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Clinical Assessment Introduction Flashcards

Find the Cause - Then treat the cause

1
Q

____ : A physical & emotional response to tissue irritation, derangement, damage, or tissue death?

A

Pain

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2
Q

What is the most common symptom for which patients seek care?

A

Pain

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3
Q

What is Pain?

a) An unpleasant sensation associated with actual or potential tissue damage
b) Mediated by specific nerve fibres to the brain
c) Conscious appreciation may be modified by various factors
d) All of the above
e) A & C

A

D) all of the above

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4
Q

What is inflammatory pain?

a) Pain results from the stretch or compression of pain sensitive structures
b) Pain results from the release of chemical irritants of inflammation
c) Pain as a result of swelling/edema that compresses nociceptors
d) A & C
e) B & C

A

E) B&C

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5
Q

What is Mechanical pain?

a) Pain results from the stretch or compression of pain sensitive structures
b) Pain results from the release of chemical irritants of inflammation
c) Structures that contain nociceptors, when stimulated produce painful sensations
d) A&C
e) All of the above

A

D) A&C

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6
Q

T/F: Acute pain is pain provoked by noxious stimulation produced by injury/disease

A

True

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7
Q

T/F: Chronic pain is pain that persists beyond the usual course of healing

A

True

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8
Q

Chronic pain Syndrome

a) involves functional limitations and often times depression
b) is a clinical syndrome in which clients present with high levels of pain that is chronic in duration
c) All of the above
d) B

A

c) all of the above

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9
Q

T/F: Neurogenic pain is pain as a result of non-inflammatory dysfunction of the peripheral or central nervous system that involves nociceptor stimulation or trauma

A

False: It DOES NOT involve nociceptor stimulation or trauma

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10
Q

____ : Pain that is felt at another location of the body that is distant from the tissues that have caused it

A

Referred pain

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11
Q

Radiculopathy

a) known as radicular or nerve root pain
b) involves spinal nerve or spinal nn root
c) pain that is felt in a dermatome, myotome, or sclerotome
d) A&C
e) All of the above

A

e)all of the above

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12
Q

T/F: A dermatome is an area of skin supplied by one dorsal nerve root

A

True. Injury can cause sensory alteration to the skin, or pain (usually burning or electric)

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13
Q

What is myotomal pain?

A

Group of muscles supplied by one nerve root

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14
Q

What is sclerotomal pain?

A

Area of bone or fascia innervated by a nerve root

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15
Q

T/F: Pain can be felt in a dermatome as a result of visceral injury

A

True

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16
Q

T/F: Untreated TrPs can be associated w/ pain syndromes that include but not limited to: Radiculopathy, tension headaches, frozen shoulder, tennis elbow ..

A

True

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17
Q

As a lesion worsens, the area of pain enlarges and moves distally from the original lesion. This concept is referred to as _____

A

Peripheralization

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18
Q

If pain is resolving, the area decreases and becomes localized, this is called ______

A

Centralization

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19
Q

If Onset of pain is immediate, it is an indication of

a) Gradual or insidious onset
b) Traumatic/more serious injury
c) Repetitive strain injury

A

B) Traumatic injury

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20
Q

Frequency & Duration of Pain Q 20 - 26

Pain all the time indicates

A

a severe injury or an active inflammatory state

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21
Q

Pain when repeating the mechanism suggests

A

Local lesion, Ligament or muscular

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22
Q

Ligament cause pain when

A

Stretched

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23
Q

Muscles cause pain when

A

Contracted

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24
Q

Pain in the morning …

A

Caused by adaptive shortening (Plantar Fasciitis)
If accompanied by stiffness may indicate intracapsular swelling that builds overnight d/t inactivity (common w/ arthritis)

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25
Q

Pain at end of day…

A

Suggests inflammation d/t overuse (excessive stress on structures through the day)
Postural strain or TrPs d/t muscle fatigue

26
Q

Pain when weight bearing..

A

Pain only w/ weight bearing suggests articular (joint surface) or muscular injury

27
Q

Quality of Pain Q 27 - 37

Sharp pain…

A

Strain
Superficial ligament (MCL/LCL)
Acute inflammation
Radicular pain

28
Q

Dull ache

A 
Joints
Deep muscles (Glute med)
Chronic mm strain
Chronic inflammation 
Deep or peripheral nerve
TrPs or Referred pain
29
Q

Tingling or Parasthesia

A

Nerve injury

Circulatory problems

30
Q

Numbness

A

Damage or impingement of a nerve innervating a particular area

31
Q

Twinge

A

Injury to local muscle or ligament

32
Q

Noises/sensations

Clicking/snapping

A

Clicking/snapping: tendon flipping over a bone, thickened bursa, meniscal tear

33
Q

Noises/sensations

Grating

A

Caused by osteoarthritic changes to a jt

34
Q

Sound of tearing

A

Indicates muscle or ligament tear

35
Q

Locking or catching

A

Loose body within joint

36
Q

Giving way or instability

A

commonly caused by severe jt damage

37
Q

Popping can be caused by

A

Negative pressure within a tendon synovial sheath, tendon flipping over bony prominence, rupture of ligament or tendon

38
Q

Name the 4 Ts when palpating

A

Texture
Tone
Tenderness
Temperature

39
Q

T/F: Active Free movement differentiate b/w contractile or insert tissue

A

False

40
Q

Six End Feels Q 40 - 46

  1. Tissue Approximation
A

Mushy Feel - Normal end feel

41
Q
  1. Bone to Bone
A

Elbow extension

Normal or abnormal (if occurs before normal end range)

42
Q
  1. Tissue Stretch
A 
Hard or firm(springy) type of mov't w/ slight give
occur toward end ROM
Elastic resistance/springy
Providing resistance to movement 
Most common type of normal end feel
43
Q
  1. Muscle Spasm
A

Sudden dramatic arrest of movt, often accompanied by pain
“sudden and hard”
result of protective reflex to prevent further mov’t /injury
Abnormal end feel

44
Q
  1. Capsular
A

Thicker feeling to it
ROM is obviously reduced
Capsule is at fault
normal/abnormal end feel

45
Q
  1. Springy
A

Abnormal end feel

loose body within jt

46
Q
  1. Empty end feel
A

No end feel
abnormal end feel
client stops mov’t before end range is felt d/t intensity of pain

47
Q

Findings w/ resisted testing

Strong and Painless

A

Normal

No lesion or neurological deficit in the muscle or tendon

48
Q

Strong & Painful

A

1st or 2nd degree muscle strain

A minor lesion of the musculotendinous unit

49
Q

Weak and Painless

A

Complete rupture of muscle or tendon
Myotome issue
full tear of nerve, pain d/t swelling

50
Q

Weak and Painful

A

Partial rupture of muscle or tendon

Strain

51
Q

Muscle testing scale

No contraction

A

0

52
Q

Normal - Overcomes maximal resistance

A

5

53
Q

Slight contraction - muscle tightens but no mov’t produced

A

1

54
Q

Able to produce mov’t w/ gravity eliminated

A

2

55
Q

Able to overcome some resistance

A

4

56
Q

Able to overcome gravity but not resistance

A

3

57
Q

Localized, subconscious muscle contractions that do not involve the whole muscle; result from the contraction of the muscle cells innvervated by a single motor axon

A

Fasciculations

58
Q

Rhytmic mov’ts of a jt result from involuntary contractions of agonist and antagonist muscle groups

A

Tremors

59
Q

Vibraton associated w/ roughened gliding surfaces of a tendon, tendon sheath, articulating surface

A

Crepitus ; often inaudible in addition to being palpable

60
Q

What are the 3 barriers of resistance?

A
  1. Physiological barrier: midrange is the range w/ least amount of resistance
  2. Elastic barrier : felt at end range + beyond, when tissue is engaged at end of passive rom
  3. Anatomical barrier: final resistance to normal range anymore will cause injury

mt (8 decks)

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