KRS421 2022 Exam 1 Study Guide PDF

KRS421 2022 Exam 1 Study Guide: Evaluation Process – HOPE o HISTORY § Subjective information § Injury Hx § Prescription Hx § MOI (onset, duration, description) § SXS Sensations, sounds Pn level Intensity & progression § Current training level, regimen, any other advice received o OBSERVATION § Signs...

KRS421 2022 Exam 1 Study Guide: Evaluation Process – HOPE o HISTORY § Subjective information § Injury Hx § Prescription Hx § MOI (onset, duration, description) § SXS Sensations, sounds Pn level Intensity & progression § Current training level, regimen, any other advice received o OBSERVATION § Signs § Obv. Gross deformity § B/L Inspection § Edema/ effusion/ ecchymosis § Skin temp. & color o PALPATION § B/L inspection of anatomical/ internal structures § Point tenderness § Swelling (pit edema) § Trigger points § Crepitus § Symmetry o EVALUATIVE TESTS § AROM –> ability, willingness, quality PROM > AROM: contractile tissue PROM = AROM: non-contractile tissue Measure w/ goniometer *refer to lab worksheet for normal ROM* § PROM –> quantity, end-feel, available movement Normal indication: o Hard - bony block o Firm – ligamentous block o Soft – soft-tissue block/ muscular Abnormal indication: o Hard – bony or cartilage o Firm – increased tightness/ muscle tone o Soft – swelling/ edema or effusion § RROM/MMT –> determines capability of muscles/ muscle groups 0/5 – no contraction felt 1/5 – no movement but some contraction is felt 2/5 – can move AROM w/out effect of gravity 3/5 – can move w/ effect of gravity, full AROM 4/5 – able to resist against moderate pressure 5/5 - able to resist against full pressure o SPECIAL TESTS § Provocative tests to reproduce MOI to help differential diagnosis Positive –> rule in Negative –> rule out § Joint Play § Stress Tests KRS421 2022 § § § EBP o o o Grade I: Firm Grade II: Soft Grade III: Empty Joint Stability Tests Hypermobile = more laxity Hypomobile = below normal laxity Neurological screening –> evaluates possible impingement, PND, CNS trauma, or disease Dermatome: sensation of nerve innervation Myotome: motor function (MMT) o Sensory nerves = AFFERENT o Motor nerves = EFFERENT Deep Tendon Reflex: reflex o 0 = no response o 1+ = hyporeflexia (precontraction) o 2+ = normal response o 3+ = hyperreflexia (very brisk response) o 4+ = hyperactive w/ clonus Vascular Screening UE Pulses o Brachial o Radial o Ulnar LE Pulses o Femoral o Post. Tib o Dorsal pedal Systemic: carotid Reliability § Intra-rater: same results will be produced with the same clinician § Inter-rater: same results can be produced between multiple clinicians (SNOUT) Sensitivity: a test’s ability to be able to rule out a test if result is negative § High sensitivity = confidence in ruling OUT (SPIN) Specificity: a test’s ability to be able to rule in a test is result is positive § High Specificity = Confidence in ruling IN (need sensitivity to have specificity) Injury nomenclature o Edema: swelling/ fluid accumulation outside the joint capsule o Effusion: swelling/ fluid accumulation within the joint capsule o Microtrauma: > chronic/ overuse injury § Not as visible § Repeated submaximal forces that tissue cannot adapt to § Grade I o Macro trauma: > acute onset § Observable damage § Single force that exceeds tissues failure point § Grade II & III o Forces § Tensile: overstretch § Compression: stress @ each end of structure § Shear: perpendicular/ side to side KRS421 2022 o o o o o o o o o o o o § Torsion: twisting § Direct Blow: contusion, fx, dislocation Strain: damage occurring to MUSCLES § MOI: Tensile overload of tissues Grade I: stretching of fibers, NO pain during concentric prom, pain during eccentric PROM Grade II: partial tearing of muscle fibers, ecchymosis (after some time), pain during MMT, PROM, AROM Grade III: complete tearing of muscles, ecchymosis, edema, pain during all evaluative tests, LOF Tendons § Tendonitis: inflammation of structures § Tendinosis: degeneration of collagen § Tenosynovitis: Inflammation of synovial sheath (has more crepitus) 1st degree: Pain and dysfunction after activity, pain during point tenderness & MMT 2nd degree: pain and LOF during and after activity, point tenderness, pain during AROM, eccentric PROM, and MMT 3rd degree: complete LOF, pain all the time Myositis Ossificans: calcific deposit on muscle belly § MOI: contusion, severe strain § Loss of ROM, point tender, pain with movement Heterotopic Ossification: bony growth in abnormal area Bursitis: inflammation of the bursa § Acute Bursitis: direct blow § Chronic Bursitis: insidious § Infection Bursitis: inflamed bursa due to infection Sprains: damage occurring to TENDONS and ligaments § MOI: tensile overload 1st degree: stretching of fibers, pain and point tender, slight swelling, firm end point, slight reduction in ROM 2nd degree: slight tear of fibers, moderate pain, ecchymosis, LOF, decrease in AROM towards and PROM away, soft but definitive end point 3rd degree: complete rupture, gross instability/ laxity, empty/ absent end point, LOF Subluxation: partial dislocation § MOI: chronic or acute § Apprehensive when stressed Dislocation: disassociation of the joint, stretching/ rupture of tissue § Pain, total LOF, obvious deformity Osteochondral defects: partial = outer layering, full = underlying bone § MOI: acute axial load or insidious degeneration § Joint line tenderness, limited ROM Osteochondral Dissecans: dislodged fragments of bone within joint space § MOI: acute trauma or insidious degeneration § Possible swelling, uncomfortable, inflammation, limited ROM (possible hard end feel) Arthritis: degeneration of joint articular surface § Osteoarthritis § Rheumatoid arthritis Exostosis: growth of extraneous bone § MOI: stress reaction, irregular forces § Pain, ROM limited (possible hard end feel) KRS421 2022 o o o Apophysitis: growth plate inflammation that causes separation § MOI: history of growth spurt Fractures: acute trauma, pain tender, constant, possible deformity, swelling, radiating § Location Diaphysis: fracture on long bone/ shaft Epiphyseal: fracture on growth plate Articular: fracture on articular cartilage § Magnitude Incomplete, displaces, open § Shape/ Direction Greenstick: incomplete, breaks on convex Fissures: incomplete, longitudinal Comminuted: complete with fragments Transverse: complete, at right angle Oblique: complete, different angle Spiral: complete, shear/ torsion § Stress fractures: when osteoclastic activity > osteoblastic activity MOI: insidious, Nagging pain, point tender, possible swelling normal ROM § Avulsion fracture: tearing away of ligament/ tendon from bony attachment MOI: Forceful contraction SXS like sprain/ strain, pint tender, swelling, limited ROM Compartment syndrome: muscles enlarge in compartments that cause increased pressure § MOI: insidious, exertional exercise § Pain, Pallor, Pulselessness, Paresthesia, Paralysis