Lecture 1: Physical Examination and Evaluation

Question 1

What are some of the goals of a physical examination?

Answer 1

determine what anatomical structures are involved, reproduce pt symptoms, link current issues with patient history

establish objective baseline info

Question 2

When should you perform an Upper Quarter Scan?

Answer 2

any pt with an UE issue that causes is unknown

ex) shoulder pain vs rotator cuff surgery

Question 3

What are components of UQS?

Answer 3

cervical AROM, reflexes, myotomes, dermatomes

Question 4

What reflexes are tested in UQS?

Answer 4

biceps, brachioradialis, triceps

Question 5

What is C1-2 myotome?

Answer 5

neck flexion

Question 6

What is C3 myo?

Answer 6

neck side bend

Question 7

What is C4 myo?

Answer 7

shoulder elevation

Question 8

What is C5 myo?

Answer 8

shoulder Abduction

Question 9

What is c6 myo?

Answer 9

elbow flexion, wrist extension

Question 10

What is c7 myo?

Answer 10

elbow extension, wrist flexion

Question 11

What is c8 myo?

Answer 11

thumb extension, ulnar deviation

Question 12

What is t1 myo?

Answer 12

hand intrinsics

Question 13

What reflexes are tested for LQS?

Answer 13

patella and achilles

Question 14

What is L1-2 myo?

Answer 14

hip flexion (ilopsoas)

Question 15

What is L3 myo?

Answer 15

knee extension

Question 16

What is L4 myo?

Answer 16

ankle DF

Question 17

What is L5 myo?

Answer 17

great toe extension (EHL)

Question 18

What is S1-2 myo?

Answer 18

ankle PF

Question 19

What is protective posture?

Answer 19

pt puts body into abnormal position to reduce pain, putting into correct alignment produces symptoms

Question 20

What is a non protective structural posture?

Answer 20

deformity that is not correctable, long standing scoliosis

Question 21

What is non protective behavioral posture?

Answer 21

result of pts personality, emotions, poor awareness, correction does not produce pain,

ex: slumped sitting posture

Question 22

What are two forms of passive motion?

Answer 22

1. physiological/ osteokinematic- flexion, extension etc.

2. accessory/arthrokinematic- between joint surfaces- glide/slide translate

Question 23

If during passive motion patient presents with pain before tissue resistance what stage is it in?

Answer 23

acute inflammation

Question 24

If pain at same time as tissue resistance?

Answer 24

subacute condition

Question 25

If pain after tissue resistance?

Answer 25

chronic with tissue fibrosis

Question 26

For joint mobility what is grade 0 and what is treatment?

Answer 26

no movement, fused do not mobilize, surgical intervention

Question 27

What are grades 1-2?

Answer 27

1- marked hypo mobility 2- slight hypo treat- with mobility

Question 28

What is grade 3?

Answer 28

normal no treatment needed

Question 29

What are grades 4 and 5?

Answer 29

4- slight hyper 5- marked hyper assess if nearby jts are hypo and treat with exercise, taping, bracing

Question 30

What is grade 6?

Answer 30

unstable possible subluxation tx- bracing, splinting, casting, surgery

Question 31

What is indicative of a early muscle spasm during joint mobilization?

Answer 31

protection following an injury

Question 32

What about late ms spasm?

Answer 32

protection from instability or pain

Question 33

What about an early tissue stretch?

Answer 33

tight muscle for example stretch appears way before normal range

Question 34

What about spasticity?

Answer 34

UMNL

Question 35

What about a hard capsular end feel?

Answer 35

adhesive capsulitis

Question 36

What about a soft capsular end feel?

Answer 36

synovitis, soft tissue edema

Question 37

What about bone to bone?

Answer 37

osteophyte formation

Question 38

What is an empty end feel?

Answer 38

pain before tissue resistance is likely an acute injury

Question 39

What about a springy block?

Answer 39

meniscal injury

Question 40

What does it mean if patient has a strong painless contraction?

Answer 40

normal

Question 41

If pt has a strong painful contraction?

Answer 41

minor muscle/ tendon lesion problem

Question 42

If pt has a weak and painful contraction?

Answer 42

major muscle/ tendon lesion

Question 43

If pt has a weak and painless contraction?

Answer 43

rupture of muscle/tendon or neurological lesion

Question 44

What are three options PT has after exam?

Answer 44

1. do they need additional info 2. can they state a PT diagnosis 3. do they need to refer pt out