful, sleepy
- Emotional state: relaxed, agitated, nervous, angry, worried, anxious
sensing information about the client through touch. It is about the feel of tissue and of movement at joints. “an art and skill which involves (1) locating a structure, (2) becoming aware of its characteristics, (3) assessing its quality or condition to determine how to treat it (4) and to detect changes in quality or condition as a result of massage”
plapation
what are following PALPATION descriptions for : hot / warm / cold / dry / damp / oily / hairless / hairy / smooth / rough / loose / taut / thin / thick / elastic / mobile / scarred
skin
what are following PALPATION descriptions for: spongy / firm / hard / tough / pliable / soft / dehydrated / puffy / swollen / congested / grainy / smooth
Soft tissue (general)
what are following PALPATION descriptions for: hypertonic / hypotonic / hard / firm / pliable / taut / taut bands / lax / knotty / smooth / ropey or ropeylike / stringy / spasm / relaxed
muscles and tendons
what are following PALPATION descriptions for : adhering / sticking / moving freely / restricted / unrestricted
Fascia
what are following PALPATION descriptions for : stiff / easy / free / clicking / hitches / glitches / crepetations / grinding / grating / stuck / bound / freely moving
joint movement
what are following PALPATION descriptions for : strong / weak / fast / slow / even / uneven / regular / irregular
pulses
what are following PALPATION descriptions for : stagnant / blocked / free flowing / pooled / fluid / excess / deficient
energy
This Range of motion evaluation offers potential muscle and tendon problems. Document any deviation from normal, pain free movement in session notes. compare movement on both sides of the body (Ex. Apley Scrach Test, Internal rotation Test, Adduction Test )
(AROM) active range of motion
This Range of motion evaluation offers potential ligaments and joint structures problems. Note any restrictions in movement, differences in left and right sides, or discomfort experienced by the client ( Ex. Compare degree of flexibility on both left and right sides)
(PROM) passive range of motion
This Range of motion evaluation may simply be a sign of tense, shortened muscles that can benefit from increased circulation in the area, muscle relaxation, and lengthening of muscle fibers
Restricted range of motion (RROM)
a branch of kinesiology and an important aspect in sports medicine. looks and analysis the body in motion, takes into account principles of motion and the structure and function of the human body, especially the muscles an skeletal system
Biomechanical analysis
similar to a protractor used in geometry to measure angles, used to measure the range of motion quantitatively . takes some practice, and are used primarily for medical applications.
Geniometer
- standing straight and tall
- avoiding locking the knees
- weight should be mostly over the balls of the feet not on the back of the heals /
- head in alignment on top of the neck and spine
- chin not pushed forward
- arms hand naturally down the sides of the body
- shoulders relaxed
Normal posture
- the back is supported
- knees are aligned evenly with the hips or slightly higher
- both feet are flat on the floor, or on floor support
- slouching should be avoided
head should be aligned over the shoulders , chin tucked in slightly - if working arms should be flexed at a 75- to 90 degree angle, shoulders squared and relaxed
good sitting posture
(heel strike, flat foot, push off, and acceleration ) (2-4 inches from heel to heel)
The phase of walking
(toe- off, midswing, deceleration ) (2-4 inches from heel to heel)
Swing phase
base width, vertical movement of the center of gravity, knee flexion, lateral shifting, length of step, and pelvis rotation
Points to look for in walking (gait)
Slow walking, limping, shuffling, twisting at the wasit, dragging, the feet, waddling(lateral movement, wide base lurching .
Deviations from normal Gait ( Note compensations may also be made for arthritic or fused joints in the feet or legs
Gait deviation : slow walk
old age, neurological disorder, joint disease, injury
Gait deviation : limping
injury to foot or leg, short leg
Gait deviation : Shuffling
weak quadriceps, Parkinson’s disease, neurological disorder
Gait deviation : twisting
arms crossing mid line during walk
Gait deviation : dragging
tibialis anterior weakness ( also called drop foot, toe scraping)
Gait deviation : waddling
pain in lower back, hips, lower extremities
Gait deviation : wide base
unsteadiness, dizziness, general weakness, vision problems
Gait deviation : lurching
weakness in gluteal muscles
- clients stated reason for massage
- initial and subsequent complaints
- health history information
- report of medications taken
- report of recent illness or injury
- description of symptoms ( pain, trouble sleeping)
- report of functional limitations ( walking , sitting)
- qualitative description (tension, pain, numbness, stress)
- quantitative rating ( tension, pain , numbness, stress)
- diagnosis from health care provider
Subjective - information from the client
- visual observations ( posture, skin color, facial expression)
- palpation ( tissue quality, joint movement quality )
- range of motion measurement
- posture analysis
- gait analysis
- orthopedic tests of function
objective - information gathered by the massage therapist
- summary of conditions or limitations
- identification of contraindications and cautions
- general goals for a series of massage sessions
- goals for a specific massage session
assessment - of the situation to set goals for the massage sessions
General strategy to achieve goals
- number of sessions and
frequency of massage
- use of adjunct modalities ( hot / cold packs)
- homework ( stretching,
relaxation exercises)
strategy for specific massage session
- time spent on each body area
- technique used
- adjunct modalities used
- results
plan - development of strategy to achieve those goals.
a practitioner observes that a client continues to limp when walking into the office , even though his injury is completely healed . this is an example of
A compensation pattern
Functional limitations impact clients :
On many levels including :Psychologically, Physically, Socially
a functional goal achieved by the client and related to benefits from regular massage is called: ___ _______ _______
a Functional outcome
A goal that is attainable is:
Realistic in relationship to the clients current condition
functional goals are written using the acronym SMART
Specific , measurable, time-bound
a pain assessment method that uses a continuum line, verbal scales, or visual scales is called:
Analog measure
one benefit of conducting a pain assessment is
documentation helps to prove client injury to an insurance providers or court
a chronic condition characterized by tender points all over the body is called:
Fibromyalgia
Pain fabricated for the purpose of achieving personal reward or satisfaction is called
Malingering pain
pain assessment are most often repeated every
6-8 weeks
to detect irregularity in tissue textures is one objective of palpation assessment during a ______ _______
Health-care session
during palpation, a grainy, fibrous texture, or the sensation that the tissues are stuck together, best describes
Scar tissue
Temperature differences felt on the clients skin can be an indication of differences in:
Circulation
To palpate attentively and continuously in order to adjust the depth and speed of strokes to ensure the clients comfort is the objective of palpation during a ________ __________
wellness session
If a posture assessment indicates that a client has hyperlordosis, a practitioner would want to be sure and address:
Hypertonic iliopsoas and rectus femoris muscles
what type of session will require a longer initial interview and evaluation
Treatment massage
The Stenocleidomastoid, Longus capitis, and Longus coli muscles are hypertonic with this condition:
Military neck
if the right shoulder is elevated, the client will probably need massage work to
Decrease hypertonicity in the right scalenes, upper trapezius, and lower trapezius
Muscles that are likely short and hypertonic when a lateral pelvic tilt is observed include:
Gluteus medius, quadratus lumborum, and abductors on the side with the elevation
Medial rotation of a lower limb is often caused by hypertonicities in the
Adductor muscles
to build strength and re-educate muscle fibers after an injury, which type of ROM is most helpful
Active-resisted
To assess the functional capacity of muscles and tendons and muscular strength, the practitioner would use:
Resisted range of motion
For a full range of motion assessment, how should the client be dressed?
undergarments/ swimsuit and barefoot
To assess inert tissues throughout the movement, and contractile tissue at end feel with a slight overpressure, the practitioner would use:
passive range of motion
Finding the angle at which the joint moves with the least resistance is known as
direction of ease
When soft tissue structures reach their maximum ability to lengthen without injury, the resulting sensation is called
Firm end feel
describe an eccentric contraction
Muscle lengthens and attachments move farther away from each other
