Intro/Examination Flashcards
SINSS
severity irritability nature stage stability
S (1st)
Severity- clinician’s assessment of the INTENSITY of symptoms and the effect of functional ability (non,minimal,moderate,maximal)
I
Irritability- the AMOUNT of activity to produce an exacerbation of the symptoms, the SEVERITY of the symptoms, and the TIME to SUBSIDE
N
Nature- the PRIMARY STRUCTURE responsible for producing the patient’s complaint according to the clinician’s hypothesis
S (2nd)
Stage- clinicians assessment of the disorder on a TIME SCALE (acute, subacute, chronic)
S (3rd)
Stability- EASE with which the condition can be DISTURBED (getting worse, better, same)
(how does current condition compare to previous one?)
acute
lasts less than 30 days
subacute
lasts from one to six months
chronic
more than six months duration (pain that extends beyond the expected period of healing)
Inflammation (acute)
injury up to 1 week
clot formation, WBC, collagen synthesis
area is warm, red, swollen, tender
rest, relieve pain, protect
Proliferation/repair (subacute)
up to 21 days
new scar, migration of fibroblasts
scar is red, limited ROM and strength
optimal stimulus for regeneration, protect, gain motion
remodeling/maturation (chronic)
up to one year
macrophages/fibroblasts diminish
scar tissue density increases
increase tissue stress, full motion, strength, function
sign
a physical examination finding in a joint or structure that is abnormal (stiffness, hyper mobility, palpable soft tissue changes, weakness, decreased ROM)
symptom
something that the patient complains of including (pain, numbness, burning, ache)
clear
without signs (a joint cannot be cleared unless firm overpressure is applied with no more discomfort than the normal joint on the opposite side
comparable sign
a sign found on objective examination that reproduces the pain or demonstrates an abnormality in a structure capable of producing the patients complaint
objective exam sequence
standing, supine, sidling, prone, sitting
AROM
tests contractile and inert tissue
forces contractile tissue to work
PROM
tests inert structures can feel end feels, capsular patterns stretches and stresses contractile tissue pain before end feel-acute inflammation pain at first barrier- less inflamed pain after first barrier- noninflammed
resisted motion testing
tests contractile structures
NOT a measurement of muscle strength
examined in resting position
no joint movement
strong and painful- minor strain
weak and painless- near problem or tendon rupture
weak and painful- moderate to major contractile lesion or more serious problem, such as a fracture
deep tendon reflex grading scale
0= no response 1+= hypo reflexive 2+= normal response 3+= hyperreflexive 4+= clonus
DTR hyporeflexive
spinal nerve root, peripheral nerve, cerebellum (rarely)
hyperreflexive
cortex, brain stem, spinal cord
nociceptors
free nerve endings, can be painful
