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PT Exam 2 > Components of Postural Eval - Class 7 > Flashcards

Components of Postural Eval - Class 7 Flashcards

1
Q

what does a postural eval involve

A

identification of the location of the body segments in relation to the LOG

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2
Q

in relation to the LOG

A

what’s in front of/behind

what is medial or lateral

is it symmetrical

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3
Q

postural evaluation requires

A

great proficiency by the examiner

d/t many postural deviations being subtle

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4
Q

for a postural eval the pt must be

A

adequately undressed

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5
Q

how should the pt start

A

in a comfortable position

may not even want to tell them were checking their posture –> they’ll try and correct it

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6
Q

if a pt wears an orthotic device

A

assess w/ and w/o and note changes

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7
Q

components of a postural eval

A

postural history

observation and inspection

muscle length assessment

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8
Q

is poor posture usually what motivates a pt to seek tx

A

no

sxs produced by pathology caused by or causing the postural abnormality compels the pt to seek tx

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9
Q

if a child is being examined

A

obtain prenatal and postnatal history

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10
Q

what does prenatal history include

A

health of the mother during pregnancy

any complications during pregnancy or delivery

any meds taken by the mother during that period
–> esp first trimester

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11
Q

what should the postural history include

A

history of the problem

pt’s general condition and health

family history

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12
Q

what should be obtained to determine whether posture is contributing to the problem

A

MOI

type, location and severity of sxs

side dominance

ADLs

driving, sitting and sleeping patterns

level and intensity of exercise

medical history

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13
Q

MOI –> overuse injuries associated w/ postural faults

A

insidious onset

no specific cause of pain

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14
Q

what does a non specific mechanism or time of injury indicate

A

injury is possibly caused by poor posture

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15
Q

common responses to questioning that may point towards postural involvement

A

insidious onset of pain

pain worsening as the day progresses

pain w/ specific postures

complaints of intermittent pain

vague or generalized pain

initially starts as an ache

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16
Q

pain associated w/ specific postures

A

hurts when they sit/stand for too long

hurts when they twist

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17
Q

pain that initially starts as an ache

A

progressively worsened over time

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18
Q

many postural dysfxns are worse/produced more

A

in the evening

after the individuals has maintained the posture all day

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19
Q

what should we ask about the sxs

A

are they constant or intermittent

are they worse at a certain time of the day

which positions/postures increase/decrease sxs

what type of pain are you experiencing

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20
Q

side dominance –> if one side is for most tasts

A

bilateral limb imbalances are likely to occur

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21
Q

bilateral limb imbalances

A

exposing the pt to overuse injuries

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22
Q

what should we ask about ADLs

A

what is the pt’s usual day like

which type of activities does the pt perform and for waht duration and frequency

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23
Q

what is the pt’s usual day like

A

many people have a repetitive daily schedule

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24
Q

driving, sitting and sleeping postures

A

ask if anything has changed in the person’s daily routine

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25
Q

changes in a routine

A

provide info about the instigating factor

pt may not thing it is a big change, but it could be the root of their issue

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26
Q

level and intensity of exercise

A

does the pt exercise regularly or at all

has their exercise routine changed

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27
Q

medical history

A

family history

previous illnesses, operations or severe injuries

history of other conditions

previous tx

deformity

difficulty breathing

28
Q

family history

A

of any back problems or special problems

-congenital problem
-spinal fusion
-scoliosis

29
Q

previous illnesses, operations or severe injuries

A

ex: thoracic surgery

30
Q

history of other conditions

A

connective tissue dzs

RA

marfans syndrome

31
Q

previous tx

A

if they had PT
–> what helped/what didnt help

32
Q

deformity

A

is it present

is it progressive

is it stationary

33
Q

difficulty breathing

A

thoracic spine affects rib cage –> rib cage affects breathing

34
Q

what should we ask about the medical history concerning a child

A

if/when had been a growth spurt

puberty

difficulty fitting into clothing

35
Q

female puberty

A

when did their period begin

does their back pain tend to be associated w/ their period

36
Q

when does female puberty occur

A

almost always occurs after their peak growth of height

usually around age 11

37
Q

male puberty

A

voice change

usually around age 13

38
Q

observation and inspection should be

A

systemic and thorough

39
Q

observation and inspection should be performed

A

for standing, sitting, supine and in prone positions

40
Q

observation and inspection –> standing

A

should note body type and emotional attitude

41
Q

how should we observe a pt in standing

A

anterior, lateral, posterior view

forward flexion

42
Q

what are we going to find during observation and inspection

A

things we will later go back and look at a little more closely

43
Q

inspection of leg length discrepancy

A

2 categories of LLD

44
Q

2 categories of LLD

A

structural (true)

fxnal (apparent)

45
Q

structural LLD

A

actual difference in the length of the the tibia or femur of one leg compared to the other

46
Q

what is structural LLD caused by

A

disruption of the growth plate of one of the bones

congenital anomaly

47
Q

how are measurements of structural LLD taken

A

ASIS to medial malleolus

48
Q

when is a discrepancy considered significant –> structural LLD

A

10-20mm

49
Q

what happens if measurements are asymmetrical –> structural LLD

A

put pt in hooklying
–> observe from the front and from the side

50
Q

observing from the front –> structural LLD

A

one knee appears higher than the other

tibia is longer on that side

51
Q

observing from the side –> structural LLD

A

one knee appears more in front of the other

femur is longer on that side

52
Q

fxnal LLD

A

attributed to something other than the length of the tibia +/or femur

53
Q

what is fxnal LLD caused by

A

tightness of muscles or joint structures

muscular weakness in the LE or spine

54
Q

how are measurements taken fxnal LLD

A

medial malleolus to the umbilicus

55
Q

when is measurement of fxnal LLD meaningful

A

test for true LLD is negative

56
Q

how do we determine LLD

A

block method

57
Q

block method

A

most clinically reliable and valid way of determining an LLD

58
Q

how does the block method work

A

pt stand on firm surface w/ feet shoulder width apart

palpate and note starting levels of iliac crest

59
Q

if heights are uneven –> block method

A

blocks of known thickness (measured in mm) are placed under the shorter leg

until the iliac crests are of equal height

60
Q

how is LLD calculated –> block method

A

totaling the sum of the heights of the individual blocks

61
Q

what is the height where tx is frequently considered –> LLD

A

10-20 mm

62
Q

radiographs and CT evals

A

most accurate methods of assessing LLD

63
Q

muscle length assessment is apart of

A

physical (objective) exam

64
Q

what does the muscle length assessment attempt to do

A

objectively measure if specific muscles are shortened or elongated

–> may contribute to postural abnormality

65
Q

if muscles crossing a joint are abnormally shortened

A

abnormal stresses may be placed on the joint

or

necessary mobility required for normal fxning may be lacking

66
Q

if muscle crossing a joint is abnormally elongated

A

joint maybe affected by abnormal stresses

or

may lack the stability required for normal fxning

PT Exam 2 (20 decks)

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