Objective assessment 2 Flashcards
Joint effusion
swelling of knee joint within joint capsule- contained within joint, seen in hemarthrosis- bleed into joint after ACL and PCL injury
effusion tests
tap test- using thumb and index finger squish fluid down into patella and while applying a downward pressure use your finger to tap
sweep test- sweep from inferior medial to superior and lateral, hold fluid, observe medial aspect of knee or palpate it for fluid- see movement of fluid
muscles test- isometric
test contractile tissue- MTU(muscle tendon unit), tests principles- with joint placed in relaxed position- mid range- isolate one muscle contracting, differentiates symptoms from contractile vs inert structures, not always conclusive
isometric muscle testing- findings
1- strong and painful- tendinosis (minor muscle injury), 2- strong and painless- normal, 3- weak and painless- muscle rupture or neuropathy, 4- week and painful- fracture (major muscle injury, 5- painful on repetition- intermittent claudication, 6- all movements painful- affective disorder- BPS
4 testing of muscles
resisted isometric testing, muscle strength tests, muscle length test, palpate lesion on muscle
all4 should come back as a problem, shows muscle problem rather than a joint
muscle strength testing
MRC/ oxford grading- through full range- concentric/eccentric), tested manually
0- no movement, 1- flicker of movement, 2- movement with gravity, 3- movement without gravity, 4- contraction against gravity and light resistance, 5- Full AROM against resistance, lengthened or shortened muscle, validity- length testing curve
muscle length test
look for decreased ROM and pain, certain muscles have a tendency to become tight and lose their extensibility, during the test- quality and ROM, pain, resistance, important to know normal ROM, what limits movement
muscle bulk test
tape measure- validity?- one person may measure the bulk at different points- have to have standardised way of testing bulk- pick broadest part of muscles, need to get exactly same point on both limbs
may be visual observation- look for atrophy
other muscle tests
diagnostic muscle tests, muscle control tests
how can contractile tissue be tested with minimum involvement of other tissue
isometric testing because of no joint movement
what might you find on resisted movement testin
strong weakness/ pain,
muscle control
look at peoples coordination during tasks that require complex motor patterns, functional positions are more relevant
e.g. squatting, calf raises
special tests/ diagnostic tests
used to determine whether disease, condition or injury is present, available for different structures, depends on skill of examiner, should not be used alone to make clinical diagnosis, carry out with caution- can be proactive,
accessory tests
all ligaments tests are accessory tests, have to know attachment site of ligament, lax joint position/ mid range for lig, normal amount of movement, feeling during movement, end feel- laity, limited, empty- increased laxity, pain- onset change with further development, resistance muscle spasm etc, what limits movement- pain and resistance- P>R, R>0, R=P
example of accessory tests- valgus and varus
valgus- test MCL- take weight of leg- apply force medially,
Varus- LCL- apply force laterally
