Week 1 MSK Flashcards
What routine assessments should you do
OB’s - alignment, atrophy, swelling, colour and deformity Palpation - swelling, temp and atrophy Effusion - sweep test Active and passive ROM - diff diagnosis Resisted testing - diff diagnosis Accessory - test joint Ligaments - test ligts Functional tests - sit to stand, hop, walk, jump, squat Palpation - confirm painful structure
What should you observe
Alignment - limb position, shape and deformity
Atrophy - muscle bulk and site
Colour
Deformity
What should you note down when doing active movements
Quality of movement - willingness to move Range Pain response - when and where Occurrence of muscle spam Any resistance to movement
What movements should you test the active ROM
Flexion
Abduction
Lateral and medial rotation
What does a AROM test
Mechanical/structural - muscle and tendon (contractile tissue) - insert tissue (joint, ligaments and capsule) - stretches and pulls - load transfer/acceptance BPS - willingness to move - pain behaviours - avoidance - reluctance - fear
What is important to know when doing PROM
Client should be comfortable and supported
The clinician should have bed at comfortable height for them
Passively take joint through available AROM
If pain free, you can apply over pressure
Feel quality of movement, further range, resistance or muscle spasm and any symptoms produced
What to look for in PROM
Limit to movement = end feel
Pain response
ROM achieved
Any other symptoms produced
What different types of end feel are they in PROM
Soft - soft tissue approximation
Hard - bony approximation
Spongy - inflamed or effused joint
Soft with a hard end feel - capsular, ligament, or muscle stretch
What should you note down when doing PROM
When and where does the pain begin How does further movement affect the pain Where and when does stiffness begin Pattern of movement limitation The “end feel” Movement of associated joints Range of motion available
What’s a normal end feel
Bone - bone (normal and abnormal)
Soft tissue approximation
Tissue stretch
What’s a abnormal end feel
Bone - bone (hard) Muscle spasm Capsular/elastic Empty Springy block Elastic/capsular (too early in range)
What are capsular patterns - “ARTHRITIS”
Only joints controlled directly by muscles have a capsular pattern.
Capsule must be tested in all physiological ranges.
Identify patterns of restrictions.
What are causes of capsular pattern
Capsular contraction
Muscle spasm
Osteophyte formation
What are non capsular patterns
Internal derangement
Extra articular lesions
Single muscle involvement
What would you document on AROM
Joint being tested The movement Active or passive Test position Start position End position ROM Limiting factor
