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MSK 1 > Patient History > Flashcards

Patient History Flashcards

1
Q

____ is often our most valuable resource

A

the patient

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2
Q

what type of questions are ideal when taking pt history?

A

open-ended

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3
Q

what are red flags?

A

symptoms that may require immediate attention and supersede PT

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4
Q

what do red flags typically indicate?

A
  • non-neuromusculoskeletal condition

- pathology of visceral origin

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5
Q

what are yellow flags?

A
  • confounding variables which may be cautionary warnings regarding the pt’s condition
  • require further investigation
  • you need to proceed with caution
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6
Q

what are some red flags that can point to neoplasm?

A
  • constant severe pain, esp at night
  • unexplained weight loss
  • loss of appetite
  • unusual fatigue
  • blurred or loss of vision
  • frequent or severe HA
  • persistent nerve root pain
  • radicular pain with coughing
  • paralysis
  • trunk and limb paresthesia
  • BL nerve root signs and symptoms
  • difficulty with balance and coordination
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7
Q

what is a red flag that can point to thyroid dysfunction?

A

unusual fatigue

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8
Q

what are some red flags that can point to neuro dysfunction?

A
  • blurred or loss of vision
  • frequent or severe HA
  • persistent nerve root pain
  • radicular pain with coughing
  • paralysis
  • trunk and limb paresthesia
  • BL nerve root signs and symptoms
  • difficulty with balance and coordination
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9
Q

what are some red flags that can point to CV dysfunction?

A
  • increased arm pain with increased CV demand
  • shortness of breath
  • dizziness
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10
Q

what is a red flag that can point to systemic infection or disease?

A

fever or night sweats

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11
Q

what is a red flag that can point to upper cervical impairment or CNS involvement?

A

dizziness

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12
Q

what is a red flag that can point to SC compression?

A

quadrilateral paresthesia

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13
Q

common components of an eval

A
  • review pt chart
  • pt history
  • systems review
  • observation/postural assessment
  • upper quarter screen
  • ROM/MMT
  • joint mobility
  • palpation
  • special tests
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14
Q

why should a systems review be done on every pt?

A

to ensure they are safe to exercise

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15
Q

what are the components of a systems review?

A
  • CV
  • Cognition
  • Neuro
  • MSK
  • Integ
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16
Q

why should a screening exam be done early on?

A

to ensure that the pt is safe for PT and that their condition is treatable by PT

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17
Q

by performing a screening exam, we are looking to either ____ or ____ the pt’s symptoms

A

reproduce or reduce

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18
Q

what are the goals of a screening?

A
  • direct focus of clinical exam
  • determine true location and nature of pt’s complaints
  • may need to refer to another health professional
  • determine if issue is an inert vs contractile tissue problem (could be both)
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19
Q

what do we analyze during an upper quarter screen?

A
  • symmetry
  • quality of movement
  • willingness to move
  • pain
  • end feel
  • scapulohumeral rhythm w/ arm elevation
20
Q

what motions should happen at the scapula during arm elevation, and what does this prevent?

A
  • ER, upward rotation, posterior tilt

- prevents subacromial impingement

21
Q

what type of exam should we perform if we suspect possible cervical involvement and/or the pt reports feelings of numbness/tingling?

A

neuro exam

22
Q

what might we test in a neuro exam?

A
  • dermatomes
  • myotomes
  • reflexes
  • pathological reflexes
23
Q

what must you do if an area of your upper quarter screen reproduces the pt’s symptoms?

A

you must perform a complete evaluation in that area

24
Q

observation begins when?

A

when the pt enters the clinic

25
Q

should we observe the pt’s resting posture, corrected posture, or both?

A

both!

26
Q

what are some causes of low shoulder?

A
  • adaptive laxity of the shoulder
  • leg length discrepancy
  • scoliosis
  • increased muscle tone
  • hand dominance
27
Q

what could a “balled up” muscle indicate?

A

possible muscle rupture

28
Q

what could atrophy of the deltoid indicate?

A

axillary nerve injury

29
Q

what could atrophy of the posterior deltoid indicate?

A

multidirectional instability

30
Q

what could atrophy of the infraspinatus and supraspinatus indicate?

A
  • RC tear

- suprascapular nerve injury

31
Q

what could atrophy of the upper trap indicate, and what other muscle would likely be impacted?

A
  • spinal accessory nerve inury

- SCM would likely be impacted as well

32
Q

what could the scapula do to make you suspicious of serratus anterior atrophy without even looking at the serratus anterior?

A

winging

33
Q

about how many cm and how many finger widths away from the thoracic spine is the medial border of the scapula?

A
  • 5-8 cm

- 2 finger widths

34
Q

what is the vertebral level of the scapula’s superior angle?

A

T2

35
Q

what is the vertebral level of the spine of the scapula?

A

T4

36
Q

what is the vertebral level of the scapula’s inferior angle?

A

T7

37
Q

abnormal position of scapula at rest is common in shoulder ____ injuries

A

overuse

38
Q

what are some signs of abnormal static scapular position?

A
  • winging
  • elevation/depression
  • ABD/ADD
  • rotation
  • tipping
39
Q

what should we observe when looking at someone’s posture?

A
  • head on neck
  • neck on trunk
  • arm and scapula position
40
Q

in normal posture, how much of the humeral head should be anterior to the acromion?

A

1/3

41
Q

if less than 1/3 of the humeral head is anterior to the acromion, what could this indicate? Greater than 1/3?

A
  • less than 1/3: tight posterior capsule

- greater than 1/3: anterior joint laxity

42
Q

what is normal hand/arm position?

A

thumbs facing anteriorly or slightly medially

43
Q

if posterior aspect of hand is showing, arms are ____

A

internally rotated

44
Q

forward head + rounded shoulders often causes scapula to be ____, ____, and ____.

A

ABD, elevated, internally rotated

45
Q

forward head + rounded shoulders often causes shoulders to be ____

A

protracted

46
Q

what is the main result of forward head + rounded shoulders, and why do we care?

A
  • decreased subacromial space

- can lead to subacromial impingement

MSK 1 (6 decks)

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