Objective assessment 1 Flashcards
Routine assessment
Obs- alignment, atrophy, swelling, colour, deformity,
palpation- swelling, temp, atrophy, effusion, AROM/PROM, resisted testing, accessory, ligament, functional tests
observations- alignment
limb position, shape, deformity
valgus more common in men, varus more common in women, bony points can highlight incorrect joint position
observations- atrophy
can be caused be neurological conditions, muscle bulk/ size, hypertrophy, atrophy- decrease in muscle size
observations- colour
necrosis- blackened grey areas of tissue, with potential wound breakdown, cellulitis- swelling/ infection of skin
observations- deformity
acquire or congenital flat foot- caused by rupture of tibialis posterior tendon, tenting- bone stretches the skin, haglunds deformity- changes on calcaneus of foot
AROM- quality
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
AROM- range
goniometer, forms objective marker, muscle spasms or any resistance to movement
AROM- pain response-
when and where, when did symptoms start/ finish,
AROM- what does it test
mechanical/ structural- muscle and tendon (contractile tissue), and inert tissue (joint, ligs, capsule) stretches and pulls, load transfers/ acceptance
If PROM is pain free or painful what does it show
free- it shows a muscle problem
pain- joint (inert) problem
AROM- biopsychosocial aspects
willingness to move, pain behaviour, avoidance, reluctance fear, could be O*
PROM
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)
what are you looking for with PROM
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
PROM- normal end feel
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
what does PROM test
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