GALS examination Flashcards
What is the first part of any introduction to an examination?
Wash hands
Intro self
Pt details
Explain a GALS exam to a patient
I’ve been asked to do a quick examination to screen for any joint problems, it’s going to involve me having a general inspection, watching you walk and getting you to do some head, arms and legs movement.
What else would you include in your intro?
Expose ok?
Chaperone?
Pain or discomfort?
What is the appropriate exposure for a GALS exam?
top, trousers, socks and shoes off
What screening questions do you ask in a GALS exam?
Do you have any pain or stiffness in your muscles, joints or back?
Are you able to completely dress and undress yourself without any difficulty?
Are you able to climb up and down stairs without any difficulty?
When inspecting from the front what are you looking at?
Posture
Body habitus
Skin rashes
Shoulders
Elbows
Leg length + alignment
Quadriceps
Knees
Ankles
Feet
When inspecting from the side what are you looking at?
Cervical spine
Thoracic spine
Lumbar spine
Knee joints
When inspecting from the back what are you looking at?
Shoulder muscles
Spinal alignment
Iliac crest alignment
Gluteal muscle bulk
Popliteal swellings
Hind-food abnormalities
When inspecting from the front what might you see when inspecting the following and what may they indicate?
a) Posture
b) Body habitus
c) Skin rashes
a) Any asymmetry/scoliosis.
b) Obesity can be associated with joint pathology like
early-onset osteoarthritis in the knees.
A thin, malnourished adult may be at increased risk of
fractures of osteomalacia.
c) Salmon coloured plaques with silvery scale over
extensor surfaces in psoriasis
Associated with psoriatic arthritis.
When inspecting the shoulders from the front what do you assess
What may changes indicate?
Assess shoulder bulk
Muscle wasting suggests chronic joint disease.
Asymmetry of the shoulders may be due to unilateral wasting or scoliosis of the spine.
When inspecting the elbows from the front what do you assess
What may changes indicate?
Assess the patient’s carrying angle (normal 5–15°).
Joint contractures can result in inability to extend elbow at rest.
When inspecting leg length and alignment from the front what do you assess?
What may changes indicate?
Note any leg length inequality.
Valgus (knock-knees)/varus (bowed legs) + deformity of the hip/knee may result in misalignment of the limb.
When inspecting the quadriceps from the front what do you do?
What may changes indicate?
Assess muscle bulk + symmetry.
Muscle wasting suggests chronic joint disease.
When inspecting the knees from the front what do you assess
What may changes indicate?
Swelling + erythema of a knee joint may suggest inflammatory arthritis or joint sepsis.
Valgus/varus deformity.
Any asymmetry from joint effusion.
Any hyperextension of the knee joints (hypermobility).
When inspecting the ankles from the front what do you assess
What may changes indicate?
Swelling + erythema of an ankle joint may suggest inflammatory arthritis or joint sepsis.