lecture 1A: UQ scanning exam and clinical decision making Flashcards by sophia carrasco

what is regional interdependence

unrelated impairment that could be the reason for the main problem

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• If a pt’s presentation is unclear OR response to tx is less than favorable … consider impact of ____ ____

regional interdependence

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Traditional biomedical model mandates that a ____ is required to prescribe treatment

diagnosis

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is the biomedical model suited for managing common no op MSK disorders

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regional interdependendce initially focuses on what

physical impairments (pain and ROM)

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what are the 3 impairments that are not related to MSK system

neurophysiologic - impact of pain on function

biopsychosocial - impact of depression

somatovisceral - impact of referred or radicular pain

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lateral elbow pain can be associated with what impairments

cervical, shoulder and wrist/hand impairments

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what can low back pain be associated with

hip impairments

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patellofemoral pain syndrome is associated with what impairments

low back and hip
foot and ankle

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what does thoracic HVLAT treatment decrease and increase

↓’s cervical spine pain
↑’s lower trap strength

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Thoracic HVLAT treatment has improved outcomes in pts with ____ ____ and ___ ____

RC tendinopathy

adhesive capsulitis

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t/f: does PT evaluation and treatment replace the biomedical model

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what does PT evaluation and treatment use as a starting point

pathoanatomy

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what is the first thing we need to figure out when a patient comes into clinic

do they belong there

-refer
-refer + PT
- PT

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what is the main goal for the scanning exam

determine that no serious pathology is present and exam can continue

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always scan __- and ___

above and below

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how do u know when to scan or not to scan

scan if…

-no obvious MOI
- proximal cause for distal symptoms
- non MSK sounding symptoms

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what is included in the UQ scanning exam

• Observation
• Patient history
• Review of systems
• Medical screening questions
• Cervical AROM (overpressure as appropriate) • UE ROM: shoulder, elbow, wrist and hand
• Myotomes (C5-T1)
• Dermatomes (C4-T1)
• Cervical compression and distraction
• Neuroprovocation testing (ULTT 1)
• Common UQ DTRs
• Pathologic reflexes
• Palpation (pulses, glands and lymph nodes

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what are the different list of systems

• General health/constitutional screening
• CV, peripheral vascular and pulmonary systems
• Hematologic system
• Gastro-intestinal (GI) system
• Genito-urinary (GU) system • Nervous system
• Integumentary system • Psychologic system
• Musculoskeletal system

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what are the 8 things that are included in a general health screen

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fatigue
malaise
fever, chills, sweats
weight loss , groin
nausea, vomiting
dizziness, lightheadedness
paresthesia , numbness, weakness
changed in mentation, cognitive abilities

what is it when someone is uneasiness , feeling that something isn’t right

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malaise

when is a fever significant

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> 99.5° for longer then 2 weeks

what is the significant weight loss, gain that is concerning

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5-10% of BW lost or gained , unexplained

what are the 4 symptoms of nausea, vomiting

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• Metabolic, CV, liver dysfunction
• Pregnancy
• Meds
• ↑ intracranial pressure, HA, hemorrhage

dizziness and lightheadedness can be from what 2 things

• Neurologic, CV dysfunction • DM, anxiety, psychosis

what can cause changes in **mentation** and **cognitive** abilities

* Delirium, dementia * Head injury * Adverse drug reactions * Infection

what is considered a **blue flag**

socioeconomic factors that may impact PT outcomes

what is a **yellow flag**

**psychological** factors that may impact pt outcomes

t/f: One red flag automatically means a serious pathology and that u need to refer

F: One red flag does NOT automatically mean serious pathology and that you need to refer • Build a case w/ subjective and objective data • Look for patterns that do NOT match MSK conditions and pain generators

what is the myotome for **shoulder abduction**? what mm is being test ? peripheral n?

C5 deltoid axillary

what is the myotome for elbow flexion? what mm is being test ? peripheral n?

C6 Biceps brachii musculocutaneous

what is the myotome for **elbow extension**? what mm is being test ? peripheral n?

c7 triceps radial

what is the myotome for **wrist extension**? what mm is being test ? peripheral n?

c6 extensor carpi radialis longus , brevis and extensor carpi ulnaris radial

what is the myotome for **wrist flexion**? what mm is being test ? peripheral n?

c7 flexor carpi radialis and flexor carpi ulnaris median n

what is the myotome for **finger flexion** ? what mm is being test ? peripheral n?

c8 flexor digitorum superficialis , flexor digitorum profundus , lumbricals median n

what is the myotome for **finger abduction**? what mm is being test ? peripheral n?

t1 dorsal interossei ulnar

when assess myotomes, u can try and find the gaps to determine if weakness is what

1. localized 2. CNS dysfunction 3. PNS dysfucntion

where are the dermatomes of C6, C7, C8

C6: thumb and pointer finger C7: middle finer C8: 4th finger and pinky

pain reproduced with cervical **compression** suggests what 5 things

• Disc herniation • Vertebral end plate fx • Vertebral body fx • Acute arthritis/joint inflammation • Nerve root irritation (if radicular symptoms produced

pain reproduced with cervical **distraction** suggests what 5 things

• Spinal ligament tear • Tear/inflammation of annulus fibrosis • Muscle spasm • Large disc herniation • Dural irritability (if non-radicular arm pain produced

what is the main difference of location for UMN and LMN lesions

UMN: CNS LMN: cranial n nuclei and anterior horn cells , spinal roots and peripheral n

what is the main difference of **tone** for UMN and LMN lesions

UMN: increased - velocity dependent LMN: decreased - hypotonia , flaccidity

what is the main difference of **reflexes** for UMN and LMN lesions

UMN: increased - hyperreflexia, clonus ,babinski LMN: decreased or absent - hyporeflexia

what is the main difference of **involuntary movement** for UMN and LMN lesions

UMN: mm spasms - flexor or extensor LMN: fasciculations - with denervation

what is the main difference of **volunatary movements** for UMN and LMN lesions

UMN: impaired or absent- dyssynergic pattterns LMN: weak or absent

what is the main difference of **strength** for UMN and LMN lesions

UMN: weakness or paralysis - ipsilateral for stroke and bilateral for SC LMN: ipsilateral weakness or paralysis in limited distribution

what is the main difference of **mm appearance** for UMN and LMN lesions

UMN: disuse atrophy LMN: neurogenic atrophy

what is the foundation for **rational pt care**

clinical decision making

what is the **main tools** that PT used for **clinical decision making**

diagnostic reasoning

lecture 1A: UQ scanning exam and clinical decision making Flashcards

(49 cards)