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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
Myotome (motor testing):
- 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
26
Reflexes:
- 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
27
Deep tendon reflex (somatic):
- caused by stimulation of stretch reflex | - note the reflex response of the finding (strong, absent, weak)
28
Deep tendon reflex (somatic) is assessing common reflex arc of:
- biceps (C5/C6) - brachioradialis (C6) - triceps (C7) - patellar (L3/L4) - achilles (S1)
29
Pathologic reflexes:
- automated response by nervous system - not normally present - indicative of abnormalities/lesions in cerebral cortex motor control pathways (CNS)
30
LE pathologic reflex:
- Babinski's sign | - by sensation to sole of the foot
31
UE pathologic reflex:
- Hoffman's sign | - by tapping finger or nail bed
32
Circulation assessment:
- quality, quantity | - extremities (pulse, cap refill)
33
Spinal palpation should be performed _____ in instances of acute injury on field. Includes light palpation for ____, ____, ____.
- immediately - pain - deformity - swelling
34
Spinal palpation in quadrant scan examination completed as part of the scan assessment:
- deeper palpation probing may elicit pain | - localize pathologic tissue (bone, soft tissue)
35
Structures to palpate in the spine:
- spinous process (SP) and transverse process (TP) - cervical spine - lumbar spine
36
In spine, palpating for...
- pain - illicit reproduce symptoms - deformity crepitus
37
Observation of spine and pelvis should include:
- bony landmarks to compare to relative location in standing or sitting - discrepancies in level - ROM
38
C spine consists of:
C1 - C7
39
Nerve roots in C spine:
- C2-C4 | - C5-T1: plexus or a network of nerves (brachial plexus)
40
Where is the brachial plexus?
through the neck, axilla and into the arm and hand
41
Peripheral nerves of brachial plexus:
median, ulnar, and radial nerve
42
Upper quadrant scanning examination consists of:
- 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
C-spine ROM:
- flexion - extension - side flexion - rotation
44
What can affect pain free ROM in C-spine?
- disc - nerves - musculature - vertebrae - spinal facet joint - refer
45
Myotomes UE scan:
- C2-T1 - isometric (RROM) - 3x repeat - hold for 5 seconds, grade strength
46
Dermatomes UE scan:
- C2-T2 - bilateral comparison - testing for sensation/altered sensation
47
Deep tendon reflexes for UE:
- test few times, note changes - biceps (C5/C6) - brachioradialis (C5/C6) - triceps (C6/C7)
48
Hoffman's reflex:
- 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
Remarkable (positive) response of Hoffman's reflex:
involuntary flexion of any digit and sometimes adduction of the thumb
50
Neurological special test for UE:
dynamic upper limb tension test (ULTT)
51
ULTT stresses neurological structures of UE by:
- peripheral nerve compression | - cervical radiculopathy
52
ULTT assesses for:
- replicates sensations - creates pain - sensations of tingling or numbness experience at any stage during positioning
53
Method to perform ULTT:
- 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
Positive test of ULTT:
reproduction of symptoms to area which confirms a degree of mechanical interference affecting neural structures
55
Functional test for UE:
Apley's scratch test
56
Apley's scratch test:
- ROM test of UE joints - assess neurological aspect in joints ROM - attempt to touch opposite scapula
57
Findings of Apley's scratch test:
- assess for full pain-free range at UE joints | - consider further joint assessment if remarkable findings
58
UE skin:
- temperature - colour - condition
59
UE pulse:
- radial - brachial - carotid
60
Palpation for UE scan:
- palpate spinous process of each vertebrae from C2-T1 - pain, tenderness, referred pain, deformity, crepitus - muscles bilaterally for tone, tension, spasm, swelling
61
L-spine:
L1-L5
62
Sacral:
S1-S5 (fused)
63
Nerve roots in L-spine:
- L2-L4 lumbar plexus (incl. femoral nerve) | - L4-S3 sacral plexus (incl. sciatic nerve)
64
Femoral nerve:
anterior hip to anterior thigh
65
Sciatic nerve:
- longest and widest single nerve in the body | - top of the leg to the foot on the posterior aspect
66
Lower quadrant scanning examination consists of...
- 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
L spine ROM:
- flexion - extension - side flexion - rotation
68
Structures that can affect pain free ROM in L spine:
- vertebrae - lumbar facet joints - lumbar disc - nerves - muscles - refer
69
Myotomes exam of LE scan:
- testing L2-S2 - effective position to test - assess strength isometrically - 3x repeat - hold for 5 sec
70
Dermatomes exam of LE scan:
- dermatomes L1-L5, S1-S2 - bilaterally compare - testing for sensation/altered sensation - S3, S4, S5: ask for sensation changes to the saddle area
71
Reflexes for LE:
- test deep tendon reflexes - test a few times - patellar tendon (L2, L3, L4) - Achilles tendon (S1, S2)
72
Babinski reflex:
- 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
Neurological special test for LE:
- slump test - straight leg raise - prone knee bend
74
Slump test:
- stresses neurological structures of LE | - peripheral nerve compression, lumbar radiculopathy
75
Method to perform slump test:
- in seated: thoracic and cervical flexion, knee extension, foot dorsiflexion - followed by release fo cervical flexion - test bilaterally, uninjured side first
76
Remarkable (positive) test of slump test:
- assess for pain - reproduction of symptoms - may have relief with thoracic/cervical extension or foot plantar flexion
77
Straight leg raise:
- indicative of stressing, neural tension | - must differentiate from hamstring tightness
78
Method to perform SLR:
- 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
Positive test for SLR:
- reproduces sensations - usually between 30-70 degrees - increases with DF at ankle - increases with C spine flex
80
Prone knee bend:
- indicative of stressing neural structures (L2, L3, L4) | - differentiate between hip flexor tension or pain
81
Method to perform prone knee bend:
- 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
Remarkable (positive) test for prone knee bend:
- pain | - limited range
83
Functional tests for spine:
- gait - squat: WB ROM assessment of LE joints - walk on heels: tests L4 function - walk on toes: tests S1 function
84
LE skin:
- temperature - colour - condition
85
LE pulse:
- femoral | - dorsal pedal
86
Palpation for LE scan:
- 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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