Lecture 1: Physical Examination and Evaluation Flashcards
What are some of the goals of a physical examination?
determine what anatomical structures are involved, reproduce pt symptoms, link current issues with patient history
establish objective baseline info
When should you perform an Upper Quarter Scan?
any pt with an UE issue that causes is unknown
ex) shoulder pain vs rotator cuff surgery
What are components of UQS?
cervical AROM, reflexes, myotomes, dermatomes
What reflexes are tested in UQS?
biceps, brachioradialis, triceps
What is C1-2 myotome?
neck flexion
What is C3 myo?
neck side bend
What is C4 myo?
shoulder elevation
What is C5 myo?
shoulder Abduction
What is c6 myo?
elbow flexion, wrist extension
What is c7 myo?
elbow extension, wrist flexion
What is c8 myo?
thumb extension, ulnar deviation
What is t1 myo?
hand intrinsics
What reflexes are tested for LQS?
patella and achilles
What is L1-2 myo?
hip flexion (ilopsoas)
What is L3 myo?
knee extension
What is L4 myo?
ankle DF
What is L5 myo?
great toe extension (EHL)
What is S1-2 myo?
ankle PF
What is protective posture?
pt puts body into abnormal position to reduce pain, putting into correct alignment produces symptoms
What is a non protective structural posture?
deformity that is not correctable, long standing scoliosis
What is non protective behavioral posture?
result of pts personality, emotions, poor awareness, correction does not produce pain,
ex: slumped sitting posture
What are two forms of passive motion?
- physiological/ osteokinematic- flexion, extension etc.
2. accessory/arthrokinematic- between joint surfaces- glide/slide translate
If during passive motion patient presents with pain before tissue resistance what stage is it in?
acute inflammation
If pain at same time as tissue resistance?
subacute condition
If pain after tissue resistance?
chronic with tissue fibrosis
For joint mobility what is grade 0 and what is treatment?
no movement, fused
do not mobilize, surgical intervention
What are grades 1-2?
1- marked hypo mobility
2- slight hypo
treat- with mobility
What is grade 3?
normal no treatment needed
What are grades 4 and 5?
4- slight hyper
5- marked hyper
assess if nearby jts are hypo and treat with exercise, taping, bracing
What is grade 6?
unstable possible subluxation
tx- bracing, splinting, casting, surgery
What is indicative of a early muscle spasm during joint mobilization?
protection following an injury
What about late ms spasm?
protection from instability or pain
What about an early tissue stretch?
tight muscle
for example stretch appears way before normal range
What about spasticity?
UMNL
What about a hard capsular end feel?
adhesive capsulitis
What about a soft capsular end feel?
synovitis, soft tissue edema
What about bone to bone?
osteophyte formation
What is an empty end feel?
pain before tissue resistance is likely an acute injury
What about a springy block?
meniscal injury
What does it mean if patient has a strong painless contraction?
normal
If pt has a strong painful contraction?
minor muscle/ tendon lesion problem
If pt has a weak and painful contraction?
major muscle/ tendon lesion
If pt has a weak and painless contraction?
rupture of muscle/tendon or neurological lesion
What are three options PT has after exam?
- do they need additional info
- can they state a PT diagnosis
- do they need to refer pt out
