medical screening Flashcards
Mechanical Pain
Patient will report an incident, traumatic event, or an event that precipitates the onset of symptoms
Symptoms can be aggravated or relieved with changes in body or limb position or as a response to specific movements
Symptoms can be reproduced or provoked with:
Palpation
Active or passive movement
Resistive Tests
Special Tests
Non-Mechanical Pain onset
Difficult to connect the onset of pain with a specific incident or event
Visceral pain characterized as
non- mechanical pain
Dull, diffuse, poorly localized
May rhythmically build and recede
May be described as “constant”
- no change with position or posture
Non-Mechanical Pain reproduced
Chemical or mechanical stimulus
Mechanical – movement
Chemical – temp change, eating, this chemical stimulus can be refereed to a specific place
Typically, within the organ’s own environment
Follow a predictable referral pattern
Broad Clinical Concerns
Fever, chills, sweats
Unexplained weight loss
Fatigue / Malise
Unexplained nausea and vomiting
Sometimes unremitting
Night Pain
Inability to increase or decrease pain / symptoms
what kind of population do we often see pathological fractures
Older individual
Female – older
Prolonged corticosteroid use
Decrease estrogen
Decrease bone and tendon generation
History of osteoporosis
Sacral Stress Fracture see with
Athletic female
Increased level of vigorous/repetitive athletic activity
Dietary insufficiency
Previous stress fractures
Nonresponsiveness to previous treatment
To get better have to shut them down
Sacral Stress Fracture pain
Pain involves the buttock
Pain reproduced with athletic activities (e.g., running
Menstrual irregularities
what is the Sign of the Buttock
It is a combination of findings that indicates serious pathology of the gluteal or low back region.
parts of the Sign of the Buttock
Limited trunk flexion noted during standing examination
Supine Straight Leg Raise (SLR) limited and painful
Hip flexion with knee flexion limited, painful and limitation is GREATER than that of the SLR
Hip rotation is painful and limited but in a non-capsular pattern
Empty end feel on hip flexion
Spondylolisthesis / Spondylolysis
Fracture of the PARS Interarticularis
Spondylolisthesis / Spondylolysis normal seen in what pop
Young individual
Spondylolisthesis / Spondylolysis normally due to
Repetitive hyperextension injury
Seen commonly in wrestlers and American football linemen
Spondylolisthesis / Spondylolysis pain
Sudden severe bilateral sciatica occurred during athletic activity
Pain with extension (prone with passive bilateral hip extension)
No urinary bowel incontinence
Abdominal Aortic Aneurysm (AAA) symptoms
Pain at rest or at night
Pulsating abdominal mass that is found with inspection or palpation of the abdomen
Patient typically complains of a throbbing type pain
Symptoms cannot be provoked with mechanical examination of the lower back
Referred pain to the lower back
risk for AAA
Family history of cardiovascular disease
Risk increases with family hx AAA
Claudication
pain in the legs or arms that occurs while walking or using the arms
caused by too little blood flow to the legs or arms.
Stenosis
narrowing
Vascular Claudication seen in what pop
Older individual
Family history of cardiovascular disease
Vascular Claudication pain and symptoms
Pain in the calf with activity relieved with rest
One foot is colder than the other
Symptoms cannot be provoked with mechanical examination of the lower back
Positive inclined treadmill test
Shopping cart – must lean forward and they fell better
