Objective assessment 1 Flashcards

1
Q

Routine assessment

A

Obs- alignment, atrophy, swelling, colour, deformity,

palpation- swelling, temp, atrophy, effusion, AROM/PROM, resisted testing, accessory, ligament, functional tests

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2
Q

observations- alignment

A

limb position, shape, deformity

valgus more common in men, varus more common in women, bony points can highlight incorrect joint position

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3
Q

observations- atrophy

A

can be caused be neurological conditions, muscle bulk/ size, hypertrophy, atrophy- decrease in muscle size

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4
Q

observations- colour

A

necrosis- blackened grey areas of tissue, with potential wound breakdown, cellulitis- swelling/ infection of skin

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5
Q

observations- deformity

A

acquire or congenital flat foot- caused by rupture of tibialis posterior tendon, tenting- bone stretches the skin, haglunds deformity- changes on calcaneus of foot

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6
Q

AROM- quality

A

willingness to move- fear fall of movement? or unable to move limb due to nerve input? or they present themselves moving by being rigid and tense, smoothness/ coordination of movement

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7
Q

AROM- range

A

goniometer, forms objective marker, muscle spasms or any resistance to movement

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8
Q

AROM- pain response-

A

when and where, when did symptoms start/ finish,

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9
Q

AROM- what does it test

A

mechanical/ structural- muscle and tendon (contractile tissue), and inert tissue (joint, ligs, capsule) stretches and pulls, load transfers/ acceptance

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10
Q

If PROM is pain free or painful what does it show

A

free- it shows a muscle problem

pain- joint (inert) problem

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11
Q

AROM- biopsychosocial aspects

A

willingness to move, pain behaviour, avoidance, reluctance fear, could be O*

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12
Q

PROM

A

client should be supported and comfortable, clinician comfortable with bed at correct height, passively take joint through available range of motion, if pain free can go to overpressure (low SIN)

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13
Q

what are you looking for with PROM

A

feel quality of movement- end feel, further range?, resistance or muscle spasm and any symptoms produced?, limit to movement- resistance or pain?, pain response, ROM achieved

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14
Q

PROM- normal end feel

A

soft- soft tissue approximation and bony end feels
hard- bony approximation
spongy- inflamed or effused
soft with hard end feel- capsular, ligament, or muscle stretch

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15
Q

what does PROM test

A

test inert tissue and non-contractile tissue, should be no muscle activity, where and when does pain begin and finish (P1 and P2), how does further movement affect pain, where and when does stiffness begin- S1

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16
Q

what are you feeling for PROM

A

the pattern of movement limitations, end feel, the movement of associate joints, the ROM,

17
Q

abnormal end feel

A

bone-bone- hard
muscle spasm
empty- no end feel, only get this when pain stops the movement, or could be fearful, or could be ligament laxity
elastic/capsular - too early in range
springy block- can be menisci- springs back

18
Q

capsuler patterns

A

only joints controlled directly by muscles have a capsular pattern, capsule must be tested in physiological ranges, identify patterns of restrictions

19
Q

causes of capsular pattern

A

capsular contraction, muscle spasm, osteophyte formation

20
Q

non-capsular patterns

A

internal derangement, extra articular lesions, single muscle involvement

21
Q

what is goniometry

A

measuring the available ROM or the position of the joint (typically PROM)

22
Q

goniometer procedure

A

position joint in 0 position and stabilize proximal joint component, move joint to end range, determine end feel at the point where measurement will be taken, identify and palpate bony landmarks, align goniometer with bony landmarks while holding joint,

23
Q

goniometer consideration- positioning

A

start at 0°, document limiting factor

24
Q

goniometer consideration- stabilizing

A

usually stabilize proximal joint components, promote patient relaxation so voluntary muscle contractions doesn’t interfere (PROM)

25
Q

goniometer consideration- accuracy

A

validity, reliability- intra-tester <5°, inter-tester >5°

26
Q

Documenting AROM

A

the joint, movement, active or passive, test position, start position, end position, ROM, limiting factor

27
Q

documenting PROM

A

the joint, movement, active or passive, test position, start position, end position, ROM, limiting factor, quality of movement, end feel