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Kines Exam 2 > Selective Tissue > Flashcards

Selective Tissue Flashcards

1
Q

T/F patient is best source of information into their condition

A

True

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2
Q

T/F Leading question should be used with patient

A

False

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3
Q

What are inherent likelihoods when diagnosing soft tissue injuries?

A
  • Soft tissue lesion behave in typical ways = regularly be faced with the same history and the same response to functional testing
  • Examiner with knowledge of these patterns can recognize them quickly
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4
Q

Why should we be cautious about relying a lot on palpation?

A

 Can help to narrow down the area/tissue to evaluate

 Can be unreliable – structures lie too deep

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5
Q

Choose contractile tissue/non-contractile tissue/both:

Stress with stretching

A

Both

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6
Q

Choose contractile tissue/non-contractile tissue/both:

Stress with isometric contraction

A

Contractile tissues

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7
Q

Choose contractile tissue/non-contractile tissue/both:

Stress with palpation

A

Both

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8
Q

Choose contractile tissue/non-contractile tissue/both:

No increase in discomfort with isometric contraction

A

Non-contractile tissues

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9
Q

Choose contractile tissue/non-contractile tissue/both:

Joint capsules, ligaments, bursae, aponeuroses, nerves

A

Non-contractile tissues

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10
Q

Choose contractile tissue/non-contractile tissue/both:

Tendons, muscle, musculotendinous junctions, bone adjacent to attachment of tendon

A

Contractile tissues

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11
Q

What is meant by the “patient’s pain”? Are we looking for that?

A

We must ask if the pain we evoke is the pain in which they are seeking treatment for (it is what we are looking for)

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12
Q

AROM is a quick way to narrow down what two things in regard to selective tissue tensioning?

A

 Quick way to narrow down source of symptoms

 Quick way to narrow down structures to test in detail

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13
Q

What 4 things should we observe during AROM?

A
  1. Pain
  2. Range of motion
  3. Quality of movement
  4. Willingness to move
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14
Q

Compare AROM to what on uninvolved side and what on ipsilateral side?

A

 Compare to uninvolved side AROM, PROM, resistance testing, and palpation
 Compare to ipsilateral results of PROM, resistance testing, and palpation

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15
Q

What 4 things should we observe during PROM?

A
  1. Pain
  2. Range of motion
  3. Willingness to allow movement
  4. End feel
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16
Q

Compare PROM to what on uninvolved side and what on ipsilateral side?

A

 Compare to uninvolved side AROM, PROM, resistance testing, and palpation
 Compare to ipsilateral results of AROM, resistance testing, and palpation

17
Q

During resistance movements, resist through full ROM for what areas?

A

 Resist through full ROM to fully rule out suspicious area; DO NOT need to do resistance through full ROM for all resistance testing

18
Q

What 4 things should we observe during resisted movements?

A
  1. Pain
  2. Willingness to allow contraction
  3. Strength
  4. Compensations
19
Q

If no pain and normal strength, what could disorder be?

A

Nothing

20
Q

If pain and normal strength, what could disorder be?

A

Contractile tissue

21
Q

If no pain and weak strength, what could disorder be?

A

Nervous lesion or complete rupture

22
Q

If pain and weak strength, what could disorder be?

A

Serious lesion, partial rupture

23
Q

If you performed resisted isometrics at mid range and the patient had no symptoms, but you still suspect that muscle or tendon is involved what should you do in regards to resistance?

A

Test through full ROM

24
Q

When palpating a stationary joint, what should you observe?

A 
o	Temperature
o	Swelling
o	Gaps
o	Tenderness
o	Pulsation
25
Q

When palpating a moving joint, what should you observe?

A 
o	Crepitus
o	Clicks
o	End-feel
o	Hypermobility
o	Hypomobility
o	Willingness to move
o	Pain
26
Q

What if everything is negative for selective tissue tensioning?

A

o A negative examination does not necessarily mean that an injury is absent
o May be a problem in a neighboring tissue which was not systematically tested in the examination

27
Q

T/F If patient has very slight pain:

Examination will never be totally negative

A

False, can be totally negative

28
Q

T/F If patient has very slight pain:

Palpation is very dangerous in these cases

A

True

29
Q

T/F If patient has very slight pain:

May ask patient to come back if symptoms return

A

True

30
Q

T/F If patient has very slight pain:

May provoke signs by having the patient exercise sufficiently to produce symptoms

A

True

31
Q

T/F If patient has very slight pain:

History is not of great importance

A

False

32
Q

T/F What if the patient has very severe pain?

All of examination components may be positive

A

True

33
Q

T/F What if the patient has very severe pain?

Hard for the patient to state accurately where and when pain is felt

A

True

34
Q

T/F What if the patient has very severe pain?

Functional testing and its interpretation will be easy

A

False - Functional testing and its interpretation are also difficult, either because excessive physical signs are presented or because the patient cannot move and is opposed to carrying out certain maneuvers

35
Q

T/F What if the patient has very severe pain?

History is not important

A

False

36
Q

Describe what you expect the results of your AROM, PROM, isometrics, and palpation will be for the following injuries:
Muscle/Tendon strain, tendonitis, possible small tear -

A
  • AROM: Likely limited due to pain and/or weakness, though may be able to move through full range, but with pain
  • PROM: if truly passive would have full pain free motion in all directions, EXCEPT direction which stretches involved area may be limited due to pain (empty end feel)
  • Isometric: Likely weak and painful when testing involved area
  • Palpation: Involved area painful to palpation
37
Q

Describe what you expect the results of your AROM, PROM, isometrics, and palpation will be for the following injuries:
Muscle or Tendon Complete Tear -

A
  • AROM: Very limited due to weakness, likely not as much pain as seen with a partial tear, but much more weakness
  • PROM: if truly passive would have full pain free motion in all directions, EXCEPT direction which stretches involved area may be limited due to pain (empty end feel) if there is muscle guarding in the area
  • Isometric: Extremely weak
  • Palpation: Involved area painful to palpation
38
Q 
Describe what you expect the results of your AROM, PROM, isometrics, and palpation will be for the following injuries:
Joint Capsule (ex: shoulder adhesive capsulitis) -
A

• AROM: Limited, possibly painful at end ranges*
• PROM: Limited in same direction as AROM with a firm end feel, possibly painful at end ranges*
• Isometrics: If done at mid range should not produce significant pain and should be strong; though may have pain due to compensating or guarding of surround musculature
• Palpation: Depends on depth of joint capsule, but more often than not cannot palpate deep enough to feel joint capsule though surrounding structures may also be inflamed and cause discomfort with palpation
• *AROM and PROM restrictions: Capsular pattern
 Highly suspicious of joint capsule, though still can be joint capsule without a capsular pattern

39
Q 
Describe what you expect the results of your AROM, PROM, isometrics, and palpation will be for the following injuries:
Ligament Injury (ex: ankle sprain) -
A
  • AROM: Full but pain at end range that stretches ligament
  • PROM: Full but pain at end range that stretches ligament
  • Isometrics: Strong and no pain when tested at mid range, unless there is guarding in the area
  • Palpation: Involved ligaments are painful to palpation

Kines Exam 2 (6 decks)

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