Management of Patient's with Musculo Pathology

Question 1

A fundamental, guiding sense of the requirements and obligations of right conduct

Answer 1

Principles

Question 2

To take charge, control or care of

Answer 2

Management

Question 3

Individual’s who are recipients of PT management who have a disease, disorder, condition, impairment, functional limitation, and/or disability

Answer 3

Patient

Question 4

Individuals who engage the services of a PT and who can benefit from the PT’s consultation, professional advice, prevention services or services promoting health, wellness, and fitness

Answer 4

Client

Question 5

Elements of a PT Examination

Answer 5

History Examination including ROS
Physical Examination including Systems Review
Specific Tests and Measures

Question 6

Review of systems

Answer 6

Included in history

Question 7

Systems Review

Answer 7

Deciding tests and measures

Screens bodily systems

Question 8

History

Answer 8

Systematic gathering of data used to form initial hypothesis of diagnosis and strategy
-Which structures; impairment; Disability

Question 9

Data generated from history

Answer 9

Demographic profile
Social/Family history
Occupation/employment
Living, working, playing environment
Health history
Functional status
Prior interventions
Current complaints
Patient expectations

Question 10

Open-Ended Interview approach

Answer 10

Guides but doesnt restrict discussion;
Patient expresses important info
Enhances rapport building

Question 11

Closed-Ended Interview

Answer 11

Direct question approach
List of predetermined questions
Answers fall into categories

Question 12

Interview Sequence

Answer 12

1. Introductions
2. Why did the patient come?
3. Symptoms; Location; constant/intermittent
4. Onset; B/W/S since onset
5. Movements or activities that relieve
6. Previous related injuries
7. Functional status
8. Medical management
9. General health/co-morbidities
10. Residual thoughts/goals

Question 13

Referred pain

Answer 13

Within a scleratome; emmanates from deep somatic tissue

Question 14

Radicular/Radiating Pain

Answer 14

Within scleratome, myotome, or dermatome; emmanates from afferent nerve pathways

Question 15

Sclerotome

Answer 15

Area of deep somatic tissue supplied by a single nerve root

Question 16

Dermatome

Answer 16

Area of skin supplied by a single nerve root

Question 17

PMH

Answer 17

Past Medical History

Question 18

PSH

Answer 18

Past surgical history

Question 19

Scanning Examination

Answer 19

Upper/Lower Quarter Screen
Subset of the System Review that emphasizes joints
Rule out referral of symptoms

Question 20

When to use a scan or screen examination

Answer 20

1. No history of trauma
2. Suspect referred or radicular symptoms
3. Doubt about location of pathology
4. Altered sensation (Para/dysasthesia)
5. Unusual pattern or collection of symptoms

Question 21

Tests & Measures

Answer 21

Conducted after history and system review
Generate data regarding impairments and functional limitations
Prioritized

Question 22

Rom Examination

Answer 22

Determines:
Quantity of AROM/PROM
Quality of ROM
Symptom provocation

Question 23

Documentation of ROM

Answer 23

1. Type of ROM
2. Quantity of AROM/PROM
3. Quality

Question 24

Quality of ROM

Answer 24

Smoothness
Capsular Pattern
Symptom provocation/End Feel

Question 25

James Cyriax

Answer 25

Developed contractile-inert testing screen AROM PROM (End Feels/patterns) Resisted isometric testing

Question 26

Limitation of AROM could mean

Answer 26

Active Muscle Dysfunction Passive Motion Restriction Joint Stability

Question 27

Active Muscle Dysfunction

Answer 27

"Organic" weakness Reflex inhibition due to pain or effusion Abnormal Motor recruitment

Question 28

Abnormal Motor recruitment

Answer 28

Antagonists guard or splint Synergists substitute Abnormal temporal characteristics

Question 29

Limitation of PROM could mean

Answer 29

Passive Insufficiency Intrarticular Obstruction Muscle Guarding or Splinting

Question 30

Capsular Pattern

Answer 30

Pattern of presentation of a capsular obstruction | AROM/PROM

Question 31

If Pain w/ ROM

Answer 31

Compressive Load Intolerance? | Tensile Load Intolerance?

Question 32

AROM is full & pain free

Answer 32

May often choose not to perform PROM

Question 33

AROM

Answer 33

Difference may be active muscle dysfunction; tensile load intolerance; patient reluctance

Question 34

AROM limitation = PROM limitation

Answer 34

Passive insufficiency Obstruction Guarding

Question 35

If AROM > PROM

Answer 35

Patient is stopping you

Question 36

Strength

Answer 36

More reps

Question 37

Power

Answer 37

1 RM

Question 38

Endurance

Answer 38

Length of time you can perform

Question 39

Concentric Contraction

Answer 39

Shortening of the muscle

Question 40

Eccentric Contraction

Answer 40

Controlled Lengthening

Question 41

Isometric Contraction

Answer 41

No motion, but the muscle is still contracting

Question 42

Cyriax Classifications of Resisted Isometric Tests

Answer 42

Strong/Painful Weak/Painful Strong/Painless Weak/Painless

Question 43

Break Testing

Answer 43

Assesses integrity of nerve roots, not strength

Question 44

Isometric Testing Procedure

Answer 44

Test position is a neutral joint position Kept still Meet my resistance If pain, do FTPO

Question 45

Strong/Painless Break Test

Answer 45

Normal Contractile Unit

Question 46

Strong/Painful

Answer 46

Minor involvement in muscle or tendon

Question 47

Weak/Painful

Answer 47

More severe muscle or tendon lesion

Question 48

Weak/Painless

Answer 48

Complete muscle or tendon rupture or neurologic problem

Question 49

Mennell's Rules for Joint Play Testing

Answer 49

``` Fully relaxed and supported One joint at a time One movement at a time Unaffected joint first One articular surface is stabilized while the other is moved Normal movements Should not cause undue discomfort ```

Question 50

Increased Tissue Temp

Answer 50

Inflammation, decreased sympathetic activity

Question 51

Decreased Tissue Temp

Answer 51

Decreased vascularity; increased sympathetic activity

Question 52

Moist & Smooth skin

Answer 52

Increased sympathetic activity

Question 53

Dry & Scaly Skin

Answer 53

Decreased sympathetic

Question 54

Tenderness

Answer 54

Inflammation; trigger sites

Question 55

Grade I palpable tenderness

Answer 55

Patient complains of pain

Question 56

Grade II Palpable tenderness

Answer 56

Patient complains of pain and winces

Question 57

Grade III Palpable tenderness

Answer 57

Patient winces and withdraws

Question 58

Grade IV Palpable tenderness

Answer 58

Patient will not allow palpation of the joint

Question 59

Reflex Integrity

Answer 59

Used to determine excitability of the nervous system and the integrity of the neuromuscular system - Developmental reflexes - Pathological reflexes (Not normally present) - Muscle stretch reflexes/ Deep tendon reflexes

Question 60

MSR

Answer 60

Muscle Stretch Reflex

Question 61

DTR

Answer 61

Deep Tendon Reflex

Question 62

Common DTRs

Answer 62

Jaw; Bicep; Brachioradialis; Triceps; Patella; Medial Hamstrings; Lateral Hamstrings; Tibialis Posterior; Achilles

Question 63

Jaw DTR

Answer 63

Site of Stim: Mandible Response: Mouth closes Nerve: CN V

Question 64

Biceps DTR

Answer 64

Site: Biceps tendon Response: Biceps contraction Nerve: C5

Question 65

Brachioradialis DTR

Answer 65

Site: Brachioradialis tendon Response: Pronation of forearm Nerve: C6

Question 66

Triceps DTR

Answer 66

Site: Distal triceps tendon Response: elbow extension/contraction Nerve: C7/C8

Question 67

Anthropomorphic

Answer 67

Describes human body characteristics including muscle atrophy & Edema

Question 68

Special Test Uses

Answer 68

``` Confirm a tentative diagnosis Make a differential diagnosis Differentiate between structures Understand unusual signs Unravel difficult signs and symptoms ```