Principles And Concepts Flashcards
Meaning of SMART
smart maneagble attainable realistic time bound
Which of these is not a relevant question:
What is the pt’s age and sex?
What is the pt’s occupation?
How many children does the pt have?
When did the symptoms started?
How many children does the pt have?
Medical diagnosis VS PT impression
Medical: Based on the pathologic or pathophysiologic state at the cellular level
PT: Based on a cluster of signs and symptom of impairment, functional limitation or disability
Why do we need to Assess?
Make sure that each patient/client is an appropriate candidate for PT.
To recognize areas that are beyond the scope of Physical Therapy
To determine what biomechanical or neuromusculoskeletal problem is present
Give the correct treatment or treat the problem as specifically as possible
Be cost-effective as possible
Components of Musculoskeletal Assessment
Pt history
Observation
Palpation
Examination of movement
Special tests
Reflexes and cutaneous distribution (Yung nerves, (CN 1-12), Brachial plexus)
Joint play movements
Diagnostic imaging
Components found in the Subjective part of the assement
Patient story
demographics (
History of present illness (HPI)
PMHx
FMHx
PSEHx
c/o
goal
ancillary procedure
Components of the Objective part
OI
Palpation
MMT
ST
OM
ROM
Components of Assessment
PT goals
Plan
Type of Notes that is
Pattern is the SOAP
Lahat ng findings nakapasok
necessary information from pt.
PCPI (body system)
Req na nandito yung SOAP.
Initial Evaluation (IE)
Type of Notes that is
Every session of the patient
Usually sa S part nalang (chief complaint ng patient) then OAP na
Daily PT Notes/PT Notes
Type of Notes that is
For every 6th and 12th session
Common practice eto pero dependent sa timetable ng clinic
Minsan dito na lang yung doctor nagbabase
minsan ginagawang RE notes
Progress Notes
Type of Notes that is
Wala na past medical history and family history (subjective). (Retake lang)
Re-evaluation Notes (RE notes)
Type of Notes that is
After madischarge ano pinakapresent the function ni pt. (Example: Independent overhead activities without pain)
Ano yung kaya na nya ngayon. (Na di nya kaya sa IE notes)
Home exercise program na gagawin ni pt.
Discharge Notes
Type of Note that is
Kapag namatay na si pt
A narrative about the patient
Ikaw gagawa kapag ikaw ang last na nakita ng patient
Expiring Notes
A 52 year old, self-referral male is examined in physical therapy. The client states that over the last three months he has experienced increasing neck stiffness pain at night. He also communicates that within the past week he had several episodes of dizziness. The client has a family history of cancer and has smoked two packs of cigarettes a day for the last twenty years. The client denies any other significant past medical history and lists the dates of his last medical examination as 10 years ago. The therapist’s most appropriate action is to?
A. Treat the client conservatively and document any changes in the client’s status
B. Inform the client that he is not a candidate for physical therapy
C. Refer the client to his primary care physician
D. Examine the patient thoroughly for any other ssx
Abnormally stiff, interrupted or rigid movement while moving the joint or body from one position to another
Guarding
A stationary position in which a fully extended limb supports and maintains an abnormal distribution of weight
Bracing
Any contact between hand and injured area (i.e., touching, rubbing, or holding the painful area
Rubbing
Obvious facial expression of pain that may include furrowed brow, narrowed eyes, tightened lips, corners of mouth pulled back and clenched teeth
Grimacing
Obvious exaggerated exhalation of air usually accompanied by the shoulders first rising and then falling; patients may expand their cheeks first
Sighing
Deformities
Structural VS Functional VS Dynamic
Structural - permanent or cannot be easily changed
Functional - can be changed with instruction
Dynamic - abnormal movement
How do you find out if a pt has edema and not just swelling?
swelling = OI
to confirm if its edema = Palpation
In palpation what grade is Pt complains not allow palpation of the joint
Grade IV
In palpation what grade isPt complains winces and withdraw
Grade III
In palpation what grade isPt complains of pain and winces
Grade II
In palpation what grade isPt complains of pain
Grade I
In edema palpation what scale is EID; rebounds > 30
4
severe
In edema palpation what scale isEID; rebounds within 15-30 sec
3
moderate
In edema palpation what scale is easily identified depression (EID) rebounds <15 sec
2
mild
In edema palpation what scale is barely perceptible depression
1
trace
T or F
Non-Pitting Edema less severe than Pitting Edema
FALSE
Non-Pitting Edema mas severe kesa sa Pitting Edema
Active Range of Motion (AROM) “physiologic”
PROM Passive Range of Motion “anatomic”
note
GONIOMETER Landmarks
Fulcrum?
Prox. Arm?
Distal Arm ?
GONIOMETER Landmarks
Fulcrum - middle part
Prox. Arm - Fixed Arm, Stabilizing arm (w/o red label)
Distal Arm - Moving Arm
Hypomobile vs Hypermobile
Hypomobile
does not start with 0 degrees or ends prematurely/does not reach the normal value
Hypermobile
excessive movement either at the beginning or end of the motion
Normal end feel and their descriptions
Soft end feel - Muscle approximation
Firm end feel - Feelings of stretching
ex: Shoulder flexion, stretch felt on the area below the axilla
Hard end feel - Bone-to-bone contact
Ex. elbow and knee extension (olecranon process and olecranon fossa)
Group of muscles innervated by single nerve root
With myotome testing, make sure that contractions are held for 5 seconds
MYOTOME
C2-C3 =
C4 =
C5 =
C6 =
C2-C3 neck flexors
C4 shoulder shrug, scapular upward rotation
C5 shoulder abductors, elbow flexors
C6 wrist extensors, pronators
C7 =
C8 =
T1 =
C7 elbow extensors, wrist flexors, finger extensors
C8 finger flexors, wrist ulnar deviation
T1 finger abductors
L2 =
L3 =
L2 hip flexors, adductor
L3 knee extensors
L4 =
L5 =
S1 =
L4 ankle dorsiflexors
L5 big toe extensors, hip abductors
S1 ankle plantarflexors, evertors, hip extensors
