Exam

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jessiekate22
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157869
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Exam
Updated:
2012-06-08 19:14:57
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First week
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2020
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  1. Physical examinations aim
    • - to test hypothesis
    • - confirm functional limitations
    • - determine extent of physical impairments
    • - sources of the symptoms
    • - determine and measure physical contributing factor
    • - identify and reassessment *
    • - inform Rx and prognosis decisions
  2. What are the compontnent of examinations?
    • - obs
    • - functional movements
    • - action movements
    • - palpation- diff types
    • - PPMS
    • - mm tests
    • - neural tests
    • -PAMS
    • - special tests
  3. What general obs?
    • - posture eg spinal shift eg lumbar lordosis (weakness in hamstrings and lower abs with tightness in the quads
    • - degree of weight bearing, gait
    • - local signs- swelling, redness/ bruising, skin changes/ damages, mm spasm/ wasting, deformity/ asymmetry
    • - irritability (how easy to stir up and settle down
  4. Functional movements
    • - pt perorms ADL identified in the history as limite or provovative
    • - care with irritable disorders to not worsen
    • - eg walking (ankle), tuckin shirt in (shoulder), putting sock on (lumbar)
    • - important for functional reassessment
    • - repeated, quick, sustained movements as indicated- static loading you moa need to hold the position. eg standing
    • - always consider the injury and how easily you can stir it up
    • - you want to reproduce the pts pain
    • - pt needs to inform you that it is their pain
  5. Active movements
    • - involves mm contraction
    • - moves jt structures and antagonist muscles stretched
    • - some structures stretched, some compressed
    • - therapist may add pressure at EROM (OP) in the movement direction to further stress structures (non- irritable cases)
    • - Note pain response and ROM
    • eg do you bend thru ur hip or Lsp
  6. What things are u palpating and looking for?
    • - tenderness
    • - temp
    • - sweating
    • - mm tone/spasm
    • - test superficial structures eg lig, mm, jt line
    • - helps avoid unnecessary discomfort with handling
    • - helps minimise false positives with other tests
    • - NOTE- do specific palpation at the end of ur obs
  7. Passive Physiological Movements
    • - - physiological movements is a movement the pt can prodcue
    • - passive- therapist does it
    • - mm not activated- non contractile
    • - helps differentiated mm vs inert structures as source of pain
    • - end- feel, ROM- normal COMPARE to other side
    • - draw movement diagram of pain response, resistance to movement
  8. Mm testing
    • - static (isometric) tests minimise jt movement but activate/ stress mm
    • -normally tested in mid- range
    • - useful in differentiating between contractile and non sources of pain
    • - strength/ length as appropriate
    • - isometric tests- instruct pt- dont let me move you
  9. Static mm tests
    • Interpretations of findings:
    • - strong and painful: injury to musculoteninous unit
    • - weak and painless: mm rupture or neurological componenet
    • - weak and painful: gross lesion eg fracture
    • - strong and painless: normal
  10. Neural tissue testing
    • Two separate components:
    • 1. Passive movement of neural tissue for mobility and sensitivity
    • 2. spinal nerve or peripheral nerve conduction
    • - learn dermatomes/ myotomes and peripheral nerve distributions
    • - conductivity- mm strength, sesation, reflexes
    • - test as appropriate
    • - neuro dynamic test- sensivity of neuro tissue to movement
    • - neurological testing is the conduction of a message
  11. Passive accessory movements
    • - an accessory movt is a movt which the pt cant do voluntarily
    • - normally occurs simultaneously with physiological movement
    • - jt play
    • - roll, spin, glif, distraction
    • - Compare to other side
  12. Convex- Concave rule
  13. Comparable sign
    • - a physical finding which reproduces the pts symptoms ie provokes symptoms comparable to the pts complaint and relevant to their functional/ movement limitation
    • - may be an active or passive movement
    • - useful for treatment planning and reassessment following intervention
  14. Special tests
    • - tests designed to evaluate the integrity of specific structures
    • - apply as appropriate depending on histroy and region affected
    • - eg lateral lig stress tests
    • - secificity and sensitivity varies
  15. Reassessment
    • - the repeated assessment of comparable sign to determine whether a given intervention has caused a change and the nature of that change
    • - especillay informs decision- making with treatment progression, the relevance of physical impairments, and the sources of the symptoms
    • - * = sign for reassessment

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