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CATA 337 - fall 2022 > Lecture 2 - Physical exam > Flashcards

Lecture 2 - Physical exam Flashcards

(65 cards)

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1
Q

Principles of physical exam (4)

A

Informed consent - recheck
Normal side first (baseline, educate patient)
Active, passive, resisted
Painful last

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2
Q

What structures are being tested during AROM (3)

A

Contractile tissue
Nervous tissue
Inert tissues (ligaments, bones, etc.)

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3
Q

If active is not painful, what do you do

A

Overpressure - used to determine end feel

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4
Q

Done if AROM or AROM with OP is painful or limited

A

Passive ROM

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5
Q

What structure is being tested at PROM

A

Non-contractile tissue except at end ROM

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6
Q

If AROM and PROM are painful, what type of injury do you suspect?

A

Bones, ligaments, cartilages, etc. = inert tissue

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7
Q

What are the 5 motions of beighton score for hypermobility?

A
  1. Pinky
  2. Thumb
  3. Elbow hyperextension
  4. Ankle dorsiflexion
  5. Hip hypermobility
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8
Q

End feel of PROM - normal (3)

A

Bone to bone
Soft tissue approximation
Tissue stretch

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9
Q

End feel of PROM - abnormal (5)

A

Muscle spasm (early or late)
Capsular (hard or soft)
Bone to bone
Empty (pain)
Springy block

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10
Q

What structures does RROM tests?

A

Contractile tissue (muscle, tendon, attachments, nervous tissue)

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11
Q

Muscle testing grading = 0/5

A

No contraction palpated

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12
Q

Muscle testing grading = 1/5

A

Evidence of slight contractility but no joint motion

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13
Q

Muscle testing grading = 2-/5

A

Initiates motion if gravity is eliminated

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14
Q

Muscle testing grading = 2/5

A

Complete ROM with gravity eliminated

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15
Q

Muscle testing grading = 2+/5

A

Initiates motion against gravity

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16
Q

Muscle testing grading = 3-/5

A

Some but not complete ROM against gravity

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17
Q

Muscle testing grading = 3/5

A

Complete ROM against gravity

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18
Q

Muscle testing grading = 3+/5

A

Complete ROM against gravity with minimal resistance

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19
Q

Muscle testing grading = 4/5

A

Complete ROM against gravity with moderate resistance

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20
Q

Muscle testing grading = 5+/5

A

Complete ROM against gravity with maximal resistance

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21
Q

Postural muscles

A

Tight, hypertonic/facilitated

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22
Q

Phasic muscles

A

Weak, inhibited

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23
Q

Other findings (4)

A

Painful arcs
Crepitus
Pain at extreme ends of ROM
Flexibility testing

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24
Q

When is special test most accurate? (3)

A
  • Immediately after an injury
  • Under anesthesia
  • In chronic conditions
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25
If a special test is negative, it automatically rules out the problem, T or F
FALSE
26
Special test considerations (4)
- Patient's ability to relax - Presence of pain - Patient apprehension - Clinician skill
27
Measures of worth - Reliability
The consistency of a measure/tool over time
28
Measures of worth - Validity
The ability of a test to measure what it says it measures
29
Measures of worth - Sensitivity
The ability of a tool to be positive when the condition/disease/injury is present
30
Measures of worth - Specificity
The ability of a tool to be negative when the condition/disease/injury is not present
31
Measures of worth - Responsiveness
The ability of a tool to detect change over time
32
Nerve injury causes (5)
Compression Stretch/traction Friction Cooling or freezing Thermal/electrical
33
Reflex grades - 0 to 4
0 - absent 1 - diminished 2 - average 3- exaggerated 4 - clonus
34
Osteokinematic
Movement you can see
35
Arthrokinematic
movement you can feel
36
Convex-CONCAVE rule
Glide and roll in same direction Convex is fixed and concave moves OK and AK motion in same direction
37
CONVEX-concave rule
Glide and roll in opposite directions Concave is fixed and convex moves AK and OK motion in opposite directions
38
Capsular patterns - temporomandibular
Limitation of mouth opening
39
Capsular patterns - atlanto-occipital
Extension, side flexion equally limited
40
Capsular patterns - Cervical spine
Side flexion and rotation equally limited, extension
41
Capsular patterns - Glenohumeral
External rotation, abduction, internal rotation
42
Capsular patterns - Sternoclavicular
Pain at extreme range of movement
43
Capsular patterns - Acromioclavicular
Pain at extreme range of movement
44
Capsular patterns - Ulnohumeral
Flexion, extension
45
Capsular patterns - Radiohumeral
Flexion, extension, supination, pronation
46
Capsular patterns - Proximal radioulnar
Supination, pronation
47
Capsular patterns - Distal radioulnar
Full range of movement, pain at extremes of rotation
48
Capsular patterns - Wrist
Flexion and extension equally limited
49
Capsular patterns - Trapeziometacarpal
Abduction, extension
50
Capsular patterns - Metacarpophalangeal and interphalangeal
Flexion, extension
51
Capsular patterns - Hip
Flexion, abduction, medial rotation (most limited in some cases)
52
Capsular patterns - Knee
Flexion, extension
53
Capsular patterns - Tibiofibular
Pain when joint is stressed
54
Capsular patterns - Talocrural
Plantarflexion, dorsiflexion
55
Capsular patterns - Talocalcaneal (subtalar)
Limitation of various range of movement
56
Capsular patterns - Midtarsal
Dorsiflexion, plantar flexion, adduction, medial rotation
57
Capsular patterns - First metatarsophalangeal
Extension, flexion
58
Capsular patterns - Second to fifth metatarsophalangeal
Variable
59
Capsular patterns - Interphalangeal
Flexion, extension
60
Causes of non-capsular patterns (3)
- Internal derangement - Extra-articular lesions - Constant length
61
AROM tests for
Contractile, nervous and inert tissues
62
PROM tests for
Non-contractile
63
RROM tests for
Contractile, nervous tissue
64
What are the muscles of the upper cross syndrome - inhibited vs facilitated?
Inhibited - deep cervical flexors + lower traps/serratus anterior Facilitated - upper trap/levator scapula + SCM/pectoralis
65
What are the muscles of the lower cross syndrome - inhibited vs facilitated?
Inhibited - Abdominals + Gluteus min/med/max Facilitated - Thoraco-lumbar extensors + Rectus femoris/ Iliopsoas

CATA 337 - fall 2022 (16 decks)

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