General Test

Question 1

Swelling or edema girth measurement

Answer 1

Use tape measure to record swelling or edema girth use body landmark
Painful swelling after acute injury = hematoma
Swelling -take 24 hrs to develop following acute injury may indicate synovial effusion - both conditions indicate referals for immediate medical attension
Edema - accumulation of fluid in the interstitial space of tissue and may present with acute or chronic conditions

Question 2

Pitted Edema test

Answer 2

To asses the presence of chronic pitted edema
Apply firm finger pressure to the edematous area for 10-20 sec
Then release
If indentation remain where pressure was applied = positive for pitted edema

Question 3

Trigger point compression test

Answer 3

Asses pain cause by latent trigger point which activate by movement , not by rest
Compress painful and affected mm
Or above affected, in a Pincer grasp while mm actively contracting
Positive for latent trigger point = if pain diminish or disappear on compression

Question 4

Tendinitis Differentiation

Answer 4

Asses tendonitis anywhere in body using active resisted isometric contraction
Positive= pain INCREASE with force of isometric contraction , there maybe also muscle weakness

Question 5

Bursitis differentiation

Answer 5

Asses for bursitis
Use Active resisted isometric contraction
Positive= pain at site of bursa is CONSTANT even force increase
Pain caused by surrounding mm and tendons compressing the inflammed bursa as the contract
Since its noncontractile pain remain constant

Question 6

Stress fracture

Answer 6

Apply direct compresion on suspected stress

Positive= severe local pain compression from the thumb

Question 7

Tinel’s sign

Answer 7

Asses nerve compression or amount of regeneration of a peripheral nerve or the presence of a neuroma at the severe end of a complete nerve lesion
Locate specific nerve to be asseses and gently tap or percuss the nerve
Positive= paredthesia pr tingling along the distribution of the nerve
COMMON TEST for CARPAL TUNNEL
Other specific Tap
1:brachial plexus - superior to clavicular
2:Ulnar nerve- elbow btw olecranon and median epicondyle
3:Sapheneous nerve -medial to tibial tubercle
4: common peroneal nerve: posterior to the head of the fibular
5:Deep peroneal nerve:anterior ankle
6:posterior tibial nerve - posterior to medial malleolus
To determine how far peripheral n has regenerated after trauma
= apply tinel sign along path of affected n

Question 8

Deep tendon reflex test

Answer 8

Asses funtional of nerve or nerve root supply the reflex
Cause by stretching of mm spindle , which synapse through sensory neuron to the spinal cord and then back through the motor neurons contracting the mm
To eliminate posibility of fading response due to developing n root lesion Tap tebdon 5-6 times or repeat several times to ensure the response is consistant
CNS- response is Hyperreflexive or Exaggerated and generally bilateral.
PNS lesion- abnomal or lost peripheral conductivity result in hypoflexibe( weakend) or areflexivf( lost)
Reflexes Grade
0-absent
1-diminish
2-average
3-exagerated
4-clonus

Question 9

Bradykinesia test

Answer 9

To asses for bradykinesia ( increasing difficult movement or lack of coordination)
Seated
Instrust to alternate probation and supination on thigh
Positive- movement slower , becoming more difficult

Question 10

Proprioception test

Answer 10

Asses proprioception loss
grasp client toe and passively move into flexion or extention
Ask client what position the digit is in
Positive: incirrect answer or hesitation

Question 11

Piloerector response test

Answer 11

Asses loss of piloerector response
Stroke clt back or upper chest with something cold , ice cube o elicit piloercetor response or goosebump
Note any area where there is no response
Positive - absense of the piloerector response in a particular area = complete peripheral nerve lesion