PTE UQ scan done Flashcards
Cervical compression/distraction This is to compare wb
vs non wb sensitivi-ties
Hearing screen
report difficulty hearing
Abdominal palpation
• If pt reports S&S’s of
visceral dysfunction
What are the characteristics of palpating glands?
• Lobulated and irregular shape•
Non tender
• Soft to firm to touch
What are the components of the Neuro Screen?
•Myotomes
•Dermatomes
•Deep Tendon Reflexes•
UMN signs
We need sensation, movement, reflexes, and to see if the issue is an UMN or a LMN, if it is indeed a UMN then we shall have to refer out.
Purpose of assessing PROM
- Assess ROM
- Pain Provocation
- Tone
- Note difference between AROM vs. PROM
- May be due to muscle spam/contraction,muscle tightness, neurological deficit, or pain
RA
Joint pain
GU system
Shoulder, lower back, or iliopsoas pain
It looks like a U, that shoulders can be an U and the lower back that it goes into the legs, and the iliopsoas they form a U.
So GI forms a form of an I and the GU forms the form of an U.
When does hair loss become a medical concern?
Think CA. •Infections •Hypothyroidism •Neoplasms •Iron deficiency •Medications •Allopurinol •Coumadin •Heparin •Chemotherapy •Oral contraceptives• Anti depressants •Amphetamines
Lymph node, squishy or hard?
Squishy.
Pulmonary dysfunction
Similar to cardiac pain pattern
What UMN tests are performed in the uq screen?
•Clonus of the wrist•
Hoffman reflex
Babinski are LQ.
What about suppinator drift and invertor?
Purpose of assessing AROM
•Quantity of motion •Quality of motion1 •Patient’s reluctance to move• Pain provocation •Compensations
These are all the things that you would want with proper movement and to see if they have them, or for some to wish to not have them.
Cervical myelopathy
Paresthesia, cervical pain
Positive distraction can indicate
Ligamentous injury•
Muscle injury
This is like when we go and we stress the muscles and the ligaments. We want to see if there is any real problems here.
C4
shoulder shrug!
What is the handshake idea of a screen?
Look at the hand, observation Touch the hand, palpate Shake, ROM Squeeze, MMT Then give him something special to verify other thi gs.
What is the purpose of palpating lymph nodes?
- Looking for obvious swelling or redness
- Cannot ascertain the pathology
- May be a sign of CA, however it can also be
- Virus
- Bacteria
- Allergy
- Thyroid conditions
- Food intolerances
- It is a sign that the immune system is workinghard
Hypothyroidism
Trigger points
Cancer
Various
So uou have done the subjective, the pmh the OPQRSTUV and if it makes notice to require inquiry of the constituitional synptoms then we inquire.
And then if it indicates a need to prod more about a specific system, them we will look into a specific system more, and if it ipdoes not hint at a need for a specific visceral system then it is the realm of PT, and if they complained about the T6 and up then wea re interested in performing an upper quadrant screen, but if we are seeing that the dysfunction is from T6 and down, then we do a lower quadrant screen.
These screens are all the issues that can arrive and affect the body for its specific quadrant, and there are neuro, muscular, osteo, integumentary, balance, which is an offshoot of neuro,
What will the sitting observation be looking for?
The hair, nail, skin the legions the color, eyes, posture.
What is horner’s syndrome?
• Sympathetic innervation of the eye is a 3 neuron arc • Any compression of the these neurons will cause miosis, ptosis, anhidroisis (dry skin) Causes: • Primary neuron lesion • Brainstem stroke • Tumors of the lung apex • Dissecting carotid aneurysm
GI dysfunction
Pain to sternum, neck, shoulder, scapula, low back , sacrum, groin, hip
GI pain loos like an I.
The shoulders, the neck, the sternum the scapula, the sacrum, the low back, the groin, the hip.
Like an I.
Gee I have an I pain pattern.
Lymoh nodes are supposed to be moved or are immibile?
Mobile.
When would a call to the MD be warranted for muscular dysfunction?
When it is very likely that it is due to an UMN issue.
What are possible causes of cyanosis?
- High blood iron level, blue iron, its the color of steel
- Cold exposure, blue ice
- Vasomotor instability, the blood cannot open enough so O2 is not reaching the tissue, so blue
Vertebral Artery Dissection
Dizziness, Cervical pain
For the skin and nails, look at the integumentary slides.
.
What are possible causes of Gray skin?
Increased iron, like war machine, it was gray.
How would you distinguish if a patient had a weak elbowextension is due to a weak triceps or it is due to dysfunction of the C7 myotome?
C7 does also wrist flexion and it is the dermatome of the forefinger and the middle finger.
You would test those and see if they are with issue.
Same with all other myotome and dermatome matters.
We can also go and look at the reflexes, if it is just an atrophy issue, then why would it give us a dysrelexia?
Diabetes
Paresthesia hands or feet
UMN tests.
Suppinator drift test Babinski. Hoffman's Inverted \_\_\_\_\_\_\_\_ test. And hyper reflexia.
All of these tell you that if the issue is UMN or LMN.
What size is a lymph node supposed to be?
Less than a centimeter.
C6
elbow flexion and/or wrist extension
These double job myotomes need to have both of their jobs assessed.
SprainStrain
AnywhereAnywhere
If the weakness is due to C7 myotome, is a UMN lesion oran LMN lesion?
This is LMN.
Balance training
• Pt reports dizziness or balance problem.
Ex?
Romberg
Lymph nodes are tender or not tender?
Not tender, they really should not hurt.
Vestibular dysfunction
Opiods use
Dizziness
Dizzziness
Liver dysfunction
Right shoulder pain
Reflex Testing
• Upper Extremity
C4 - Rhomboids, the myo was shoulder shrug
• C5 - Biceps the myo was the shoulder abduction
• C6 - Brachioradialis the myo was elbow flexion
• C7 – Triceps the myo was elbow extension
• C8 – Thumb ext the myo was the same
• T1 – Hypothenar emi-nence the myo was finger abduction
The C4 and C5 and T1 are really different from their myotomes.
C8
thumb extension, FDP
How often should AROM be done?
• Done usually 1-2 times • However if the PT suspects certain motions to be the pain generator the PT may• Repeat 5 to 10 times • Sustained for 5 to 20 seconds • Change in speed
Breast Cancer
Chest, back
C7
elbow extension and/or wrist flexion
Fractures
Anywhere
Why would we look for gait and posture at the UQ screen?
Because maybe there is a UMN legion that is causing a problem with balance.
Cervical compression/distraction• This is done during the
UQ Scan
T1
Finger abduction
What are possiblecauses of pallor?
•Albinism (albino) •Lack of sunlight •Anemia •Internal bleeding• Chronic GI bleed• Cancer •Syncope• Stress
Positive compression can indicate
Foraminal compression of nerve root
The observation part of the screen is forst to have the therapist to look at what?
The gait and posture, wide gait, UMN issues.
What are possible causes of yellow skin?
Liver disease • Gallstone blockage of bile duct • Hepatitis • Ingestion of food high in carotene and vita- min A But really consider liver issues.
Are we done with the observation after the standing, gait and posture?
Nope.
There is still the sitting observation.
C5
shoulder abduction
Cranial Nerve Assessment
• Difficulty performing any of the functions ofthe cranial nerves
• If the PT suspects Vertebral Artery Dysfunc-
tion
.
Lung cancer
Chest pain, but spreads
Imagine that the very air burns, so as one breathes in the air spreads out and this burning breathe hurts.
Cardiac dysfunction
Chest, neck, upper trapezius, left shoulder or arms
Headache
Brain tumor
What colors of the skin, should aPT observe for?
- Pallor (pale)
- Cyanosis (blue)
- Yellow
- Gray
- Brown (hyperpigmentation)