Exam 1 Flashcards

Question

What does a check mark on a body chart indicate?

Answer 1

That area of the body has been cleared and there appears to be no symptoms of pain that are being derived from that area

Answer 2

-Information gathered that may suggest serious pathology -Should act as a STOP sign; decide WHO a referral should be made to -Sometimes based on situation, we immediately refer without continuing examination/evaluation, other times we continue AND REFER -regardless if it is a red flag you HAVE TO refer

Answer 3

-unexplained weight loss -Severe pain that is unchanged by position/movement -changes in bowel/bladder function -Recent persistent history of fever,chills,night sweats, nausea, vomiting -Symptoms that awaken a patient at night and are not altered by change in position -Uncontrolled co-more items such as diabetes, hypertension, eating disorder -Undiagnosed fractures -Suicide plans or attempts

Answer 4

-Non emergent conditions or psychosocial factors which require cation and can be monitored while the patient is still being treated; May hinder prognosis -Must be monitored because they can become emergent or “red flags” -Can either refer and treat if you feel a referral is necessary or treat and monitor the concern Factors: -developing/perpetuating long term disability -controlled Co-morbidities (that are taken care of;want to watch/pay attention to)(diabetes, HTN,etc) -depression,anxiety, fear avoidance are yellow flags

Answer 5

Asking the patient about different systems in their body (cardiopulmonary, endocrine, GI, neurological and many more to find out any medical history you may need to know for treatment/that are of concern

Answer 6

-Support systems-family, friends, caregivers etc -Home environment- city or rural, single or multiple level, steps/stairs/location/handrails, Tub/shower/grab bars, others -Religious beliefs

Answer 7

Drinks per day/week/both Smoking history-packs per day Nutrition Sleep-hours per night Physical activity- active/sedentary etc Stress level

Answer 8

Active ROM Active Assistive ROM Passive ROM (All the ROMS)

Answer 9

Normal types and directions of movements that occur in everyday life Ex. Raising arms over head for shoulder abduction etc.

Answer 10

Arthrokinematic/accessory movements Joint play

Answer 11

-controlled movements generated by the BODY region that you’re assessing -no external assistance (no other body parts or people or devices) -one of the first components of every physical exam -Helps determine patient willingness to move, quality/quantity of motion, and muscle function

Answer 12

-patient allows SOMEONE ELSE to take their joints through their available range of motion -joints and tissues are relaxed and not assisting! -commonly used to treat individuals where AROM might be contraindicated to keep them moving while minimizing adverse affects from AROM or no movement at all -want to compare with opposite side

Answer 13

Active assistive range of motion -Motion performed by PATIENT with some amount of OUTSIDE assistance (another person/body parts/external devices like wall/cane/strap etc) -Typically used to help the transition from PROM to AROM -Helps determine the amount of assistance necessary to improve the quality or quantity of motion

Answer 14

Arthrokinematic/Accessory -Motions that occur between JOINT surfaces that enable the osteokinematic motions to occur -Can be assesed passively by examiner but cannot be performed actively by the patient -Not the angular motion the joint is going through but what is going on inside

Answer 15

-Ligaments and capsules are taut (No slack) -Maximal congruency between joint surface -Position of maximal joint stability -Position to avoid for assesment of joint play and mobilization (very little motion available)

Answer 16

Full extension of the knee with external rotation of the tibia

Answer 17

-Ligaments and capsule have greatest amount of laxity (slack) -Joint surfaces maximally separated (least amount of congruency) -Appropriate position to initiate assessment and joint mobilization

Answer 18

-Anything outside of the close-packed position (including but not limited to loose packed) -Appropriate position for mobility assesment and joint mobilization

Answer 19

-Loose packed and open packed

Answer 20

No -With AROM you only need as much strength as it takes to move your arm etc but it's not actively a measurement of how strong you are (that is more manual muscle testing or others to measure strength) -ROM is only really telling you if something is weak/wrong

Answer 21

Muscle length testing (flexibility) and muscle strength testing (MMT, gross MT, myotome testig, functional strength testing)

Answer 22

Flexibility tests to determine if muscle length is normal, limited, or excessive. -Accomplished by taking all involved joints through their ROM to maximize the distance between the muscle's origin and insertion

Answer 23

To determine if strength of muscles (muscle groups) is normal or diminished (to determine how they might be impacting someone's function) -Accomplished by isolating muscles (muscle groups) and testing their ability to resist movement as provided by the clinician

Answer 24

Manual muscle testing (MMT) Gross muscle testing (GMT) Myotome testing Functional strength testing

Answer 25

-Diagnoses of peripheral nerve injury or nerve root injuries -Effects of spinal cord injury and potential recover (can determine level of injury then moitor their recovery) -Basis for treatment planning and prognosis (any level of strength measured can help us determine their prognosis and guide our decisions for best treatment interventions) -Determination for need of supportive devices/orthoses(brace) -Provide measure for treatment progress (see if our treatments are working)

Answer 26

Manual Muscle Testing

Answer 27

Gross Muscle Testing

Answer 28

Myotome testing

Answer 29

-Standardized tests of functional strength -ex. sit to stand 5 times -30 second sit-stand test -arm curl test -Test specific grading -All settings -Documentation [name of test][result]

Answer 30

1. Explain assessment, answer questions, ask permission 2. Position patient 3. Asses PROM (visually measuring)(necessary to determine what motion is necessary for 3/5 grade 4. Screen AROM (to determine if patient has 3/5 strength 5. Stabilize as needed (need to stabilize typically proximal tissues to the joint) 6. Apply resistance (progressively build over 3-5 seconds) 7. Determine grade 8. Palpate as needed, if <2/5 and/or when assessing for possible compensations (only with permission)

Answer 31

-No activity -Palpation or visual inspection fail to provide evidence of a contraction

Answer 32

Trace activity -can detect visually some contractile activity in one or more of the muscles for the action being tested

Answer 33

Poor -Able to move the body segment through full ROM when gravity is minimized (typically horizontal plane of motion)

Answer 34

Fair - Full ROM against gravity but can only tolerate small/mild amount of resistance?

Answer 35

Good - Full ROM against gravity, but unable to hold test position against max resistance (therapist able to break test position)

Answer 36

Normal -Full ROM against gravity and able to hold test position against max resistance (therapist unable to break test position)

Answer 37

age gender area of body

Answer 38

Pain Limited Joint ROM Muscle Hypertonicity/Spasticity Lack of Standard Patient Positioning Others: fatigue, cognition, cultural/social norms

Answer 39

The science that defines physical measurements of a person's size, form, and functional capacities as defined by the NIOSH (national institute for occupational safety and health)

Answer 40

Height Weight Body composition Girth measurements Volumetric measurements

Answer 41

Measuring the proportion of lean tissue (also called fat free mass or FFM) to body fat tissue - Fat free mass=any mass accounted for by muscles, connective tissue, bones, blood, nervous tissue, skin, and organs

Answer 42

-Computes body composition -Called a hydrodensitometry (underwater weighing tank with scale and a machine to measure RV) -Very accurate -Expensive -Not the most convenient (takes up lots of space, and some patients may not tolerate being under water/hard transition) -Nearly all other methods are based on formulas derived from this approach

Answer 43

Least expensive Grabbing subcutaneous skin and not muscle 3-7 standard locations to perform it Errors more likely in individuals who are obese or extremely thin Most widely accessible Accurate when done correctly

Answer 44

Muscle atrophy/hypertrophy Edema (many cond. listed under this) Fitting equipment Track progress via comparisons to baseline measurements or contralateral extremity ALWAYS TAKE MEASUREMENTS BILATERALLY (both sides when possible but if not then at least take measurement of un-injured side to have a baseline)

Answer 45

-Use bony landmarks or weight bearing surface as starting point or location that are easy to reproduce (15cm distal to knee joint line) -Mark starting point with skin safe marker -use nonelastic yet flexible tape -Tape should be snug but avoid excessive indentation of the skin -Maintain contact with skin (or through tight form fitted clothing) -2 measurements and take the average -Allow 20-30 seconds between measurements (incase there is any indentation in the skin)

Answer 46

-Patient positioning -Distance from easy to identify landmarks -Units of Measurement (cm. vs. inches) -Baseline measures, contralateral "norms" (when available)

Answer 47

-For complicated extremities like the hand or foot that are not easily measured by regular measuring tape for girth -Uses concept of displacement -More accurate than girth measurements -Best for distal extremities -Equipment: volumeter with spout and calibrated collection container -Be careful if working with open wounds (avoid cross-contamination)

Answer 48

-straight through axial spine -line that extends from center of gravity through base of support (feet) (remember the pictures of people forward bending or carrying things without proper positioning)

Answer 49

-Lies right at the level of S2 in the spine/sacrum -Want to get lower and hold things closer to keep them in your center of gravity -ex. holding a box out in front of you therefore it shifts center of gravity from S2 point out to somewhere in between the box and your spine ex. holding a weight close to you rather (lowers strain on spine)

Answer 50

Foot position -Width=under hips -Or one foot forward Direction: -Pointed toward movement -Approximately perpendicular

Answer 51

-keep load close -create appropriate base of support -Use isometric contraction of trunk -Lift with legs (corset affect) -Do not twist

Answer 52

Lowest= supine standing erect sitting standing with forward lean Highest stress: sitting with forward lean

Answer 53

-the use of ones body to produce motion that is safe, energy efficient and maintains body balance and control -Limit stress and prevent cumulative trauma

Answer 54

gravity base of support movement

Answer 55

T position

Answer 56

using larger muscles to move while maintaining stable core

Answer 57

Plan ahead Alternatives Equipment

Answer 58

Visualize- path of movements and hazards Help- know limitations and have good communication