Global assessment

Question 1

Acutely ill

Answer 1

• Painful distress
• Respiratory distress
• Excessive sweating
• Pallor
• Dehydration

Question 2

Chronically ill

Answer 2

• Cachectic, emaciated
• Evidence of weight loss
• Muscle wasting

Question 3

Antalgic Gait

Answer 3

• Assoc w limping and pain
• Short stance, long swing
• Short stance phase and extended swing phase on the affected limb.
• Extended contralateral stance
• site of pain:
  
  • Foot – foot contact ground abnormally e.g. on side of foot
  • Knee – stiff knee (no flexion or extension

Question 4

Coxalgic gait

Answer 4

• due to weak AB-ductors
• hips drop to opposite side of pathology
• Trendelenburg
• Extension is limited towards the end of stance (normal 20degrees)
• Lateral lurch in stance phase wit arm abducted

Question 5

Weak Gluteus maximus

Answer 5

• Abnormal backward trunk lean during early stance
• Center of gravity behind hip

Question 6

Spastic gait

Answer 6

Hemiplegic

• Arm flexed, adducted and internally rotated, fingers flexed. Leg on same side in extension with plantar flexion of the foot and toes.
• When walking, the patient will hold his or her arm to one side and drags his or her affected leg in a semicircle (circumduction) due to weakness of distal muscles (foot drop) and extensor hypertonia in lower limb

Question 7

Diplegic gait

Answer 7

• Tiptoe gait
• Spasticity in all extremities, lower>upper.
• Flexion at hip and knees; thighs in adduction at hip;
• Ankles extended and feet internally rotated;
• Forearm in midguard position.
• Walk with a narrow base, thighs rub against each other, legs dragged in semicircle (circumduction),
• Toes scraping the floor with each advancing step,
• In some, the knees tend to slide over each other like the blades of a pair of scissors

Question 8

Parkinson rigiditiy

Answer 8

• Neck, trunk, arms and hips flexed
• Rigidity of movement
• Steps flatfooted, small and shuffling with a narrow base
• Diminished arm swing
• Involuntary hastening of gait (festination)

Question 9

Sensory ataxia

Answer 9

• Stomping gait
• Loss of proprioception
• Looks down while walking
• Knees raise high, foot slaps down hard on ground, placing them irregularly in a broad base

Question 10

Frontal gait disorder

Answer 10

• similar to Parkinson’s but the gait is wide
• Slow shuffling wide base gait
• Hesitation in starting to walk
• Difficulty picking up feet of the ground
• Poor postural control