Examination - Musculoskeletal

Question 1

what does a good subjective exam include

Answer 1

history

Question 2

parts of the history

Answer 2

age/language/race/sex

history of present illness

past medical history

medications

lab tests

family history/growth and development

work/play history

fxnal status/activity level

social habits/living environment

Question 3

history of present illness includes

Answer 3

pt complaint

determining the onset and development of the present episode

what predisposing factors could have contributed to the pt’s problems

Question 4

what’re we doing during taking the pt complaint

Answer 4

asking the pt to help you determine what kind of disorder is present

Question 5

what is critical to the exam

Answer 5

pt’s account of their own sxs

Question 6

what should we use to determine the pt complaint

Answer 6

combo of open and closed end questions

Question 7

predisposing factors that could’ve contributed to the pts problem

Answer 7

postural stresses

fatigue

emotional stress

other illness

Question 8

what could we do one we know how the problem started

Answer 8

determine where the sxs occur

Question 9

what do we want to recreate

Answer 9

accurate picture of where the sxs started

where have the sxs spread since onset

Question 10

how would we record the site of sxs

Answer 10

body chart

Question 11

behavior of the sxs includes

Answer 11

character of sxs

how the sxs respond to rest, posture or activity

Question 12

character of sxs

Answer 12

is the pain sharp or stabbing

does it radiate

is it constant or intermittent

etc.

Question 13

how the sxs respond to rest, posture or activity

Answer 13

gives us an idea of the severity of the sxs

important to know before proceeding w/ objective exam

Question 14

general guidelines concerning pain

Answer 14

pain that does not change w/ posture or rest

persistent night pain is unusual in MS problems

pts who have degenerative joint dx

pts w/ inflammatory processes

Question 15

pain that does not change w/ posture or rest

Answer 15

may not be the result of MS problems

pt may need to be referred to another practitioner

Question 16

persistent night pain is unusual w/ MS problems

Answer 16

except in the case of an acute condition
–> nerve root involvement and bursitis

Question 17

pts who have degenerative joint dz

Answer 17

more likely to have morning stiffness

Question 18

pts with inflammatory processes

Answer 18

more likely to have morning pain

Question 19

if the pain takes less than 30 min to go away

Answer 19

degenerative in nature

Question 20

the pain takes more than 30 min to go away

Answer 20

inflammatory in nature

Question 21

PMH

Answer 21

is the present episode a recurrence of the same problem

what other types of tx has the pt sought

other medical problems

are they taking any meds

Question 22

is the present episode a recurrence of the same problem –> PMH

Answer 22

have they had this before

Question 23

lab tests

Answer 23

do they know the results of the diagnostic imaging

ask for the report

Question 24

work/play history

Answer 24

affects on their recreation

how do the sxs affect the pt’s ability to work

Question 25

social habits/living environment

Answer 25

does the pt have good support from family or friends