Ch 1 Intro to PT Examination

Question 1

Patient

Answer 1

Refers to individuals with a disease, condition, impairment, or disability who receive PT examination, evaluation (diagnosis and prognosis), and intervention

Question 2

Client

Answer 2

Refers to individuals who seek PT services for consultation, professional advice, health promotion and wellness, or preventative services

Question 3

Patient examination consists of:

Answer 3

-Patient history
-Systems review
-Tests and measures

Question 4

Sources of information in the patient interview

Answer 4

-Patient
-Family member / caregiver
-Chart review

Question 5

Patient History

Answer 5

Involves a verbal interview in which information relevant to the pt’s condition is gathered

Question 6

Systems review

Answer 6

A brief assessment of the cardiovascular/pulmonary, integumentary, musculoskeletal, and neuromuscular systems as well as the pt’s cognitive, language, and learning abilities

Question 7

What do you use to decide when to assess further than the systems review?

Answer 7

Clinical judgment / reasoning

Question 8

Tests and measures

Answer 8

Selected based on hypotheses formed during the Hx-taking process and findings during the system review

Question 9

Evaluation Process

Answer 9

Requires synthesis of all data collected during the examination and helps to answer the question “What does it all mean?”

Question 10

Patient Evaluation Overall consists of

Answer 10

Interpretation of tests & measures results
-Synthesis of data
-Diagnosis
-Prognosis

Question 11

Diagnosis and Prognosis
(Subfactors within the evaluation)

Answer 11

Subfactors within the evaluation process

Question 12

Diagnosis

Answer 12

A label that describes a cluster of signs and symptoms typically associated with a disorder or syndrome leading to impairments, activity limitations, or participation restrictions

Question 13

What does diagnosis guide the PT to?

Answer 13

Determining appropriate intervention strategies for each patient

Question 14

Diagnosis answers what question?

Answer 14

“Into what clinical pattern does the patient presentation fall?”

Question 15

Prognosis answers what question?

Answer 15

“what is the pt’s expected level of functional improvement based on all influential factors (biological, psychological, and social)?”

PLOF-previous level of function
PMH-past medical Hx
HPI-Hx of present illness

Question 16

Interventions

Answer 16

Selected and implemented based on findings from the examination and evaluation

Question 17

What interventions can be included?

Answer 17

-Therapeutic exercise
-Functional training
-Training inn self-care
-Patient instruction

Question 18

Outcomes

Answer 18

The results of the interventions that can be assessed periodically during or at the end of episode of care (POC)

Question 19

Outcome measures

Answer 19

Patient goals
Therapeutic alliance-patient participationPT facilitated
Collaborative

Through:
Patient reported
Performance based

Question 20

PT Management

Answer 20

-Plan of care
-Coordination & communication
-Documentation
-Ongoing assessment

Question 21

Clinical reasoning

Answer 21

-Apply knowledge and skill
-Intuitively make decisions based on self reflection, prior experience, pt characteristics/presentations
-Requires collaboration with pt

Question 22

What must the Patient Interview Setting include?

Answer 22

-Patient comfort
-Patient privacy
-Avoid / minimize distractions
-Therapist appearance / dress

Question 23

Responsibility for obtaining pertinent info lies with the PT by ensuring what?

Answer 23

-Clarifying questions
-Delve (into) as in: to explore, to search through or into

Not just specific and necessary info, but also details about and connect with patient

Question 24

Interview techniques

Answer 24

• Open versus close ended questions
• Multiple option questions (ie pain: “is it dull, achy, burning?”)
• Prompters (tell me more, go on, yes)
• Clarifying questions: general  more specific
• Reflection or echoing (can be strategy to get more clear answer)
• Reflective feeling: “it sounds as though this has been stressful”
• Paraphrasing: “let me be sure I understand what you have said”
• Summarizing: PT connects pertinent points (patient approves)

Question 25

Nonverbal communication

Answer 25

-Facial expressions
-Hand gestures
-Body positioning
-Eye contact

-Cultural differences

Question 26

What must you take into consideration while conducting the interview?

Answer 26

-Patient setting
-Patient cognition
-Pain levels
-Endurance / activity tolerance
-Signs (results of test/measures) vs Symptoms (felt/experienced)
-Red vs Yellow flags
-Differential diagnosis

Question 27

Yellow flags

Answer 27

Proceed with caution

Factors that could affect treatment, sometimes refer to psychological

Question 28

Red flags

Answer 28

Findings during the pt interview or examination possibly associated with:

-serious medical condition
-systemic/local infection
-viscerogenic pain
-fracture
-cancer

Question 29

What are other pt statements that could be considered red flags?

Answer 29

-Heaviness in chest
-Difficulty breathing
-Unexplained weight changes
-Diaphoresis
-Vision/hearing changes

Question 30

What must follow if you detect any red flags?

Answer 30

Immediate attention or physician referral

Question 31

Differential diagnosis

Answer 31

Rule out diseases and conditions that masquerade as MSK conditions

Question 32

What is relevant information?

Answer 32

-Current condition
-Patient’s history
-Life and Living environment

Question 33

Theme 1: Current condition of patient (HPI)

Answer 33

-General demographics
-Current condition/ chief complaint
-Medications
-Lab or diagnostic results, imaging

Question 34

Theme 2: Patient history (PMH)

Answer 34

-Past episodes of current condition & past interventions
-Past medical and surgical Hx
-Family medical HX

Question 35

Theme 3: Patient’s life and living environment

Answer 35

-Physical env and available resources
-Employment
-Recreation and social activities
-Current and previous activity levels
-General health status and lifestyle