Session 1: Examination & Palpation Flashcards
Basics of Examination Process
Assess BP Clinical examinations (Cardiovascular, neurological, ect.) Observation, regional & functional screening Active ROM Passive ROM Joint play Resisted isometric muscle testing Palpation of musculoskeletal structures Orthopaedic and musculoskeletal testing
Types of Movement
- Active (anatomical mov performed by patient, tests muscles)
- Passive (anatomical mov performed by prac, tests lig & capsular structures)
- Segmental/accessory (mov patient cannot perform but is req for normal ROM)
Barriers of Motion
Active motion - physiological barrier
Passive motion - Elastic barrier
Injury - Anatomical barrier
What is palpation?
The application of different amounts of pressure to the surface of the body to determine the size, shape, consistency, motility and the health of the tissues below.
Parts of your Schema
(observation) Skin Boney points Muscles Nerves Vessels Organs Anatomical Spaces
Palpate to Discover…
T - Tissue texture change
A - Asymmetry
R - Range of motion
T - Tenderness
Effective Palpation
Greater surface area Slow, steady motions (sensory feedback) Light - deep palpations Use diff parts of hand for diff sensations Listens and asks for feedback
Components of Screening Examination
Observation (swelling, redness, bruising) Functional Movements (daily activities) Gait Posture Cervical spine motion Upper extremities screen Pelvis Lower extremities screen
Observation: Look for…
Lumps Scars Unusual hair distr. or colours Rashes Scars Common conditions Odd things
Functional Movements
- ask patient to demonstrate movements they struggle with (movement will be used as an outcome measure to assess recovery)
- Fear avoidance manouvers (things that a patient choses not to do in case they will cause pain).
Gait
- How a person walks
- Should be observed as a patient is walking into your treatment room
- Things to look for inc: limp, poor coordination, drag foot, heel-toe strike off.
Posture
Should be assessed from all of; posterior, anterior and lateral sides.
Look to ensure that; ear levels, cervical spine, shoulder heights, inferior scap angle, thoracic spine curve, pelvic crest, glute folds, knee, achilies and foot arches are all in line or even.
Cervical Spine
Get patient to perform following movements;
- forward-backward rotation
- left-right rotation
- ear to shoulder (both sides) rotation
Upper Extremities Screen
Ask patient to;
- raise arms out to side
- touch back of hands together above head
Lumbar/Thoracic Motion
Ask patient to;
- bend forwards (flexion)
- bend backwards (extension)
- run hand down leg as far as they can (lateral)
- rotate from side to side as far as possible