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Clinical skills > Terms > Flashcards

Terms Flashcards

1
Q

Direct technique

A

directly engages the restrictive barrier

(muscle energy, myofascial release -commonly)

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2
Q

indirect technique

A

joint/tissue position is away from restricted barrier or tissue bind

(counterstrain -although does not use barrier positioning)

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3
Q

Muscle energy technique - MET

A
  • direct technique
  • can be applied to a muscle or joint
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4
Q

Myofascial release

A

Direct technique, applied to muscle, no patient input \

The restrictive barrier is engaged for the myofascial tissues and the tissue is loaded with a constant force until tissue release occurs

Muscle is simultaneously stretched whilst a longitudinal soft tissue technique is applied for 60-90 seconds or until tissue texture change

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5
Q

MET for joints

A

ake the joint to the restrictive barrier like a normal articulation technique
* Get the patient to do the opposite movement lightly against your unyeilding resistance for 3-7 seconds
* Repeat 3-5 times - engage the new barrier and retest

Eg. Hip flexion - e the patient to push against you into extension

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6
Q

MET for muscles

A
  • Stretch the muscle to the restrictive barrier like a normal stretch
  • Get the patient to the concentrically contract the muscle lightly against your unyielding resistance for 3-7 seconds
  • Repeat 3-5 times - engaging the new barrier and retest
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7
Q

Observation and regional screening function

A
  • Provides an overview of the patient and functioning
  • General appearance may provide an indication of underlying condition
    Guides to areas that need more examination detail
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8
Q

purpose of clinical examinations

A
  • Used to provide further information to determine
  • If treatment is contradicted
  • Referral is necessary
  • Provide a baseline for monitoring aspects of the patient’s presenting complaint
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9
Q

Observation and regional screening screens for…

A
  • Functional movements
  • Biomechanically related regions
    Areas where pain can be referred to/from
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10
Q

What to look for in observation

A

redness
bruising
scars
swelling
varicose veins
cuts / abrasing
infections

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11
Q

what to look for in Gait

A

○ Limp
○ Poor coordination
○ Dragging one foot
○ Coordinated movement/heel to toe

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12
Q

Posterior view of posture

A
  1. Ear levels
    1. Cervical spine
    2. Shoulder heights
    3. Inferior scapula angle
    4. Thoracic spine/curvatures
    5. Pelvic crest levels
    6. Gluteal folds
    7. Popliteal folds
    8. Achillies tendon
    9. Foot arches
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13
Q

anterior view of posture

A
  1. Head position
    1. Shoulder heights
    2. Clavicle heights
    3. Arm carriage
    4. Innominate levels
    5. Anterior superior iliac spine
    6. Patellae
    7. Femur/tibia angles Q angle
    8. Foot posture
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14
Q

lateral view of posture

A
  1. Cervical spine curve
    1. Head carriage
    2. Scapulae position
    3. Thoracic spine curve
    4. Lumbar spine curve
    5. Pelvis orientation
    6. Knees
    7. Ankles
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15
Q

Fear-avoidance beliefs

A
  • Stems from the belief system of patients
  • can manifest in the form of fear avoidance of movements
  • Normal in short-term
    • With normal tissue healing
  • Unhelpful in long-term
    • Can be a predictor of chronic pain

Examples
* Avoiding reaching overhead
* Always lifting with a straight back
* Keeping upright posture all the time
* Tensing ‘core’ all the time

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16
Q

What does active ROM assess?

A

○ ROM
○ Control of movement/quality
○ Patient willingness
○ Pain levels
○ Fear avoidance movements

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17
Q

what does passive ROM assess?

A

○ Hypo-mobility/Hyper-mobility
○ Patient willingness to allow practitioner to perform movements
○ Pain levels with movement

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18
Q

Palpation of the skin

A
  1. Temperature
    a. Best done with the back of your hand
  2. Thickness
    a. By gently rolling the skin between your fingers
  3. Drag
    a. Assess whether the skin is dry or moist
  4. Vitality
    a. Is assessed with a gentle pinch and watching it recoil
  5. Roughness/smoothness
    a. Assess the texture of the skin with your fingertips
  6. Mobility
    a. Gently moving the skin on the tissues below
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19
Q

Joint play definition

A

A movement that is essential for normal ROM that the patient cannot perform themselves

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20
Q

Things to asses in joint play

A

○ Direction of motion loss
○ Translation (linear movement)
○ Pain levels
○ Hypo/hyper mobility
○ Patient willingness to allow prac to perform movement

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21
Q

Resisted isometric muscle testing definition

A

Practitioner provides a force counter to patient movement while there is no change in joint angle/muscle length with muscle contraction

22
Q

R.I.M.T evaluates

A
  • Evaluates the contractile unit and tissues - muscular and neurological test

Enables the practitioner apply stress to
- Muscle belly and connective tissue layers
- Tendon and musculotendinous junctions
In an attempt to reproduce pain and/or weakness

23
Q

R.I.M.T rules

A

does not have to be used in examination each time*
- Typically used in peripheral joints, rarely in the spinal region
- Joints start in mid-range
- Hold for at least 5 seconds, may repeat 2-3 times
- Perform bilaterally where possible
- watch and ask if there is any familiar pain of the patient

24
Q

RIMT grade 5

A

complete ROM against gravity with full resistance

25
Q

RIMT grade 4

A

complete ROM against gravity with some resistance

26
Q

RIMT grade 3

A

complete ROM against gravity with no resistance (active ROM)

27
Q

RIMT grade 2

A

complete ROM with some assistance and gravity eliminated

28
Q

RIMT grade 1

A

evidence of slight muscular contraction, no joint motion evidence

29
Q

RIMT grade 0

A

no evidence of muscle contraction

30
Q

what is an orthopaedic test

A

A biomechanical stress test

A manoeuvre designed to place functional stress on isolated tissue structures that are thought to be responsible for patient’s pain or disfunction

31
Q

orthopaedic test features

A
  • Provides support to clinical thinking, not a diagnosis
  • Usually use combined movements/stresses to attempt to provoke pain or dysfunction
  • Depends on examiner’s skill at selecting and applying tests appropriately

Perform bilaterally where possible

32
Q

What is the evidence for orthopaedic tests

A

sensitivity and specificity

33
Q

Sensitivity

A

the proportion of individuals who have the condition, who test positive

34
Q

specificity

A

the proportion of individuals who do not have the condition who test negative

35
Q

what are highly sensitive tests good for?

A

ruling out conditions if a patient tests negative to the test

36
Q

contraindication definition

A

A circumstance, condition, symptom, or factor that increases the risk associated with a medical procedure, drug or treatment

37
Q

examples of absolute contraindications

A
  • Weak bone
  • Neurological dysfunction
  • Vascular insufficiency
  • Lack of working diagnosis
  • Pain and or excessive tissue feedback
    No consent
38
Q

examples of relative contraindications

A
  • Intervertebral disc herniation
  • Severe scoliosis
  • Vertigo
  • Active inflammatory disease (rheumatoid arthritis, grout)
  • Gross degenerative change (severe osteoarthritis)
  • Acute or chronic systemic disease
  • Calcification of the aorta
  • Previous history of malignancy (cancer)
  • Pregnancy (especially in 1st trimester)
  • Patient’s age and general health status
  • Adverse reaction by the patient to treatment
  • Patient’s with a psychological dependency on treatment
    Patient who has recently been treated by another practitioner
39
Q

Red flag definition

A

A sign or symptom that indicates the possible or probable presence of a serious medical condition that can cause irreversible disability or untimely death unless managed properly

40
Q

example of red flags

A

· Onset of new complain under age of 20 or over 50
· Recent onset headache (with no previous history)
· Fever and or night sweats
· Sudden onset severe neck pain (with no previous Hx)
· Constant unremitting pain
· Persistent night pain
· Pain that doesn’t change with position/movement
· Chest pain
· Constant and severe extremity pain
· Frequent or severe abdominal pain
· Loss of appetite
· Unexplained weight loss
· Frequent nausea and/or vomiting
· Changes in bladder function
· Shortness of breath
· Changes in vision, speech and hearing
· Changes in balance and coordination
· Sudden weakness
· Progressive neurological symptoms
· Neurological symptoms over more than one dermatome
· Bilateral neurological symptoms
· Constant unexplained fatigue

41
Q

therapeutic mechanisms of osteopathic techniques

A
  1. Decrease pain
    1. Promote mobility and movement
    2. Support tissue healing and collagen remodelling
    3. Promote fluid drainage
42
Q

major adverse reactions

A
  1. Joint sprain
  2. Fracture
  3. Stroke
  4. Disc herniation
  5. And cauda equina syndrome
43
Q

Articulation definition

A

The use of repetitive passive movement, usually employing a lever and fulcrum

44
Q

what barrier does articulation engage

A

restrictive barrier

45
Q

indications for cross-fibre soft tissue

A

hypertonic muscles
shortened muscles

46
Q

indications for inhibition soft tissue

A

Healing small muscles
Painful muscles

47
Q

indications for myofasial release

A

Pain
motion restrictions

48
Q

indications for friction soft tissue

A

Inflamed tendon/lig

49
Q

indications for effleurage soft tissue

A

Venous and lymphatic congestion
Anxiety

50
Q

indications for stretching soft tissue

A

Shortened muscles
Painful muscles

Clinical skills (1 decks)

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