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UM - Tests and Measures > Intro to Patient Examination - E1 > Flashcards

Intro to Patient Examination - E1 Flashcards

1
Q

What is the sequence of examination?

A
  1. History/Systems Review/Vitals
  2. Observation/Inspection/Posture
  3. AROM
  4. PROM
  5. MM tests
  6. MM length
  7. MM strength
  8. Special Tests
  9. Functional Measures
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2
Q

What are contraindications to ROM?

A

Acute or subacute injury
If motion would increase damage
If subluxed, dislocated, or fractured
If myositis ossificans or ectopic ossification is suspected

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3
Q

What are precautions to ROM?

A

Pain
Inflammatory process in Jt or region around a Jt
MM relaxer or pain medication
Osteoporosis or fragility concern (PROM > AROM concern)
Hypermobile
Hemophilia
Hematoma, esp @ elbow, hip, or knee
Anklyosis
Disruption of soft tissue repair (check surgical protocol)
Recently healed fracture
After prolonged immob of a part

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4
Q

What are precautions for strenuous movements

A

Neurological surgery, abdominal surgery, eye surgery and intervertebral disc surgery
Overworked/overfaituge

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5
Q

What are the steps to measure PROM

A
  1. Visual estimation
  2. Quality of movement
  3. End feel and limiting factors
  4. Presence of pain
  5. Capsular or noncapsular pattern
  6. Goniometer to measure
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6
Q

Define capsular pattern

A

Particular pattern of restriction involving all or most of the passive motions of the joint

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7
Q

Define noncapsular pattern

A

Limitations of passive motor that is not preportioned similarly to a capsular pattern

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8
Q

Why do we measure ROM before MMT

A

To clear the joint

To know if it is a 3/5

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9
Q

What is considered a reliable difference in ROM measurement

A

1-2 degrees of error

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10
Q

What is a significant improvement in ROM for

a) UE
b) LE

A

a) UE - 5 degrees

b) LE - 6 degrees

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11
Q

What is the min MMT strength needed to complete functional activities with

a) UE
b) LE

A

a) 3/5 UE

b) 4/5 LE

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12
Q

What are the contraindications to mm strength testing

A 
Same as ROM (Acute or subacute injury
If motion would increase damage
If subluxed, dislocated, or fractured
If myositis ossificans or ectopic ossification is suspected)
PLUS:
inflammation present
Inflammation neuromuscular disease
Pain (can inhibit mm contraction)
Pt w/sever cardiac or respiratory disease or disorders
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13
Q

What are the precautions to mm strength testing?

A

Same as ROM (Pain
MM relaxer or pain medication
Osteoporosis or fragility concern (PROM > AROM concern)
Hypermobile
Hemophilia
Hematoma, esp @ elbow, hip, or knee
Anklyosis
Disruption of soft tissue repair (check surgical protocol)
Recently healed fracture
After prolonged immob of a part)
PLUS:
Neurological surgery, abdominal surgery, eye surgery and intervertebral disc surgery
Pt w/IV disc pathology or herniation of abdominal wall
History of CV problems
Situations where fatigue or detrimental to condition

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14
Q

MMT steps

A
  1. Pt position
  2. Explain procedure
  3. Watch them move to test position/correct compensation (uninvolved then involved)
  4. If they can get there - Grade 3
  5. Palpate prime mover
  6. Instruct Pt “hold, don’t let me move you”
  7. Stabilize proximal
  8. Hand placement distal (lumbrical grip)
  9. Apply force (gradual 3-4 seconds)
  10. Repeat
  11. Grade
  12. Document
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15
Q

What is a grade of 5 indicative of

A

Full ROM, against gravity, max resistance

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16
Q

What is a grade of 4 indicative of

A

Full ROM, against gravity, mod resistance

17
Q

What is a grade of 3+ indicative of

A

Full ROM, against gravity, min resistance

18
Q

What is a grade of 3 indicative of

A

Full ROM, against gravity

19
Q

What is a grade of 3- indicative of

A

Full ROM complete in gravity minimized position, greater than 1/2 ROM against gravity

20
Q

What is a grade of 2+ indicative of

A

Full ROM complete in gravity minimized position, less than 1/2 ROM against gravity

21
Q

What is a grade of 2 indicative of

A

Full ROM complete in gravity minimized position

22
Q

What is a grade of 2- indicative of

A

Can’t complete full ROM in gravity minimized position

23
Q

What is a grade of 1 indicative of

A

Trace motion, mm contraction

24
Q

What is a grade of 0 indicative of

A

No mm activity

25
Q

What kind of lever is more indicative of functional demands - short or long

A

Long lever arms

UM - Tests and Measures (2 decks)

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