Assessment Intro Flashcards
(43 cards)
what is a medical differential diagnosis
comparison of symptoms of similar diseases and medical diagnosis
what is a therapy differential diagnosis
comparison of neuromusculoskeletal signs and symptoms to indentify the underlying movement dysfunction so that treatment can be planned as specifically as possible
what composes a differential diagnosis
thorough and systematic examination
knowledge of pathology and MOI
clinical signs and symptoms
physical exam
provocation and palpation
lab and imaging
what are the steps to find a differential diagnosis
patient history
observation
screening (if necessary)
examination of movement (physical exam)
special test
reflexes and cutaneous distribution
joint play
palpation
imaging
what can we find in the subjective aspect of an assessment (S)
patient’s descrption of his complaints
relevant data from history
patients environment
past medical history
what can we find in the objective aspect of an assessment (O)
patient chart
results of your examiation (observation, ROM, ST)
what can we find in assessment (A)
professional eval of overall impairments based on integration of the subjective and objective findings
identify and interpret problems
patients specific response to intervention
what can we find in the plan (P)
the treatment
progression of the plan
education planned
frequency/duration of treatment
follow-up, referral
what is the difference between SOAP and SOAPIE
Implement:
this is what you have done (treatment)
Evaluation: has the treatment been effective in helping the patient reach the goals
t/f palpation is before special tests in Canada
false
history question example
past injury
medication
job
kids
sport
past medical history
what happened
did it get better
hows the pain
what have you been doing
what’s important to have good rapport with the patient
informed consent
keep patient focused
discourage irrelevant info
communicate within their level
why are close ended questions sometimes bad
can be misleading
list yellow flags
abnormal s/s
bilateral symptoms
symptoms peripheralizing
neurological symptoms
multiple nerve root involvement
abnormal sensation patterns
saddle anesthesia
upper motor neuron symptoms
fainting drop attacks
vertigo
ANS symptoms
progressive weakness
progressive gait disturbances
multiple inflamed joints
psychosocial stresses
circulatory or skin changes
list red flags: cancer
persistent pain at night
constant pain anywhere in the body
unexplained weight loss
loss of appetite
unusual lumps or growths
unwarranted fatigue
red flags: CV
shorteness of breath
dizziness
pain or heavy in chest
pulsating pain anywhere in the body
constant and severe pain in lower leg/arm
dicolored or painful feet
swelling (no MOI)
red flags: Gastrointestinal genitourinary
frequent or severe abdominal pain
frequent heartburn or indegestion
frequent nausea or vomiting
changes in or problems with bowel and bladder function
unusual menstrual irregularities
red flags :neuro
changes in hearing
frequent or severe headaches with no MOI
problems with swallowing or changes in speech
changes in vision
problems with balance, coordination or falling
faint spells
sudden weakness
red flags: miscellaneous
fever or night sweats
recent severe emotional disturbances
swelling or redness in any joint with no MOI
pregnancy
what do we find in pt HX
age, sex
occupation
chief complaint
function ability
allergies, medication
previous injuries/surgeries
other medical history, family medical history
what is important to know for injury Hx
Moi
opqrst
onset timing
symptoms
duration of injury
previous occurence
whats important to know with pain
where,when
at time of injury
type
course of pain
rating
why is pain very subjective
is influenced by physiological, sensory, affective, cognitive, behavioural, sociocultural-ethnosultural components
what does pain that is not affected by rest or activity indicates
bone pain
organic/systemic disorders
other severe pathology
