Final Review Sheet PDF

Normative BOM Values xion 0 120 Extension 0 20 Abduction 0 40 Adduction 0 20 Medial Rotation 0 45 Lateral Rotation 0 45 IExion 0 135 Extension 0 10 TEETH flexion 0 20 0...

Normative BOM Values xion 0 120 Extension 0 20 Abduction 0 40 Adduction 0 20 Medial Rotation 0 45 Lateral Rotation 0 45 IExion 0 135 Extension 0 10 TEETH flexion 0 20 0 so u Plantarflexion 0 50 Extension 0 70 70 0 450 Inversion 0 35 Eversion 0 150 Extension IT 0 25 Right Lateral Flexion 0 35 Right Rotation 0 45 Goniometry ROM Landmarks Hip knee can flex Flexion supine pelvis neutral hips 0 AB AD rotation 3ft I lateral midline of pelvis E lateral aspect of hip greater trochanter as reference D lateral midline of femur lateralepicondyle as reference stabilize ipsilateral pelvis to prevent posterior tilt rotation contralateral LE should be flat neutral for additional stability Extension prone knees extended hips 0 AB AD rotation Firmendfeel I lateral midline of pelvis E lateral aspect of hip greater trochanter as reference D lateral midline of femur lateral epicondyle as reference stabilize ipsilateral pelvis to prevent anterior tilt and keep contralateral LE flat for additional stability Abduction supine kneesextended hipO flex ext rotation Firm endfeel P imaginary line between both ASIS's E ASIS I Anterior midline of femur patella for reference Stabilize on iliac crest toprevent lateral tip superiorelevation watch for lateral flexion Adduction supine kneesextended hipO flex ext rotation Firm endfeel P imaginary line between both ASIS's E ASIS  I Anterior midline of femur patella for reference Stabilize on iliac crest toprevent lateral tip superiorelevation watch for lateral flexion IR Medial sitting knees flexedso hip 0 B AD go.ae hiias fafid I to the floor E anterior aspect of patella I anterior mid line lower leg between malleoli for reference Stabilize distal end of femur to prevent AB AD or flexion at hip instruct patient to sit in proper posture ER Lateral sitting knees flexed90 hip 0 ABAD90 flex hand'sfnfabÑ I to the floor E anterior aspect of patella I anterior mid line lower leg between malleoli for reference Stabilize distal end of femur to prevent AB AD or flexion at hip instruct patient to sit in proper posture knee Flexion Supine Knee extended hip00 BAD Ext towelunderanklet f E lateral midline femur greater trochanter for reference E lateral epicondyle of femur I lateral midline of fibula lateral malleolus fibularhead reference Stabilize femur to prevent hip AB AD and rotation Extension supine 0 kneeflex towel under ankle Firmendfeel  I lateral midline femur greater trochanter for reference E lateral epicondyle of femur I lateral midline of fibula lateral malleolus fibularhead referente Stabilize femur to prevent hip AB AD and rotation Ankle Foot Dorsiflexion TCT sitting kneeflex900 0 inversion eversion Firmendfee I lateral midline of fibula head of fibula forreference E lateral aspect of lateral malleolus I 11 to lateral aspect of 5ᵗʰ metatarsal stabilize tibia and fibula to prevent kneemotion hiprotation Plantarflexion TCT sitting kneeflex900 0 inversion eversion Firm orhard I lateral midline of fibula head of fibula forreference E lateral aspect of lateral malleolus I 11 to lateral aspect of 5ᵗʰ metatarsal stabilize tibia and fibula to prevent kneemotion hip rotation Inversion TarsalJoints sitting kneeflex90 hip00ABADrotation Firmendfee I anterior mid line of lowerleg tibial tuberosity for reference I anterior aspect of ankle between malleoli D anterior midline of 2nd metatarsal Stabilize tibia and fibula to prevent medial rotation ext of knee and lateral rotation Abduction of hip Eversion Tarsaljoints sitting Kneeflex90 hip00ABADrotation Firm or hard P anterior mid line of lowerleg tibial tuberosity for reference É anterior aspect of ankle between malleoli D anterior midline of 2nd metatarsal Stabilize tibia and fibula to prevent medial rotation ext of knee and lateral rotation Abduction of hip Thoracolumbar spine Flexion standing feet shoulderwidth apart 0 lateralflex rotation Firm Tape Measure Method 10cm or 4 in is average Mark T1 and S2 measure distance at beginning of ROM Hold tape measure as patient flexes and record new distance at end range end of ROM when there is resistance to flex pelvisantenny Subtract Final and initial measurements flexion ROM Stabilize pelvis to prevent anterior tilt Fingertip to Floor Method Ask individual in standing position to slowly bend forward as far as possible to touch floor kneesextended feet together At end of motion measure distance between tip of middle finger and floor Stabilize No stabilization allows for hip motion less accurate Extension standing feet shoulderwidth apart 0 lateralflex rotation Firm Tape Measure Method Mark T1 and S2 measure distance at beginning of ROM Hold tape measure as patient extends and record new distance at end range end of ROM when pelvis tilts posteriorly Subtract initial and final measurements Extension ROM stabilize pelvis to prevent posterior tilt Lateral Flexion Standing feetshoulderwidthapart O Flex Ext rotation Firm Hard Goni Method Mark T1 and S2 I to the ground E posterior aspect of 52 D posterior aspect of T1 Stabilize pelvis to prevent lateral tilting Fingertip to Floor Method In standing position with flat back against wall tell patien to bend to their side as far as possible keep back shoulders against wall feet flat knees extended At end of ROM mark wherethe tip of the middle finger reaches Measure distance from the mark to the floor and that is ROM Fingertip to Thigh Method  In standing position with flat back against wall arms hanging freely at side mark where tip of middle finger is on the thigh Tell patient to bend to their side as far as possible keep back shoulders against wall feet flat knees extended At end of ROM mark wherethe tip of the middle finger reaches on thigh Measure distance oftip of middle finger at side in normal standing and the mark from side bending and that isROM Firm or hard Rotation sitting feeton floor 0 flex Ext rotation atcervical thoracia lumba Goni Method I I imaginary line between twoprominant tubercles on iliac west E over center of cranial aspect of individual's head D align with imaginary line between acromion processes Stabilize pelvis to prevent rotation avoid flex ext and later flex of spine Have patient turn body to one side as far as they ran keep trunk erect feet flat on floor End of ROM when pelvis begins to rotate Lumbar spine Flexion standing 0 lateral flex rotation in cervical thoracic lumbar Firm Modified Modified Schober Test MM ST Mark 52 and then go 15 cm above for second mark Align measuring tape between the marks and tell patient to bend forward as far as possible with knees straight Maintain tape measure during motion Measure distance between marks at the end of ROM ROM End measurement 15am stabilize pelvis to prevent anterior tilt Extension standing 0 lateralflex rotation in cervical thoracic lumbar Firm Modified Modified Schober Test MM ST Mark 52 and then go 15 cm above for second mark Align measuring tape between the marks and tell patient to bendbackward as far as possible with knees straight Maintain tape measure during motion Measure distance between marks at the end of ROM ROM 15 am End measurement stabilize pelvis to prevent posterior tilt Muscle Length Tests Thomas Test Hip Flexors sitting edge of table Firm Have patient sit at the edge of table and cradle them into supine Have them flex both knees and bring towards chest Ask patient to hold knee in flexed position toward one chest and have them slowly lower other leg off table Measure ROM normal ext ROM 0 20 I lateral midline of pelvis E lateral aspect of hip joint greater trochanter for reference I lateral midline of femur lateral epicondyle for reference Stabilize If patient can't stabilize hip that is not being tested we help them Interpretation If less than normal shorthipflexor extensionROMat least 10 Ex 0 5 extension loss of 15 of extension ROM If extension ROM is equal or within 10 ofnormal no length discrepancies If extension ROM surpasses normal very lengthened or stretched muscle hypermobile Single Leg Raise SLR Test Hamstrings supine firm endfeel Have patient lay supine knees extended and hipneutral Passively lift one LE off table with knee in extension Get them to end range ROMends when resistance is felt hip knee flex posterior pelvic tilt or lumbar flex Measure ROM normal 0 120 I lateral midline of pelvis  E lateral aspect of hip joint greater trochanter for reference D lateral midline of femur lateralepicondyle for reference stabilize knee of LE being tested in fullextension and keep other extremity flat on table for pelvicstability interpretation If flexion ROM is at least 10 less than normal tight hamitrin Ex 0 105 flexion loss of 15 of flexion ROM If flexion ROM is equal or within 100 of normal no length discrepancy If flexion ROM surpasses the normal very lengthened or stretched muscle hypermobile TFL and IT Band Outcome Measures Introduction What are outcome measures Tools to assess any change in outcomes Any change from the initial visit throughout and until end of the plan of care could be a positive Falls risk or negative change TUG results Pain Why Outcome measures Contribute toEBP provides baseline data provides objective outcomes Measures change over time baseline data intervention reasses Justification for 3rdparty payers Research purposes Types of Outcome Measures Performance Based vs Self Report General Health Status SF 36 Sickness Impact Profile SIP Clinical Measurements ROM MMT Functional Assessments Quality of life very important General Multidimensional FIM Physical Performance Test Function Specific Balance Gait Disease Specific Measures stroke Fugh Meyer Stroke Impact Scale Multiple Sclerosis EDSS Expanded disability status scale Parkinson's Disease D A S H Unified Parkinson's Disease Rating Scale PDQ 39 Questionnaire Low Back Pain  Oswestry LBP Questionnaire Population Specific Measures Pediatrics Wee FIM Peabody Development Motor Scale Home Care setting specific Home Health OASIS Examination of Integumentary System Integumentary System Functions homeostasis protection biochemical synthesis temperature regulation absorption sensory reception Relevant Parts for Observation Skin observation should be Hair concurrent Nails Significant Findings PT could be the first person to notice skin abnormalities Aging age spots  Exposureto environment sun burn too much can lead to skin cancer Local skin disease or trauma Manifestation of organ disease Systemic illness Skin Color Condition Pallor Pale Absence of pigment or pigmentation change Blood Abnormality Anemia Temporary interruption or diversion of blood flow Internal disease Cyanosis Blue Decreased oxygen in blood blood is still circulating but does not have sufficient oxygen Central Cyanosis Cause circulatory respiratory problem that leads to poor blood oxygenation in the lungs Occurs in the lips and tongue Acute cyanosis can result from asphyxiation or choking and is one of the surest signs that respiration is blocke Peripheral cyanosis blue tint in fingers extremities due to inadequate circulation blood reaching extremities is not oxygen rich occurs in the fingers underneath fingernails and extremities Jaundice Yellow Skin Tone bilirubin and it earotene could be a liver issue Common causes Hepatitis inflammation of liver usually viral infection Blockage of the bile duct gallstone Eating food priarotene and Avitamin A Hyperpigmentation Brown skin tone Darkening of an area of skin nails caused by 19melanin Also caused by disturbances of adrenocortical hormones Other Local Alterations in Color Cellulitis bacterial infection redness local heat edema tenderness and blisters could start as a nick in the skin and get infected Rubor of Dependency intense rubor when the limb assumes a dependent position Inadequate venous return in the extremity in a certain position Ischemic Ulcers thin shiny skin hair loss paleness of elevated extremity and intense rubor of dependency Could be from poor blood flow to an area Cuts and Bruises Be aware of certain patterns of injury make appropriate referrals or reports Physical Abuse usually on head face neck Defensive Injuries presence on forearms Nails changes may indicate presence of occult disease could be change in nail itself or surrounding tissue there may be something under nails that could be causing further issues Beau's Lines  transverse depressions found in patients with severe systemic insult high fever renal disease infection hepatic disease look like EKG readings Koilonychia spoon Nails nail bed is flat or concave and dips waves are visible on the surface often harmless but could indicate more serious problem Can also be caused by trauma to nail matrix causing edges to curl up could be a sign of systemic disease Terry's Nails appear white with a ground glass appearance No lunula Possibly dueto dovascularity and toconnectivetissue Associated with liver and heart problems look like french tip nails Psoriasis pitting of nail bed found in 50 of patients with psoriasis looks like a pin poked a bunch of little holes on nail Mee's Lines white discoloration of nail plate that form transverse lines across the nail do not extend across whole nail found in patients with arsenic poisoning and also renal failure heart disease and pneumonia Half and Half Nails Top half brown Bottom half white Indication of chronic renal failure Clubbing of Digits Nail plate is nonvex shaped Proximal nail fold and plateangle 1 Lovibund's angle Associated mostly with heart lung diseases Lacks Schamroth's sign Hair Growth Pattern typically found all over body except palms and soles of feet and portions of genitalia If local circulation is compromised aka arterial insuffiliency then hair loss will occur extremely important indicator of distal circulation Alopecia Baldness male and female pattern baldness hereditary results from diseases side effect of meds If hair loss occurs quickly or does not begin in the frontal parietal scalp then it sebeinvetigated Skin Lesions loss or change of the local tissue continuity structure or function disease or trauma to skin Associated with skin cancer melanoma is the most aggressive PTshavemaj0 ee frole.in prevention Recognize atypical skin to flesionsandpossiblyretertoth andakened haggusennbotherpractitioned the Farrier mail.de  ABCD Rule for Melanoma Atsymmetry Porder irregularity CColor variation or black clor Diameter greater than 6mm Notsymmetrical rassed or Borg S rotorvaries throughout diameter 6mm consistency Itar Ulceration Benign seldom Malignant often Mobility Benign Mobile Malignant Earlystage mobile laterstage Rate ofchange immobile Benign slow Malignant slow or Rapid Comprehensive Skin Assessment Inpatient Facility usually nurses PT can catch things that nursing missed always check with nursing Home Health PT could be responsible for skin assessment OutpatientFacility PT is responsible Types of Patients burn victims patients with autoimmune disease geriatric patients Neuro patients diabetic patients Pay Attention To Bony prominences likely chance of pressure ulcers Skin to skin areas inner thighs butt All of impaired sensation areas Skin beneath orthotics devices rompression socks 5 Parameters Temperature Turgor firmness Color Moisture level Skin integrity is it open area rashes etc