Subjective & Objective Exam Components

Question 1

Severity

Answer 1

intensity of symptoms & the effect on functional ability

Non, Min, Mod, Max

Question 2

Irritability

Answer 2

amt of activity to produce exacerbations & the time it takes to subside (ease)
(Non, min, mod, max)

Question 3

Nature

Answer 3

the structure(s) involved

Question 4

Stage

Answer 4

stage of healing of the injury

acute, subacute, chronic

Question 5

Stability

Answer 5

how stable the injury is

stable, progressing, worsening

Question 6

Components of the SUBJECTIVE exam

Answer 6

1. patient profile
2. chief complaint (P1)
3. site of symptoms (body chart)
4. behavior of symptoms
5. history (past & present)
6. special questions
7. patient goal

Question 7

Patient profile

Answer 7

age, gender, current daily activity level, work status, hobbies/recreation, psychosocial factors

Question 8

Site of symptoms

• types of pain
• body chart

Answer 8

location & description

• visceral (diffuse & difficult to locate)
• deep somatic (dull, aching & poorly localized)
• superficial somatic (sharp & well defined)
• peripheral neuropathic pain (burning, tingling, stabbing, pins & needles)

Must clear other areas & determine if there is a relationship

Question 9

Behavior of symptoms

Answer 9

severity - 24hour period, 7 days a week

irritability - aggravating & easing factors

Question 10

History

Answer 10

present condition history
- determine stage & stability

past history if same or similar disorder

Question 11

Special questions

Answer 11

general health, medication, BP, operations, diagnostic imaging, systems review

Question 12

Components of OBJECTIVE Exam (10)

- for peripheral joint assessment

Answer 12

1. Observation (posture, mvmt limitations, edema, skin, etc)
2. Scanning (cervical &/or lumbar spine, neuro-segmental exam)
3. AROM
4. PROM
5. Flexibility
   (goniometry for 3-6 if applicable)
6. Joint play (PAM’s)
7. MMT
8. Special tests
9. Palpation
10. Additional tests (functional, gait, balance, questionnaires)

Question 13

Cervical & lumbar spine scans

Answer 13

Cervical

• flexion, extension, & rotation w/ OP
• quadrant (side bending w/ rotation) - NO OP

Lumbar

• flexion & extension w/ OP
• quadrant - NO OP

Objective - rule out possible referral pain from spine

Question 14

What do PAM’s tell us in the Objective Assessment?

- restricted vs. unrestricted

Answer 14

If UNrestricted…

• excessive motion = instability or joint laxity (hypermobility)
• Normal = intergrity of ligaments & capsule

If restricted…

• limited distraction = contracture of conn. tissue
• painful distraction = poss. tear in conn. tissue
• easing pain w/ distraction = articular surface is affected
• painful compression = articular surface affected
• easing pain w/ compression = joint capsule/ligaments are affected

Question 15

What does MMT tell us?

Answer 15

besides their level of strength…

Strong & painless = normal
Weak & painless = complete tear/rupture, palsy or neuropathy
Strong & painful = partial tear or minor muscle lesion
Weak & painful = must do more assessment; could be big problem