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APA > WEEK 1 - subjective exam and massage > Flashcards

WEEK 1 - subjective exam and massage Flashcards

1
Q

what is the purpose of a subjective exam?

A

to obtain sufficient information about a person symptoms so as to be able to plan an efficient, effective and safe physical exam

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2
Q

identify the components of a subjective exam

A
  1. patient info (DOB, gender etc)
  2. body chart (WOCSNOR)
  3. behaviour of symptoms
  4. history of presenting complaint
  5. special/ screening questions
  6. past medical history
  7. social history
  8. family history
  9. interests
  10. patient perspectives
  11. outcome measures
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3
Q

what is involved in the body chart component of a subjective exam

A

W – where are main area of symptoms
O – other symptoms related to main area of pain
C – constant / intermittent / variable
S – severity and superficial or deep
N – nature of symptoms
O – other areas of body with symptoms
R- relationship of all symptom areas

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4
Q

what is involved in the behaviour of symptoms component of a subjective exam?

A
  • Aggravating factors -> Include functional activities + pain rating (severity) and time to pain level (gives you clues as to the anatomical structure concerned, the histology and aetiology)
    • Easing factors -> include time to settle and pain level once settled (severity) (gives you clues as to if the problem is inflammatory or mechanical in nature + movements or factors that may help during treatment)
    • 24 hour pattern
      >AM (when wake and get out of bed (GOOB) / how long do the symptoms last?/ can you do anything to ease them?)
      >Day (end of day (EOD)
      >PM (how long to get to sleep?/ do you wake?/ if you wake how long to get back to sleep?)
    • Irritability -> how long for pain to come on with aggs, to what pain level and how long for pain to subside with easing factors/ mild/ moderate/ severe
    • Status of injury (is condition getting better, staying the same, getting worse?
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5
Q

what is involved in the history of presenting complaint component of a subjective exam?

A
  • Current history (when/how/ what has happened since injury/ any treatment + did it help/no)
    • Past history (has this happened before?/when/ how often)
    • Past treatment (what type of treatment & who provided?/ what was the treatment?/did it help or not?)
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6
Q

what is involved in the special/ screening questions component of a subjective exam?

A
  • General health (GHx)
    • Loss of weight (LOW) and/or history of cancer (Hx Ca)
    • Night pain
    • Major illness/ injuries/ surgeries
    • Current medications
    • Corticosteroid use
    • Anticoagulants
    • Body mass index
    • Physical activity (PA) levels
    • Imaging (x-ray, CT, MRI, bone scan)
      Blood tests
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7
Q

what is involved in the past medical history component of a subjective exam?

A
  • hospitalisations
  • chronic conditions
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8
Q

what is involved in the social history component of a subjective exam?

A

home situation - who they live with, dependent etc

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9
Q

what is involved in the family history component of a subjective exam?

A

anyone else in family have similar condition

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10
Q

what is involved in the patient perspective component of a subjective exam?

A
  • What do they think is going on?
    • what have they been told by others?
    • Previous experience with physio?
    • Goals?
    • Flags
      Ø orange - mental health factors
      Ø Yellow - psychological factors
      Ø Blue - social factors
      Ø Black - litigation & threats to financial security
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11
Q

what are the flags that can present in a subjective exam

A

Ø orange - mental health factors
Ø Yellow - psychological factors
Ø Blue - social factors
Ø Black - litigation & threats to financial security

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12
Q

what is an aggravating factor?

A

Include functional activities + pain rating (severity) and time to pain level (gives you clues as to the anatomical structure concerned, the histology and aetiology)

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13
Q

what is an easing factor?

A

include time to settle and pain level once settled (severity) (gives you clues as to if the problem is inflammatory or mechanical in nature + movements or factors that may help during treatment)

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14
Q

define massage

A

a mechanical stimulation of the tissues by means of rhythmically applied pressure and stretching

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15
Q

why is massage used/ purpose?

A
  • To increase flexibility, coordination, venous return, and blood flow
    • To reduce muscle spasm
    • To promote relaxation
    • To decrease neuromuscular excitability and pain
    • To stimulate circulation
    • To facilitate healing and restore joint mobility
    • To remove lactic acid and oedema
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16
Q

what are the cardiovascular physiological effects of massage?

A
  • Increase blood flow to the area being massaged, histamine release and temperature
  • Decreased heart rate, respiratory rate, and blood pressure especially when massage is used for relaxation
17
Q

what are the neuromuscular physiological effects of massage

A
  • Increase flexibility by stretching muscles and breaking down scar tissue
  • Decrease neuromuscular excitability (relaxation) but only during the massage and only to the areas- muscles being massaged
18
Q

how does massage reduce pain?

A
  • Activate sensory nerves – inhibits pain via spinal gate and the release of
    endogenous opiates
    • Decreasing pressure from swelling, mechanical pain can be reduced
    • Interrupting m. spasm, mechanical pain can be reduced
    • Reducing oedema, mechanical pain can be reduced
    • Increasing b. flow & encouraging waste removal, chemical pain can be reduced
      Activates sensory nerves – inhibits pain
19
Q

what are the psychological implications of massage?

A
  • Reduces patient anxiety, depression, and mental stress
20
Q

when is massage condraindicated?

A
  • Acute contusions
    • Acute inflammatory conditions
    • Sever varicose veins
    • Open wounds/ abscesses
    • Skin infections
    • Failed or incomplete fracture healing
      Thrombophlebitis and embolisms
21
Q

what are the 3 stages of massage prepartaion?

A
  1. massage media/ lubricant
  2. setting/ environment
  3. therapist and client
    - therapist: base of support, clothing, hands
    - client: informed consent, expose part, client comfort
22
Q

what are the 6 massage techniques?

A

stroking
effleurage
petrissage
kneading
tapotement
friction
trigger points

23
Q

what is stroking?

A
  • Stroking of the skin in any direction with the hand and palm moulding to the contours of the tissue
    • Use at beginning and end of massage
    • Usually applied parallel to the muscle fibre
      Superficial or deep
24
Q

what is effleurage?

A
  • Stroking – utilizes longitudinal sweeping motion covering large areas of the body
    • Long Gliding
    • Use at the beginning and end of the massage
    • Usually applied in direction of lymphatic flow
    • Superficial:
  • slow strokes for relaxation
    • Deep:
  • Elongates muscle fibres
  • Stretches fascia
25
Q

what is petrissage?

A
  • Rhythmic Lifting, rolling and squeezing of subcutaneous tissue * Performed across the muscle ( usually)
    • Can incorporate wringing and kneading
    • Frees adhesions:
  • Stretches and separates muscle fibre, fascia, and scar tissue
26
Q

what is kneading?

A
  • Circular motion – tissue moved in a circular manner on the underlying tissue
    • Can be performed across the muscle fibres or parallel to the muscle fibres
      *Can be applied in a stationary position or with movement
  • Frees adhesions by stretching & separating muscle fibre, fascia, & scar
27
Q

what is tapotement?

A
  • Soft Tapping or pounding of the skin
    • Can involve : * Hacking
    • Pounding
    • Beating
    • Clapping/ Cupping
    • Tapping
    • Performed with a light, fast tempo
  • Promotes muscular and systemic relaxation and desensitization of irritated nerve endings
28
Q

what is friction in massage?

A
  • Small , deep localized movements with the tips of fingers/ thumbs
    • Circular or transverse direction
  • Use to break up scar tissue, adhesions and even consolidated oedema
29
Q

what does trigger points involve in massage?

A

*Trigger Points are bands within the muscle that have become ischaemic, fibrous and knotted – held in contraction
* Produce pain on palpation and can refer pain
* Trigger point therapy  direct pressure to specific point and held till
pain subsides

APA (8 decks)

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