physical examination Flashcards
what does a physical examination do?
- confirm that it is an MSK dysfunction
- prove or disprove the hypothesis made from subjective exam
- acts as a giude for treatment - pain and movement resppnses to physical tests
- establish baseline data to compare after intervention
what are important things to consider for the physical exam?
- consider the severity and irritability of pain - decide what physical tests need to be included
- precautions or contraindications for certain tests or activities
- decide on priority of tests
what kind of tests are done in a physical exam of a patient ?
- observation
- functional testing - eg walking or squatting
- ROM-active and passive
- muscles tests - strength, length and control
- accessory movements
- palpation
- special tests - eg testing for achilles tear
- neurological tests
- neurodynamic tests
what are different things that can be observed in a physical exam?
- gait - walking
- general build - ie are they over weight etc
- posture type
- bony structure and alignment
- muscle bulk and tone
- skin
- presence of oedema
- obvious deformities
what instrument can ROM be measured with?
a goniometer
what is a capsular joint pattern?
- proportional motion restriction that indicates iritation of the entire synovial membrane or joint capsule
- can occur with active inflammatory or degenerative joint changes
what is a non-capsular joint pattern?
- motion restrictions that occur for reasons that are different to the capsular pattern
eg involving structures around the joint like soft tissue
what are 2 main ways you can test muscle?
- resisted testing - eg using the Oxford scale, 1 rep max / 10 rep max
- muscle control - eg during functional tasks, squatting etc
what are the 2 main ways that muscles react to pain or stress?
- spasm / overactivation
- inhibition / underactivity
what is the function of a neurological examination?
- to test the conduction and function of the nerve
- to differentiate between a lower and upper motor lesion
what is an upper motor lesion?
lesion in the brain or spinal cord
what is a lower motor lesion?
- a lesion in the peripheral nerves
what are examples of special tests done in a physical exam for hip, knee & ankle?
- hip - flexion / adduction Scour test
- knee - Mc murrays meniscal tests
- ankle - anterior drawer test
what are the aims of functional tests?
- observe techniques
- control movement dysfunction
- provoke (stimulate ) pain
what are examples of functional tests?
- gait
- running on threadmill
- squatting
- overarm throw
- reaching overhead
