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631: Clinical Management of the Musculoskeletal System I > Patient-Client Management > Flashcards

Patient-Client Management Flashcards

1
Q

What does examination refer to?

A

the gathering of information from the chart, other caregivers, the patient, the patient’s family, caretakers, and friends

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2
Q

What does evaluation refer to?

A

the level of judgment necessary to make sense of the findings in order to identify a relationship between the symptoms reported and the signs of disturbed function

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3
Q

What does the strength of an examination rely on?

A

The accuracy of the findings of the testing procedures

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4
Q

What are the 2 main categories of diagnostic tests?

A
  • tests that result in a discrete outcome (present/absent, disease/not disease, mild/moderate/severe, etc.)
  • tests that result in a continuous outcome (data on interval or a scale of measurement such as degrees of range of motion)
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5
Q

What are 3 characteristics that deem a test useful?

A
  • Reliability
  • Validity
  • Significance
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6
Q

When is a test considered reliable?

A

if it produces precise, accurate, and reproducible information

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7
Q

When is a test considered valid?

A

Determined upon the degree to which it measures what it purports to be measuring, and how well it correctly classifies individuals with or without a particular disease

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8
Q

When is a test considered significant?

A

When the test can describe the probability of something happening

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9
Q

What are the 2 categories in which examination tools can be divided?

A
  • Performance-based or self-report measures

- Generic or disease-specific measures

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10
Q

What do performance-based measures involve?

A

The clinician’s performance of the test or observation of the patient’s performance

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11
Q

What are some examples of performance-based measures?

A

special tests, balance tests, etc.

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12
Q

What do self-report measures involve?

A

The patient’s rating his/her performance during activities

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13
Q

What are disease-specific measures?

A

Questionnaires that concentrate on a region of primary interest that is generally relevant to the patient & clinician (focuses on populations, symptoms, function)

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14
Q

What are the 3 components of the examination process?

A
  • Patient history
  • Systems review
  • Tests and measures
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15
Q

If a patient’s pain has a recent onset what is likely the source of pain

A

inflammation

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16
Q

If a patient’s pain has am insidious or gradual onset what is likely the source of pain

A

predisposing factors such as changes in ADLs, exercise, etc.

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17
Q

Mechanical pain is thought to be the result of what?

A

sustained deformation of collagen

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18
Q

How can you determine if pan is chemical in nature?

A

it is less affected by movement/position

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19
Q

What are the 4 major sources of referred pain?

A
  • Neurogenic
  • Vasculogenic
  • Viscerogenic
  • Spondylogenic
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20
Q

3 are the characteristics that an irritable structure had?

A
  • a progressive increase in the severity of pain with movement or specific posture
  • symptoms increased with minimal activity
  • increased latent response of symptoms
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21
Q

What are the 3 stages of healing and their associated timelines?

A
  • Acute present for 7-10 days
  • Subacute present for 10 days to several weeks
  • Chronic present for more than several weeks
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22
Q

Why do prolonged symptoms usually indicate a poorer prognosis?

A

It may indicate the presence of chronic pain syndrome

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23
Q

Musculoskeletal conditions are typically aggravated with _____ and ______ with rest

A

movement

alleviated

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24
Q

Stimulation of the cutaneous A-delta fibers leads to what type of pain?

A

pricking

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25
Q

Stimulation of the cutaneous C fibers leads to what type of pain?

A

burning or dull pain

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26
Q

What are the 7 behavioral indicators that suggest motivational-affective pain?

MADISON

A
  • Multiple complaints
  • Authenticity claims in an attempt to convince the clinician that the symptoms are present
  • Denial of the negative effect the pain is having on function
  • Interpersonal variability (different complaints to different staff)
  • Singularity of symptoms (special consideration requested by patient)
  • The clinician is singled out and patient is dependent upon them
  • Nothing works
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27
Q

Imaging tests have a ___ sensitivity but a ____ specificity, so they are used in clinical decision-making but should not be used in isolation

A

high

low

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28
Q

Structural deformities are present at ____.

A

rest

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29
Q

Functional deformities are a result of what?

A

postures and disappear when posture is changed

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30
Q

What is normal body temperature?

A

96.5F-99.4F

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31
Q

What is normal respiratory rate?

A

8-14 breaths per minute

32
Q

Who developed the scanning examination?

A

Cyriax

33
Q

What are the 3 purposes of the scanning exam?

A

to help rule out the possibility of symptom referral from other areas, to ensure that all possible causes of the symptoms are examined, and to ensure a correct diagnosis

34
Q

Shoulder abduction tests which spinal root level?

A

C5

35
Q

Elbow flexion and wrist extension tests which spinal root level?

A

C6

36
Q

Elbow extension and wrist flexion tests which spinal root level?

A

C7

37
Q

Finger flexion tests which spinal root level?

A

C8

38
Q

Finger abduction tests which spinal root level?

A

T1

39
Q

Hip flexion tests which spinal root levels?

A

L1-L2

40
Q

Knee extension tests which spinal root levels?

A

L2-L4

41
Q

Hamstrings tests which spinal root levels?

A

L4-S3

42
Q

Dorsiflexion with inversion tests which spinal root level?

A

L4

43
Q

Great toe extension tests which spinal root level?

A

L5

44
Q

Plantarflexion with eversion tests which spinal root level?

A

S1

45
Q

Hip extension tests which spinal root levels?

A

L5-S2

46
Q

Which movements should be tested last?

A

Those that are known or suspected to cause pain are performed last

47
Q

What is a joint’s capsular pattern of restriction?

A

a limitation of pain and movement in a joint-specific ratio, which is usually present with arthritis, or following prolonged immobilization

48
Q

What is the GH joint capsular pattern of restriction?

A

ER > abduction > IR

49
Q

What is the humeroulnar joint capsular pattern of restriction?

A

flexion > extension

50
Q

What is the hip joint capsular pattern of restriction?

A

IR > flexion > abduction

51
Q

What occurs at the zygapophyseal (facet) joints during flexion?

A

They glide superiorly (open)

52
Q

What occurs at the zygapophyseal (facet) joints during extension?

A

They glide inferiorly (close)

53
Q

Who introduced the concept of the end-feel?

A

Cyriax

54
Q

If AROM and PROM are limited or painful in the same direction what tissue is affected?

A

inert tissue

55
Q

If AROM and PROM are limited or painful in the opposite direction what tissue is affected?

A

contractile tissue

56
Q

If a muscle contraction is weak and painless what is affected?

A

There is palsy or complete rupture of musculotendinous unit

57
Q

If a muscle contraction is weak and painful what is affected?

A

minor to serious pathology such as muscle tear or inflammation

58
Q

If a muscle contraction is strong and painful what is the problem?

A

grade I contractile lesion

59
Q

Pain that does not occur during the test, but occurs upon the release of the contraction is thought to have an ______ source

A

articular

60
Q

What is passive insufficiency?

A

the point at which a muscle is not capable of generating its maximum force because it is stretched too far

61
Q

What is defined as the ability to demonstrate the skillful and efficient assumption, maintenance, modification, and control of voluntary postures and movement patterns

A

Motor Function

62
Q

What are the criteria for simple motor patterns?

A

That the movement is…

  • performed exactly in the desired position
  • smooth and of a constant speed
  • follows the shortest and most efficient path
  • performed in its full range
63
Q

What are the criteria for complex motor patterns?

A
  • Synchronization between the primary movers in the distal and proximal regions
  • Smooth propagation of motion from one region of the body to another
  • absence of inefficient movement patterns or muscle recruitment
  • optimal relationships between the speed of motion initiated in one region vs. other regions
64
Q

List some relevant physiological issues

A

functions of body systems, healing status, energy systems, adaptation and overall fitness level

65
Q

List some relevant biomechanical issues

A

functional anatomy, direction/planes of motion and stress, kinematics, and kinetics

66
Q

List some relevant motor behavior issues

A

proprioception, perception, transfer, practice, learning, control, coordination, and performance

67
Q

What are the 2 categories of special tests according to intent?

A
  • Provocative tests

- Clearing tests

68
Q

Describe provocative tests

A

They are tests that are designed to put pressure on an involved structure and reproduce the symptoms

69
Q

Describe clearing tests

A

They are tests that can rule out a structure or region as a potential source of the patient’s symptoms

70
Q

Describe pattern recognition

A

Occurs when the patient conforms to a previously learned pattern of disease

71
Q

Define test validity

A

The degree to which a test measures what it purports to be measuring. In other words, how well it correctly classifies individuals with or without a particular disease

72
Q

What are the 2 concepts that are directly related to validity?

A

Sensitivity and Specificity

73
Q

What is sensitivity?

A

the proportion of patients with a disorder who test positive

74
Q

When sensitivity of a symptom is high, a negative response rules ___ the disorder

A

out

SnNout

75
Q

What is specificity?

A

the proportion of patients without the disorder that test negativy

76
Q

When specificity is high, a positive test rules ___ the disorder

A

in

SpPin

77
Q

What are the goals of the examination?

A

to identify and define the patient’s problem(s) and design an intervention plan

631: Clinical Management of the Musculoskeletal System I (19 decks)

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