front 1 National institute on aging in 2021 | back 1 83% of adults in 60s-70s had used at least 1 prescription drug in the
last 30 days
about 33% had used 5+ drugs |
| back 2 70-90% of evaluation is done in subjective (talking to people) |
front 3 subjective examination questions | back 3 - Do they have an existing disease?
- What else is going
on?
- Family history that can increase risk of health
problems?
- What meds they on?
|
| back 4 - chart review
- medication review
- Look at PROs
(patient-reported outcome)
- Talk to the patient (Funnel
Technique)
- Systems review
- Check your red/yellow
(mental health) flags
- screening questions
- 3-5
diagnosis
- objective testing
|
front 5 S.E: Good questions to ask | back 5 - WHat brings you in today?
- How can I help you?
- When did it start?
- Patterns?
- Have you PT
before?
- Ever had surgery?
- Limitations?
- Goals?
|
| back 6 - medical emergency
- ask if they have a
"plan"
- need to ask permission to take them to
ER
|
| back 7 - Vitals
- Inspections
- Palpation
- Join
and muscle function assessment
- Active ROm
- Manual
muscle testing
- passive ROM
- Joint stability
testing
- Stress Testing
- Joint play
|
front 8 Objective Examination: Vitals | back 8 BP (systolic/distaolic). heart rate, respiratory rate |
front 9 Objective Examination: palpation | back 9 - not very reliable/quantitative => more qualitative
- bones, ligaments, muscles and tendons
- palpate all
structures, begin away from pain site and progress toward suspected
injury
|
front 10 Objective Examination: Joint and muscle funtion assessment | back 10 - perform bilaterally
- which test depends on you
- AROM, PROM, manual testing, joint stability testing, stress
testing, joint play
|
front 11 Objective Examination: Active ROM | back 11 - how much the patient can move themselves
- Goniometry-
the center of goni is the center of joint you are moving
|
front 12 Objective Examination: Manual muscle testing | back 12 - at midrange of joint
- stabilize limb proximatly =>
press distal to muscle attachment=> grade up => do not let me
move you
- testing force output
|
front 13 Objective Examination: Passive ROM | back 13 - patient is relaxed, provider moves the joint
- if range
ok (no pain) => provide over-pressure
- PROM>ROM =>
muscular problem
- AROM> PROM (and limited)=> may be
joint problem
|
front 14 Objective Examination: Joint stability testing | back 14 - apply specific stress to noncontractile tissue
- hypermobile (more laxity than normal)
- hypomobile (below
normal laxity)
- laxity (clinical; sign of the amount of
"give" in a joint, shown in stress testing
- instability (join't inability to function under stresses of
function activity)
|
front 15 Objective Examination: Stress testing (compare bilaterally) | back 15 - Grade I, firm: slight ligament stretch, pain, regular
laxity
- Grade II, soft: partial tearing of fibers, increased
joint play ("opens up") in compare to other side,
- Grade II, empty: complete tearing, excessive tearing, restricted
by tendons (2nd restraints)
|
| back 16 - rolling, spinning, gliding
- procedure: relaxe patient
in loose-pack position, apply glide/distractinf stress, assessed
degree of movement, compare bilaterally
|
| back 17 - specific to selected tissues
- results compared: side to
side, cause provocation, cause alleviation
- reported as
positive or negative
|
| back 18 - is a nerve root involved?
- symptoms: numbness or weird
sensations, abnormally weak
- dermatomes: which parts of skin
are innervated by which nerve groups (preform bilaterally)
|
front 19 neurological screening: dermatomes | back 19 - which parts of skin are innervated by which nerve groups
(preform bilaterally)
- patient eyes closed and head turned
away
- discrimination test: light tough, sharp and dull,
2-point
|
| back 20 - tests another muscle innervated by same nerve root
- 1
muscle weak= suspect muscle pathology or peripheral nerve
pathology
- 2 muscles weak= suspect nerve root od peripheral
nerve pathology
|
| back 21 - increased response neuron lesion = upper motor
- decreased response neuron lesion = lower motor
- Deep
tendon reflex (DTR)= muscle stretched+relaxed, patient look away,
strike tendon with reflex hammer (0-4+ // 2= normal response)
|
front 22 Lower quarter neuro screen | |
| |
| back 24 - capillary refill (nail beds)
- pulses (LE: femoral,
posterior tibial, dorsal pedal) (UE: brachial, radial, ulnar),
systemic (carotid)
|