Scenarios/questions (week 1) Flashcards
When asking patient history what types of questions should we ask the patient?
Open-ended &Closed-ended
What does the Acronym SINSS mean and what does it determine
S:severity
I:irritability
N:nature
S:stage
:stability
It determines the vigor and extent of the physical exam and intervention as well as the prognosis
If a patient comes in with a 6/10 pain , what type of severity would this patient have?
Moderate severity
A patient comes in and states that the pain they experience starts in the morning and gets worse throughout the day. Many ADLs such as reaching,pulling,lifting,and cleaning aggravate the shoulder. The only relief that the patient gets is when they lay down on their back at night. What would the patients irritability be?
Maximal irritability
What type of irritability symptom are a Red flag, and what are some examples?
Non-mechanical symptoms
Fever/chills, unremitting night pain, substantial weight loss, frequent or severe headaches
What kinds of questions would help you determine the Nature of a patients pain?
When you do movements that aggravate you (area of pain) how long does it last?
What type of pain do you experience when it gets aggravated; sharp,dull, pins and needles,etc. ?
What could a sharp pain indicate?
Inflammation
What could a vague,dull, and achy pain indicate?
MSK or viscerogenic
What could pins and needles, numbness and tingling indicate?
Neuropathic
What would a suspicious MSK S&S be?
Unwillingness to move the neck after trauma
Splinting or lack of motion After trauma
What the Stage questions determine?
The duration of a patients pain or discomfort
At the patients reevaluation, you subjectively get that the patients says they can move more freely without pain, and objectively you determine that the patients ROM has gained 10 degrees and the muscle manual test has shown improvement. In the SINSS acronym which letter does this example fall under?
Stability
What are things to consider in a patients history?
Social history
Medical history
Medication
Date and results
Imaging
Occupation
Beliefs and values
Etc.
When does observation begin?
From introduction through the intervention
What are things that you can observe in a patient?
Conversation
Structural(body type, posture, swelling,asymmetries)
Functional( limping, extremity dominance, compensation)
Guarding
Facial grimaces
Mental
Etc.
What does a systems review determine?
Possible health problems that require a consultation with or referral to another healthcare provider
Why is a scan or a screen
A general assessment
What is a biomechanical exam?
A greater detailed assessment based on the scan findings
A patients says that hey feel discomfort when reaching and lifting, Is this a sign or symptom?
Symptom
When reviewing a patients chart you see an x-ray that shows a fracture in the humeral head, when evaluating you notice that the patients ROM is limited, is this a sign or symptom?
Sign
Can a patient have signs and NO symptoms?
Yes
What are the 5 purposes of a Scan or Screen
1: further assess for red flags
2: assess neurovascular status
3; determine if symptoms are referred
4:assess severity of condition
5: identify need for more in-depth bio mechanical exam
What does Selective Tissue Tension Testing intel?
AROM
PROM
Resisted Test
How much time should we shoot for to complete a scan?
10-15 minutes
