Lecture #1 - Principles of Assessment
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Questions and Answers

What is the significance of subjective and objective data in assessments?

Subjective data captures personal, unverifiable patient reports, while objective data provides observable, measurable facts that inform clinical decisions.

How do validity and reliability contribute to the effectiveness of assessments?

Validity ensures that a test accurately measures what it intends to assess, while reliability guarantees consistent results across multiple test executions.

Differentiate between inter-rater reliability and intra-rater reliability.

Inter-rater reliability refers to consistency of results among different assessors, while intra-rater reliability pertains to consistency of results from the same assessor over time.

What do sensitivity and specificity indicate regarding diagnostic tests?

<p>Sensitivity measures the ability to correctly identify true positives, while specificity reflects the ability to correctly identify true negatives in individuals with and without the pathology, respectively.</p> Signup and view all the answers

Explain the role of clinical reasoning in therapy decision-making.

<p>Clinical reasoning integrates professional knowledge, personal experience, and professional craft knowledge to guide clinicians in making informed decisions regarding patient care.</p> Signup and view all the answers

What is the main purpose of ongoing assessments in therapy treatment?

<p>Ongoing assessments provide a continuous base of information for decision-making and medical referrals.</p> Signup and view all the answers

How does professional craft knowledge differ from personal knowledge in clinical reasoning?

<p>Professional craft knowledge is gained through clinical experience, while personal knowledge is based on individual life experiences.</p> Signup and view all the answers

In the context of differential diagnosis, what are the three critical considerations a clinician should explore?

<p>A clinician should consider common pathologies, life-threatening conditions, and rarer pathologies that may present similarly.</p> Signup and view all the answers

What role does clinical reasoning play in differentiating between similar diseases?

<p>Clinical reasoning helps to weigh probabilities and identify distinguishing features among similar presenting diseases.</p> Signup and view all the answers

Explain the importance of validity in assessments.

<p>Validity ensures that a test accurately measures what it is supposed to measure, yielding correct results.</p> Signup and view all the answers

What is the difference between hardware and software issues in assessment?

<p>Hardware issues pertain to physical limitations or mechanical problems, while software issues involve movement coordination or motor control flaws.</p> Signup and view all the answers

Define specificity in the context of diagnostic tests.

<p>Specificity refers to the probability of obtaining a negative test result for individuals who do not have the pathology.</p> Signup and view all the answers

What outcome results from the interaction of professional, personal, and professional craft knowledge?

<p>The interaction leads to enhanced clinical decision-making and improved patient care.</p> Signup and view all the answers

What is the desired duration for holding each reflex test during assessment?

<p>5-7 seconds.</p> Signup and view all the answers

When re-testing for reflexes, what should you avoid doing?

<p>Taking a break between the 1st and 2nd test.</p> Signup and view all the answers

How are reflexes graded in a clinical assessment?

<p>On a scale from 0 to 4.</p> Signup and view all the answers

Which type of reflex arc is primarily involved in deep tendon reflex testing?

<p>Simple reflex arc.</p> Signup and view all the answers

What technique is applied to enhance reflex testing in the lower extremities?

<p>Jendrassik's maneuver.</p> Signup and view all the answers

What must the patient be during reflex assessments?

<p>Relaxed.</p> Signup and view all the answers

What is the most neglected range of motion (ROM) in assessments?

<p>Passive Range of Motion (PROM).</p> Signup and view all the answers

What two aspects can significantly reduce the number of steps in a clinical assessment?

<p>Information from history and early inspection.</p> Signup and view all the answers

What is the primary reason you should not perform palpation first in an assessment?

<p>It can irritate tissues and cause inaccurate findings.</p> Signup and view all the answers

What should be your approach when something aggravates the patient during functional testing?

<p>Save it until the end of the assessment.</p> Signup and view all the answers

What role does inspection of the non-injured limb serve during an examination?

<p>It provides a reference for symmetry, alignment, and color of the superficial tissues.</p> Signup and view all the answers

In assessing range of motion (ROM), what constitutes the anatomical barrier?

<p>The anatomical barrier refers to the maximum range of motion achievable by the patient without assistance.</p> Signup and view all the answers

What two types of tissues are tested during Active Range of Motion (AROM)?

<p>Inert and contractile tissues.</p> Signup and view all the answers

What must the patient be for Passive Range of Motion (PROM) testing?

<p>The patient must be relaxed.</p> Signup and view all the answers

List one reason when passive movements may be deemed unnecessary.

<p>If AROM is full and pain-free.</p> Signup and view all the answers

In Isometric Muscle Testing (ISOM), what is the purpose of the phrase 'don’t let me move you'?

<p>It aims to gauge the muscle's ability to produce force against resistance.</p> Signup and view all the answers

What are the three types of normal end feel in joint assessments?

<p>Hard, soft, and firm.</p> Signup and view all the answers

What does a normal AROM and restricted PROM indicate?

<p>It suggests a software issue, meaning the AROM constraints are due to patient contributions rather than structural limitations.</p> Signup and view all the answers

What are the five functions that special tests are designed to evaluate?

<p>Function of specific muscles, arthrokinematics, neurological function, selective tissues, and integrity of ligaments.</p> Signup and view all the answers

What is measured in a neurological assessment's sensory component?

<p>Anaesthesia, paresthesia, and hyperesthesia.</p> Signup and view all the answers

What does a larger index of suspicion indicate about patient assessment?

<p>It indicates that the clinician is considering multiple potential serious conditions to avoid missing something vital.</p> Signup and view all the answers

Why should clinicians avoid using the term 'diagnosis' in their assessments?

<p>They should avoid it because 'diagnosis' implies a definitive conclusion based on exhaustive testing, which may not always be appropriate.</p> Signup and view all the answers

What does the grading scale for ISOM testing categorize as a 3/5?

<p>Fair, where the patient can move the body part against gravity through the full range of motion.</p> Signup and view all the answers

What are the four general steps of informed consent?

<p>The steps are explaining what and why you’re doing it, how you’re doing it, the risks, and reasonable alternatives.</p> Signup and view all the answers

In terms of motion direction during joint play, which three motions are primarily assessed?

<p>Roll, glide, and spin.</p> Signup and view all the answers

List three of the seven purposes of documentation in clinical practice.

<p>Legal requirement, communication, and organization.</p> Signup and view all the answers

When performing neurological testing, what method is used for assessing motor function?

<p>Myotomes.</p> Signup and view all the answers

What acronym represents the documentation requirements, and what does the 'C' stand for?

<p>The acronym is CCASSEL, and 'C' stands for Chronological and timely.</p> Signup and view all the answers

What determines the quality of end feel during PROM testing?

<p>It is determined by the resistance felt at the end of a joint's range of motion.</p> Signup and view all the answers

What is the correct order of the SOAP format in documentation?

<p>Subjective, Objective, Assessment, Plan.</p> Signup and view all the answers

Name one of the two aspects of verbal communication in a healthcare context?

<p>Speaking.</p> Signup and view all the answers

What are the eight aspects of non-verbal communication?

<p>Facial expressions, eye contact, posture, positioning, gestures, attitude, tone, and distractors.</p> Signup and view all the answers

How many critical rule-outs should be performed during an assessment?

<p>They should be performed multiple times, as indicated in the 16 steps of assessment.</p> Signup and view all the answers

What is one of the six things to do throughout your assessment?

<p>Look.</p> Signup and view all the answers

During a history taking, what should be avoided to ensure clarity?

<p>Leading questions.</p> Signup and view all the answers

What information do the three components 'FAV' in observation gather?

<p>Functional deficits, abnormalities of alignment and movement, visible defects.</p> Signup and view all the answers

What is the primary focus during an evaluation in terms of aspects?

<p>One aspect at a time.</p> Signup and view all the answers

What should a therapist possess after a comprehensive subjective assessment?

<p>An index of suspicion.</p> Signup and view all the answers

What constitutes a 'red flag' in history taking related to back issues?

<p>Symptoms like unrelenting pain, history of cancer, or unexplained neurological deficits.</p> Signup and view all the answers

What three areas are essential for spinal history taking, represented by MMFFCV?

<p>Medications, Menstruation/pregnancy/menopause, Family history.</p> Signup and view all the answers

What observation should be made regarding a patient's knees during assessment?

<p>Determine if the knees are relaxed or locked in extension.</p> Signup and view all the answers

Describe Pottenger's saucer and its significance in assessment.

<p>Pottenger's saucer refers to a loss of kyphotic curve, correlated with digestive disorders.</p> Signup and view all the answers

List the eight factors influencing posture represented by the acronym 'Hyper, Hypo, Leg, Lack, Pain, Neuro, Muscle, Density, Bone.'

<p>Factors include hypermobile joints, hypomobile joints, leg-length discrepancies, lack of postural awareness, pain, neurological pathology, muscle imbalances, and bony abnormalities.</p> Signup and view all the answers

What is the main purpose of performing a scanning exam?

<p>To assess potential causes of symptoms that may be referred from another location or involve multiple body parts.</p> Signup and view all the answers

Explain the difference between clearing and scanning in musculoskeletal assessment.

<p>Clearing examines joints above and below an injury, while scanning looks at multiple areas potentially related to the complaint.</p> Signup and view all the answers

Identify the six cases when a scanning exam is indicated based on the acronym 'DIALReScue.'

<ol> <li>Diffuse/non-specific MOI, 2) Insidious onset, 3) Altered sensation, 4) Long track signs, 5) Many joints involved, 6) Radicular signs.</li> </ol> Signup and view all the answers

What does regional interdependence imply in musculoskeletal assessment?

<p>It implies that symptoms may be influenced by impairments from various body regions, regardless of proximity.</p> Signup and view all the answers

Name the first step of a lower quadrant scanning exam.

<p>Perform T-spine PAIVMs (Passive Accessory Intervertebral Movements).</p> Signup and view all the answers

What does the term 'dynamic observations' encompass in a spinal assessment?

<p>It includes evaluating gait and conducting functional tests.</p> Signup and view all the answers

Why is it recommended to start testing non-painful movements first in an evaluation?

<p>To establish a baseline and avoid exacerbating pain early in the assessment.</p> Signup and view all the answers

In the context of spinal assessments, what does 'hyperreflexia' indicate?

<p>It indicates upper motor neuron pathologies.</p> Signup and view all the answers

What is the significance of observing a patient's breathing patterns during an assessment?

<p>To assess whether breathing is primarily chest or abdominal and to check for anterior, lateral, and posterior expansion.</p> Signup and view all the answers

How does pain influence posture according to the provided information?

<p>Pain can result in antalgic posture, where the body adopts a position to avoid discomfort.</p> Signup and view all the answers

What are the reflex tests associated with the following levels: C4, C5, C6, and C7?

<p>C4 - deltoid, C5 - biceps, C6 - brachioradialis, C7 - triceps.</p> Signup and view all the answers

What should be taken into account regarding patient and therapist positioning during examinations?

<p>Both should be positioned for comfort and efficiency, minimizing stress and maximizing assessment accuracy.</p> Signup and view all the answers

What is the main difference between subjective data and objective data in assessments?

<p>Subjective data refers to information that cannot be specifically verified, while objective data consists of observable facts that can be visually assessed.</p> Signup and view all the answers

How do sensitivity and specificity relate to the effectiveness of diagnostic tests?

<p>Sensitivity measures the probability of a true positive result in someone with the pathology, while specificity measures the probability of a true negative result in someone without the pathology.</p> Signup and view all the answers

What is the role of clinical reasoning in the differential diagnosis process?

<p>Clinical reasoning helps clinicians weigh the probabilities of various diseases by comparing symptoms and identifying potential pathologies.</p> Signup and view all the answers

What three considerations are essential for clinicians when performing a differential diagnosis?

<p>Clinicians should consider the most common pathologies, life-threatening conditions with similar presentations, and rarer pathologies that may also align.</p> Signup and view all the answers

In the context of assessments, what is meant by 'hardware' and 'software' issues?

<p>'Hardware' refers to physical movement restrictions or mechanical issues, while 'software' pertains to flaws in movement coordination or motor control.</p> Signup and view all the answers

Why is ongoing assessment essential in therapy treatment?

<p>Ongoing assessment provides a base of information that informs appropriate medical decisions and referrals throughout treatment.</p> Signup and view all the answers

How does the interaction of professional, personal, and professional craft knowledge influence clinical decision making?

<p>This interaction enhances a clinician's ability to make informed and reasonable decisions regarding a patient's health and care.</p> Signup and view all the answers

What does 'validity' signify in the context of assessments?

<p>Validity indicates that a test accurately measures what it is supposed to measure, ensuring that the results are true.</p> Signup and view all the answers

What is the proper duration for holding each reflex during assessment?

<p>5-7 seconds.</p> Signup and view all the answers

How many times should deep tendon reflex tests be performed?

<p>3 to 5 times.</p> Signup and view all the answers

What is a key technique to use during lower extremity reflex testing?

<p>Jendrassik’s maneuver.</p> Signup and view all the answers

What should you do with movements that aggravate the patient's condition during functional testing?

<p>Save them until the end of the assessment.</p> Signup and view all the answers

When should palpation be performed in an examination process?

<p>After other tests.</p> Signup and view all the answers

What are the three main principles to follow during palpation?

<p>Move slowly, avoid excessive pressure, and focus on what you’re feeling.</p> Signup and view all the answers

What two factors can significantly decrease the number of steps in a clinical assessment?

<p>Information from history and early inspection.</p> Signup and view all the answers

What are the seven Ts of palpation used to describe findings?

<p>Texture, tenderness, temperature, tissue tension, thickness, tremors.</p> Signup and view all the answers

What is the most often overlooked range of motion during assessments?

<p>Passive Range of Motion (PROM).</p> Signup and view all the answers

What does an increased index of suspicion indicate about a clinician's assessment approach?

<p>It suggests that the clinician is considering multiple potential serious conditions to avoid missing something significant.</p> Signup and view all the answers

What are the components included in the ongoing process of informed consent?

<p>They include the purpose of treatment, how it will be done, associated risks, and reasonable alternatives.</p> Signup and view all the answers

Why is documentation considered a legal requirement in clinical practice?

<p>Documentation serves to provide a formal record of patient interactions which can be referred to in legal circumstances.</p> Signup and view all the answers

What does the acronym 'SOAP' stand for in clinical documentation?

<p>Subjective, Objective, Assessment, Plan.</p> Signup and view all the answers

In assessment, why should a clinician avoid leading questions during history taking?

<p>Leading questions can bias responses and lead to inaccurate clinical impressions.</p> Signup and view all the answers

What is the main focus of observation during a patient assessment?

<p>To identify functional deficits, abnormalities of alignment and movement, and visible defects.</p> Signup and view all the answers

What are the expectations for attention focus throughout the assessment process?

<p>Attention should be focused on one aspect at a time, gradually increasing to multiple aspects as expertise grows.</p> Signup and view all the answers

What should a therapist have after completing a comprehensive subjective assessment?

<p>An index of suspicion related to the patient's condition.</p> Signup and view all the answers

List three of the six documentation requirements represented by the acronym 'CCASSEL'.

<p>Chronological, Confidential, Accurate.</p> Signup and view all the answers

Why is paraphrasing used during a patient assessment?

<p>Paraphrasing helps clarify patient responses and confirms understanding.</p> Signup and view all the answers

What are the four essential components of the 16 steps of an assessment?

<p>History, Observation, Examination, Clinical Impression.</p> Signup and view all the answers

What is the significance of the 20 history red flags during patient interviews?

<p>These red flags help identify serious underlying conditions that need immediate attention.</p> Signup and view all the answers

What does the term 'functional deficits' refer to in the context of patient observation?

<p>Functional deficits refer to limitations in a patient's ability to perform daily activities.</p> Signup and view all the answers

Name two aspects of non-verbal communication important in clinical settings.

<p>Facial expressions and eye contact.</p> Signup and view all the answers

What does the Pottenger’s saucer relate to in terms of spinal health?

<p>It correlates a loss of kyphotic curve with digestive disorders.</p> Signup and view all the answers

Name two factors influencing posture according to the acronym 'Hyper, Hypo, Leg, Lack, Pain, Neuro, Muscle, Density, Bone.'

<p>Hypermobile joints and pain.</p> Signup and view all the answers

What do the terms 'clearing' and 'scanning' refer to in the context of a physical assessment?

<p>'Clearing' involves assessing joints above and below an injured area, while 'scanning' refers to examining specific quadrants or areas of the body.</p> Signup and view all the answers

What is the mechanism behind the concept of regional interdependence?

<p>It suggests that musculoskeletal symptoms may be influenced by impairments from various body regions, regardless of proximity.</p> Signup and view all the answers

List two components examined during an upper quadrant scanning exam.

<p>Peripheral joint movements and UQ myotomes.</p> Signup and view all the answers

What is the purpose of testing the non-painful movements first during an examination?

<p>To avoid exacerbating the patient's discomfort and ensure a more accurate assessment.</p> Signup and view all the answers

Which spinal pathologies can be indicated by long track signs or symptoms?

<p>Hyperreflexia and ataxia.</p> Signup and view all the answers

What should be the therapist's positioning focus during an assessment?

<p>To maintain good body mechanics and avoid personal stress.</p> Signup and view all the answers

What is assessed in a neurological evaluation's motor function component?

<p>Muscle strength through myotome testing.</p> Signup and view all the answers

How can skin conditions be relevant during a spinal examination?

<p>Skin conditions like wounds can indicate possible underlying issues or complicate the assessment.</p> Signup and view all the answers

What is dynamic observation in the context of spinal assessment?

<p>It involves assessing gait and performing functional tests.</p> Signup and view all the answers

What role does inspection of the non-injured limb play during the examination process?

<p>It provides a reference for symmetry, alignment, and color of the superficial tissues.</p> Signup and view all the answers

Explain the difference between Active Range of Motion (AROM) and Passive Range of Motion (PROM).

<p>AROM is what the patient can achieve on their own, while PROM measures how far the joint can move with external assistance.</p> Signup and view all the answers

What does the ‘inverted T’ observation examine?

<p>It assesses alignment and stability of the person when they squat.</p> Signup and view all the answers

What are the three components of neurological testing?

<p>Sensory, motor, and reflex functions.</p> Signup and view all the answers

What are some common patterns associated with shingle outbreaks?

<p>Shingles typically follows a dermatomal pattern.</p> Signup and view all the answers

What is assessed during the lower quadrant scanning exam regarding reflexes?

<p>L4 – patellar reflex, L5 – Achilles reflex, and S1 – medial hamstring reflex.</p> Signup and view all the answers

Name the three types of normal end feel during joint assessments.

<p>Hard, soft, and firm.</p> Signup and view all the answers

In which circumstances may passive movements be deemed unnecessary?

<p>If AROM is full and pain-free, overpressure does not produce symptoms, or the end feel is normal.</p> Signup and view all the answers

What does the term 'elastic barrier' refer to in terms of range of motion?

<p>It describes the boundary between what the patient can actively achieve and the maximum passive movement of the joint.</p> Signup and view all the answers

Identify the two types of tissues evaluated during Active Range of Motion (AROM) testing.

<p>Inert and contractile tissues.</p> Signup and view all the answers

What does a restricted AROM and normal PROM typically indicate?

<p>It suggests a 'software issue', meaning the muscular contribution to movement is impaired rather than a mechanical limitation.</p> Signup and view all the answers

Outline the grading categories for Isometric Muscle Testing (ISOM).

<p>0/5 (no contraction), 1/5 (trace contraction), 2/5 (poor movement), 3/5 (fair movement against gravity), 4/5 (good resistance), 5/5 (normal resistance).</p> Signup and view all the answers

What should be evaluated during Passive Range of Motion (PROM) testing?

<p>Range of movement, the onset and location of pain, and the quality of the end feel.</p> Signup and view all the answers

What does ISOM testing primarily assess?

<p>The contractile and nervous tissues involved in producing force.</p> Signup and view all the answers

Why is the empty end feel the most difficult to understand during assessments?

<p>Because it often relies on the patient's cooperation, and they may limit movement due to pain or discomfort.</p> Signup and view all the answers

Describe the three types of muscle tissue tested during AROM.

<p>Inert, contractile, and nervous tissues.</p> Signup and view all the answers

What is the importance of evaluating the quality of movement during AROM testing?

<p>It provides insight into the patient’s control, coordination, and efficiency of the movement.</p> Signup and view all the answers

How do subjective and objective data complement each other in assessments?

<p>Subjective data provides personal insights from the patient, while objective data offers measurable evidence; together, they create a comprehensive picture for clinical decision-making.</p> Signup and view all the answers

In clinical reasoning, why is it important to consider life-threatening pathologies alongside common conditions?

<p>Considering life-threatening pathologies ensures that critical conditions are not overlooked and appropriate interventions are prioritized.</p> Signup and view all the answers

What is the significance of ongoing assessments in the clinical reasoning process?

<p>Ongoing assessments provide continuous updates to patient data, allowing for informed adjustments to treatment plans as the patient's condition evolves.</p> Signup and view all the answers

Why is the concept of reliability fundamental in assessments, particularly in intra-rater testing?

<p>Reliability ensures that consistent results can be achieved when the same clinician conducts a test multiple times, enhancing the test's credibility.</p> Signup and view all the answers

What role does differential diagnosis play in the assessment process?

<p>Differential diagnosis helps clinicians evaluate and compare potential diseases based on presenting symptoms, guiding accurate diagnosis and treatment.</p> Signup and view all the answers

How does the interplay of professional, personal, and craft knowledge enhance clinical decision-making?

<p>This interplay incorporates empirical evidence, personal experiences, and practical insights, leading to more informed and nuanced clinical decisions.</p> Signup and view all the answers

In what ways can hardware and software issues impact patient assessments?

<p>Hardware issues refer to physical limitations affecting movement, while software issues pertain to coordination or control; both can hinder accurate assessment outcomes.</p> Signup and view all the answers

How does the assumption of normative data influence clinical reasoning?

<p>Assuming normative data allows clinicians to identify deviations from expected patterns, guiding them toward potential pathologies likely present in the patient.</p> Signup and view all the answers

When performing reflex tests, what is the purpose of using the Jendrassik's maneuver?

<p>It is used as a distraction technique to engage lower extremity reflexes.</p> Signup and view all the answers

How many superficial reflexes are mentioned that indicate upper motor neuron lesions?

<p>Four superficial reflexes are mentioned.</p> Signup and view all the answers

Which reflex grading indicates no response during an assessment?

<p>0/4 indicates no response.</p> Signup and view all the answers

What should be the primary focus during palpation in a clinical assessment?

<p>The focus should be on gently feeling the tissues to determine their condition.</p> Signup and view all the answers

How is the duration for holding reflex tests structured in an assessment?

<p>Each test should be held for 5 to 7 seconds.</p> Signup and view all the answers

Which two factors can notably reduce the number of steps during a clinical assessment?

<p>Information from the patient's history and early inspection.</p> Signup and view all the answers

What is the importance of performing palpation after other tests in an assessment?

<p>It prevents tissue irritation that could result in inaccurate findings.</p> Signup and view all the answers

What indicates hyper reflexivity during reflex testing?

<p>A grading of 3/4 indicates hyper reflexivity.</p> Signup and view all the answers

What is the recommended approach when initial functional tests aggravate the patient?

<p>It should be saved until the end of the assessment.</p> Signup and view all the answers

What does having more than three items on your index of suspicion typically indicate?

<p>It indicates that you are considering not missing something substantial or serious.</p> Signup and view all the answers

Why should the term 'diagnosis' be avoided in the context of clinical impressions?

<p>It should be avoided because 'diagnosis' implies a more exact and exhaustive process based on accurate testing.</p> Signup and view all the answers

What is one key principle to follow when conducting patient assessments?

<p>Always avoid leading questions during history taking.</p> Signup and view all the answers

What acronym represents the general steps required for informed consent?

<p>The acronym is 'Wisdom Hates Rebels Against it'.</p> Signup and view all the answers

What are the two components encompassed by verbal communication in a healthcare context?

<p>The two components are speaking and listening.</p> Signup and view all the answers

What should a therapist possess following a comprehensive subjective assessment?

<p>An index of suspicion.</p> Signup and view all the answers

During observation, which three types of information should be gathered based on the acronym FAV?

<p>Functional deficits, abnormalities of alignment and movement, and visible defects.</p> Signup and view all the answers

What do the components of the documentation acronym CCASSEL emphasize?

<p>Chronological, Confidential, Accurate, Suitable abbreviations, Signed, Error correction, and Legible.</p> Signup and view all the answers

In the context of an assessment, what does the term 'non-verbal communication' encompass?

<p>It encompasses aspects like facial expressions, eye contact, posture, gestures, and tone.</p> Signup and view all the answers

What is the importance of maintaining patient confidentiality during documentation?

<p>It is a legal requirement and vital for maintaining trust in the healthcare provider-patient relationship.</p> Signup and view all the answers

What does an increase in muscle testing scores during ISOM indicate?

<p>It indicates improvement in muscle strength or functional capabilities.</p> Signup and view all the answers

How many critical rule-outs should be performed during a comprehensive assessment?

<p>At least two critical rule-outs should be performed.</p> Signup and view all the answers

What role does patience play in the observation process during patient assessments?

<p>Patience allows for a thorough and detailed evaluation of the patient's condition over time.</p> Signup and view all the answers

What should you do if you experience difficulty understanding a patient’s response during history taking?

<p>You should paraphrase their response for clarification.</p> Signup and view all the answers

What do selective tissue tests provide a reference for?

<p>Pathology of individual ligaments, joint capsules, and musculotendinous units.</p> Signup and view all the answers

What is the primary purpose of conducting a joint stability test?

<p>To evaluate for hypermobility, hypomobility, laxity, and instability.</p> Signup and view all the answers

In assessing Active Range of Motion (AROM), what are the two types of tissues being tested?

<p>Inert and contractile tissues.</p> Signup and view all the answers

What does the elastic barrier refer to in joint assessment?

<p>It describes the limit of movement before pain or resistance is felt, indicating available ROM.</p> Signup and view all the answers

What are the three aspects you should evaluate during AROM?

<p>Quality of movement, quantity of movement, and timing of pain onset.</p> Signup and view all the answers

Why is patient relaxation crucial during Passive Range of Motion (PROM) testing?

<p>A relaxed patient allows for more accurate assessment of inert tissue movement.</p> Signup and view all the answers

What does an empty end feel during a joint assessment indicate?

<p>It suggests that the patient is limiting the test due to pain, making it difficult to assess joint range.</p> Signup and view all the answers

How is Isometric Muscle Testing (ISOM) primarily performed?

<p>In a neutral/static position to assess the muscle's ability to produce force without movement.</p> Signup and view all the answers

What are the three common directions of movement in joint play?

<p>Longitudinal, anterior-posterior, and posterior-anterior.</p> Signup and view all the answers

What is the grading scale for ISOM testing's highest score, and what does it represent?

<p>5/5, which indicates that the patient can resist against maximal pressure.</p> Signup and view all the answers

What two general purposes do special tests serve for a clinician?

<p>To confirm a tentative clinical impression and to unravel difficult signs and symptoms.</p> Signup and view all the answers

What is primarily assessed during the neurological testing's sensory component?

<p>Dermatomes and the presence of anesthesia, paresthesia, or hyperesthesia.</p> Signup and view all the answers

What does a restricted AROM with normal PROM suggest about the patient?

<p>It indicates a software issue, where the movement is limited by the patient’s contribution.</p> Signup and view all the answers

What does the acronym WASPSKICKeDRIBSC represent in spinal observation?

<p>It stands for the 13 new aspects to observe for spinal assessments, including weight, knee alignment, scapulae, and dynamic observations.</p> Signup and view all the answers

How can Pottenger's saucer affect kyphotic curves, and what is its implication?

<p>Pottenger's saucer indicates a loss of kyphotic curve correlated with digestive disorders, suggesting an interplay between spinal health and digestion.</p> Signup and view all the answers

Describe one factor influencing posture and provide an example.

<p>Muscle imbalances can influence posture, such as weak abdominal muscles leading to increased pelvic angles.</p> Signup and view all the answers

What is the primary difference between scanning and clearing examinations?

<p>Scanning examines broader regions of the body while clearing focuses specifically on joints above and below the site of injury.</p> Signup and view all the answers

Explain the concept of regional interdependence in musculoskeletal assessments.

<p>Regional interdependence refers to how musculoskeletal symptoms in one area may be influenced by conditions in different body regions.</p> Signup and view all the answers

List the five steps involved in an upper quadrant scanning exam.

<p>T-spine PACVPs, peripheral joint assessments, UQ myotomes, UQ dermatomes, and UQ reflex testing.</p> Signup and view all the answers

What are the importance and implications of testing the non-painful movements first?

<p>Testing non-painful movements first helps assess function without aggravating the patient, gathering essential baseline data.</p> Signup and view all the answers

Identify a characteristic of joint dysfunction as related to pain from spinal origin.

<p>Pain is often referred from proximal (spinal) to distal joints, contributing to additional dysfunction in areas not directly injured.</p> Signup and view all the answers

Describe one significant observation factor in the assessment of breathing patterns.

<p>Observing the balance between chest vs. abdomen breathing provides insights into respiratory mechanics and potential dysfunction.</p> Signup and view all the answers

What does the acronym DIALReScue stand for in the context of scanning exams?

<p>It represents cases that require scanning exams: Diffuse injury, Insidious onset, Altered sensation, Long track signs, several joints, and Radicular symptoms.</p> Signup and view all the answers

What is the role of patient positioning in clinical assessments?

<p>Patient positioning is essential for comfort, facilitating effective gravitational effects, and enhancing test accuracy.</p> Signup and view all the answers

How does the order of performing painful movements affect the assessment process?

<p>Testing painful movements last prevents potential distress and ensures all necessary tests can be completed without interruption.</p> Signup and view all the answers

Explain the significance of knee alignment in spinal assessments.

<p>Knee alignment, such as genu valgum/varum, can impact overall posture and biomechanics, indicating possible underlying issues.</p> Signup and view all the answers

What is a common neurological pathology that may present with scapula winging?

<p>Inhibition of the long thoracic nerve can cause winging of the scapula, affecting shoulder mechanics and stability.</p> Signup and view all the answers

What type of data cannot be specifically verified?

<p>Subjective data</p> Signup and view all the answers

Sensitivity measures the probability of a positive test result in someone without the pathology.

<p>False</p> Signup and view all the answers

What is the main purpose of differential diagnosis?

<p>To weigh the probability of one disease against others that may account for a patient's illness.</p> Signup and view all the answers

Reliability refers to the extent to which comparable results are achieved every time a test is ________.

<p>repeated</p> Signup and view all the answers

Match the following terms with their definitions:

<p>Validity = Correctly measures what it is supposed to measure Sensitivity = Probability of a positive test result in someone with pathology Reliability = Consistency of test results Clinical reasoning = Process clinicians use to make decisions about patient care</p> Signup and view all the answers

Which of the following best describes hardware issues in assessments?

<p>Tissue limitations</p> Signup and view all the answers

Intra-rater reliability involves multiple people performing the same task.

<p>False</p> Signup and view all the answers

Name one of the three knowledge systems involved in clinical reasoning.

<p>Professional knowledge, Personal knowledge, or Professional craft knowledge.</p> Signup and view all the answers

How many sides should be tested at one time during assessment?

<p>One</p> Signup and view all the answers

The Jendrassik’s maneuver must be engaged for all reflex tests if used for one.

<p>True</p> Signup and view all the answers

What is the grading scale for reflex responses?

<p>0 to 4</p> Signup and view all the answers

The most undervalued range of motion is __________.

<p>PROM</p> Signup and view all the answers

Match the reflex type with its description:

<p>Deep tendon = Simple reflex arc, performed 3 to 5 times. Superficial = Indicates upper motor neuron lesions. Pathological = Reflexes that are normally not present.</p> Signup and view all the answers

What should you avoid doing when re-testing a reflex?

<p>Taking a break</p> Signup and view all the answers

Palpation should be performed before other tests during an assessment.

<p>False</p> Signup and view all the answers

What are the three main principles of palpation?

<p>Move slowly, avoid excessive pressure, focus on what you’re feeling.</p> Signup and view all the answers

In a gross assessment of blood flow, __________ refill is a key indicator.

<p>Capillary</p> Signup and view all the answers

Which of the following is NOT one of the new aspects of observation for spinal assessment?

<p>Muscle flexibility</p> Signup and view all the answers

Winging of the scapula is a common sign of musculoskeletal dysfunction due to neurological pathology.

<p>True</p> Signup and view all the answers

What is the acronym used for the factors influencing posture?

<p>Hyper, Hypo, Leg, Lack, Pain, Neuro, Muscle, Density, Bone</p> Signup and view all the answers

_____ is a common adult form of chickenpox characterized by a dermatomal presentation.

<p>Shingles</p> Signup and view all the answers

Match the following observations with their primary focus:

<p>Weight = COG assessment Knee alignment = Leg posture Chest deformities = Pulmonary function Breathing = Respiratory assessment</p> Signup and view all the answers

Which of the following scenarios indicates that a scanning exam is appropriate?

<p>Altered sensation in the limb</p> Signup and view all the answers

Regional interdependence implies that musculoskeletal symptoms can be affected by distant body regions.

<p>True</p> Signup and view all the answers

What is the primary purpose of a joint stability test?

<p>To determine hypermobility or hypomobility in the joint</p> Signup and view all the answers

What does the 'DIALReScue' acronym represent?

<p>Diffused/non-specific MOI, Insidious onset, Altered sensation, Long track signs/symptoms, Several joints involved, Radicular signs/symptoms</p> Signup and view all the answers

In assessing the upper quadrant, the joint tested first should be the _____ side.

<p>normal</p> Signup and view all the answers

Passive Range of Motion (PROM) should always provide more range than Active Range of Motion (AROM).

<p>True</p> Signup and view all the answers

What does AROM stand for?

<p>Active Range of Motion</p> Signup and view all the answers

Which step is performed last during a lower quadrant scanning assessment?

<p>Painful movements</p> Signup and view all the answers

Pain is frequently referred from distal to proximal sites in musculoskeletal assessments.

<p>False</p> Signup and view all the answers

The _____ barrier refers to what the joint is actually able to move compared to what the patient can reach.

<p>physiological</p> Signup and view all the answers

Match each movement type with the correct description.

<p>AROM = Movement performed by the patient themselves PROM = Movement performed by an external force ISOM = Strength testing in a neutral position Joint play = Accessory motions present in joint movement</p> Signup and view all the answers

What does PACVP stand for in the context of scanning exams?

<p>Palpation, Active, Compression, Vibration, Pain</p> Signup and view all the answers

The principle of _____ refers to examining the joint above and below the area of interest.

<p>clearing</p> Signup and view all the answers

Which factor is NOT considered during AROM testing?

<p>Patient's medical history</p> Signup and view all the answers

In an ISOM test, the examiner's force must always exceed the patient's muscle force to get an accurate measurement.

<p>False</p> Signup and view all the answers

Match the myotomes with their corresponding muscle groups:

<p>C3 = Neck and upper shoulder C5 = Anterior arm L4 = Ankle dorsiflexion S1 = Plantarflexion of ankle</p> Signup and view all the answers

What does the acronym FANSI represent in special tests?

<p>Function, Arthrokinematics, Neurological function, Selective tissues, Integrity of ligaments and joint capsules</p> Signup and view all the answers

In neurological testing, the term _____ refers to an increased touch perception.

<p>hyperesthesia</p> Signup and view all the answers

What is one of the three components assessed in neurological testing?

<p>Sensory</p> Signup and view all the answers

The three types of normal end feel include hard, soft, and firm.

<p>True</p> Signup and view all the answers

What does a larger index of suspicion typically indicate during a patient assessment?

<p>You are considering the possibility of a significant issue</p> Signup and view all the answers

List one type of abnormal end feel.

<p>Spasm</p> Signup and view all the answers

The term 'diagnosis' is preferred in clinical impressions because it is more exact.

<p>False</p> Signup and view all the answers

List the four general steps of informed consent.

<p>What and why you're doing, How you're doing it, The risks and impact, Reasonable alternatives</p> Signup and view all the answers

The grading scale for ISOM testing categorizes muscle strength from 0/5 to _____ /5.

<p>5</p> Signup and view all the answers

When is joint play typically performed?

<p>When there are limitations in AROM</p> Signup and view all the answers

The acronym 'CCASSEL' stands for the documentation requirements: Chronological and timely, Confidential, Accurate, Suitable abbreviations, ______, Error correction/ blank spaces, Legible and permanent.

<p>Signed/ co-signed</p> Signup and view all the answers

During an assessment, what is emphasized in the SOAP format?

<p>Subjective, Objective, Assessment, Plan</p> Signup and view all the answers

Match the following components of clinical documentation with their purposes:

<p>Legal requirement = 1 Communication = 2 Organization = 3 Improve and maintain quality of care = 4 Research data = 5</p> Signup and view all the answers

Observations during an assessment only take place after the physical tests are completed.

<p>False</p> Signup and view all the answers

What are the two aspects of verbal communication mentioned in the content?

<p>Spoken and written language</p> Signup and view all the answers

In a comprehensive subjective assessment, the therapist should have an ______ of suspicion.

<p>index</p> Signup and view all the answers

Which of the following are included in the 20 history red flags?

<p>Unexplained weight loss</p> Signup and view all the answers

It is important to ask leading questions during spinal history taking.

<p>False</p> Signup and view all the answers

Name three of the six things to do throughout your assessment as represented by the acronym FALLTR.

<p>Feel, Assess, Listen</p> Signup and view all the answers

The seven purposes of documentation can be remembered with the acronym ______.

<p>Lawyers Create Orderly Budgets, Overseeing Research for Quality Care</p> Signup and view all the answers

A patient's comfort and positioning are part of informed consent.

<p>True</p> Signup and view all the answers

What does the acronym MMFFCV stand for regarding spinal history taking questions?

<p>Medications, Menstruation, Family history, Fracture history, Chronic illnesses, Vertebral basilar insufficiency</p> Signup and view all the answers

What is the primary response you are observing for during a reflex test?

<p>Fatiguability.</p> Signup and view all the answers

How many superficial reflex tests should be performed at a time?

<p>3 to 5.</p> Signup and view all the answers

Why should palpation be performed after other tests in an assessment?

<p>It can irritate the tissues and cause inaccurate findings.</p> Signup and view all the answers

What does a reflex graded as 2/4 indicate?

<p>Normal reflex activity.</p> Signup and view all the answers

What is the recommendation for performing Jendrassik's maneuver during reflex testing?

<p>It should be engaged for all reflex tests to avoid exaggerated responses.</p> Signup and view all the answers

What are the '7 Ts' of palpation used to describe tissue condition?

<p>Texture, Tenderness, Temperature, Tissue tension, Thickness, Tremors.</p> Signup and view all the answers

What outcomes should be provided at the end of an assessment?

<p>Your clinical impression and a minimum of 2 differential diagnoses.</p> Signup and view all the answers

How is a reflex graded as 4/4 interpreted in a clinical assessment?

<p>Indicates clonus and suggests an upper motor neuron lesion.</p> Signup and view all the answers

What is an important first step when performing a vascular screening?

<p>Check capillary refill.</p> Signup and view all the answers

What is the significance of conducting a functional test at the end of an assessment?

<p>It helps identify the day-to-day impact and potential kinetic chain dysfunctions.</p> Signup and view all the answers

What does a larger index of suspicion usually indicate during assessment?

<p>It indicates that the clinician is considering not missing something substantial or serious.</p> Signup and view all the answers

Why should clinicians avoid the term 'diagnosis' in their assessments?

<p>The term 'diagnosis' is more exact and exhaustive, typically reliant on more accurate testing processes.</p> Signup and view all the answers

What does the acronym 'WASPSKICKeDRIBSC' stand for in spinal observation?

<p>It represents 13 aspects to examine, including Weight, Are the knees relaxed, Scapulae, and more.</p> Signup and view all the answers

What four general steps are included in informed consent?

<ol> <li>What and why you’re doing it 2. How you’re doing it 3. Risks and impacts 4. Reasonable alternatives.</li> </ol> Signup and view all the answers

Name three out of the eight factors influencing posture listed in the content.

<p>Hypermobile joints, Lack of postural awareness, and Muscle imbalances.</p> Signup and view all the answers

List three documentation requirements represented by the acronym CCASSEL.

<ol> <li>Chronological and timely 2. Confidential 3. Accurate.</li> </ol> Signup and view all the answers

What is the primary focus of a scanning exam?

<p>To assess a broader area for potential issues related to a specific complaint.</p> Signup and view all the answers

What does the acronym FAV represent in observation during assessment?

<ol> <li>Functional deficits 2. Abnormalities of alignment and movement 3. Visible defects.</li> </ol> Signup and view all the answers

What is the primary purpose of maintaining confidentiality in documentation?

<p>To protect patient privacy and ensure that sensitive information is not disclosed inappropriately.</p> Signup and view all the answers

Explain the significance of regional interdependence in musculoskeletal symptoms.

<p>It indicates that symptoms may be affected by impairments in different body areas, not just the site of pain.</p> Signup and view all the answers

How many history red flags should be considered during assessment?

<p>Twenty history red flags should be examined.</p> Signup and view all the answers

What does 'clearing' involve during a physical assessment?

<p>It involves examining the joints above and below an area of concern.</p> Signup and view all the answers

What are the two types of verbal communication emphasized in clinical contexts?

<p>Spoken language and written language.</p> Signup and view all the answers

List two tests that are influenced by patient history in examinations.

<p>Physical examination tests and functional performance tests.</p> Signup and view all the answers

Identify one key observation for assessing breathing patterns.

<p>Observe for whether the patient breathes using the chest or abdomen.</p> Signup and view all the answers

What are the six critical components to conduct throughout a clinical assessment according to FALLTR?

<ol> <li>Feel 2. Assess 3. Listen 4. Look 5. Test 6. Record.</li> </ol> Signup and view all the answers

What factors should be considered regarding patient positioning during examinations?

<p>Patient comfort and gravity influence should be prioritized.</p> Signup and view all the answers

During an assessment, what should be the focus of attention?

<p>Attention should be focused on one aspect at a time.</p> Signup and view all the answers

What is the role of inspection in assessing the non-injured limb?

<p>Inspection provides a reference for symmetry, alignment, and color of the superficial tissues.</p> Signup and view all the answers

List the two types of tissues classified during Active Range of Motion (AROM) testing.

<p>Contractile and inert tissues.</p> Signup and view all the answers

What is the desired outcome of a comprehensive subjective assessment?

<p>To establish an index of suspicion.</p> Signup and view all the answers

Explain the term 'scanning' in clinical assessments.

<p>Scanning refers to a focused examination of a specific body part or quadrant, looking for issues.</p> Signup and view all the answers

What is the purpose of dynamic observations in the assessment process?

<p>To evaluate the patient's gait and functional capabilities during movement.</p> Signup and view all the answers

What does the observation process begin with?

<p>The observation begins on the first sight of the patient.</p> Signup and view all the answers

What is the expected outcome when AROM is described as 'full and pain-free'?

<p>Passive movements may be unnecessary.</p> Signup and view all the answers

What are the steps involved in a lower quadrant scanning exam?

<p>T-spine PACVPs, Peripheral joints assessment, LQ myotomes, LQ dermatomes, and LQ reflexes.</p> Signup and view all the answers

What does the 'empty' end feel indicate during a joint examination?

<p>It indicates the patient may not allow full assessment due to pain or discomfort.</p> Signup and view all the answers

What is the significance of the history of cancer in recognizing red flags?

<p>A history of cancer can indicate potential cancer-related complications during assessment.</p> Signup and view all the answers

Explain the difference between anatomical and physiological barriers in ROM.

<p>Anatomical barriers refer to what the patient can reach independently, while physiological barriers indicate how far the joint can physically move.</p> Signup and view all the answers

List any three of the eight aspects of non-verbal communication.

<ol> <li>Facial expressions 2. Eye contact 3. Tone.</li> </ol> Signup and view all the answers

Name one reason to test the normal side first during an assessment.

<p>It establishes a baseline for comparison against the affected side.</p> Signup and view all the answers

What documentation is required for recording errors and blank spaces?

<p>Error correction and ensuring that blank spaces are not left unaddressed.</p> Signup and view all the answers

In terms of joint stability tests, what are the four types of outcomes that may be observed?

<p>Hypermobility, hypomobility, laxity, and instability.</p> Signup and view all the answers

How do you assess joint movement for painful conditions?

<p>Start with non-painful movements and reserve painful movements for testing last.</p> Signup and view all the answers

What is the relevance of assessing knee alignment during spinal examinations?

<p>Knee alignment can provide insight into lower limb and spinal mechanics.</p> Signup and view all the answers

What should a clinician evaluate in PROM testing regarding pain?

<p>The range of movement, when and where onset of pain occurs, and quality of end feel.</p> Signup and view all the answers

What are the three common directions of movement assessed in joint play?

<p>Longitudinal, anterior-posterior, and posterior-anterior.</p> Signup and view all the answers

Describe the importance of weight assessment in spinal observations.

<p>Correcting the center of gravity (COG) allows for a proper evaluation of alignment and posture.</p> Signup and view all the answers

What common pathway does shingles typically follow in adults?

<p>It typically follows a dermatomal pattern, mirroring the underlying nerve distribution.</p> Signup and view all the answers

During ISOM testing, which tissues are assessed for function?

<p>Contractile and nervous tissues.</p> Signup and view all the answers

What is the grading scale outcome for a patient that can resist against moderate pressure in ISOM testing?

<p>4/5 – good.</p> Signup and view all the answers

Name two considerations a clinician should keep in mind during AROM testing.

<p>Adaptive strategies by the patient and the quality of movement.</p> Signup and view all the answers

What technique is used to evaluate the motor component in neurological testing?

<p>Myotomes.</p> Signup and view all the answers

In joint assessments, what does a 'normal' AROM and 'restricted' PROM indicate?

<p>It suggests a software issue, implying movement restrictions exist only when the patient's contributions are factored out.</p> Signup and view all the answers

What should be the state of the patient during PROM testing?

<p>The patient must be relaxed.</p> Signup and view all the answers

What are the three components evaluated in neurological testing?

<p>Sensory, motor, and reflex functions.</p> Signup and view all the answers

What is the primary focus of differential diagnosis when assessing a patient?

<p>To weigh the probability of one disease against other possible diseases that could explain the patient's illness.</p> Signup and view all the answers

How does ongoing assessment contribute to clinical decision-making?

<p>It provides a continuous base of information that supports informed decisions and potential medical referrals.</p> Signup and view all the answers

In clinical reasoning, what three knowledge systems are considered essential?

<p>Professional knowledge, personal knowledge, and professional craft knowledge.</p> Signup and view all the answers

What is meant by the terms 'hardware' and 'software' in the context of assessments?

<p>'Hardware' refers to mechanical issues, while 'software' relates to flaws in movement coordination or motor control.</p> Signup and view all the answers

What does the term 'sensitivity' signify in diagnostic testing?

<p>It indicates the probability of obtaining a positive test result in someone who has the pathology.</p> Signup and view all the answers

What are the key considerations in selecting the approach for clinical reasoning?

<p>The approaches should account for multiple perspectives, including the patient's presentation and clinical context.</p> Signup and view all the answers

What is meant by the reliability of a test, specifically in the context of inter-rater reliability?

<p>Inter-rater reliability measures the consistency of results obtained by different individuals performing the same task.</p> Signup and view all the answers

In the assessment process, what must be assumed about the patient's population?

<p>It is assumed that the patient population has normative data findings.</p> Signup and view all the answers

Study Notes

Assessments in Therapy

  • Assessments are fundamental to all therapy treatments.
  • They provide a foundation for making informed decisions and potential medical referrals.
  • Assessments must be ongoing.

Types of Data

  • Subjective data: Information that can't be directly verified.
  • Objective data: Measurable and observable information.

Assessment Quality

  • Validity: Accuracy of a test in measuring what it intends to.
  • Reliability: Consistency of results when a test is repeated.
    • Inter-rater reliability: Consistency between different testers.
    • Intra-rater reliability: Consistency within one tester.
  • Sensitivity: Probability of a positive result in someone with the condition.
  • Specificity: Probability of a negative result in someone without the condition.

Factors Affecting Movement

  • Hardware: Physical limitations affecting movement (e.g., tissue restrictions, mechanical issues).
  • Software: Issues with movement coordination or motor control (input or output problems).

Clinical Reasoning

  • Clinical reasoning: The process clinicians use to make decisions about a patient's health, status, and care.
  • Knowledge Systems: Involves interaction of three knowledge systems
    • Professional knowledge: Based on empirical data and textbooks.
    • Personal knowledge: Based on life experiences.
    • Professional craft knowledge: Based on practical clinical experience.
  • Approaches: Many different approaches exist.
  • Expert vs. Novice Clinicians: Different approaches distinguish between expert and novice clinicians.
  • Outcome: Clinical decision-making.

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Description

This quiz covers the essential concepts related to assessments in therapy, including types of data, assessment quality, and factors affecting movement. Understanding these principles is crucial for making effective therapy decisions and referrals.

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