week 1: assessment & management of musculoskeletal injuries Flashcards
what 2 developmental considerations do you need to take into account for infants & children?
spinal curve changes
developmental dysplasia of hip
what 2 developmental considerations do you need to take into account for pregnant woman?
increased joint mobility
progressive lordosis
what 2 developmental considerations do you need to take into account for late adulthood?
osteoporosis
postural changes
apart from the general principles of subjective data what 2 things are specific to the MSK system?
GALS screening assessment
ADLs
what does the GALS screening assessment stand for?
gait, arms, legs & spine
what does ADLs (functional assessment) stand for?
activities of daily living
what 2 additional history data do you need for infants & children?
labour trauma (resuscitation) motor milestones
what 2 additional history data do you need for adolescents?
sport participation
special equipment/training
what 3 additional history data do you need for older adults?
changes/increasing in weakness
increase in falls/stumbling
walking aids
what is the order for the 3 components of a physical examination?
inspect
palpate
move
what is the order of the 4 aspects of a systemic approach to a physical examination?
head to toe
proximal to distal
compare corresponding paired joints
neurovascular assessment of upper & lower limbs
what 2 things do you take into account for a GALS screening assessment?
appearance
movement
during an MSK physical examination what is not normally palpable?
boggy synovial membrane
what is crepitation?
crunching or grating sound on movement
do you look for both active movement & passive motion during a physical examination of the MSK system?
yes
what do you look for during muscle testing during a physical examination?
equal bilateral strength & should resist opposing force
what 2 things do you test in movement & ROM?
without resistance
with resistance
when do you palpate the temporomandibular joint & what do you palpate?
as person opens mouth
muscles of mastication
what 3 things do you ask the patient to do to test motion & ROM with the temporomandibular joint?
open mouth maximally
protrude lower jaw
& move side to side
what do you inspect during a physical examination of the cervical spine?
alignment of head & neck
what 2 things do you palpate during a physical examination of the cervical spine?
spinous processes
muscles
what 4 things do you ask a patient to do to test motion & ROM of the cervical spine?
chin to chest
lift chin
each ear to shoulder
turn chin to each shoulder
what criteria do you use to rule out cervical spine fracture clinically, without need for x-ray?
NEXUS
what 5 things are do you check for in the NEXUS criteria?
no: focal neurologic deficit midline spinal tenderness altered level of consciousness intoxication distracting injury present
what 2 things do you do in the case of a positive NEXUS criteria?
immobilise
apply c-spine collar
how many health care workers are required for cervical spine immobilisation?
2
what do you palpate during a physical examination of the shoulders?
shoulders
axilla
what 4 things do you ask a patient to do to check motion & ROM during a physical examination of the shoulders?
arms forwards & up
arms behind back & hands up
arms to sides & up over head
touch hands behind head
in what 2 positions do you inspect the elbow?
flexed
extended
what 2 things do you ask a patient to do to check motion & ROM in the elbow?
bend & straighten elbow
pronate & supinate hand
do you inspect joints in the wrist & hand on only the dorsal side?
no, dorsal & palmar sides
what 5 actions do you ask the patient to do to check motion & ROM for the wrist & hand?
bend hand up, down bend fingers up, down turn hands out, in spread fingers, make fist touch thumb to each finger
what is this test called?
phalen’s test
what is the phalen’s test used to detect?
numbness & burning in carpel tunnel syndrom
what is the tinel’s sign for carpal tunnel syndrome?
percussion of the median nerve produces burning & tingling
where do you use percussion to test the tinel’s sign?
median nerve (wrist)
what does this test for?
tinel’s sign (burning & tingling)
when do you inspect the hip?
as person stands
what position should the patient be in when you palpate the hip?
supine
what 5 actions do you ask the patient to do to check motion & ROM of the hip?
raise leg knee to chest flex knee & hip; swing foot out, in swing leg laterally, medially stand & swing leg back
what is 1 specific thing you should inspect during a physical examination of the knee?
atrophy of quadriceps muscle
can you inspect the knee when it is extended or dangling?
yes
what does the bulge sign test for in the knee?
swelling in suprapatellar notch
what does the bulge sign in the knee confirm?
presence of fluid as you move fluid from one side of joint to the other .
what does this test for?
the bulge sign
when is ballottement of patella reliable?
large amounts of fluid present in knee
what does ballottement of patella check for?
crepitus
how do you do ballottement of patella?
holding hand on the patella while flexing & extending knee
what is this?
ballottement of patella
what 3 things do you ask the patient to do to check motion & ROM in the knee?
bend knee
extend knee
check knee during ambulation (walk around)
which 3 ways do you inspect the ankle & foot?
sitting
standing
walking
what 3 things do you ask a patient to do to check the motion & ROM of the ankle & foot?
point toes down, up
turn soles out, in
flex & straighten toes
where do you inspect the spine from?
behind
side
what 3 ways to you check the ROM for the spine?
flexion
extension
rotation
what is another name for the lasegue’s test?
straight leg raising
when is the lasegue’s test positive?
produces sciatic pain
what does a positive lasegue’s test confirm?
presence of a herniated nucleus pulposis
what does RICE(R) stand for?
rest ice compression elevation referral
when do you recommend RICE(R)?
fractures, dislocations & soft tissue injuries
