INDIVIDUAL HEALTH EVALUATION Flashcards
During history taking, what are the main points that should be asked about?
Onset
Type
SIte
Pattern of pain
Pain radiation
Duration of symtpoms
Aggravating and relieving factors
Previous episodes
Associated symtoms
Weight loss
Muscle spasm
Red flags
Impact on daily functioning
Drug treatments
Risk factors
What are some potential red flags for someone suffering with lower back pain?
Cauda equina syndrome
Spinal fracture
Cancer
Infection
How should you take a history for someone with suspected sciatica?
Pain symptoms: onset, duration, location, radiation, character, progression, severity, aggravating and alleviating factors
Sensory and strength changes
Urinary retention?
A history of back pain or sciatica and any previous treatments
A history of malignancy
Recent trauma
Current medication and comorbidities
Work activities
Impact on family, social and work ability
Risk factors
Asssess for presence of red flags
What are some risk factors for sciatica?
Smoking
Obesity
Occupation factors - whole body vibration, strenuous physical activities
General health and comorbidities
Older age
Genetic influences
What are yellow flags?
Pshychological factors that afect a patient and their treatment
Beliefs, appraisals and judgements
Emotional response
Pain behaviour/coping
E.g.
Lack of support
History of depression
Innapproriate expectations regarding treatment and low expectations of active participation in treatment
High levels of stress
Belief that pain/activity are harmful
Sickness behaviours such as extended rest and/or avoidance of movement
Social withdrawal
Problems with claims or compensations or time off work
What are red flags?
Specific attributes derived from a patient’s medical history and the clinical exam that are usually linked with a high risk f having a serious disorder like an infection, cancer r a fracture.
What are some topics that should be covered when taking a history?
Introduction and explanation of the session
Presenting complaint
Aggravating and easing factors
24 hour pattern
Nature of pain
History of presenting complaint
Social history
Past medical history and general health
Drug history
Spinal red fags (eg questioning for cauda equina)
Other red flag questions
Concerns and expectations
Any other questions from the practioner and from the patient/chance to provide further information.
What are orange flags?
Pshychiatric symptoms eg depression, anxiety, personality disorder
What are blue flags?
Perceptions about relationships between work and health
What are black flags?
System or contextual obstacles (insurance/injury claim, legislation restricting options for return to work)
What is the SOCRATES aconym?
Site, onset, character, radiation, associations, time course, exacerbating and relieving factors, severity
What steps should you go through when taking a history? abbreviations
HPC - history of presenting complaint
PC - present complaint
SOCRATES
PMH - past medical history
GH - general health
SH - social health
DH - drug history
SQs - special questions
Name the sections involved in a physical examination?
Observation - to gain a general overview of how your patient sits, stands, lays and moves
Movement testing - specific test and observations to get a more detailed look at your patients range and quality of movement
Palpation - using touch to assess the patients join motion and muscle tone
Muscle function - specific tests to assess the strength or power of your patient
Neurological examination - tests which assess the integrity of your patients sensory and motor pathways
Functional tests - bespoke replications of the specific everyday tasks that your patient reports troublesome
Cardiovascular/cardiorespitory examination - tests to assess your patient’s blood pressure and breathing function
Abdominal examination - using your hands to assess structures of your patient’s anterior torso.
Give some examples of sensory tests (neurological)
Light touch
Pin-prick
Joint positioning
Give some examples of motor tests (motor)
Muscle tone
Muscle bulk
Reflex
Muscle power
What is overpressure?
A passive range of movement which excedes its available range
What is end feel and end of range?
End feel - a type of sensation or feeling that the examiner experienced when the joint is at the end of its available passive range of motion in assessment
End of range - the point where a joint cannot be moved any further actively or passively.
What is hypertension?
High blood pressure.
Blood pressure is recorded with 2 numbers: the systolic pressure is the force at which your heart pumps blood around your body. The diastolic pressure is the resistance to the blood flow is the blood vessels between heart beats (when the heart is at rest)
They are both measured in mmHg (milimetres of mercury)
High blood pressure is considered to be from 140/90
Normal blood pressure is considered to be 90/60 and 120/80.
If you have high blood pressure, there are some associated risks:
- heart disease, heart attacks, stroke, heart failure, aortic aneurysms, kidney disease, vascular dementia
What does SOCRATES stand for?
Site
Onset
Character
Radiation
Associated symptoms
Time course
Exacerbating and relieving factors
Severity
What is the medical research council dyspnea scale?
1 - breathless during strenuous exercise onlu
2 - breathless when hurrying or walking up a slight incline
3 - walks slower than people of the same age due to dyspnea
4 - pauses for breath after walking 100m
5 - too breathless to leave the house, or breathless when dressing
