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DPT 672: Assessment Skills > Assessment Skills > Flashcards

Assessment Skills Flashcards

1
Q

What is Muscle Insufficiency?

A

When a muscle cannot exert normal force or bring normal movement of the part to which it is attached.

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2
Q

Active Insufficiency vs. Passive Insufficiency

A
  1. Active Insufficiency = When a prime mover (agonist) becomes shortened to the point that it cannot generate or maintain active tension.

When a two joint muscle cannot shorten enough to move through full ROM at all joints crossed simultaneously.

(Ex: Maximally extend your knee, then flex your hip / Maximally flex your wrist, then make a fist).

  1. Passive Insufficiency = When a two-joint muscle cannot lengthen to the extent required to allow full ROM of all joints it crosses simultaneously.

(**Ex: **Unable to achieve normal ankle dorsiflexion with full knee extension (passive gastroc insufficiency / unable to flex trunk without bending knees (passive hamstring insufficiency)

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3
Q

Two options for Muscle Strength Testing?

A
  1. Manual Muscle Testing (MMT) = Easy and efficient way to assess strength.
  2. Dynamometry = More objective, Takes more time, Requires equipment
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4
Q

How to Perform a Manual Muscle Test?

A
  1. Put the patient in the appropriate test position. Think about what the muscle does.
  2. Position yourself to maximize force.
  3. Instruct your patient to go through full AROM. ***If **patient has full AROM, place the limb in mid range and apply resistance. **If **patient does not have full AROM, put the patient in gravity-reduced position and assess how much they can actively move.
  4. Grade the test
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5
Q

Grading Strength:

Grade = ?

Description = No palpable muscle contraction

A

Grade = 0/5 (zero)

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6
Q

Grading Strength:

Grade = ?

Description = Palpable muscle contraction

A

Grade = 1/5 (Trace)

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7
Q

Grading Strength:

Grade = ?

Description = Partial ROM in gravity-reduced position

A

Grade = 2-/5

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8
Q

Grading Strength:

Grade = ?

Description = Completes ROM in a gravity-reduced position / Partial ROM in gravity.

A

Grade = 2/5 (Poor)

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9
Q

Grading Strength:

Grade = ?

Description = Able to move through > 50% ROM against gravity

A

Grade = 3- /5 (Fair Minus)

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10
Q

Grading Strength:

Grade = ?

Description = Completes movement against gravity; no resistance

A

Grade = 3/5 (Fair)

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11
Q

Grading Strength:

Grade = ?

Description = Full anti-gravity ROM and able to hold minimal resistance

A

Grade = 3+/5 (Fair Plus)

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12
Q

Grading Strength:

Grade = ?

Description = Full anti-gravity ROM and breaks between minimal and moderate resistance.

A

Grade = 4- /5

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13
Q

Grading Strength:

Grade = ?

Description = Full anti-gravity ROM and able to hold moderate resistance

A

Grade = 4/5 (Good)

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14
Q

Grading Strength:

Grade = ?

Description = Full anti-gravity ROM and breaks between moderate and maximum resistance

A

Grade = 4+/5

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15
Q

Grading Strength:

Grade = ?

Description = Full anti-gravity ROM and able to hold maximum resistance

A

Grade = 5/5 (Normal)

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16
Q

3 Normal End-Feels

A

**End Feel **= Type of resistance you encounter when passively moving a joint through ROM

  1. Firm or Capsular (stretch), ( when in doubt = firm) - Finger extension
  2. Hard (bone to bone) - Elbow extension
  3. Soft (soft tissue approximation) - Elbow flexion
17
Q

Abnormal End-Feels

A
  1. Empty (cannot reach end feel, usually because of pain) / Ex: Joint inflammation, Fracture, Bursitis
  2. Firm / Ex: Increased tone, Tightening of the capsule, Ligament shortening
  3. Hard (elbow ext / supination) Fracture / Ex: OA or osteophyte formation
  4. Soft / Ex: Edema, Synovitis, Ligament instability or tear
18
Q

Grading Joint Play

A
  • 0 = ankylosed - fused
  • 1 = significant hypomobility
  • 2 = hypomobility
  • 3 = normal
  • 4 = hypermobility
  • 5 = significant hypermobility
  • 6 = subluxation
19
Q

M.R.S.

A
  • M = Myotomes
  • R = Reflexes
  • S = Sensation
20
Q

Assessing M.R.S.

Myotome Testing

A
  • Myotome = A set of muscles innervated by a single spinal nerve
  • We do not grade like with MMT
  • We compare right to left:
  • Absent
  • diminished
  • symmetrical (WNL),
  • asymmetrical
21
Q

Assessing M.R.S.

Reflexe Testing

A
  • Observe the excursion of the distal segment
  • Grading Scale:
  • 0 = No response, always abnormal
  • 1+ = A slight but present response; may or may not be normal
  • 2+ = A brisk response; normal
  • 3+ = A very brisk response; may or may not be normal
  • 4+ = A tap elicits a repeating reflex (clonus); always abnormal; always abnormal.
  • Clonus = repetitive movement
22
Q

Sensation

How to test Dermatomes

A
  1. Show patient what it feels like in an area you aren’t formally testing (Select an area that is NOT compromised).
  2. Have the patient close his/her eyes
  3. Using equal pressure L and R, gently touch the area one side at a time (Use consistent cues and questions, Ex: “Does this feel the same on both sides?”).

Dermatome = An area of skin that a single nerve innervates.

Gives information about a spinal level that may have a lesion: Absent, diminished, symmetrical (WNL), asymmetrical.

23
Q

Summary of Grading:

Reflexes

A
24
Q

Summary of Grading:

MMT

A
25
Q

Summary of Grading:

Sensation

A
26
Q

Summary of Grading:

Myotomes

A
27
Q

Summary of Grading:

ROM

A
28
Q

Summary of Grading:

Joint Play

A

DPT 672: Assessment Skills (17 decks)

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