Injury assessment basics

Question 1

History

Answer 1

listen- most info will come up
group of follow up questions

Question 2

History- introduction

Answer 2

introduce self. Know their age. Ask what can help with

Question 3

History-injury story

Answer 3

how, timeline, choric or acute-where may they be in healing process

Question 4

History-clinical presentation

Answer 4

focus on consequence of injury. signs-objective ie a bruise and symptoms-subjective-ie pain and functional impact of injury

Question 5

History-this person

Answer 5

pervious injuries, general health, previous physical activity demands-sports, daily living. Learn about factors that might contribute to current issue and ideal living.

Question 6

Observation

Answer 6

use information from history to guide observation. First-get consent. Qualitative and bilateral assesment (affected vs unaffected side), swelling, deformity, discolouration-inflammation, bruising, lack of blood- need to look closer for those with darker skin tones.

Question 7

ROM

Answer 7

make table of all ranges that joint can do. Look at active-person does all the work with no help, passive-person relaxes and tester takes throguh max ROM, strength test. Note painful motions with *

Question 8

Interpreting ROM

Answer 8

limited- is the ROM smaller than expected- compare to average and other limb.
excessive- can indicate ligament damage
painful- **
interpret- painful motion what does it main- are we pulling apart in injured structure? Does this test ask an injured structure to contract- active and strength columns

Question 9

Manual strength test grading

Answer 9

isometric test- in mid ROM- graded 0-5 (categorical)
0-can’t contract at all (ie neurological)
1-flicker of contraction but not enough to move joint
2-enough to move joint but not enough to overcome gravity- think testing position (start w/ antigravity position-if can’t overcome then change position)
3-overcome gravity-if press down fail
4-tester can provide some resistance- can overcome you and gravity
5-strength= opposite side- no limitation

Question 10

Special tests and palpation

Answer 10

your index of suspicion list- pick specific tests to test specific structures that are most likely candidates- need special test for each structure/condition
-reproduce mechanism of injury- as described in history
-reproduce symptoms- does test reproduce injury pain/symptoms
-No test is perfect- some are more sensitive- may need to perform several that test the same thing
-know you anatomy- need to know surface anatomy to be able to palpate structures- where should they be.

Question 11

Assesment funnel

Answer 11

history
observation
ROM
Resistance
Special tests