Scanning Exam Flashcards
Purposes
-narrow search
-look for red flags
-determine body regions
-identify primary impariments
-improve outcomes
-provide guidance
When to Scan
- No obvious MOI
- Proximal Cause for Distal S/s
- Non-mechanical sounding Sx
LQ Scan
- Vitals***
- Observation: posture, plumb line
- Gait: look for gross abnormalities
- Functional MMts: squats***
- Balance Testing***
- Clear the spine**
- SI Joint Provocation**
- Myotomes: include functional testing
- Dermatomes
- DTR: patellar, med hamstring, achilles
- UMN Testing: Babinski, clonus***
- Neurodynamic Testing: SLR, slump test**
- LE ROM: FABER, flx, DF/PF, toe flx/ext
- Pulses (optional)
- Lymph Nodes (optional)
UQ Scan
- Vitals (HR and BP)
- CNs (optional)***
- Observation: posture, plumb line, head, face, neck, mouth***
- Gait: look for gross abnormalities
- Clear the spine
- UE ROM (apleys)
- Dermatomes (C4-T2)
- Myotomes (C5-T1)
- DTR: bicep, brachioradialis, tricep
- UMN Testing: Hoffman’s ***
- Upper Limb Tension Testing**
- Pulses (carotid, axillary, brachial, radial, ulnar) (optional)
- Thyroid (optional)
- Lymph Nodes (neck, and axilla) (optional)
Thoracic/Abdominal Scan
- Observation: posture, plumb line, sitting, rib hump, rashes
- Vitals (HR and, BP)
- Respiratory Excursion
- Clear the spine (sitting, cue for thoracic only)***
- DTR: Upper AND lower***
- UMN Testing: Upper AND Lower***
- Slump Test***
- Dermatomes (T2, T5, T8, T10, L1)
- Superficial Abdominal Reflex (T7-T12)
10: Aortic Pulse Palpation
- Abdominal Palpation
12: Chest Ascultation (heart and lungs) (optional)***
Observations from Behind
Even: ears, scapula, ribs, arm gaps, iliac crests, PSIS, booty cheeks, knees, how many toes can you see?
-knee valgum/varum
Observations from Side
-spinal curves
-ears even with acromion
-ASIS to PSIS angle
-knee recurvatum
Observations from Front
Even: ears, clavicles, niples, arm gaps, iliac crests, ASIS, greater troch, knees, foot arch
-knee valgum/varum
Gait Observations
-decreased WB
-hip, ankle, foot
-BOS
-flat food
-shuffling
Functional Movements
Squat:
-how low
-lean
-trunk // to tibia
-DF
-knee
-arms
-hips
-asymetries/leaning
Balance Testing
-Eyes open and closed
-bilat and SL
Myotome Testing
-fatiguable weakness=nerve root
-constant weakness=MMT/Peripheral nerve
-C5-T1
-L2-S1
Heel (L4) and Toe walking (S1/S2)
Dermatome Testing
-test face first
-C4-T2
-L2-S2
T2: arm and axilla
T5: Nipplie line
T8: xiphoid process
T10: umbilicus
L1: inguinal
Reflex Testing
0: no response
1: low
2: normal
3: brisk
4: very brisk
5: sustained/clonus
C5: biceps
C6: brachiorad
C7: Triceps
L4: patellar
L5: medial hamstring
S1: achilles
UMN Signs
-babinski
-clonus
UE: Hoffman’s
Clearing the Spine
Normal: flx/ext, LSB, rot
Provocation: compression and distraction, 5-8s
Lumbar, cervial Spine and SI joint
ROM
LQ:
-FABER
-FADIR
-hip and knee ex
-toe flx/ext
UQ:
-hold and check for s/s
Straight Leg Raise
-test for sciatic n
- actively raise leg
- passively raise leg
- flex/ext head
- DF finally
Pain in 0-30: acute/severe MSK
Pain in 30-70: nerve issue
Pain >70: not positive
Crossed SLR sign: opposite s/s, disc protrusion
Slump Test
-test neuromobility
- Hands behind back
- Head and neck flexed
- Lumbar flx
- Straighten knee
- overpressure
- DF of ankle
Pulses
-Carotid, axilla, brachial, radial, ulnar
-femoral, popliteal, post tib, dorsalis pedis
0: absent
1: reduced
2: slightly reduced
3: normal
4: bounding
Lymph Nodes
-inguinal area, axilla, neck (behind ears and jaw)
-check for swelling, pain
Upper Limb Tension Testing
- Use elbow to depress scap
- Abduct
- Extend wrist and fingers
- ER
- Elbow extension
- Lat sidebending
+ Findings: differences btw sides, different elbow ROM, reproduction of s/s
Respiratory Excursion
-watch
Manual:
-symmetry
-upper: anterior/posterior
-Middle: bucket handle, med/lat
-Lower: caliper/ in and out
Superficial Abdominal Reflex
-stroke in each of 4 quadrants in counterclockwise motion
-Upper: t7-t9 (right below xiphoid)
-lower: t10-t12 (under belly button)
+: abdomen contraction toward stimulus, normal
- : absense is abnormal
Aortic Pulse Palpation
-supine with knees flexed to relax tissue
-left side of linea alba
-check for bounding or pain and size (more tthan 1-2 fingers)
0: absent
2: normal
4: bounding
Abdominal Palpation
-knees bent
-starts superficial then deep
LUQ: stomach, L kidney, liver
RUQ: liver, gallbladder, r kidney
LLQ: sigmoid colon, L ovary, spermatic cord
RLQ: appendex, r ovary, colon
Chest Ascultation
Heart:
-aortic, tricuspid, pulmonary, mitral (top r, bottom r, top L, bottom far L)
Respiratory:
-3 on each side
Lab Values
Hemoglobin: 12-18
- <8: no exercise
->10: resistve as allowed
Hematocrit: 37-52%
-<25: no exercise
->30: resistve as allowed
WBC: 4,500-11,000
-<1,000 mask and no exercise
-1,000-5,000 light or no
Platlets: 150,000-450,000
-<20,000 no exercise
-20-30: light
-30-50: moderate
->50: resistive as tolerated
Glucose: 80-120
-<70: snack
->180-200: insulin
Fastin Blood Glucose: 70-110
