General Exam Scheme Flashcards
List the traditional 4 step exam flow.
- Listen
- Look
- Feel
- Move
What 5 categories should be considered before determining how aggressive a PT can be in their exam?
SINSS
- Severity: Mild/ Moderate/ Severe effect on function
- Irritability: Stimulus required to irritate/ time to baseline (Mild/ Moderate/ Severe)
- Nature of the problem: What’s wrong?
- Stability: Getting worse? Better? Unchanging?
- Stage: Acute? Subacute? Chronic?
What does the therapist do during the listen stage?
- Allows the patient to speak
- Summarizes and repeats complaints/ history
- Asks open ended questions
- Delves deeper into specific areas of interest
How can musculoskeletal pain be differentiated from visceral pain? What some sources of visceral pain?
- Pain does not change with muscle/ joint positioning
- Pain is not related to activity (except for heart/ lung pain)
Sources: - Heart
- Lungs
- Vasculature
- Kidneys
- etc.
What does the therapist assess during the look portion of the exam?
- Posture/ alignment
- Swelling/ edema
- Muscle hyper/atrophy
- Skin/ nail color/texture changes
- Splinting/ guarding, spasms
- Facial expressions
- Adaptive devices
- Willingness to move
What determines the aggressiveness of the therapist during the Feel stage of the exam?
SINSS
What can the therapist asses in the feel portion of the exam?
- Dermal/ subdermal flexibility
- Density/ edema
- Tenderness
- Temperature
- Muscle spasm
- Trigger points
- Tender points
- Fascial tightness or tenderness
- Joint lines and bony prominences
In what manner should the therapist work through the feel portion of the exam?
From superficial to deep.
What types of tests are performed during the movement portion of the exam?
- Clearing tests
- Movement tests
- Muscle strength tests
- Neurological tests
- Special tests
- Functional tests
What joints should be cleared in an exam?
The joint above and below the area of complaint, and also either the cervical or lumbar spine.
If pain is felt from AROM and PROM in the same direction, what type of lesion is indicated?
Inert (joint, ligament, capsule)
If pain is found in AROM and PROM in opposite directions, what type of lesion is indicated?
Contractile (muscle)
How much great is PROM than AROM in a healthy joint?
5 degrees.
Where is pain felt in relation to the movement barrier of ROM for the acute inflammatory stage, the subacute stage, and the chronic stage of irritability.
Acute inflammatory: Before barrier
Subacute: At barrier
Chronic: After barrier
What scale is used to assess arthrokinematic motion?
0 (anklyosed) - 6 (hypermobile)
What are some methods of neurological examination tools/ tests?
- Light touch
- Temperature
- Vibration
- DTR
- Proprioception
- Balance
- Tinel
- etc…
What are steps are left after the examination is complete?
- Evaluation
- Diagnosis
- Prognosis
- Interventions
- Outcomes/ re-evaluations
What are the 3 philosophical approaches to Musculoskeletal therapy assessment?
- Biomechanical - Pathological model
- Patient response model
- Mixed
What is the common systematic approach to all MS therapy assessment models?
- Clinical exam
- Treatment
- Re-exam
Generates diagnostic label.
What are pathology-based diagnostic labels?
- Medical diagnoses
- Linked to pathology
Why are pathology-based diagnostic labels rarely used to guide PT treatment?
- No information on severity, nature, stage of MS problem.
What are impairment-based diagnostic labels?
- Clinical subjective, objective, and patient response combine to form label.
- Treatment guided by what relieves symtpoms
What type of diagnostic label is used by the PT guide?
Impairment-based.
What is the systematic process used to generate an impairment-based diagnostic label?
- Generate hypothesis
History/intake
Systems review
Lab tests and imaging studies
- Eliminate and refine hypotheses
Physical exam/ special tests
