Physical Therapists and Diagnosis

Question 1

Why bother with “diagnosis?”

Answer 1

Should direct treatment
helps to develop prognosis

Question 2

Do PTs diagnose?

Answer 2

yes within the limits of our practice

Question 3

what is a Pathoanatomic diagnosis?

Answer 3

anatomically based
pathology based
pathology drives prescription

Question 4

What is a Movement Diagnosis?

Answer 4

Impairment based
what is/ are the primary impairments (s)? what is causing them?
Impairment drives prescription
based on assumption that impairments relate to limitations in function, activity and participation

Question 5

What is the purpose of Pathoanatomy?

Answer 5

to direct general treatment approach and informs prognosis
the “ball park”

Question 6

What is the purpose of impairments?

Answer 6

to dictate what we actually do with a patient
the “row and seat”

Question 7

What is the Cyriax approach?

Answer 7

Diagnosis by selective tissue tension

Question 8

what does inert mean?

Answer 8

incapable of producing movement on its own; capable of producing pain and symptoms

Question 9

What can not be a direct source of symptoms?

Answer 9

Cartilage because it is not innervated

Question 10

What parts of the body are contractile?

Answer 10

Muscle
Tendon
Tenoperiosteal junction

Question 11

What parts of the body are inert?

Answer 11

Capsule
ligament
menisci
bone
bursa

Question 12

What tissue had the lesion?

Answer 12

Shoulder
Knee

Question 13

What is the steps to cyriax approach?

Answer 13

1. AROM
   2.PROM
2. Isometric Resistance

Question 14

what is a comparable sign?

Answer 14

reproduction of the patient’s chief complaint
asterisk on exam findings

Question 15

What do you do when irritability high?

Answer 15

this means pain is prior resistance so treat the pain

Question 16

What do you do when irritability is low?

Answer 16

this means resistance prior to pain so treat the limitation

Question 17

What is a capsular pattern?

Answer 17

predictable pattern of decreased PROM for a specific joint; suggests involvement of entire joint capsule/ synovium

Question 18

What is an example of capsular pattern?

Answer 18

arthritis, snyovitis, capsulitis (all synonymous)

Question 19

What is a non-capsular pattern?

Answer 19

something other than entire joint capsule/ synovium

Question 20

What an example a non-capsular pattern?

Answer 20

isolated ligament adhesion. internal derangement (meniscus tear), extra particular tissue

Question 21

What is a capsular end feel?

Answer 21

Normal

Question 22

What is a spasm end feel?

Answer 22

abrupt muscle contraction because of fear or pain

Question 23

What is an empty end feel?

Answer 23

PROM and no physical restriction but you see patient is in intense pain; serious condition

Question 24

What is an bony end feel?

Answer 24

abrupt stop to movement without that give that would be consistent with capsular ex: elbow extension

Question 25

What is an tissue approximnation end feel?

Answer 25

elbow flexion; flex elbow forearm bumps into biceps

Question 26

what is a springy block end feel?

Answer 26

motion stops abnormally and there is a kind of spring like quality to it; common for meniscal lesions or intra articular derangements`

Question 27

What is it called when AROM is less than PROM?

Answer 27

Lag

Question 28

What does it indicate when AROM is less than PROM?

Answer 28

indicates a problem with force production

Question 29

What is midrange?

Answer 29

minimize stress to inert structures

Question 30

What does strong/painless mean?

Answer 30

normal

Question 31

What does strong/painful mean?

Answer 31

minor lesion in contractile unit usually tendinitis minor muscle strain

Question 32

What does weak/painless mean?

Answer 32

complete tear neurologic spinal (nerve root) peripheral nerve

Question 33

What does weak/painful mean?

Answer 33

partial tear occult fracture other

Question 34

What does AROM mean?

Answer 34

ability/willingness to move

Question 35

what does PROM mean?

Answer 35

Passive tension inert and contractile

Question 36

what is high irritability?

Answer 36

severe pain symptoms easily provoked no control of symptoms acute trauma

Question 37

What is low irritability?

Answer 37

less pain symptoms controlled symptoms more predictable

Question 38

What does irritability reflect?

Answer 38

The degree of inflammatory active present The tissue's ability to handle physical stress

Question 39

What are the treatment goals of high irritability?

Answer 39

control symptoms stress relief no end range

Question 40

what are the treatment goals of low irritability?

Answer 40

adress impairments stretching strengthening

Question 41

what are examples of special test?

Answer 41

joint play (accessory motion) imaging EMG other clinical exam