Subjective and Objective Exams Flashcards
3 things that make up a PT Examination
history/current health status
systems review
tests and measures
sign vs. symptom
sign= physical exam finding in a joint or other structure that is "abnormal" symptom= something the pt c/o (pain, N/T, aching, etc)
What is a cluster or sings and symptoms that characterize a particular condition?
a syndrome
Exam in a nutshell?
1) is it neuromm in nature or non-neuromm?
2) come up with 3 possible hypothesis…
3) perform objective exam, hypothesis modification
4) develop treatment plan and modify PRN
use of good verbal communication skills is the key to which approach?
Maitland
items such as asking one question at at time, speaking slowly, using layman’s terms, avoiding baised questions, not assuming anything and showing empathy to the patient are all key aspects of which approach?
maitlands
What are SINSS?
Severity irritability nature stage stability
what is a comparable sign?
sign that is found during an OE and reproduces the pt’s pain
what part of the exam do u find the body chart and descriptions of the symptoms?
S
what all goes into a SE? (8 things)
pt profile chief complaint body chart symptom behavior (agg., easing, 24 hr.) special Qs systems review (if necessary) current history (MOI, comorbidities, other tx?) past history
What are the 10 special questions?
1) GH (general health)
2) WL/WG
3) RA
4) VA
5) A/S
6) CS (cord symptoms- bilateral N/T, gait disturbances)
7) CE cauda equina (bowel/bladder dysfunction, saddle paresthesia)
8) Diagnostic imaging?
9) C/S (will increase pain in load sensitive injuries)
10) Meds
Progression of OE for pt. positioning
standing–>supine–>sidelying–>prone–>Sitting
OE in standing
posture, gait, palpation, clearing, neuro exam, AROM with and w/o OP, MMT, fxnl tests, special tests
OE in supine
palpation, girth measurements, clearing, sensation, AROM, PROM, mm length tests, mmt, special tests, neurodynamics tests, passive accessory movement testing
OE in sidelying
passive accesory movement testing, mm length, MMT
OE in prone
palpation, clearing, complete spine exam (PAIVMS and PIIVMS), AROM, PROM, mm length, MMT, special tests, neurodynamic tests
OE in sitting
palpation, clearing, neuro exam (finger to nose, rapid alternating movements etc.), AROM, PROM, passive accessory movement testing, MMT, special tests
REVIEW UQ and LQ clearing…
Aye Aye Cap’n
Axillary nerve
C5, 6
Musculocutaneous nerve
C5,6
radial N
C5,6,7,8
median N
C6,7,8, T1
Ulnar
C7,8, T1
Femoral
L1-4
obturator
L2-4
Sciatic
L4-S3
superfiscial peroneal N
L4-S2
deep peroneal
L4-S2
Tibial N.
L4-S3
Consistency of repeated measures
reliability
degree to which a test measures what it is intended to measure
validity
ability to correctly identify anyone who HAS the disorder, Negative result RULES OUT
Sensitivity
ability of a test to correctly identify ppl that do NOT have the disorder, positive RULES IN
specificity
incorporating validated functional scales in an OE in a clinic?
functional outcomes measures
What is Cyriax’s scanning examination?
combo of observation, pt history, segmental exam, AROM, PROM, MMT, special tests and STT (selective tissue tension techniques) that is performed until the clinician is confident that no serious pathology is present.
indications to perform a segmental neuro exam?
weakness or paresthesia, no obvious MOI or pathology
where are symps located to perform an UQ SNE (segmental neuro exam)
below AC joint/medial border of scapula
where are symps to indicate performing a LQ SNE
below gluteal fold/groin
components of a SNE
myotomes, reflexes, dermatomes
what do SNEs test?
the motor, sensory and elit disturbances of a specific nerve root!
when do u perform a PNE (peripheral neuro exam)
when there is a peripheral injury, compression, nerve injury, weakness or pasesthesia with obvious MOI
When do u perform a CNE? (central neuro exam)?
head trauma, stroke, cord compression, UMNL
what is in a CNE?
clonus, tone, babinski, reflexes, sensation
