GALs Flashcards
What is GALS?
Gait
Arms
Legs
Spine
What is the adequate exposure?
Exposed chest, upper and lower body
Ideally in shorts +/- vest
What are the screening questions?
Any joint stiffness and/or pain?
Can you dress yourself?
Can you walk up and down stairs?
What are you looking for in gait?
Gait cycle
Able to turn
Evidence of pain
What are abnormal gaits?
Antalgic
Myopathic
Ataxic
Parkinsonian
What is an antalgic gait?
Decreased stance phase due to pain
‘limping’
What is a myopathic gait?
Hip abductors fail and hip drops on affected side
What is an ataxic gait?
Prolonged stance
Reduced swing
Wide base position
What is a parkinsonian gait?
Small shuffling gait
Often with leaning forward to build up speed
What can you inspect from the front?
Scioliosis/asymmetry Obesity / cachexia Rashes Shoulder bulk Nromal elbow extension (5-15 degrees) Varus/valgus deformity Knee deformity
What can you inspect from the side?
Hyperlordosis in neck Thoracic kyphosis Lumbar lordosis Knee flextion Foot arches
What can you inspect from behind?
Shoulder bulk Scoliosis Pelivic tilt Gluteal wasting Popliteal swellings Achilles tendon
What do you assess in the hands?
Feel all hand joints
Assess temperature
What deformities can be seen in the hand?
Bouchard nodes Heberden nodes Z-thumb Swan neck deformity Boutonnieres
Thenar/hypothenar wasting
What are Bouchard nodes?
Nodes at PIPJs
What are Heberden nodes?
Nodes at DIPJs
What is a z-thumb?
Seen in RA
Z shaped thumb
What is swan neck deformity?
Flexed DIPJ
Hyperextended PIPJ
What is Boutonnieres?
Extended DIPJ
Flexed PIPJ
What movements do you ask in the arms?
Hands behind head
- shoulder abduction
- elbow flexion
Hands out with fingers outstretched
- pronation
- shoulder flexion
- finger extension
Turn hands over
- supination
Make fist
- finger flexion
Squeeze finger
- grip strength
Touch each finger to thumb
What movements do you do in legs?
Passive
- knee flexion
- knee extension
- hip internal rotation
What else do you look for in the legs?
Patellar effusion
- tap
- sweep
What do you look for in the spine?
Scoliosis
Lordosis
Kyphosis
What is scoliosis?
Sideways curvature of spine
What is kyphosis?
Excessive outward curvature of the spine
What is lordosis?
Excessive inward curvature of the spine
What movements do you ask for in spine?
Lateral flexion of cervical spine
What else do you assess?
TMJ
- ask patient to put 3 of own fingers in their mouth
