ch6: clinical assessment and diagnosis

Question 1

what should the pland portion of SOAP include

Answer 1

• imediate tx given
• referal if needed
• freq and duration of tx, modalities
• eval standards to det progress
• ongoing pt education
• criteria for discharge

Question 2

somatic pain:

Answer 2

arises from the skin, lig, m., bones, and joints

two types
deep: diffuse or nagging, longuer lasting, often serious
superficial : injury to epidermis or dermis usually sharp, prickly

Question 3

Visceral

Answer 3

disease or injury to an organ in the thoracic or abdominal cavity such as compression, tension, distention

deeply located nagging pressing pain.
refered pain

Question 4

liver referes pain

Answer 4

right sh
RUQ

Question 5

spleen refered pain

Answer 5

L sh

Question 6

categories of physical test

Answer 6

• ROM and funct
• stress test
• special test
  -neuro test
• activity specific

Question 7

normal end feels

Answer 7

• soft tissue approximation
• tissue stretch
• capsular stretch
• lig stretch
• bone to bone

Answer 8

• pain
• soft, firm or hard compared to other side
• empty (pain)

Question 9

closed pack position
GH jnt

Answer 9

abd
lat rot

Question 10

closed pack position
elbow

Answer 10

ext

Question 11

closed pack position
radio humeral

Answer 11

elbow flex 90 + 5deg supination

Question 12

closed pack position
prox/distal radio ulnar

Answer 12

5deg supination

Question 13

closed pack position wrist/radiocarpo

Answer 13

ext + radial dev

Question 14

closed pack position
hip

Answer 14

ext, med rot, abd

Question 15

closed pack position kn

Answer 15

ext, lat rot of tibia

Question 16

closed pack position
ankl talocrural

Answer 16

max DF

Question 17

MMT grading

Answer 17

5: full vs gravity + max overload
4: full vs gravity + mod overload
3+: full vs gravity + min overload
3: full vs gravity
3-: not full vs gravity
2+: initiates mvt vs gravity
2: full vs no gravity
2-: initiates rom no gravity
1: some m. contraction no motion
0: rien

Question 18

normal ROM
shoulder

Answer 18

flexion: 180
ext: 35
abd: 180
int rot: 70
ext: 90
hz: 130

Question 19

nor mal rom

elbow

Answer 19

flex: 150
ext: 10

Question 20

normal ROM
knee

Answer 20

flex: 135
ext: 15norm

Question 21

normal ROM ank

Answer 21

DF: 20
PF 50

Question 22

2 components of nerve roots

Answer 22

somatic: innervates series of sskt m. and provides sensory feedback from skin, fascia, m. and jnts

Visceral: part of autonomic ns

Question 23

how are nerves injured

Answer 23

tensile or compressive forces

Question 24

hypoesthesia
hyperestesia
anesthesia
paresthesia

Answer 24

hypo: dec tactile sens
hyper: inc tactil sens
anesthesia: loss of sens
paresthesia: abnormal sens (NTB)

Question 25

MYOTOMES

Answer 25

see goodnotes

Question 26

DERMATOMES

Answer 26

see goodnotes

Question 27

babinski

Answer 27

what: stroke lat aspect of sole of foof +ve: extenion of toes pathology: pyramidal tract lesion, organic hemiplegia

Question 28

chaddock

Answer 28

what: stroke lat side of foot beneath lat malleolus +VE: SAME as babinski patho: pyramidal tract lesion

Question 29

oppenhein test

Answer 29

what stroke anteromedial tibial surface +ve: same as babinski patho: pyramidal tract lesion

Question 30

gordon test

Answer 30

squeeze calf +ve same as babinski pyramidal tract lesion

Question 31

brudzinski

Answer 31

what: passive flexion of one lower limb +ve: similar mvt in opposing limb patho: meningitis

Question 32

hoffman

Answer 32

what: flicking of terminal phalanx of index, middle or ring finger +ve flexion of non flick finger patho: inc irritability of aensory n. in tetany pyramidal tract lesion

Question 33

blood testing: RBC

Answer 33

dec count = - possible anemia - chronic infection - internal hemorrhage - certian types of cancers - deficiency in iron, B12, folic acid -

Question 34

Blood testing: whit BC

Answer 34

dec count= inability to fight infections

Question 35

blood testing: hemoglobin

Answer 35

(carries o2) dec count - anemia - carbon monoxide poisonning

Question 36

blood testing: hematocrit

Answer 36

dec value= - anemia

Question 38

synovial fluid classification

Answer 38

1: clear yellow = no trauma 2: cloudy= inflammatory, arthritis, 3: thick exudate, brownish= septic arthritis, gout 4: hemorrhagic= trauma, bleeding disorder, tumors, fx

Question 39

Xray MRI CT bone scan US

Answer 39

xray= fx, infections, neoplasm MRI: CNS, spine, msk, cv systems CT: abnorm bone, fat, soft tissue, tendon, lig bone scan: long bones, vertebrae, DDD, infections, tumors US: organs, soft tissue, tendons

Question 40

purpose of soap notes

Answer 40

- enhance communication among those providing care - facilitate continuing of care - provide evidence of service

Question 41

8 basic principles when documentiing the evaluation process and tx

Answer 41

1- use correct medical terminology 2- use only standerdized and accepted medical abreviations 3- use correct punctuations 4- be as accurate as possible 5- strive for brievity 6- write legebly with an instrument that cannot be erased or altered 7- doc should be completed and filed at the time services are rendered 8- clinicians needs to sign and date each note