clinical Flashcards
What is the GALS assessment
Gait, arms, Legs, Spine
Gait
Walk, limping, turning, range of movement
Arms
Grip strength, precision grip, making a fist
Legs
Passive knee flexion and extension, internal rotation of the hip, metatarsophalangeal joint squeeze, patellar tap
Spine
Flexion, TMJ
Look feel move
Swelling, wasting, erythema, deformity , scars
Knee inwards vs knees outwards
Inwards = genu valgum Outwards = genu vacrum
High arch vs low arch
High = pes cavus Low = pes planus
Most commonly fractured bone
Clavicle
Fall on shoulder or direct blow
Why is clavicle more prone to fractures than dislocation
Strong ligaments at either of the clavicle
Scapula - is it fractured often
rarely fractured, despiteits thinness, because it is covered in thick muscles
Axillary surgery- what nerve can be damaged
The long thoracic nerve can be injured during axillary surgery leading to the clinical sign of a winged scapula
Most commonly dislocated joint
SHOULDER
Risk of recurrent dislocation
The supraspinatus tendon and subacromial bursa are at risk of impingement under coracoacromial arch; inflammation may cause a ‘painful arc’ of movement and tendon may rupture (rotator cuff disease)
Carpal tunnel syndrome
compression of the median nerve; it can lead to thenar eminence muscle wasting
•Older patients may suffer ulnar nerve damage due to degenerative changes in the cubital tunnel where the ulnar nerve passes behind the medial epicondyle
Compartment syndrome
occurs if excessive pressure builds up in the limb, e.g. due to closed fracture, or swelling. This pressure must be relieved urgently to avoid damage to the limb by fasciotomy.•
