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KIN 440 > The Evaluation Process Pt. 2 > Flashcards

The Evaluation Process Pt. 2 Flashcards

1
Q

Observation begins when?

A

the moment the client meets the evaluator

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2
Q

Observation starts with a ____ ____ –> ____ and ____.

A
  • visual inspection

- locally and globally

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3
Q

Local observation is where:

A
  • at site of injury

- at joint above and below

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4
Q

Global observation is where:

A
  • whole body
  • extremity, trunk
  • kinetic chain
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5
Q

Local observation is looking for signs of ….

A
  • trauma or injury

- inflammation

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6
Q

Signs of trauma or injury include:

A
  • deformity
  • discolorations
  • contusions
  • crepitus
  • abrasions
  • avulsions
  • penetrations and punctures
  • burns
  • lacerations
  • swelling
  • symmetry
  • tenderness
  • instability
  • crepitation
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7
Q

How to expose sign of inflammation:

A
  • bilateral comparison

- view joint of chief complaint

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8
Q

Characteristics of inflammatory response:

A

SHARP

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9
Q

SHARP stands for:

A
  • swelling
  • heat
  • altered function
  • redness
  • pain
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10
Q

Global observations is looking at…

A
  • alignment and posture
  • gait
  • functions of ADL
  • observe pain
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11
Q

What to look for with alignment and posture:

A
  • position of the joints

- relative to injury, relative to context

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12
Q

What to look for with gait:

A
  • weight bearing (WB) of lower extremity (LE)

- movement of UE while in gait

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13
Q

We should observe pain through…

A
  • apprehension in movement
  • compensatory movement
  • carrying position
  • facial expression
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14
Q

Considerations for observation:

A
  • alignment vs malalignment
  • symmetries vs asymmetries
  • multiple viewpoints
  • many positions or postures depending on context
  • understanding the kinetic chain and compensatory movements
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15
Q

Alignment vs malalignment: ______ comparisons of _____.

A
  • bilateral

- extremities

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16
Q

How to assess symmetries vs asymmetries:

A
  • bony landmarks
  • muscle girth or tone
  • limb orientation
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17
Q

Multiple viewpoints:

A
  • anterior
  • lateral
  • posterior
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18
Q

Many positions or postures depending on context includes:

A
  • standing
  • sitting
  • functional position
  • sport specific position
  • position in movement or while moving
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19
Q

Understanding the kinetic chain and compensatory movements includes looking at…

A
  • joints above or below

- joint’s injury affect to movement (stress)

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20
Q

Lateral view of standing alignment: what anatomical landmarks should we look at?

A
  • back of ear
  • middle of shoulder
  • middle of greater trochanter
  • back of patellae
  • front of malleolus
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21
Q

Anterior view of standing alignment: what anatomical landmarks should we look at?

A
  • shoulders
  • nipple line
  • ASIS
  • hands
  • patellae
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22
Q

Posterior view of standing alignment: what anatomical landmarks should we look at?

A
  • shoulders
  • scapulae
  • elbows
  • posterior dimples
  • hands
  • popliteal fossae
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23
Q

Global affect of alignment: balanced posture:

A

smaller forward bending pressure

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24
Q

Global affect of alignment: flat back:

A
  • forward head
  • greater forward bending pressure
  • upper back extensors weak
  • chest muscles short, tight
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25
Q

Global affect of alignment: swayback:

A
  • forward head
  • greater forward bending pressure
  • upper back extensors weak
  • chest muscles short, tight
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26
Q

Global affect of alignment: kephotic-lordotic:

A
  • forward head
  • greater forward bending pressure
  • upper back extensors weak
  • chest muscles short, tight
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27
Q

Postures change with ____.

A

age

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28
Q

What is text neck?

A
  • postural position
  • curve of repetitive stress
  • early disk degeneration in the cervical spine
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29
Q

2 components of observational assessment of posture:

A
  • views

- findings

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30
Q

Views of posture includes:

A
  • standing, sitting, functional work or sport

- anterior, lateral, posterior views

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31
Q

Findings of posture includes:

A
  • comment on notable

- report on remarkable

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32
Q

Report on remarkable includes:

A
  • identify alignment imbalances
  • different from
  • deviate from
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33
Q

When looking at the impact of balance in observation, consider…

A
  • the upright or standing alignment

- the musculature (imbalance)

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34
Q

Factors influencing alignment and a posture:

A
  • structural abnormalities (spine, leg length)
  • neurological dysfunction
  • vestibular dysfunction
  • pain
  • fatigue
  • joint pathology
  • respiratory conditions
  • muscle dysfunction (imbalance)
  • vision
  • age
  • habit (height, body image)
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35
Q

Common malalignments of LE alignments:

A
  • genu valgum, genu varum
  • patella baja, patella alta
  • high arch, flat arch
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36
Q

Common malalignments of UE alignments:

A
  • winged scapula
  • sway back, lumbar lordosis, thoracic kyphosis, forward head
  • gorilla hands, internal rotation
  • cubitus varus, cubitus valgus
  • step deformity, piano key
  • malangulation
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37
Q

ROM:

A

the distance and direction a joint can move to achieve its maximal potential

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38
Q

How is ROM measured?

A
  • quantified (degrees eyeball, goniometer, %)

- descriptor (full)

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39
Q

Is ROM the same as flexibility?

A

no

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40
Q

ROM terms:

A
  • flexion, extension, hyperextension
  • abduction adduction
  • int rot, ext rot.
  • circumduction
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41
Q

Evaluation of ROM is used to:

A
  • assess inert and contractile tissue components at joint
  • assess joint movement or joint function
  • assess strength in selective tissue testing
  • assess pain with that ROM of a structure (severity)
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42
Q

Assessing inert and contractile tissue components at joint is used to ….

A

differentiate between tissues

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43
Q

Assessing joint movement or function can include…

A

1 ROM (joint specific) or sum of ROMs (pattern, functional movement)

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44
Q

Compare ROM ______, check _____ side first.

A
  • bilaterally

- unaffected

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45
Q

ROM is _____ many times, since it is a useful measure in assessing _____.

A
  • reassessed

- progress

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46
Q

3 components of assessing and evaluating AROM:

A
  • range (measured by degrees, % quantified)
  • visually observing the quality of motion (ease, speed)
  • Q pain location; when in movement (painful arc); grade /10
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47
Q

Cause of limited AROM or pain in AROM:

A
  • not yet determined
  • can be:
  • surrounding tissues
  • condition of the joint or bones
  • swelling
  • joint
  • muscle weakness/inhibition
  • referred pain
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48
Q

How to measure ROM:

A
  • goniometer

- estimate eye ball

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49
Q

Goniometer:

A
  • degrees

- poor reliability

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50
Q

Estimate eye ball:

A
  • degrees

- %

51
Q

In PROM, muscles are not _____, contractile tissues are _____.

A
  • activated

- relaxed

52
Q

3 components of assessing and evaluating PROM:

A
  • ROM at joint (degrees)
  • examiner feeling the end range or end point (descriptor)
  • Q pain: grade, where
53
Q

Cause of pain or limited range of motion (deficiency) or abnormal end in PROM:

A
  • not determined yet
  • can be:
  • swelling
  • joint locking
  • ligament injury
  • muscle injury
  • neurologic issue
  • bone injury
54
Q

End feel:

A

the sensation imparted to the examiner’s hands at the end of the available ROM

55
Q

Normal end feels: check for…

A
  • soft tissue approximation
  • capsular (joint)
  • bone to bone
56
Q

Soft tissue approximation should feel:

A
  • soft and spongy

- gradual painless stop (elbow flexion)

57
Q

Capsular (joint) should feel:

A

abrupt, hard, firm end point with only a little give (shoulder rotation)

58
Q

Bone to bone should feel:

A

a distinct and abrupt end point where 2 hard surfaces come in contact with another (elbow extension)

59
Q

Abnormal end feels:

A
  • empty
  • spasm
  • loose
  • springy block
60
Q

Empty feel:

A
  • movement definitely beyond the anatomical limit

- pain prevents body part from moving through normal ROM (ligament rupture)

61
Q

Spasm feel:

A

involuntary muscle contraction that prevents normal ROM due to pain (muscle spasm)

62
Q

Loose feel:

A

extreme hypermobility (chronic ankle sprain)

63
Q

Springy block feel:

A

a rebound at the end of motion (meniscal tear or loose body formation)

64
Q

RROM assesses status of ____ _____ (____ or ____).

A
  • contractile tissue

- muscle or tendon

65
Q

In RROM, we can ____ or ____ specific contractile tissue or focus on _____ of muscles that activate that range.

A
  • isolate or target

- groups

66
Q

2 components of assessing and evaluating RROM:

A
  • q pain (location, painful-painless/grade)

- strength (assess strong-weak-absent)

67
Q

RROM we need ____ grade.

A

bilateral

68
Q

Grade RROM on a scale out of ____.

A

5

69
Q

Cause of pain or weakness in RROM:

A
  • not determined yet
  • can be:
  • muscle or tendon strain
  • pain inhibition
  • peripheral nerve or nerve root injury
  • psychological overlay
70
Q

Grade 5 strength:

A
  • 100%
  • normal
  • complete ROM against gravity with full resistance
71
Q

Grade 4 strength:

A
  • 75%
  • good
  • complete ROM against gravity, with some resistance
72
Q

Grade 3 strength:

A
  • 50%
  • fair
  • complete ROM against gravity, with no reisstance
73
Q

Grade 2 strength:

A
  • 25%
  • poor
  • complete ROM with a gravity omitted
74
Q

Grade 1 strength:

A
  • 10%
  • trace
  • evidence of slight contractility, with no joint motion
75
Q

Grade 0 strength:

A
  • 0%
  • zero
  • no evidence of muscle contractility
76
Q

RROM is used to assess:

A
  • strength

- pain

77
Q

Group of muscles shoulder abduction RROM:

A
  • joint RROM
  • muscles are compared bilaterally and graded numerically
  • mid range position
  • test for abduction muscles
78
Q

Muscle specificity (MMT) shoulder abduction RROM:

A
  • joint RROM that specifically targets a muscle
  • positions of muscle isolation testing
  • muscles are compared bilaterally and graded numerically
  • test for anterior deltoid
79
Q

Cyriax orthopedic method of assessment:

A
  • ROM evaluation
  • ’+’ = pain
  • ’-‘ = no pain
80
Q

When looking at ROM pain, differentiate between…

A

contractile tissue and inert (non-contractile) tissue

81
Q

ROM exercises are used to …

A

preserve or restore flexibility and mobility of the joint

82
Q

3 classifications of ROM exercises:

A
  • PROM
  • AROM
  • Active-assisted ROM
83
Q

PROM exercises:

A

assistance is provided by another individual to move the joint through a ROM

84
Q

AROM exercises:

A

you perform the movement

85
Q

Active-assisted ROM exercises:

A
  • you perform the movement to your limit and then assistance is provided to produce a great ROM
  • contract-relax; contract-contract
  • PNF = pattern for ROM
86
Q

MMT is used to assess ____ and _____ of a _____ muscle.

A
  • strength
  • integrity
  • specific
87
Q

MMT may be the same as … but we add…

A
  • joint ROM testing

- muscle isolation (specificity)

88
Q

MMT is compared ____ and graded in _____. ____ is noted.

A
  • bilaterally
  • strength
  • pain
89
Q

Special tests:

A

clinical orthopedic tests (special) used to further distinguish between pathologic and normal tissue

90
Q

Special tests are designed to ____ ____ or ____ ____ specific musculoskeletal problems.

A
  • rule in

- rule out

91
Q

Special tests assess integrity of a ____ tissue type such as…

A
  • specific
  • ligament
  • meniscus
  • bursa
  • muscle
  • nerve
  • joint
92
Q

Examples of types of special tests:

A
  • stability tests of a joint
  • stress tests
  • anthropometric assessments
93
Q

FMT =

A

functional movement tests

94
Q

FMT used to assess client _____ and /or _____.

A
  • function

- progress

95
Q

FMP should reflect types of ____ that patient will experience during ____ activities such as…

A
  • stresses
  • normal
  • activity, work, sport, ADL
96
Q

FMT can assess ____ or _____. Inspect for potential tissue ____ or ____.

A
  • pain
  • discomfort
  • stress
  • strain
97
Q

With FMT, observe for _____ motions. Instruct for a ____, _____ movement pattern.

A
  • compensatory
  • slow
  • controlled
98
Q

Ideally, FMT lend themselves to a _____ system to assess movement _____ and _____.

A
  • grading
  • efficiency
  • success
99
Q

When should palpation be done? Why?

A
  • end of objective assessment

- can cause pain

100
Q

When should palpation be performed in instances of acute injury on field?

A
  • immediately
  • light palpation for SHARP
  • may warrant referral to physician/EMS
101
Q

Deeper palpation might…

A
  • probing may elicit pain

- detracting from later evaluation stages

102
Q

Purpose of palpation is to…

A

localize pathologic tissue involved

103
Q

Palpation should be performed in a ____ fashion including…

A
  • sequential
  • bones
  • joints
  • soft tissue
104
Q

Palpation should include ____ comparison.

A

bilateral

105
Q

Palpate to assess for:

A
  • pain
  • point tenderness
  • trigger points
  • tissue quality
  • crepitus
  • temperature
  • symmetry
106
Q

3 components of assessment:

A
  • IOS
  • impression
  • diagnosis
107
Q

There should be ____ diagnosis.

A

more than one = differential diagnosis

108
Q

How to rule of differential diagnosis?

A
  • diagnostic testing (xray, MRI, blood work etc.)

- further evaluation (expertise)

109
Q

Plan is a outline of ____ based on ….

A
  • goals

- subjective assessment (history) and objective assessment (the findings and problem list)

110
Q

Plan is needed to address ____ and ____ recorded.

A

signs and symptoms

111
Q

For every significant sign and symptom, a corresponding _____ should be set.

A

goal

112
Q

Plan is based on ____ which is supported by ____ _____ and ______.

A
  • goals
  • healing timelines
  • processes
113
Q

Need to set ____ and ____ ____ goals.

A

short and long term

114
Q

Decisions on RTP had a list of criteria to be safe:

A
  • full ROM
  • 100% strength
  • pain free
  • full participation; unrestricted (able to perform sport skills)
  • psychological readiness
115
Q

Primary list of short-term goals: direct or pertaining to:

A
  • treatment of site, prevention of secondary complication
  • pain
  • flexibility/ROM
  • strength
  • proprioceptive
  • posutre
  • cardio/fitness
  • education/psychological readiness
  • RTA
116
Q

Examples of long term goals:

A
  • address ADL
  • address psychological concerns
  • introduce functional progressions
  • core/posture stability
  • educate on injury, limitations, restrictions
117
Q

How to achieve goal of decreasing pain:

A
  • PRICE
  • medication (refer)
  • rest (psych)
  • modalities (pain relief)
  • acupuncture (refer)
118
Q

How to achieve goal of increasing strength:

A
  • isometric
  • concentric
  • isokinetic
  • eccentric
  • resistance training (may refer)
119
Q

How to achieve goal of increasing neuromuscular training:

A
  • balance

- hand-eye coordination

120
Q

How to achieve goal of correcting alignment:

A
  • orthotics (refer)
  • taping, bracing
  • stretching
  • strengthening
  • posture education
121
Q

When rehab is occurring, ____-_____ evaluations must be performed to ____ progress.

A
  • follow-up

- monitor

122
Q

Seeing the client regularly allows for frequent ____.

A

modifications

123
Q

Progress evaluations should be based on …

A
  • healing timelines
  • pain
  • functional progress
  • client’s response to the previous treatment or home program given
124
Q

Documentation and charting progress identifies ____ plans.

A

future

KIN 440 (10 decks)

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