Injury Evaluation

Question 1

Evaluation in Order

Answer 1

• History
• Observation/Inspection
• Palpate
• Neurological
• Range of Motion
• Ligamentous & Capsular
• Special Testing

Question 2

Considerations

Answer 2

On & Off field evaluations are different!

• On: first aid/emergency training
• Off: comprehensive testing

Question 3

History

Answer 3

• Most important!
• Open ended questions
• Identifies past & present injuries
• Identifies specific area/structure of concern

Question 4

Basic History

Answer 4

• General complaints
• Location of symptoms
• Onset & Duration
• Mechanism of injury
• Relevant sounds & sensations

Question 5

Basic History/Pain

Answer 5

• Location & Size of Area
  > Referred pain: “pain perceived at a
  location other than the site of the
  painful stimulus/ origin”
• Intensity
  > 0-10 scale
  > Visual analog scale: l————l
• Duration
• Changes
  > what makes it better or worse

Question 6

Observation/Inspection

Answer 6

• Begins as soon as they walk in
• Bilateral comparison
• Male: just shorts
• Female: just shorts and a bra
  > Allows to better identify
• Gross deformity
  > Postural deviations
  > Fracture: abnormal bone contours
  > Dislocation: abnormal limb position
  > Muscle girth: Muscle atrophy or
  tears
• Swelling
  > Localized vs. diffuse
  > Can be measured to show progress
  overtime
  ~ Girth (tape measurer) or
  Volumetric (water)
• Skin
  > Color
  ~ Red: inflammation or infection
  (Rubor)
  ~ Blue: poor blood flow (cyanosis)
  > Texture
  ~ Calluses or blisters: excess
  friction

Question 7

Palpation

Answer 7

• Bilateral Comparison
• Identifies involved tissues
  > refer properly
• Affected side first
  > takes patient by surprise and makes
  them less likely to flex/tense up
• Begin w/ light pressure then increase
• Note areas of point tenderness & possible structures
• Note any differences in structures/tissues

Question 8

Range of Motion

Answer 8

• Movement Assessments (in order)
  > Active
  ~ patient moves through all
  planes of motion as much as
  possible
  ~ if not able to perform, try
  Passive movement. If able to
  perform skip Passive movement
  > Passive
  ~ examiner helps patient move
  through all planes of motion as
  much as possible
  > Resistive
  ~ patient moves through all
  planes of motion as much as
  possible w/ resistance
  • full ROM or break testing
  • helps identify muscles
  involved to direct rehab
  ~ Grading System: 0-5

Question 9

Neurological

Answer 9

Lower Quarter Screen

Question 10

Ligamentous & Capsular

Answer 10

• Evaluates non-contractile tissues surrounding joint
• Applies specific stress to asses laxity or amount of “give”
  > Laxity: clinical sign of excess
  movement (identified)
  > Instability: inability to function
  under stress (symptom/verbal
  complaint)

Question 11

Special Tests

Answer 11

• Specific procedures to determine a specific presence of disease, etc.
• Used to confirm findings of initial assessment

Question 12

When is medical referral needed?

Answer 12

• When diagnosis or care is beyond ATs skill set or scope of practice
• When ATs job description/responsibilities don’t allow for proper care even when skills needed are within skill set or scope of practice