PEDIALEC_S1_L2 - P7-P10 Flashcards
SPECIAL TESTS (6)
Ortolani’s
Barlow’s
Galeazzi’s
Telescoping
Silfverskiold
Staheli
Hip dislocation special test
Ortolani’s
Hip relocation special test
Barlow’s
t or f pt is in supine for both ortolani and barlow
t
ortolani position
Hip and knee are flexed and the hip is ABducted
remember: ORAB
barlow position
Hip and knee are flexed and the hip is ADducted
remember: BAD
t or f barlow and ortolani should always be
done to test for dislocation
f, Not usually done since it is dangerous
Test to check knee height difference
Galeazzi’s
procedure of galleazi:
Hip slightly flexed to flex the knee
t.or f in galleazi the pt is in sidelying
f, in supine
Test to check hip joint laxity (dislocation)
telescoping
Patient in prone for telescoping t or f
f, supine
telescoping position of hip/knee
Hip and knee flexed in 90 degrees
procedure of telescoping:
PT will push and pull the femur (up and
down movement)
hand placement of telescoping:
one hand at hip jt, and other below the knee
Test to evaluate the contraction of ankle joint; also for PF tightness
Silfverskiold
Patient in supine for silverskiold t or f
t
1st position of silverskiold
knee extended and passively
dorsiflex the ankle
2nd position of silverskiold
knee flexed and passively
dorsiflex the ankle
Used to identify the site of rotational
deformity of lower extremity in children
Staheli
what muscle is tesetd in staheli
Iliopsoas tightness
proecudre of staheli:
Extend the leg, the trunk will have an ant.
movement
staheli position:
Long standing w/c use
what special tests are valid for infants 6 mos & below
Ortolani’s, Barlow’s, Galeazzi’s, & Telescoping
angle between the longitudinal axis of foot and direction of gait progression:
Foot progression angle
foot progression angle (FPA) is what test of staheli
Staheli test 1
Foot progression angle gives a measure of degree of __
in or out due to contributions from foot, tibia and femur.
toeing
Foot progression angle gives a measure of degree of toeing in or
out due to contributions from foot, tibia and femur: what test of staheli
Staheli test 1: foot progression angle (FPA)
The normal foot progression is _ with a mean
angle of_ (range −5 to +15°) in children aged _ears
outward, 6, 1-3
Prone position with knees flexed to 90: what staheli test
Staheli test 2
staheli test 2 also called
Medial And Lateral Rotation Of Hip
Internal rotation of hip greater than 70 deg indicates excessive femoral anteversion in stage _
staheli test 2
Internal rotation of hip greater than 70o indicates _
excessive femoral anteversion
Determines the tibial torsion
Staheli test 3:
staheli test 3 also called
Thigh foot angle
Observed from above with patient in prone position and knee flexed to 90: what staheli test
Staheli test 3: Thigh foot angle
in staheli test 2, The foot deformity is assessed by noting the position
of _ in relationship to _by the _ ine.
forefoot, hindfoot, heel bisector
In infants, the average thigh-foot angle measures _ internal (range −30° internal to +20° external).
5
tibial rotational profile changes from _ torsion to _ torsion by _ years of age.
internal to external, 4-5
By the age of _ years, the thigh foot angle averages _ external
8 years, 10
GROSS MOTOR SKILLS (4)
Head control
Trunk control
Pelvic control
Balance and tolerance
Head control is assess at what month
4 mos and up
head control : what tests to do?
sitting, pull-to-sit, prone
head control is inappropriate for what month
1-3 mos
Support forehead/side of head in trunk control t or f
f, in head control
trunk control: what tests to do
roll-over, prone, sitting
pelvic control: what tests to do?
quadruped, kneeling, & standing
balance and tolerace: what tests to do?
sitting, kneeling, & standing
trunk control is assessed at what month?
6 mos
let go of the pelvis & support the trunk and head: what gross motor skill is tested here
pelvic control
if you want to check head, trunk, and pelvic control in quadruped
position, let go of the patient but be in close-guard position: what gross motor skills do you test
here>
head, trunk, pelvic control
PT must be _ guarding when doing these gross motor skills
close
t or f Control is only assessed when the certain body part is not supported
t
t or f you can assess control in supine since the head, trunk, and pelvis.
f, cannot assess control in supine since the head, trunk, and pelvis are supported
case: PT pulled to sit the pt but PT obsevred that pt cannot. So
PT put the pt in an upright position, but pt cannot maintain also. Document it.
O> Gross motor skills > Poor head control in pull-to-sit. Pt cannot assume & maintain position.
t or f When positioning the child in prone, always rotate the head to
one side so they can breathe
t
poor tolerance: how many mins
< 15 min
fair tolerance: how many mins
16 to 30 mins
good tolerance: how many mins
31 to 45 mins
normal tolerance: how many mins
> 45 mins
Gross Motor Skills Grading: Can BOTH assume and maintain
good
Gross Motor Skills Grading: Can assume but not maintain
fair
Gross Motor Skills Grading: Can NEITHER assume or maintain position
poor
Gross Motor Skills Grading: Can maintain but not assume
fair
FUNCTIONAL BALANCE GRADES
normal
good
fair
poor
0
functional balance grading: Requires support to maintain balance
poor
functional balance grading: Requires maximal support to maintain balance
0
functional balance grading: Able to maintain balance s support;
can’t tolerate challenge & maintain balance while shifting weight
Fair
functional balance grading: Able to maintain balance without support;
accept maximal challenge & can weigh shift in all directions
normal
functional balance grading: Able to main balance s support; accepts mod
challenge & can shift weight, although limitations are evident
Good
FINE MOTOR SKILLS: what will u test
Reach grasp, carry, release
(RGCR) meaning
Reach grasp, carry, release
FINE MOTOR SKILLS: how to docu
Reach grasp, carry, release (RGCR)
laterality
Hand preference
Hand dominance
Handedness
voluntary RGCR
Handedness: what years old
7 y/o
hand dominance: what years old
5-6 y/o
Hand preference: what years old
2-4 y/o
A PT wants to know a patient’s skills. When PT positioned the child in sitting,
the PT needs to position the child’s head upright and notes that the child can do this without
external support for almost 10 minutes. However, when child was pushed forward, the
child’s head bent and lagged forward. DOCUMENT
O: GMS > F head control in sitting
A child was able to look for toy using his head in sitting without falling.
However, when the child tried to reach for toys beyond arm’s length, the child falls. DOCUMENT
O: GMS > F dynamic sitting balance
Similar to FA/FMT, can be documented under FA/FMT
ADLs
FEEDING ADLs
● Hand-to-mouth pattern
● Bottle feeding/fed
● Finger feeding
● Spoon feeding/fed c or s spillage
● Able to drink from glass/cup or sip from straw
● Position while feeding
● Diet: liquid, semi-solid, solid
● Amount of food per meal
● Time spent in feeding
DRESSING ADLs
● Level of assistance/dependence
● Undress/dress UE/LE garments
● Cooperativeness
● Difficulty with type of garment
GROOMING/HYGIENE ADLs
● Level of assistance/dependence
● List down skills
● Cooperativeness
TOILETING ADLs
● Able to indicate needs
● Toilet-trained
MOBILITY/TRANSFER ADLs
● Rolling
● Cruising
● Creeping
● Crawling
● Kneel-walking
● Running
Wheelchair
MOBILITY & TRANSFERS GRADING: Modified independence
6
MOBILITY & TRANSFERS GRADING: complete independence
7
MOBILITY & TRANSFERS GRADING: supervision
5
MOBILITY & TRANSFERS GRADING: minimum assitance required
4
MOBILITY & TRANSFERS GRADING: max assist required
2
MOBILITY & TRANSFERS GRADING: Mod assist required
3
MOBILITY & TRANSFERS GRADING: total assist required
1
GMFCS is originall used for
CP
GMFCS cannot be used for other conditions t or f
f, can be used
GMFCS 1
Full ambulatory
GMFCS 3
c wc
GMFCS 2
c ad
GMFCS 5
bed bound
GMFCS 4
c powered wc
FUNCTIONAL GRADES FOR DMD in UE: 1
Starting with the arms at the sides, the patient can abduct the arms in full circle
FUNCTIONAL GRADES FOR DMD in UE: 5
Cannot raise hand to mouth but can hold a pen or pick-up pennies
FUNCTIONAL GRADES FOR DMD in UE: 2
Can raise the arms above the head only by flexing the elbow
FUNCTIONAL GRADES FOR DMD in UE: 4
Can raise hand to mouth but not an 8 oz glass of water
FUNCTIONAL GRADES FOR DMD in UE: 3
Cannot raise the hand above the head but can only raise an 8 oz glass of water
FUNCTIONAL GRADES FOR DMD in UE: 6
Cannot raise hand to mouth and has no useful hand function
FUNCTIONAL GRADES FOR DMD in LE: 10
confined to bed
FUNCTIONAL GRADES FOR DMD in LE: 3
Walks and climb stairs slowly c aid of railing
FUNCTIONAL GRADES FOR DMD in LE: 8
Stands in long leg brace but unable to walk c assistance
FUNCTIONAL GRADES FOR DMD in LE: 6
Walks only c assistance or walk indep c brace
FUNCTIONAL GRADES FOR DMD in LE: 5
Walks unassisted but cannot rise from chair or climb stairs
FUNCTIONAL GRADES FOR DMD in LE: 7
Walks in long leg brace but requires assistance for balance
FUNCTIONAL GRADES FOR DMD in LE: 1
Walks and climbs stairs s assistance
FUNCTIONAL GRADES FOR DMD in LE: 4
Walks unassisted and raise from chair but cannot climbs stairs
FUNCTIONAL GRADES FOR DMD in LE: 2
Walks and climbs stairs c aid of railing
FUNCTIONAL GRADES FOR DMD in LE: 9
W/c borne
Though with gait deviations, a child with CP is observed to walk
indep inside the facility. However, the father reports the the child uses walker for school.
DOCUMENT
O:> FA> GMFCS IIx
A PT prompted the child to reach for toys using both hands sideways to the
right in supine. The child needs the PT to push on the pt’s shoulders to complete
the task. Upon pushing, the PT notes that the child is “heavy” and doesn’t seem to
follow even if it is evident that the child wants the toy. DOCUMENT.
O:> FA> (2) rolling supine → ® sidelying c +1 assist on shoulders
Walking c hand support (holding onto furnitures): WHAT IS THIS CALLED
CRUISE
HOPS: what years old
4 yo
SKIPS: what years old
5 yo
t or f creep is in prone position
f, quadruped
Baby on belly and moves forward: what is this
CRAWL
t or f Head control preceds before trunk control
t
lumbar lordosis precedes cervical lordosis t or f
f, cervical lordosis before lumbar lordosis