Steps of orthopedic assessment
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| What are the three main reasons for doing an interview? | 1.gather info about client as it relates to the chief complaint 2.decide if the client has musculoskeletal condition that the therapist can work on, or refer out to another healthcare practitioner 3.to develop an index of suspicion
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| List the 19 questions to ask when performing an interview? OL’ DR FICARA and more. | Cheif Comp, Onset( injury?), Location, Duration, Referral, Frequency, Intensity, Character, Aggravation, Relieving, & Associated symptoms(ADLs, neurological) Occupation, sports/hobbies, medications, previous diagnosis & treatment, past&family history
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| What is an index of suspicion? | A list of possible conditions that the information from the interview has led the therapist to suspect.
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| List the 8 points that you need to go over with the client for informed consent. | 1.purpose, benefits, effects 2.process 3. time 4. dress 5.refusal 6. questions 7. confidentiality 8. explicit consent
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| What do you learn from a postural assessment? | Musculoskeletal imbalances or deviations from normal.
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| What are the reference points for a plumb line? Anterior, Lateral, and posterior. | Anterior:Midway between the medial malleoli. Lateral:Just anterior to the lateral malleolus. Posterior:Midway between the medial malleoli.
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| When demonstrating a postural assessment you will start by asking your cleint to? | shoes off, behind plumb line.
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| Posture assessment landmarks for Anterior | Anterior:midway b/w medial malleoli, midway b/w knees, pubic symphysis, umbilicus, sternal notch, chin, nose, b/w eyes.
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| Posture assessment landmarks for Lateral | Lateral: just anterior to lateral malleolus, just anterior to the head of fibula, greater trochanter, acromion process, external auditory meatus.
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| Posture assessment landmarks for Posterior | Posterior:midway b/w medial malleoli, midway b/w knees, gluteal cleft, spinous processes, midway through head (external occipital protuberance)
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| What do you learn from performing a gait assessment? | Musculoskeletal imbalances or deviation from normal during motion; abnormal gait patterns (i.e. antalgic ataxic)
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| When demonstrating a gait assessment | Shoes off, Anterior view: feet position, body sway. Lateral view: arm swing, step length, abnormal gait (ataxia, antalgic) Posterior view: feet position, body sway
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| List the 4 "Ts" of palpation and give an example. | Temperature:heat (inflammation), coolness(ischemia)
Texture:Boggy, ropy, firm, fascial restrictions
Tenderness:Point tender or referring
Tone: Hypertonic muscles
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| When palpating you should? | Palpate unaffected side first to compare. Use a broad flat hand to start, gradually moving closer to the painful area and becoming more specific.
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| In active free ROM what tissue is being tested? What are you observing? | Contractile and non-contractile.
Ease or quality of movement.
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| In passive relaxed ROM what tissue is being tested? Where does a passive relaxed movement stop? What movement is performed at the end of a passive relaxed ROM? | Non-contractile
The barrier at the end of the pain-free range.
Over pressure
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| In active resisted ROM what tissue is being tested? What type of contraction is used? How long do you hold it? What do you say to the client? What results are you looking for? | Contractile
Isometric
5 Seconds
"Don't let me move you" or "Meet my resistance"
Pain and/or weakness
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| When performing ROM what will the teacher be looking for? List 6 | 1.hand placement 2. instructions to client 3.knowledge of ranges 4.confidence 5.positioning of client 6.mention scanning the joints above and below 7.mention testing unaffected side first.
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| What division of the reflex arc is dermatome testing? What is a normal result? | Sensory
Equal quality of sensation on both sides.
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| Dermatome testing for cervical: | C1:top of head C2:side of head C3:side of neck C4:yoke C5:over deltoids C6:lateral forearm to thumb C7:middle forearm to middle fingerC8:lower medial forearm to baby finger T1:medial elbow T2: axilla
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| Dermatome testing for lumbar: | L1:around low back to ASIS L2:inner thigh L3:medial knee L4:around medial malleolus L5:top of foot down 2nd and 3rd toes S1:lateral side of bottom of foot S1/S2:bottom of calcaneus
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| What part of the reflex arc is myotome testing? What is a normal result? | Motor
Equal and adequate strength on both sides
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| Myotome testing for cervical: | C1-C2:neck flexion C3:neck lateral flexion C4:shoulder elevation C5:shoulder abduction C6:elbow flexion/wrist extension(waiter) C7:elbow extension/wrist flexion C8:thumb extension/ulnar deviation T1:hand intrinsics
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| Myotome testing for lumbar: | L1-L2:hip flexion L3:knee extension L4:ankle extension L5:toe extension S1:ankle plantar flexion, ankle eversion, hip extension, knee flexion S2:knee flexion
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| What part of the reflex arc is deep tendon reflex testing? What is a normal response? | Both motor and sensory
Equal response on each side
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| What is the normal reflex response for biceps tendon? What is the nerve root for biceps tendon reflex? | Elbow flexion
C5/C6
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| What is the normal reflex response for triceps tendon? What is the nerve root for triceps tendon reflex? | Elbow extension
C7/C8
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| What is the normal reflex response for petellar tendon? What is the nerve root for patellar tendon reflex? | Knee extension
L3/L4
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| What is the normal reflex response for calcaneal tendon? What is the nerve root for calcaneal tendon reflex? | Ankle plantar flexion
S1/S2
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| What are the points of a clinical impression? | 1.summary of signs and symptoms noted in the assessment 2. location 3. stage of healing (if applicable) 4. possible condition 5. possible cause
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