Musculoskeletal Screening

Question 1

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what is posture

Answer 1

alignment of body parts in relation to one another during functional positions of movement

Question 2

what affects posture / what does posture affect

Answer 2

movement
muscle force production
gait
muscle length

Question 3

what are examples of disease-specific poor posture and how does this differ from habitual?

Answer 3

kyphosis or scoliosis
- more structural rather than someone being in a slouched position for example

Question 4

what is the ideal posture alignment

Answer 4

COM over BOS

Question 5

benefits of ideal posture

Answer 5

low energy expenditure to maintain alignment

Question 6

what are consequences of sustained poor positioning/posture

Answer 6

imbalance between strength and flexibility ratio due to imbalance of stretched, weaker muscles and contracted muscles

Question 7

in the thoracic region, what muscles become tight due to bad posture

Answer 7

tight trapezius and levator scapula
tight pectoralis

Question 8

in the thoracic region, what muscles become weak due to bad posture

Answer 8

deep neck flexors
rhomboids and serratus anterior

Question 9

in the lumbar region, what muscles become tight due to poor posture

Answer 9

erector spinae
iliopsoas

Question 10

in the lumbar region, what muscles become weak due to poor posture

Answer 10

abdominals
gluteus maximus

Question 11

what may cause a patient to alter posture during PT exam

Answer 11

response to pain / movement

Question 12

what is routine posture compared to corrected posture

Answer 12

routine = normal, everyday
corrected = changed to fix

Question 13

what to look for during an informal assessment

Answer 13

forward head with protruded chin
shoulders aligned or protruded
leaning to / away from a side
guarded posture
aligned or rotated LE

Question 14

what are the methods for a formal assessment of posture

Answer 14

plumb line
postural grid

Question 15

how to conduct a full body postural assessment

Answer 15

patient in standing
no footwear unless needed/culturally unacceptable
normal fitting clothes

Question 16

from what views can a postural assessment be completed

Answer 16

anterior/posterior and lateral

Question 17

where should the earlobe lie in a lateral view postural assessment

Answer 17

in line with acromion

Question 18

what type of exam can palpation be useful in

Answer 18

neurological
cardiovascular
pulmonary
integumentary

Question 19

what are the key principles of palpation

Answer 19

positioning/alignment of tissue
quality and contour/mass of tissue
abnormal patient experience with tissue palpation

Question 20

what superficial things can be seen with palpation

Answer 20

skin turgor
pliability of skin
temperature
areas of bruising
pulse patency / rate

Question 21

what deep structures can be found with palpation

Answer 21

bone/joints
muscles and tendons
nerves / blood vessels
abdominal viscera

Question 22

when to stop palpation

Answer 22

dont even begin if no consent
if patient declines or is hesitant

Question 23

what is layered palpation

Answer 23

slow and rhythmic palpation that gets deeper progressively

Question 24

what to avoid when palpating

Answer 24

avoid poking or “on/off” approach

Question 25

what can bone and joint palpation be helpful for?

Answer 25

reference points

Question 26

what can be found with muscle palpation

Answer 26

muscle tone or spasms tenderness and the extent of it swelling / scar tissue trigger points

Question 27

what can be found in palpation during a cardio exam

Answer 27

pulse rate/patency chest wall movement swelling varicosity of veins

Question 28

what is a movement screen

Answer 28

an initial screen of quantity /quality of movement to guide further examination

Question 29

what is observed during a movement screen

Answer 29

gross body movement regional movement joint specific movement

Question 30

what factors lead to movement deficits

Answer 30

damaged articular surfaces capsular tightness muscle length shortening age, gender, occupation

Question 31

if pain occurs at the start of a movement, what may that indicate

Answer 31

muscle issue

Question 32

if pain occurs throughout a movement, what may that indicate

Answer 32

soft tissue or bursa issue

Question 33

if pain occurs at the end of a movement, what may that indicate

Answer 33

joint/capsule issue

Question 34

is it easier to predict muscle length issues for one or two joint muscles

Answer 34

two

Question 35

what is maximum elongation for a muscle

Answer 35

maximum separation between origin and insertion of a muscle produced

Question 36

what is the most essential pre-requisite for gross movement

Answer 36

absence of movement restrictions and availability of maximum muscle elongation