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Assesment Fundamenta
Test 1
| Question | Answer |
|---|---|
| What is pt centered care? | to ID, respect, and care about pt's differences, values, preferences, and expressed needs; patient is in control |
| why is pt centered care important? | it's the right thing to do (philosophical) |
| what are the 8 dimensions of pt- centered care? | pt preference, emotional support, physical comfort, info and education, continuity and transition, coordination of care, access to care, family and friends |
| what is a social determinant of health? | the conditions in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes |
| what are the 5 categories of social health determinants? | economic stability, education access/quality, healthcare access/quality, neighborhood and built environment, social and community context |
| what is cultural competency? | the ability of both providers and systems to provide care to pts with diverse values and tailoring to meet patients needs |
| what is cultural humility? | lifelong process of self- reflection and critique where an individual willingly interacts with diverse individuals |
| what is culture? | patterns of attitudes, verbal cues, and body language that distinguishes one group of people from another |
| what is cultural competence? | recognizing one's own cultural attitudes, beliefs, and biases to better understand the patient's culture and health care practices |
| what is cultural imposition? | intrusively applying the majority cultural view to individuals and families |
| what is platinum rule? | treat others how they want to be treated |
| How do we evaluate ICF (international classification of functioning, disability, and health) | health condition, impairment, limitation, restriction, personal factors, environmental factors |
| What is the EDUCATE model? | related to health literacy--> Enhance comprehension and retention; Deliver pt centered education; Understand the learner; Communicate clearly and effectively; Address health literacy and cultural competence; Teaching and Education goals |
| What are the 3 steps in perception check? | description, interpretation, clarification |
| What does SOLER stand for? | Squarely face the person, Open your posture, Lean towards the sender, Eye contact maintained, Relax while attending |
| What does SPIKES stand for? | Setting, Pt perspective, Invitation for information, Knowledge, Explore emotion/Empathize, Summarize |
| What does NURSE stand for? | Naming, Understanding, Respecting, Supporting, Exploring |
| What is the 6 step approach? | 1- assess pt understanding of situation 2- discuss big picture 3- ask about worries 4- respond to emotion 5- propose care plan 6- check for understanding |
| What is IPE? | when 2 or more professions learn about each other to collaborate |
| what is IPCP? | when multiple professions collaborate together to coordinate care |
| What are SMART goals? | Specific, Measurable, Achievable, Relevant, Timely |
| What is PDSA? | Plan, Do, Study, Act |
| what 3 things go into EBP? | best research evidence, clinical expertise, pt values |
| who is archie cochrane? | promoted RCT's to inform clinical practice |
| who are sackett and guyatt? | promotion and teaching of EMB, ID'd best evidence, coined the term clinical epidemiology |
| what are the 5 steps of EBP? | 1- ask question 2-search 3-critically appraise 4- implement 5-evaluate |
| What are the types of clinical questions? | intervention/therapy, etiology, meaning phrased, diagnosis, prognostic |
| what is intrarater reliability? | how often does the same examiner get the same results of a pos/neg test? |
| what is interrater reliability? | how often do different examiners get the same results? |
| what is the nominal scale? | scales that place subject into mutually exclusive categories (y/n, playing position) |
| what us the ordinal scale? | gives quantitative order to variables but it doesn't indicate how much better one score is (1st, 2nd, 3rd) |
| what is the interval scale? | has equal units of measurements but there is no 0 |
| what is the ratio scale? | based on order, equal units of measurement, and uses 0 (ex weight) |
| What is ICC | a measure of agreement between observers/;observations that can be used when the measurement scale is interval or ratio |
| what is kappa statistic? | a measure of agreement for categorical/nominal data |
| what is validity? | the degree to which an instrument or tool measures what it is intended to measure |
| what is diagnostic accuracy? | how often do the results correctly identify whether or not the pathology is present |
| what is sensitivity? | the true positive rate TP/(TP+FN |
| what is specificity? | true negative rate TN/(TN+FP) |
| when do you believe sensitivity? | when it is negative SnNout) |
| when do you believe specificity? | when it's positive (SpPin) |
| what is the positive likelihood ratio? | how much more likely is a positive test to be found in a person with a disease than without it? |
| what is the negative likelihood ratio? | how much more likely is a negative test to be found in a person without the disease than a person with it? |
| for LR (likelihood ratio) what shows a large and conclusive shift in probability? | positive LR--> 10 negative LR <0.1 |
| what are ottawa rules? | criteria for radiographic referral for ankle; inability to walk 4 steps after injury and pain during palpation of the zones |
| what is MDC | minimum detectable change; smallest clinically significant difference in scores of 2 administrations of the instrument |
| what is MCID | minimal clinically important difference; ID's smallest change that's important to pt |
| what are 3 approaches to pt care? | fix it, evaluate and treat, outcomes |
| what is a POEM? | pt- oriented evidence that matters |
| what 3 characteristics differentiate b/t outcome tools | breadth (uni vs multi dimensional), administration (pt vs clinician report), focus (generic vs disease vs region specific) |
| what is tenosynovitis? | inflammation of synovial membrane around tendons |
| what is peritendinitis | inflammation of tendon |
| what is calcific tendinopathy | formation of deposits of calcium crystals in one or several of the rotator cuff tendons |
| what is bursitis? | inflammation of the bursae |
| what is a contusion? | a bruise |
| what is heterotopic ossification? | the formation of extraskeletal bone in muscle and soft tissues |
| what is compartment syndrome? | an increase in pressure inside a muscle, which restricts blood flow and causes pain |
| what is a sign of a grade 1 sprain? | ligament stretched, no tear; local pain with mild tenderness and swelling; ROM normal, firm endpoint on stress testing |
| what is a sign of grade 2 sprain? | partial tearing; moderate pain and swelling; loss of ROM, soft endpoint on stress testing |
| what is a sign of a grade 3 sprain? | complete rupture; severe pain or limited pain; marked swelling, complete loss of function, empty/absent endpoint on stress testing |
| what is cellulitis? | common bacterial skin infection that causes redness, swelling, and pain in the infected area of the skin |
| what are osteochondral lesions? | when articular cartilage breaks off |
| what is arthritis? osteo vs rheumatoid | osteo-occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates rheumatoid-immune system attacks articular cartilage |
| what is exostosis? | a benign overgrowth of a pre-existing bone |
| what is Wolff's Law? | the idea that natural healthy bones will adapt and change to adapt to the stress that it is subjected to |
| what is apophysitis? | an inflammation or stress injury to the areas on or around growth plates in children and adolescents |
| where are the locations of fractures? | epiphysis on the end, physis in the middle of the head, metaphysis on the beginning of the shaft, diaphysis on the shaft |
| what is the difference between a displaced and a non- displaced fx? | displaced is pulled out of normal alignment |
| what does SALTER mean? | straight across; above; lower/ below; two or through; ERasure of growth plate or cRush |
| what is angulated malunion? | two ends of the bone are angled to each other |
| grade 1 fx | stress reaction found on imaging; pt asymptomatic |
| grade 2 fx | pain in hx; TTP; stress rxn found on imaging |
| grade 3 fx | nondisplaced fx line on imaging |
| grade 4 fx | fx displacement >2mm on imaging |
| grade 5 fx | nonunion fx on imaging |
| what is neuropraxia | mildest form of traumatic peripheral nerve injury. It is characterized by focal segmental demyelination at the site of injury without disruption of axon continuity and its surrounding connective tissues |
| what is axonotmesis | a term that describes the range of PNIs that are more severe than a minor insult |
| what us neurotmesis | a complete transection of a peripheral nerve |
| what is complex regional pain syndrome (CRPS) | describing excess and prolonged pain and inflammation that follows an injury to an arm or leg |
| what is type 1 CRPS | no measurable nerve damage |
| what is type 2 CRPS | nerve involvement detectable through testing |
| what is CRPS-NOS (not otherwise specified) | pt partially meets diagnostic criteria and no other diagnosis is likely |
| what are symptoms of CRPS? | disproportional pain, edema, muscle spasm |
| in a physical exam, how do you measure swelling? | joint line, muscle mass |
| what are things to look for with a skin exam? | redness, ecchymosis, open wounds |
| what are things to look for in an infection? | SHARP, red streaks |
| what are things to identify with palpation? | point tenderness (TTP), trigger points, crepitus, tissue temperature, tissue density changes |
| what is the cause of a spongy boggy feeling over a joint? | synovitis |
| what is a possible of a thickened, warm tissue density change | blood accumulation, infection |
| what is a possible cause of a dense thickened tissue change? | scar tissue formation |
| what is a possible cause of a dense/viscous tissue change? | pitting edema |
| what is a possible cause of increased muscle tone? | muscle spasm, hypertrophy |
| what is a possible cause of a hard change in tissue density? | bone outgrowth |
| how to assess joint and muscle function | compare bilaterally, AROM, PROM, muscle testing, joint stability, stress testing, joint play |
| how to measure ROM? | goniometer |
| What to note with PROM? | quantity of movement, changes in pain patterns, capsular patterns, compare to AROM |
| what might you feel with normal soft, firm, and hard end feels? | soft- soft tissue; firm- muscle capsule ligament stretch; hard- bone |
| what might you feel with irregular soft end feels; example? | sooner or later in ROM than usual or in a joint that is usually firm or hard; soft tissue edema, synovitis |
| what might you feel with irregular firm end feels; example? | sooner or later in ROM than usual or in a joint that is usually soft or hard; capsular, muscular, ligamentous shortening, osteoarthritis |
| what might you feel with irregular hard end feels; example | sooner or later in ROM than usual or in a joint that is usually soft or firm; feels bony; loose bodies, heterotopic ossification, fx |
| what might you feel with irregular spasm end feels; example | ROM stopped by involuntary or voluntary muscle contraction; inflammation, muscle tear, joint instability |
| what might you feel with irregular empty end feels; example | no real end feel b/c ROM isn't reached due to pain; no resistance; acute joint inflammation, bursitis, abscess, fx, psychogenic origin |
| grade 1 ligamentous laxity? | firm (normal) slight stretching with little to no tearing of fibers; pain with little to no laxity when bilaterally compared |
| grade 2 ligamentous laxity? | soft; partial tearing of fibers, increased play of the joint surfaces; joint line opens up significantly compared bilaterally |
| grade 3 ligamentous laxity? | empty; complete tearing of ligament; excessive motion |
| what is the score breakdown for joint play? | 0-2 hypomobile; 3 normal; 4-6 hypermobile |
| what might a decreased pulse mean? | edema in distal extremity |
| what is a disablement model? | conceptual models that provide a framework for clinical practice and research |
| what are some key points in how to provide injury education? | Break information into small doses Give the most important information first Repeat important points at the end Write down instructions Use language they can understand Ask patients to paraphrase key points Ask about concerns at every session |
| what are 5 key important factors of IPE | improve pt outcomes, reduce medical errors, initiate treatment faster, reduce inefficiencies, improve staff relationships and readiness |
| what is reliability? | the level of consistency in which an instrument or tester measures a variable |
| how is a clinical prediction rule developed? | derivation, validation, impact analysis |
| what type of pain does the mcgill pain questionnaire assess? | general pain |
| what type of pain does the oswestry pain questionnaire assess? | low back pain |
| what type of pain does the global rating of change pain questionnaire assess? | low back pain |
| what type of pain does the 36 short form pain questionnaire assess? | general pain |
| what type of pain does the DPA pain questionnaire assess? | general pain |
| what type of pain does the WOMAC pain questionnaire assess? | osteoarthritis |
| what type of pain does the LEFS pain questionnaire assess? | lower extremity pain |
| what is the physical stress theory? | biological tissues respond to the forces placed on them |
| what is the stress- strain curve? | how much tensile (stretching) load tissues can tolerate before failure |
| macro vs micro trauma | macro- single force micro- excessive stresses over time |
| what 4 major types of forces that cause musculoskeletal trauma | tension, compression, shear, torsion |
| type 1A muscle injury | fatigue induced muscle disorder- Dull, diffuse, tolerable pain in involved muscles, circumscribed increase of tone. Athlete reports of ‘muscle tightness’ |
| type 1B muscle injury | DOMS, Oedematous swelling, stiff muscles. Limited range of motion of adjacent joints. Pain on isometric contraction. Therapeutic stretching leads to relief |
| type 2a muscle injury | spine-related neuromuscular muscle disorder Circumscribed longitudinal increase of muscle tone. Discrete oedema between muscle and fascia. Occasional skin sensitivity, defensive reaction on muscle stretching. Pressure pain |
| type 2b muscle injury | muscle related neuromuscular disorder- Circumscribed (spindle-shaped) area of increased muscle tone, oedematous swelling. Therapeutic stretching leads to relief. Pressure pain |
| type 3a muscle injury | minor partial muscle tear; Well-defined localised pain. Probably palpable defect in fibre structure within a firm muscle band. Stretch-induced pain aggravation |
| type 3b muscle injury | moderate partial muscle tear; Well-defined localised pain. Palpable defect in muscle structure, often haematoma, fascial injury Stretch-induced pain aggravation |
| type 4 muscle injury | sub muscle tear; Large defect in muscle, haematoma, palpable gap, haematoma, muscle retraction, pain with movement, loss of function, haematoma |
| What type of pain scales? Injury Psychological Readiness to Return to Sport Scale University of Wisconsin Running Injury and Recovery Index Attachment OSU Pt-Completed Health Outcomes Measures.pdf Attachment Age-Appropriate Pediatric Sports Patient- | general |
| What type of PRO? FAAM FADI Cumberland Ankle Instability Tool VISA-A Questionnaire Development and Reliability of the Ankle Instability Instrument Reliability and Validity of a New Questionnaire Created | ankle |
| what kind of pain scale? IKDC KOOS Kujala Patellofemoral Score | knee |
| what type of pain scale? Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (HOOS) Harris | hip, pelvis, thigh |
| what type of pain scale? DASH liverpool BCQT MHQ hospital for special surgery | elbow |
| what type of pain scale? DASH oxford PENN SPADI WOSI UCLA | shoulder |
| 6 steps in physical exam | Set the stage Obtain the agenda Begin interviewing with non-focusing skills Understand the impact of problems Identify social factors Transition into the clinician-centered interview and exam |
Created by:
beccalamb
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