Week 1 Flashcards
Outline of a Musculoskeletal Assessment
- History: Verbal and Written
- Observation
- Examination: ROM, Muscle Testing, Special Testing, Joint Play,
Neurological Tests - Palpation
- Diagnostic Imaging
Factors to add in a Health History Form
- Demographics: name, address, contact info etc
- Personal Info: Hobbies, work, sports
- Past Medical History
- Family Medical History
- Medications
- Presenting Symptom/Condition: Location of pain etc.
- Aggregating Factors
- Relieving Factors
- Concurrent Problems
- Previous to and/or imaging
- Goals for treatment
- Acknowledgment of the the above info is correct
Benefits of Verbal Subjective History
- Allows the clinician to focus on areas of importance from the written history
- Allows the clinician to “get a feel” for the patients personality
- Allows the clinician to ask quart ions about the patient’s condition that the patient may not have thought of. Do not lead the patient but do ask closed ended questions
- Observe body posture, facial expressions, tension level etc.
Things to look for in Observation
- General Appearance: Deformities, swelling, body shape,
Emotional state - Posture (Using Plumb line): *Arches
* Head Position
* Spinal Curves
* Location of shoulders
* Position of hands/knees
* Position of the scapulas
What does Pes Cavus mean?
High Arches
What does Pes Planus mean?
Fallen Arches
What is AROM?
Patient moves on their own to the end range of the joint being tested
Allows the clinician to see the patients willingness and ability move as well as provide info on where pain begins during movement and behaviour of pain
What is PROM?
The therapist passively moves the supported limb with no active contraction of muscle from the patient
Allows the clinician to feel the actual ROM of the joint and the type of end feel
2 Types of Muscle Testing
- General strength testing: Kendall muscle grading
2. Specific Strength Testing: Isometric muscle grading
Kendall Muscle Grading Benefits:
- Provides in for on muscle strength in relation to joint range
- Must have full passive ROM
- Muscles are strongest physiologically when lengthened
- Muscles are weakest physiologically when shortened
- Muscles can produce most force in mid range
Isometric Muscle Testing
- Tests contractile structures, bone and bursar by compression
- No joint movement should occur
- Just enough resistance to reproduce symptoms “don’t let me move
You” - Provides info on direction and amount of force needed to reproduce
Symptoms
Why use Special Tests
- To test specific structures
- Unique to each body area
- Used to confirm or disconfirm a diagnosis
4 Types of Special Tests
- Ischemic Tests
- Stability Tests
- Provocative Tests
- Combined movement tests, quadrants
Types of Neurological Tests
Myotomes/Key Muscle Testing
Dermatomes
Reflexes
Neural Tension Tests
Cutaneous Distribution
What are Myotomes?
Muscles which are supplied by a single segmental level
What is Key Muscle Testing?
Muscles which are most representative of given segment
Procedure for Myotomes:
Performed in the shortened position and held in a contraction for 6-10 seconds.
Positive Findings: Fading or progressive weakness with repeated
Contractions indicating a neuromuscular lesion
*Characteristics of muscle weakness will have no fading but consistent weakness with repeated contractions
What’s a Dermatome?
An area of skin supplied by a single nerve root
Used to evaluate the nerve conductivity to the brain for sensation