Physical Examination Flashcards

1
Q

aims of physical exam

A

confirm musculoskeletal dysfunction
prove or disprove diagnostic hypotheses from subjective - articular, muscular, neural combo
- pain and movement responses to physical tests
establish baseline data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

overview of physical exam

A
observation
functional testing
ROM - active, passive physio, capsular pattern
scan adjacent regions
muscle tests
neurological tests
neurodynamic tests
palpation
accessory movements
ligamentous tests
special region specific tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

muscle tests

A

Strength:
Isometric /Conc/Ecc
Muscle Control
Length / Flexibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

neurological tests

A

function / conduction (2nd year)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

neurodynamic tests

A

nerve sensitivity to movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ligamentous tests

A

stability / function

pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what determines PE inclusions

A
Pain - severity, irritability
stability of condition - improving or worsening
clinical reasoning
time constraints
patient comfort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

observations needed to be made

A
willingness to move/ functional level
gait
general build
posture
bony structure and alignment
muscle bulk, tone
skin - incision, texture, colour
presence of oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

functional testing examples

A
gait
running on treadmill
squatting
overarm throw
reaching overhead
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when should we start with functional test

A

if pain is;
non severe
non irritable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

aim of functional testing

A
observe technique / control / movement dysfunction
provoke pain (if not severe/irritable)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

capsular pattern

A

proportional motion restriction that indicates irritation of the entire synovial membrane or joint capsule, as occurs with an active inflammatory or degenerative joint changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

non capsular pattern

A

motion restrictions in proportions other than the capsular pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

isometric/resisted muscle testing

A

Resistance applied in joint rest position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does isometric/resisted muscle test for

A

Assess for weakness
Assess for provocation of pain
implies contractile unit lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

strength muscle testing

A

Graded isotonic contraction - see Kendall & McCreary (2005)

E.g. Oxford Scale

17
Q

purpose of strength muscle testing

A

to see how injured muscles react to pain

18
Q

how do injured muscles react to pain

A

spasm -overactivation

inhibition - underactivation

19
Q

examples of muscle control testing

A

E.g. During functional tasks
Stepping on and off step
Squatting

20
Q

purpose of neurological examination

A

examine state of peripheral and central nervous

21
Q

neuro tests

A
Deep Tendon Reflexes (DTRs)
E.g. Patellar, Achilles 
absent 0,  depressed +1, normal +2, exaggerated +3 
MYOTOMES
DERMATOMES
Balance
Co-ordination
22
Q

what us palpation useful for

A

Useful to record also on body chart or palpation chart

23
Q

palpations note

A
Temp
Skin moisture
Oedema / effusion
Superficial tissues: mobility, ganglions / cysts
Muscle spasm /Trigger points 
Bony prominence / tenderness
24
Q

accessory movements assess

A
Motion abnormality (hyper or hypo)
Quality of motion
Pain behaviour through range: local & referred
Resistance through range
Reactivity of muscle
25
Q

possible findings of ligamentous tests

A

Lax & painful
Lax & painless
Normal laxity & painless
Normal laxity & painful

26
Q

examples of region specific tests

A

Shoulder: Empty Can test
Knee: McMurray’s meniscal tests
Hip: Flexion/Adduction (Scour)test

27
Q

by the end of the physical exam i should

A

Identify the dysfunction Confirmed or rejected hypothesis from Subjective examination
Identify treatment options
Identify outcomes to establish goals and monitor treatment
Determine Prognosis