Screening basics for LQS Flashcards
why do we screen?
to ensure the pt is appropriate for PT- musculoskeletal problem falls within our clinical practice
look for for yellow or red flag indicators
what do we screen for as yellow flags?
cautionary signs or symptoms that require further investigation
ex) difficult with coping mechanisms, anxiety, depression, dizziness, abnormal sensation patterns, fainting, progressive weakness, and circulatory or skin changes
what do we screen for as red flags?
raise one’s level of suspicion that there is a serious medical condition that could be presenting as a common musculoskeletal condition
what should we do as a PT if we identified a red flag with a patient?
refer them out to allow for further diagnostic testing
what is a sign?
an observable, objective finding related to a person’s condition. often able to be quantified by using valid and reliable measurement instruments
what is a symptom?
how a person experiences a condition. a subjective finding, often difficult to measure accurately
where should we screen if the patient complains of an upper extremity symptom?
screen cervical spine
where should we screen if the patient complains of a lower extremity symptom?
screen lumbar spine
where should we do if the patient complains of a thoracic region symptom?
if symptoms are not affected by movement, this area should arouse suspicion
T/F: certain movements should relieve pain for musculoskeletal injuries and they should follow a pattern?
True
is this a red flag?:
pain that is not made worse or better by anything
yes
what are Stoddard’s warning signs?
previous malignancy
late onset in life
serious loss of function
intense pain
areas other than cervical and lumbar
constitutional signs
gross weakness
loss of bowel/bladder
continuous pain
blood work
what are constitutional (red flag) signs
fever
diaphoresis
(night) sweats
nausea/vomiting
diarrhea
pallor
dizziness
fatigue
unexplained weight loss
what may shortness of breath indicate?
a cardiac or pulmonary dysfunction
what may dizziness or nystagmus indicate?
not associated or resolving with vestibular treatment
what may unilateral, bilateral, or quadrilateral paresthesias indicate?
cord compression or myelopathy
what should we look for with ambulation?
changes in gait, pattern, difficulty with stairs, or loss of balance.
what should we look for with posture when the patient is standing?
spinal curves- lateral view and posterior view
lateral shifts
boney landmark levels (iliac crests, ASIS, PSIS, greater trochanter, patella)
what are the single active ranges of motion in the trunk for standing?
flexion
extension
sidebend
rotation
slide glide
what are the repeated movement testing for the trunk?
flexion in standing
extension in standing
side glides in standing
what are some standing screening tests for the LQS?
heel walking/toe walking (L4/S1 involvement)
heel drop test (gross compression test)
trendelenberg- SLS vs walking vs lowering from step
what can heel drop test indicate?
appendicitis- in combination with WBC
spinal- compressive load intolerance, schmoral’s node
peritonitis- severe abdominal inflammation
what should we look for with posture when the patient is sitting?
head alignment
spinal curves
when should we assess the pulse during activity?
resting
periactivity
recovery
how do we calculate a persons maximum HR?
estimated maximum HR = 220 - person’s age
how do we calculate a persons target HR?
estimated target HR for aerobic training = maximum HR x desired intensity (%)
where are some locations to manually assess HR when seated?
radial artery in adults
brachial artery in infants and when preparing for BP assessments in adults
carotid artery for self-monitoring and during CPR
what are the single active ranges of motion and repeated active range of motion movements in the trunk when supine?
trunk flexion
where are some locations to manually assess HR when supine?
radial
femoral
popliteal
dorsal pedal
what are the single active ranges of motion and repeated active range of motion movements in the trunk when prone?
trunk extension
what are some additional observations to look for?
Fawn’s beard
Café Au Lait Spot
what is Fawn’s beard?
patch of hair on low back
indicative of spina bifida
what is Café Au Lait Spot?
neurofibromatosis
birthmarks with focal region to lumbar spine
may be present with scoliosis
What are some CNS impairments that are considered red flags that we do screening tests for?
gait deficits
romberg test
babinski sign
clonus test
cauda equina sequelae
what are some musculoskeletal impairments that are considered red flags that we do screening tests for?
fracture (people with advanced age + corticosteroid use + trauma = consider serious risk)
what are some cardiovascular and pulmonary impairments that are considered red flags that we do screening tests for?
constitutional S/S
intermittent claudication
anginal symptoms- typical and atypical
shortness of breath
what are some integumentary impairments that are considered red flags that we do screening tests for?
skin changes, rashes, itching
wounds
