Session 1: Examination & Palpation

Question 1

Basics of Examination Process

Answer 1

Assess BP
Clinical examinations (Cardiovascular, neurological, ect.)
Observation, regional & functional screening
Active ROM
Passive ROM
Joint play
Resisted isometric muscle testing
Palpation of musculoskeletal structures
Orthopaedic and musculoskeletal testing

Question 2

Types of Movement

Answer 2

1. Active (anatomical mov performed by patient, tests muscles)
2. Passive (anatomical mov performed by prac, tests lig & capsular structures)
3. Segmental/accessory (mov patient cannot perform but is req for normal ROM)

Question 3

Barriers of Motion

Answer 3

Active motion - physiological barrier
Passive motion - Elastic barrier
Injury - Anatomical barrier

Question 4

What is palpation?

Answer 4

The application of different amounts of pressure to the surface of the body to determine the size, shape, consistency, motility and the health of the tissues below.

Question 5

Parts of your Schema

Answer 5

(observation)
Skin
Boney points
Muscles
Nerves
Vessels
Organs
Anatomical Spaces

Question 6

Palpate to Discover…

Answer 6

T - Tissue texture change
A - Asymmetry
R - Range of motion
T - Tenderness

Question 7

Effective Palpation

Answer 7

Greater surface area
Slow, steady motions (sensory feedback)
Light - deep palpations
Use diff parts of hand for diff sensations
Listens and asks for feedback

Question 8

Components of Screening Examination

Answer 8

Observation (swelling, redness, bruising)
Functional Movements (daily activities)
Gait
Posture
Cervical spine motion
Upper extremities screen
Pelvis
Lower extremities screen

Question 9

Observation: Look for…

Answer 9

Lumps
Scars
Unusual hair distr. or colours
Rashes
Scars
Common conditions
Odd things

Question 10

Functional Movements

Answer 10

• ask patient to demonstrate movements they struggle with (movement will be used as an outcome measure to assess recovery)
• Fear avoidance manouvers (things that a patient choses not to do in case they will cause pain).

Question 11

Gait

Answer 11

• How a person walks
• Should be observed as a patient is walking into your treatment room
• Things to look for inc: limp, poor coordination, drag foot, heel-toe strike off.

Question 12

Posture

Answer 12

Should be assessed from all of; posterior, anterior and lateral sides.
Look to ensure that; ear levels, cervical spine, shoulder heights, inferior scap angle, thoracic spine curve, pelvic crest, glute folds, knee, achilies and foot arches are all in line or even.

Question 13

Cervical Spine

Answer 13

Get patient to perform following movements;

• forward-backward rotation
• left-right rotation
• ear to shoulder (both sides) rotation

Question 14

Upper Extremities Screen

Answer 14

Ask patient to;

• raise arms out to side
• touch back of hands together above head

Question 15

Lumbar/Thoracic Motion

Answer 15

Ask patient to;

• bend forwards (flexion)
• bend backwards (extension)
• run hand down leg as far as they can (lateral)
• rotate from side to side as far as possible

Question 16

Thoracic Cage/Ribs

Answer 16

Get patient to breath in and out as you palpate;

• rib 1
• upper ribs
• middle ribs
• lower ribs

Question 17

Pelvis

Answer 17

Perform standing flexion test.
- thumbs on PSIS
- patient bend forward
Do they move evenly?

Question 18

Lower Extremities Screen

Answer 18

Ask patient to;
- squat as far as they can without bringing feet off the floor
Note any asymmetry that exists