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KIN 440 > Quadrant Scanning Exams > Flashcards

Quadrant Scanning Exams Flashcards

1
Q

Key to successful evaluation:

A

be effective and be safe

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2
Q

To be effective and safe:

A
  • recognize and evaluate
  • identify physical basis
  • understand client’s problem
  • accurately diagnose (IOS)
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3
Q

Must be sure to complete a thorough exam in order to provide a ____ and ____ treatment plan.

A
  • safe

- effective

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4
Q

Quadrant scan examinations are used to:

A
  • differentiate serious pathology
  • regionalize an IOS
  • determine the type of tissue that is affected
  • determine any neurological defects
  • determine severity, irritability and nature of pain
  • determine if MSK or other (visceral)
  • determine whether to continue to assess, to manage/treat, or to refer
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5
Q

Quadrant scan is a systems check of:

A
  • musculoskeletal
  • neurological
  • vascular
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6
Q

IOS with differential diagnosis for pain to the left shoulder:

A
  • supraspinatus strain
  • heart attack
  • ruptured spleen (Kehr’s sign: pain tip of left shoulder)
  • diaphragm (phrenic nerve)
  • C5 nerve injury
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7
Q

How is the spine a complex region of the body?

A

extensive MSK region with spinal cord and nerves and blood vessels in close proximity

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8
Q

Movement of spine:

A
  • designed for high degree of flexibility

- dependent on articular facets

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9
Q

4 parts of the spine:

A
  • cervical
  • thoracic
  • lumbar
  • sacral
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10
Q

Muscular support of the spine:

A
  • abdominal muscles
  • superficial and deep muscles of spine
  • muscles of the hip region
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11
Q

Ligamentous support of the spine:

A

segmental stability of spine

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12
Q

Spinal cord is made up of:

A
  • spinal nerves

- plexuses

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13
Q

In your objective assessment, HCP should always perform _____ and ____ tests.

A
  • neurologic

- vascular

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14
Q

History or MOI may or may not indicate _____ testing.

A

neurological

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15
Q

Signs and symptoms by client may or may not indicate _____ testing.

A

neurological

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16
Q

Consider the major areas for assessment:

A
  • cerebral
  • cranial nerves
  • cerebellar
  • sensory functioning
  • motor function
  • reflex testing
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17
Q

Perform neurological examination generally by assessing….

A
  • spinal nerve roots

- associated peripheral nerves

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18
Q

Nerve roots =

A

motor and sensory in a pattern

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19
Q

Dermatome:

A
  • nerve to specific sensation pattern

- area of skin supplied by the dorsal or sensory root fibres of a single spinal nerve

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20
Q

Myotome:

A

nerve to specific joint ROM

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21
Q

Peripheral nerve:

A

confined to more localized area or specific muscle

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22
Q

Specific muscle =

A

MMT

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23
Q

Dermatome (sensory) testing:

A
  • determined distribution of dermatomes and peripheral nerves
  • assessment via touch = pattern
  • bilateral assess
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24
Q

What to bilaterally assess when dermatome testing:

A
  • superficial sensation
  • superficial pain
  • deep pressure pain
  • sensitivity to temperature
  • sensitivity to vibration
  • position sense
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25
Q

Myotome (motor testing):

A
  • represents a muscle or a group of muscles that are innervated (supplied) by the ventral or motor root fibres from specific nerve
  • assessed and tested by isometric contractions of specific groups of muscles of specific spinal nerve
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26
Q

Reflexes:

A
  • a stretch reflex that is mediated through the spinal cord
  • deep tendon reflex response
  • tested to assess the segment of the nerve root
  • produces muscles contraction
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27
Q

Deep tendon reflex (somatic):

A
  • caused by stimulation of stretch reflex

- note the reflex response of the finding (strong, absent, weak)

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28
Q

Deep tendon reflex (somatic) is assessing common reflex arc of:

A
  • biceps (C5/C6)
  • brachioradialis (C6)
  • triceps (C7)
  • patellar (L3/L4)
  • achilles (S1)
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29
Q

Pathologic reflexes:

A
  • automated response by nervous system
  • not normally present
  • indicative of abnormalities/lesions in cerebral cortex motor control pathways (CNS)
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30
Q

LE pathologic reflex:

A
  • Babinski’s sign

- by sensation to sole of the foot

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31
Q

UE pathologic reflex:

A
  • Hoffman’s sign

- by tapping finger or nail bed

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32
Q

Circulation assessment:

A
  • quality, quantity

- extremities (pulse, cap refill)

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33
Q

Spinal palpation should be performed _____ in instances of acute injury on field. Includes light palpation for ____, ____, ____.

A
  • immediately
  • pain
  • deformity
  • swelling
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34
Q

Spinal palpation in quadrant scan examination completed as part of the scan assessment:

A
  • deeper palpation probing may elicit pain

- localize pathologic tissue (bone, soft tissue)

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35
Q

Structures to palpate in the spine:

A
  • spinous process (SP) and transverse process (TP)
  • cervical spine
  • lumbar spine
36
Q

In spine, palpating for…

A
  • pain
  • illicit reproduce symptoms
  • deformity
    crepitus
37
Q

Observation of spine and pelvis should include:

A
  • bony landmarks to compare to relative location in standing or sitting
  • discrepancies in level
  • ROM
38
Q

C spine consists of:

A

C1 - C7

39
Q

Nerve roots in C spine:

A
  • C2-C4

- C5-T1: plexus or a network of nerves (brachial plexus)

40
Q

Where is the brachial plexus?

A

through the neck, axilla and into the arm and hand

41
Q

Peripheral nerves of brachial plexus:

A

median, ulnar, and radial nerve

42
Q

Upper quadrant scanning examination consists of:

A
  • AROM of C spine
  • neurological tests (myotomes, dermatomes, reflexes)
  • neurological special tests for C spine
  • functional tests
  • UE vascular tests
  • palpations of C spine
43
Q

C-spine ROM:

A
  • flexion
  • extension
  • side flexion
  • rotation
44
Q

What can affect pain free ROM in C-spine?

A
  • disc
  • nerves
  • musculature
  • vertebrae
  • spinal facet joint
  • refer
45
Q

Myotomes UE scan:

A
  • C2-T1
  • isometric (RROM)
  • 3x repeat
  • hold for 5 seconds, grade strength
46
Q

Dermatomes UE scan:

A
  • C2-T2
  • bilateral comparison
  • testing for sensation/altered sensation
47
Q

Deep tendon reflexes for UE:

A
  • test few times, note changes
  • biceps (C5/C6)
  • brachioradialis (C5/C6)
  • triceps (C6/C7)
48
Q

Hoffman’s reflex:

A
  • tap nail bed or flick end of finger of middle or ring finger
  • then pull finger quickly across nail
  • test 5 times to uncover fading reflex response
49
Q

Remarkable (positive) response of Hoffman’s reflex:

A

involuntary flexion of any digit and sometimes adduction of the thumb

50
Q

Neurological special test for UE:

A

dynamic upper limb tension test (ULTT)

51
Q

ULTT stresses neurological structures of UE by:

A
  • peripheral nerve compression

- cervical radiculopathy

52
Q

ULTT assesses for:

A
  • replicates sensations
  • creates pain
  • sensations of tingling or numbness experience at any stage during positioning
53
Q

Method to perform ULTT:

A
  • bilateral test, testing uninjured side first
  • order of positioning joints: can further modify test using position of each joint
    1. depress shoulder girdle
    2. shoulder: abduct to 90, externally rotate
    3. elbow: flex
    4. forearm: supinate
    5. wrist: extend and radially deviate
    6. fingers/thumb: extend
    7. C spine side flex to contralateral side
  • move through full UE ROM
    8. shoulder: abduct to 110
    9. elbow: extend, supinate
    10. wrist extend, fingers/thumb extend
54
Q

Positive test of ULTT:

A

reproduction of symptoms to area which confirms a degree of mechanical interference affecting neural structures

55
Q

Functional test for UE:

A

Apley’s scratch test

56
Q

Apley’s scratch test:

A
  • ROM test of UE joints
  • assess neurological aspect in joints ROM
  • attempt to touch opposite scapula
57
Q

Findings of Apley’s scratch test:

A
  • assess for full pain-free range at UE joints

- consider further joint assessment if remarkable findings

58
Q

UE skin:

A
  • temperature
  • colour
  • condition
59
Q

UE pulse:

A
  • radial
  • brachial
  • carotid
60
Q

Palpation for UE scan:

A
  • palpate spinous process of each vertebrae from C2-T1
  • pain, tenderness, referred pain, deformity, crepitus
  • muscles bilaterally for tone, tension, spasm, swelling
61
Q

L-spine:

A

L1-L5

62
Q

Sacral:

A

S1-S5 (fused)

63
Q

Nerve roots in L-spine:

A
  • L2-L4 lumbar plexus (incl. femoral nerve)

- L4-S3 sacral plexus (incl. sciatic nerve)

64
Q

Femoral nerve:

A

anterior hip to anterior thigh

65
Q

Sciatic nerve:

A
  • longest and widest single nerve in the body

- top of the leg to the foot on the posterior aspect

66
Q

Lower quadrant scanning examination consists of…

A
  • AROM of L-spine
  • neurological tests (myotomes, dermatomes, reflexes)
  • neurological special tests for L spine
  • functional tests
  • LE vascular tests
  • palpations of L spine and sacral spine
67
Q

L spine ROM:

A
  • flexion
  • extension
  • side flexion
  • rotation
68
Q

Structures that can affect pain free ROM in L spine:

A
  • vertebrae
  • lumbar facet joints
  • lumbar disc
  • nerves
  • muscles
  • refer
69
Q

Myotomes exam of LE scan:

A
  • testing L2-S2
  • effective position to test
  • assess strength isometrically
  • 3x repeat
  • hold for 5 sec
70
Q

Dermatomes exam of LE scan:

A
  • dermatomes L1-L5, S1-S2
  • bilaterally compare
  • testing for sensation/altered sensation
  • S3, S4, S5: ask for sensation changes to the saddle area
71
Q

Reflexes for LE:

A
  • test deep tendon reflexes
  • test a few times
  • patellar tendon (L2, L3, L4)
  • Achilles tendon (S1, S2)
72
Q

Babinski reflex:

A
  • big toe remains extended or extends itself when the sole of the foot is stimulated (abnormal except in young infant)
  • abnormal reflex (when Babinski reflex is present) in a child older than 2 years or in an adult, it is often a sign of a brain or nervous system disorder
73
Q

Neurological special test for LE:

A
  • slump test
  • straight leg raise
  • prone knee bend
74
Q

Slump test:

A
  • stresses neurological structures of LE

- peripheral nerve compression, lumbar radiculopathy

75
Q

Method to perform slump test:

A
  • in seated: thoracic and cervical flexion, knee extension, foot dorsiflexion
  • followed by release fo cervical flexion
  • test bilaterally, uninjured side first
76
Q

Remarkable (positive) test of slump test:

A
  • assess for pain
  • reproduction of symptoms
  • may have relief with thoracic/cervical extension or foot plantar flexion
77
Q

Straight leg raise:

A
  • indicative of stressing, neural tension

- must differentiate from hamstring tightness

78
Q

Method to perform SLR:

A
  • patient in supine, head not on pillow
  • therapist passively flexes patient’s leg at hip joint with extended knee
  • increase tension by dorsiflex foot and/or actively flex C-spine
  • test bilaterally, uninjured side first
79
Q

Positive test for SLR:

A
  • reproduces sensations
  • usually between 30-70 degrees
  • increases with DF at ankle
  • increases with C spine flex
80
Q

Prone knee bend:

A
  • indicative of stressing neural structures (L2, L3, L4)

- differentiate between hip flexor tension or pain

81
Q

Method to perform prone knee bend:

A
  • client in prone position while assessor passively flexes the client’s knee to max range
  • passively extend the patient’s hip avoiding L-spine extension
  • test bilaterally, uninjured side first
82
Q

Remarkable (positive) test for prone knee bend:

A
  • pain

- limited range

83
Q

Functional tests for spine:

A
  • gait
  • squat: WB ROM assessment of LE joints
  • walk on heels: tests L4 function
  • walk on toes: tests S1 function
84
Q

LE skin:

A
  • temperature
  • colour
  • condition
85
Q

LE pulse:

A
  • femoral

- dorsal pedal

86
Q

Palpation for LE scan:

A
  • palpate spinous process of each vertebrae from L1-S2 (pain, tenderness, deformity, crepitus)
  • muscles palpated bilaterally for tone, tension, spasm, swelling
  • palpate SI joints bilaterally

KIN 440 (10 decks)

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