GALS

Question 1

What initial questions should you ask in a GALS exam?

Answer 1

• do you have any pain or stiffness in any muscles, joints or the back?
• can you completely dress and undress yourself without difficulty?
• are you able to climb up and down stairs without difficulty?

Question 2

What does asking about back and joint pain and stiffness screen for?

Answer 2

• RA
• OA
• ankylosing spondylitis

Question 3

Why should you ask about getting dressed?

Answer 3

• fine motor impairment
• restriction of joint range of motion

Question 4

Why should you ask about climbing stairs?

Answer 4

• impaired gross motor function

Question 5

What should you inspect from the front?

Answer 5

• abnormalities in the shoulders, chest, elbows, wrists, hands
• hips, thighs, knees, feet

Question 6

What should you inspect from the side?

Answer 6

• normal spinal curvatures
• cervical lordosis
• thoracic kyphosis
• lumbar lordosis
• hip and knee deformities
• knee hyperextension

Question 7

What should you inspect from the back?

Answer 7

• abnormalities in the shoulders, spine, paraspinal muscles
• levels of iliac crests, gluteal regions, popliteal fossae, calves, Achilles tendon, hind feet

Question 8

How do you assess gait?

Answer 8

• ask patient to walk a few steps, turn and walk back

Question 9

What should you comment on in gait?

Answer 9

• arm swing, pelvic tilt, stride length
• ability to turn quickly
• antalgic (painful) gait
• if walking is painful

Question 10

How do you assess the spine?

Answer 10

• Place 2 fingers on adjacent lumbar vertebrae, ask pt to bend forward and touch toes
• observe fingers moving apart and back together
• lateral flexion: ear to shoulder and ask if it is painful

Question 11

How do you assess the shoulders?

Answer 11

• put hands behind head and push shoulders back
• comment on ROM of shoulder abduction, external rotation and elbow flexion

Question 12

How do you inspect the hands?

Answer 12

• arms out, palms down then turn over and palms up
• joint swelling, deformity, loss of contour, muscle wasting, skin/nail changes, nodules in wrists and hands
• squeeze MCP joints

Question 13

What should you observe for in the elbows?

Answer 13

• ability to supinate and pronate
• ability to fully straighten the elbow

Question 14

How do you move the hands?

Answer 14

• ask patient to make full fist covering nails
• ask patient to squeeze your fingers to assess grip strength
• ask pt to touch each finger to thumb

Question 15

How do you move the legs?

Answer 15

• knee to chest and hand over knee to assess for crepitus
• flex hip and knee, move foot for int and ext rotation
• patellar tap: slide hand from mid thigh, tap over patella

Question 16

How do you look at the feet?

Answer 16

• inspect soles for swelling, deformity, callosities
• squeeze across MTP joints

Question 17

What is Trendelenburg’s gait?

Answer 17

• unilateral weakness of hip abductor muscles
• secondary to superior gluteal nerve lesion or L5 radiculopathy

Question 18

What is waddling gait?

Answer 18

• bilateral weakness of hip abductor muscles