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CATA 337 - fall 2022 > Lecture 2 - Physical exam > Flashcards

Lecture 2 - Physical exam Flashcards

1
Q

Principles of physical exam (4)

A

Informed consent - recheck
Normal side first (baseline, educate patient)
Active, passive, resisted
Painful last

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2
Q

What structures are being tested during AROM (3)

A

Contractile tissue
Nervous tissue
Inert tissues (ligaments, bones, etc.)

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3
Q

If active is not painful, what do you do

A

Overpressure - used to determine end feel

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4
Q

Done if AROM or AROM with OP is painful or limited

A

Passive ROM

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5
Q

What structure is being tested at PROM

A

Non-contractile tissue except at end ROM

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6
Q

If AROM and PROM are painful, what type of injury do you suspect?

A

Bones, ligaments, cartilages, etc. = inert tissue

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7
Q

What are the 5 motions of beighton score for hypermobility?

A
  1. Pinky
  2. Thumb
  3. Elbow hyperextension
  4. Ankle dorsiflexion
  5. Hip hypermobility
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8
Q

End feel of PROM - normal (3)

A

Bone to bone
Soft tissue approximation
Tissue stretch

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9
Q

End feel of PROM - abnormal (5)

A

Muscle spasm (early or late)
Capsular (hard or soft)
Bone to bone
Empty (pain)
Springy block

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10
Q

What structures does RROM tests?

A

Contractile tissue (muscle, tendon, attachments, nervous tissue)

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11
Q

Muscle testing grading = 0/5

A

No contraction palpated

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12
Q

Muscle testing grading = 1/5

A

Evidence of slight contractility but no joint motion

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13
Q

Muscle testing grading = 2-/5

A

Initiates motion if gravity is eliminated

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14
Q

Muscle testing grading = 2/5

A

Complete ROM with gravity eliminated

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15
Q

Muscle testing grading = 2+/5

A

Initiates motion against gravity

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16
Q

Muscle testing grading = 3-/5

A

Some but not complete ROM against gravity

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17
Q

Muscle testing grading = 3/5

A

Complete ROM against gravity

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18
Q

Muscle testing grading = 3+/5

A

Complete ROM against gravity with minimal resistance

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19
Q

Muscle testing grading = 4/5

A

Complete ROM against gravity with moderate resistance

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20
Q

Muscle testing grading = 5+/5

A

Complete ROM against gravity with maximal resistance

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21
Q

Postural muscles

A

Tight, hypertonic/facilitated

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22
Q

Phasic muscles

A

Weak, inhibited

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23
Q

Other findings (4)

A

Painful arcs
Crepitus
Pain at extreme ends of ROM
Flexibility testing

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24
Q

When is special test most accurate? (3)

A
  • Immediately after an injury
  • Under anesthesia
  • In chronic conditions
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25
Q

If a special test is negative, it automatically rules out the problem, T or F

A

FALSE

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26
Q

Special test considerations (4)

A
  • Patient’s ability to relax
  • Presence of pain
  • Patient apprehension
  • Clinician skill
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27
Q

Measures of worth - Reliability

A

The consistency of a measure/tool over time

28
Q

Measures of worth - Validity

A

The ability of a test to measure what it says it measures

29
Q

Measures of worth - Sensitivity

A

The ability of a tool to be positive when the condition/disease/injury is present

30
Q

Measures of worth - Specificity

A

The ability of a tool to be negative when the condition/disease/injury is not present

31
Q

Measures of worth - Responsiveness

A

The ability of a tool to detect change over time

32
Q

Nerve injury causes (5)

A

Compression
Stretch/traction
Friction
Cooling or freezing
Thermal/electrical

33
Q

Reflex grades - 0 to 4

A

0 - absent
1 - diminished
2 - average
3- exaggerated
4 - clonus

34
Q

Osteokinematic

A

Movement you can see

35
Q

Arthrokinematic

A

movement you can feel

36
Q

Convex-CONCAVE rule

A

Glide and roll in same direction
Convex is fixed and concave moves
OK and AK motion in same direction

37
Q

CONVEX-concave rule

A

Glide and roll in opposite directions
Concave is fixed and convex moves
AK and OK motion in opposite directions

38
Q

Capsular patterns - temporomandibular

A

Limitation of mouth opening

39
Q

Capsular patterns - atlanto-occipital

A

Extension, side flexion equally limited

40
Q

Capsular patterns - Cervical spine

A

Side flexion and rotation equally limited, extension

41
Q

Capsular patterns - Glenohumeral

A

External rotation, abduction, internal rotation

42
Q

Capsular patterns - Sternoclavicular

A

Pain at extreme range of movement

43
Q

Capsular patterns - Acromioclavicular

A

Pain at extreme range of movement

44
Q

Capsular patterns - Ulnohumeral

A

Flexion, extension

45
Q

Capsular patterns - Radiohumeral

A

Flexion, extension, supination, pronation

46
Q

Capsular patterns - Proximal radioulnar

A

Supination, pronation

47
Q

Capsular patterns - Distal radioulnar

A

Full range of movement, pain at extremes of rotation

48
Q

Capsular patterns - Wrist

A

Flexion and extension equally limited

49
Q

Capsular patterns - Trapeziometacarpal

A

Abduction, extension

50
Q

Capsular patterns - Metacarpophalangeal and interphalangeal

A

Flexion, extension

51
Q

Capsular patterns - Hip

A

Flexion, abduction, medial rotation (most limited in some cases)

52
Q

Capsular patterns - Knee

A

Flexion, extension

53
Q

Capsular patterns - Tibiofibular

A

Pain when joint is stressed

54
Q

Capsular patterns - Talocrural

A

Plantarflexion, dorsiflexion

55
Q

Capsular patterns - Talocalcaneal (subtalar)

A

Limitation of various range of movement

56
Q

Capsular patterns - Midtarsal

A

Dorsiflexion, plantar flexion, adduction, medial rotation

57
Q

Capsular patterns - First metatarsophalangeal

A

Extension, flexion

58
Q

Capsular patterns - Second to fifth metatarsophalangeal

A

Variable

59
Q

Capsular patterns - Interphalangeal

A

Flexion, extension

60
Q

Causes of non-capsular patterns (3)

A
  • Internal derangement
  • Extra-articular lesions
  • Constant length
61
Q

AROM tests for

A

Contractile, nervous and inert tissues

62
Q

PROM tests for

A

Non-contractile

63
Q

RROM tests for

A

Contractile, nervous tissue

64
Q

What are the muscles of the upper cross syndrome - inhibited vs facilitated?

A

Inhibited - deep cervical flexors + lower traps/serratus anterior
Facilitated - upper trap/levator scapula + SCM/pectoralis

65
Q

What are the muscles of the lower cross syndrome - inhibited vs facilitated?

A

Inhibited - Abdominals + Gluteus min/med/max
Facilitated - Thoraco-lumbar extensors + Rectus femoris/ Iliopsoas

CATA 337 - fall 2022 (16 decks)

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