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25 Cards in this Set
- Front
- Back
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The goals of the interview w pt include
a. b. c. d. e. |
a. Discovering information leading to diagnosis and management
b. Providing information to the pt concerning diagnosis c. Negotiation management; it is not something to be inflexibly imposed but must be considered in light of the pt's life situation d. Establishing a joint effort regarding positive health behavioral change and disease prevention e. Supporting the emotional and spiritual needs inherent in the impact of disease and illness |
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Ethics provides a disciplined approach to undertanding and to determing ultimate behavior. Several concepts must be considered:
a. b. c. d. e. f. |
a. Autonomy
b. Beneficence c. Nonmaleficence d. Utilitarianism e. fairness and justice f. Deontologic imperatives |
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Beneficence
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The clinican needs to do good for the patient
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Nonmaleficence
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The clinician must do no harm to the patient
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Examination and findings
Inspection a. b. c. d. e. |
a. Begin your examination of the musculoskeletal system by observing the gait and posture when the pt enters the examining room
b. Inspect the ant, post, lat aspects of pt's posture c. Note any lordosis, kyphosis, or scoliosis d. observe the extremities for overall size, gross deformity, bony enlargement, alignment, contour, and symmetry of length and position e. Expect to find bilateral symmetry in length, circumference, alignment, and the position and number of skin folds |
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Palpation
a. b. c. d. |
a. Palpate all bones, joints and surrounding muscles
b. Note any heat, tenderness, swelling, fluctuation of a joint (associated w effusion), crepitus, and resistance to pressure c. Muscle tone should be firm, not hard or doughy d. Spasticity is an increase in muscle tone |
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Range of motion
a. b. |
a. Examine both the active and passive range of motion for each major joint and its related muscle groups
b. Pain, limitation of motion, spastic movement, joint instability, deformity, and contracture suggest a problem w the joint, related muscle group or nerve supply |
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Muscle Strength
0. 1. 2. 3. 4. 5. |
0. No evidence of movement
1. Trace of movement 2. Full range of motion, but not against gravity 3. Full ROM, against gravity but not against resistance 4. Full ROM, against gravity and some resistance, but weak 5. Full ROM, against gravity, full resistance |
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ROM
TMJ Open and close: Laterally move the jaw side to side Strength of the ___ & ___ muscles is evaluated by asking the pt to clench teeth while you palpate the contracted muscles and apply opposing force. CN___ is simultaneously tested w this maneuver. |
3-6cm
1-2cm temporalis masseter V |
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ROM
C-spine Flexion Hyperextension Lateral bending Rotation ___ & ___ muscles are evaluated w pt maintaining each of the above position while you apply opposing force. W rotation, CN___ is simultaneously tested |
45
45 40 70 SCM Trap XI |
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ROM
Thoracic and Lumbar spine Flex Hyperext Lateral bending Rotation |
75-90
30 35 30 |
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ROM
Shoulder Shrug Flex Hyperext Abd Add IR ER |
Symmetrically
180 50 180 50 55 45 |
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ROM
Elbow Carrying angle Cubitus valgus Cubitus varus Flex Full Ext Pronation Supination |
5-15 laterally
A lateral angle exceeding 15 A medical carrying angle 160 180 90 90 |
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Hands & Wrist
Deviation of fingers to the ulnar side and swan neck or boutonniere deformities of the fingers usually indicates ___ |
rheumatoid arthritis
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Heberden nodes
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Distal Interphalangeal joints
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Bouchard
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Proximal Interphalangeal joint
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Hands
Metacarpophalangeal flex Hyperextension as much as |
90
20-45 |
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Wrist
Flex Hyperext W palm side down, turn each hand to the R and L: Radial motion; Ulnar motion |
80
70 20 30 |
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ROM
Hip While supine, raise the leg w knee extended above the body |
up to 90 degrees of hip flex
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ROM
Hip Hyperext |
30
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ROM
Hip While supine, raise one knee to the chest while keeping the other leg straight |
Hip flex of 120 degrees
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ROM
Hip IR ER |
40
45 |
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ROM
Legs & Knees Q-Angle Genu valgum Genu varum Genu recurvatum |
less than 15
Knock knees Bowleg Excessive hyperextension of the knee w WB may indicate weakness of the quadriceps muscles |
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ROM
Legs and knees Flex Hyperext |
130
up to 15 |
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ROM
Feet and Ankles Dorsiflexion Plantar flex Inversion Eversion Abd Add |
20
45 30 20 10 20 |
