Lab Manual Stuff Flashcards
occurs prior to seeing the patient
- Review of patient reported materials
- Intake form, pain diagram, functional scales.
- Radiological and/or other information from medical sources
What examination process occur before history?
- Review of patient reported materials (Intake form forms, imaging)
- Initial observation prior to seeing the patient
Steps of the examinations process:
- Review of reported materials
- Initial observation
- Hisotry
- Review of systems
- Decission: refer out/ continue exam/focus on exam specific
- Structural inspections
- Screening (asses neurological sympstoms)
- Movement analysis (demo of what hurts)
- AROM
- PROM: ostokinematic (en feel), arthorkinematic
- resistive test
- muscle lenght
- special tets
Why is it recommened to no review MRI’s or X-Rays until the end of the examination?
So that the therapist is not influenced by those results
What are the 2 tasks in initial observation?
- Stablishing rapport
- observing movement , affect, posture, and ability to communicate
What is the purpose of the history?
- Idenditying red flags
- understanding the location and nature of the complain and its severity, irritability, potential mechanism and impact on function
At a minimum, every patient should be questioned regarding the following red-flags, whether verbally or by intake form:
- Fatigue which decreases function
- Malaise
- Fever/chills: greater than 99.5 more than 2 weeks.
- Unexplained weigh loss/gain: more than 5%-10% body weight
- Dizziness, lightheadedness
- Billateral paresthesia/numbness
- Weakness: that can not be explained
- N/V
- Change incognition abilities: time/place/person
For every YES answer to a red flag the thrapist must determine what?
- Is there an explanation for it?
- Have you explained this to a physician?
- If the physician is aware of it, has it become worse?
History questions:
- Why have you come to see me? (pain or loss of function)
- When did the pain first started?
- Where did it occur the 1st time? (Anatomic location)
- How did it change over the time from its first occurrence?
- How do you feel now?
- Have you had anything similar to this complaint in the past?
- What makes it worse?
- What makes it better?
- How does it change over the course of a day?
- Is it getter better, worse, or staying the same?
- What do you think is causing this complaint?
- Are you taking any medications?
- What are your goals for physical therapy?
- Have you seen a physician or do you plan to see a physician?
- Is there anything else you want to tell me?
The REVIEW OF SYSTEMS is designed to determine two things:
- Referal to another practicioner
- Which systems require further investigation
Primary systems reviewd in the ROS:
- Musculoskeletal
- Cardiopulmonary
- Integumentary
- Neuromuscular
- Communication ability, affect, cognition, learning ability
After history and ROS, what decission do you make?
- continue to examine
- refer to another practicioner
- continue the examination, but then refer to another practitioner after the exam.
Sometimes this is appropriate if you feel you can safely continue the examination but need “clearance” from the MD prior to initiating the treatment. This can also serve to provide you more information to give to the MD regarding the patient when you arrange the referral.
True or false:
structural inspection involves palpation to determine tenderness
False
- structural inspection is to determine landmarks, temperature, skin condition, scars, etc..
- determining tederness comes later in the physical exam
Structural inspection by palapation and observation to determine what?
- skin condition
- muscle tonicity
- edema
- temperature
- scars
- moistness or dryness
- symmetry of landmarks
Why shoulder and hip problems require inspection of the spine?
because the motion at those joints is so dependent on normal spinal function
When non shoulder extremity problems (elbow, wrist, ankle, etc.) require examination of the spine?
if the symptoms and screening exam point to any potential central (spinal) involvement (nerve roots, brachial plexus, thoracic outlet, etc.). If not, you do not need to look at the spine.
genu valgum (knock-knee)
genu varum
