1. describe the considerations of objective data in a systematic examination:
    • Baseline measures: is the swelling today more/less than yesterday? is the patient able to move better today? is the patient still guarding/protecting the injury? what is the pain on a scale of 1 to 10?
    • Re-evaluations: 24 hours later, days later
    • Rehabiliation/treatment protocols: goniometric measurements, ROM, girth measurements
  2. describe the considerations of Documenatation in a systematic examination:
    • medical records: create medical records from objective data
    • legally required
    • communication tool: so that the next provider can know the details
  3. list two goals of the examination process:
    • to obtain an clinical diagnosis
    • to obtain sufficient information to deermine a treament plan that will improve patients quality of life
    • rule out idfferential diagnosis
    • identify impairments and functional limitations
  4. describe the strengths of performing each task on the uninjured limb first as an evaluation strategies:
    • provides an immediate reference point to determine the relative dysfucntion of the injured limb
    • pt. may use uninjured lime to demonstarate mechanism of injury

    • a comparison for the injured limb
    • intact structural integrity
    • allows the athlete to relax (decrease apprehension)
  5. voluntarily or involunatarily assuming a posture to protect an injured body area, often throught muscular spasm:
    muscle guarding
  6. describe the strengths of performing each taks on the injured limb first as an evaluation strategies:
    • the tests should be preformed a short time after the injury has occured
    • test is preformed before muscle guarding sets in
    • rule out a fracture first
  7. the sensation of numbess of tingling, often described as a "pins and needles" sensation, caused by compression or a lesion to a peripheral nerve:
  8. describe the relevance of the history segment of the examination process:
    • past medical history: establishes pre-injury health baseline and identifies conditions that can influence the current problem
    • history of present condition: replicates the mechanism of injury, primary complaint, and functional limitations and disabliltiy
  9. describe the relevance of the inspection segment of teh examination process:
    • provides a reference for symmetry and color of the superfical tissues
    • observations of function determines any limiations between the extremitites. most meaningful when compared to baseline measures
  10. describe the relevance of the paplation segment of the examination process:
    provides a reference for the comparison of bilateral symmetry of bones, alignment, tissue temperature, or other deformit as well as the presence of increased tenderness
  11. describe teh relelvance of the joint and muscle function assesment segement of the examination process:
    provides a reference to identifity impairments relating to available ROM, strength, and pain with movement
  12. describe the joint stablility test segement of the examination process:
    provides a reference for end-feel, relative laxity or hypombility and pain
  13. describe the special test segement of the examination process:
    provides a reference for pathology of individual ligaments, joint capsules and musculotendinous units, and the body's organs
  14. describe the neurolgical tests segements of the examination process:
    provides a reference for bilateral sensory, reflex, and motor function
  15. describe the vascular screening segments of the examination process:
    determines blood circulation to and from the involved extremity
  16. what are the differences between clinical assesments vs. acute evaluatoins:
    • clinical
    • patients are seen by appointments
    • PT's

    • acute
    • patients are seen right after injury occured
  17. describe the speical considerations in a clinical assessment:
    • discretion: private areas to talk
    • religious considerations: people who dont belive in doctors or take meds; pray pain away
    • informed consent: signed written statement, verbal, emergency medical care (if unconscious, you have consent to revive them unless there is a DNR order)
  18. Questions for the past medical history portion of the examination process should include:
    • is there a history of injury to the body area?
    • are there any possible sources of weakness from a previous injury?
    • is there a history of injury to the body part on either side of the body? if so, as the pt. to descibe and compare
    • do the present symptoms duplicate the previous symptoms?
  19. describe some considerations of general health that would effect an athlete's participation:
    • comorbidity: the presence of multiple unrelated disorders in the same person at the same time
    • relevant illness and lab work: may affect injury management and/or the healing process
    • medications: what medications are they currently taking? waht interactions or effect may the have on healing, treatments?
    • smoking: decrease exercise tolerance, increased risk for CV disease, may delay fracture and would healing
  20. list the considerations for the mechansim of injury in the history of the present condition:
    • mechansim of injury: how did the injury occur? describes the involved structures and forces placed on them
    • relevant sounds/sensations
    • onset and duration of sympotoms: acute (signs presented immediately) chronic (gradual onset microtrauma from overuse)
  21. list the considerations for pain as part of history of present conditions portion of the examination:
    • Location of pain
    • type of pain: sharp (fx), stinging, aching, throbbing
    • referred pain: CNS misinerprets the location/source for stimulus
    • radicular pain: nerve root/peripheral never is compressed or damaged
    • daily pain patterns:  when during the course of the day is the pain worse? better?
    • provaocation/alleviation patterns: description of a positon that provokes pain may help identifiy what tissues are stressed
  22. bleeding into a joint cavity:
  23. the collection of fluids in the intercelluar spaces:
  24. in the inspection part of the examination inspect the injured body part for:
    • deformity: visual deviations from normal; can be gross (apparent) or subtle
    • swelling: enlargement of a body part; subtle or dramatic; can occur rapidly or over time; measured using girth measurements
    • skin: look for redness, ecchymosis
  25. a blue or purple area of the skin caused by blood escaping into the extravascular spaces under the skin:
  26. list some observations to look for immediatly as the pt. enters the facility:
    • gait
    • posture
    • function
    • guarding
    • splinting
    • always look for bilateral comparison
  27. structures other than bone, including muscle, tendons, ligaments, capsule, buras, and skin:
    soft tissues
  28. describe how the functional assesment can be related back to the history portion of the examination:
    • ask the pt. to preform functional tasks that were identified as problematic during the history portion
    • consider the underlying impairment that could lead to functional limitations
  29. describe how standardized, reproducable fxn tests are designed to asses the body parts:
    • reaching, one leg hop for distance, ROM, strength, and balance
    • replicate the activity performed by athlete in real life situation
    • relative effectivness of an intervetion can be determined
  30. describe the purpose of the palpation portion of the examination:
    • the process of touching/feeling the tissues; to detect tissue damage/change by comparing the finding of one body part with those of the opposite one
  31. describe the sequencing strategy # 1 of the palpation portion of the examination and in what situation is it used for:
    • palpate bones and ligaments first
    • palpate muscles and tendons next
    • lastly locate any other areas such as pulses

    use this strategy to rule out a fx
  32. describe the sequencing strategy # 2 of the palpation portion of the exam and what situation is it used for:
    • palpate all the structures (bones, muscles, ligaments) farthest from teh susupected injury
    • then palpating prgressing toward the injured site

    use this strategy if the pain they are saying doesnt make sense to what you are seeing; maybe the athlete didnt understand what you were saying
  33. make note of the following potential findings during the palpation portion:
    • point tenderness: increased tenderness of the structure relative to the surrounding structures and structure on opposite side of body
    • trigger points: hypersenstive area located in muscle belly; when irritated refers pain to another body area; feels like small nodes
    • change in tissue density: indicating muscle spasm, hemorrhage, edema, scarring, myositis, ossifications
    • crepitus: audible (or not) creeking; may indicate a fx when felt over bone or inflammation when felt over a tendon, bursa, or joint capsule
    • tissue temperature: increased temp typical during active inflammatory process; decrease temperature associated with vascular insufficiency
  34. describe the joint and muscle function assessment of the examination:
    • to quantify the patients current functional status
    • found as the result of AROM, MMT (manual muscle tests), adn PROM (when no fx is present)
    • joint stability tests
    • stress testing
    • joint play
Card Set
Exam 1