Lower Extremities // Lecture 3-4 (Exam #1) Flashcards

83% of adults in 60s-70s had used at least 1 prescription drug in the last 30 days

about 33% had used 5+ drugs

70-90% of evaluation is done in subjective (talking to people)

• Do they have an existing disease?
• What else is going on?
• Family history that can increase risk of health problems?
• What meds they on?

1. chart review
2. medication review
3. Look at PROs (patient-reported outcome)
4. Talk to the patient (Funnel Technique)
5. Systems review
6. Check your red/yellow (mental health) flags
7. screening questions
8. 3-5 diagnosis
9. objective testing

• WHat brings you in today?
• How can I help you?
• When did it start?
• Patterns?
• Have you PT before?
• Ever had surgery?
• Limitations?
• Goals?

• medical emergency
• ask if they have a "plan"
• need to ask permission to take them to ER

1. Vitals
2. Inspections
3. Palpation
4. Join and muscle function assessment
5. Active ROm
6. Manual muscle testing
7. passive ROM
8. Joint stability testing
9. Stress Testing
10. Joint play

BP (systolic/distaolic). heart rate, respiratory rate

• not very reliable/quantitative => more qualitative

1. bones, ligaments, muscles and tendons
2. palpate all structures, begin away from pain site and progress toward suspected injury

• perform bilaterally
• which test depends on you
• AROM, PROM, manual testing, joint stability testing, stress testing, joint play

• how much the patient can move themselves
• Goniometry- the center of goni is the center of joint you are moving

• at midrange of joint
• stabilize limb proximatly => press distal to muscle attachment=> grade up => do not let me move you
• testing force output

• 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

• 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)

• 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)

• rolling, spinning, gliding
• procedure: relaxe patient in loose-pack position, apply glide/distractinf stress, assessed degree of movement, compare bilaterally

• specific to selected tissues
• results compared: side to side, cause provocation, cause alleviation
• reported as positive or negative

• 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)

• 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

• 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

• 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)

• L1-L5
• S1-S2

• C4-C8
• T1

• capillary refill (nail beds)
• pulses (LE: femoral, posterior tibial, dorsal pedal) (UE: brachial, radial, ulnar), systemic (carotid)