GALS Flashcards
What are the main points should be addressed in MSK history taking?
History of preseneting problem (acute/chronic)
Pain (SOCRATES)
Joint swelling
Joint Stiffness
ICE
rest of normal med history
family history
social history
What q’s do you ask about Joint swelling in MSK history
Noticed any swollen joints?
Which joints?
At what time of the day do they notice it the most?
Duration of swelling (night, all the time, after activity)
What Q’s do you ask about joint stiffness in MSK history?
nability to get joints moving after rest
Have they experienced it?
Which joints?
At what time of the day do they notice it the most?
How does stifness relate to rest and exercise?
What is the duration of stiffness? (how long does it take them to loosen up?)
Describe the general presentation of Non-inflammatory arthritis.
localized stiffness, lasts less than thirty minutes and may progressively worsen as the day progresses
what are important things to ask in a MSK past medical history and medication allergies?
Past
-Surgeries for MSK problems or injuries
-Mental health: depression and anxiety can be a cause and effect for chronic MSK
Medications and allergies:
-meds they purchase for MSK conditions
-NSAI’s, paracetamol, glucosamine, topical rubs and fish oil are common.
what are yellow flags in a MSK history?
Psychological based
May be masquerading as a physical condition
Depression, anxiety, emotional abuse
What are Red flags in a MSK presentation?
Potentially life or limb-threatening
Must be excluded from consultation
E.g
Open fractures, fracture with nerve/ vascular compromise
Casua Equina syndrome
Infections, carcinoma, temporal arteries
What are the components of a GALS exam?
Inspection,
Palpation
Movement
What are the two types of palpation?
Subjective
-what they experience
-tenderness, pain
objective
-what exmainer feels/observes
warm
swelling
crepitus with movement
What are the two types of movements assessed in GALS?
Active movement
-A person can perform without assistance
-Assess range and fluidity of movement
Passive movement
-Performed with assistance of examiner
-Only in certain situations
-Assess range/ limitations of guided movement
-Determines level of discomfort or pain
How would you explain the GALS procedure to the patient?
, DOB, preferred name
Explain the procedure ‘ I would like to perform an MSK- GALS Screening Test to look at your walk as well as the movements of your arms, leg, and spine, is that ok?’
What are the two essential requirements of Patient Preparation Requirements in a GALS exam?
ESSENTIAL: ask/ assist (if needed) person to remove clothing that may restrict movement/viewing.
ESSENTIAL: ask to remove shoes and socks.
Steps to Gait assesment
Walk several steps to nominated mark on floor, turn briskyly and walk back
Observe gait for symmetry, smoothness
Steps for Arms assesment
Stand in front of person and ensure they in neutral position
Ask person to raise arms in front of them, bend elbows, wrists and fingertips and place them on each shoulder.
Aske person to raise elbows towards ceiling
Instruct to return to neutral position
ESSENTIAL: ask person ‘was there any pain or discomfort?’
