Orth Exam 1: Eval/planning

Front 1

What percent of PT practice is ortho

Back 1

70% (LBP, Joint replacement, fractures, sprains and strains, cervical pain, arthritis, shoulder injury)

Front 2

What are the 3 responsibilities of the physicians seeing a patient with an orthopaedic problem

Back 2

1) rule out disease
2) order appropriate test
3) referrals to appropriate health care professionals

Front 3

What are the 4 roles of the PT when seeing a patient with an orthopaedic problem

Back 3

1) evaluate pt to rule out disease
2) evaluate pt to establish appropriate intervention plan and goals
3)effectively treat the pt
4) interact with physician and other health care professionals as needed

Front 4

What is the success of the evaluation process process is directly related to

Back 4

1) clinical knowledge
2) skills in assessment of history, provocation, and function

Front 5

What is the success of treatment directly related to

Back 5

1) accuracy of examination findings
2) clinical knowledge
3) skills in selection and administration of interventions

Front 6

Physical therapists treat ____ not _______

Back 6

treat PEOPLE not just ANATOMICAL PART

Front 7

What are the goals of the orthopeadic PT evaluation?

Back 7

1)Obtain sujective information objective information, and functional measurements
2) obtain baseline data
3) monitor/document changes over time
4) determine specific diagnosis from non-specific diagnosis
5) identify the structure at fault
6) Identify the severity of the problem
7) Identify the causative factor(s)
8) Identify a treatment-based category
9) Screening for disease

Front 8

The objective examintion requires _______

Back 8

prior planning

Front 9

What are the 5 components of the objective examination

Back 9

1) inspection
2) function
3) palpation
4) neurological test
5) Special additional tests

Front 10

what are the 4 components of the assessment

Back 10

1) establising a "clinical impression" (diagnosis)
2) developing a list of problems
3) establishing the short- and long-term goals
4) prognosis

Front 11

What are the components of the Plan

Back 11

1) treatment plan
2) need for further assessment, equipment and/or tests

Front 12

Where is the "review of the chart" encorporated in the evaluation

Back 12

Subjective Examination

Front 13

What are the 6 components of "background information" that are usually obtained from the chart?

Back 13

1) name, age, gender
2) diagnosis
3) referring physician
4) medication
5) current and past medical history
6) results of lab tests

Front 14

what three items are sometimes included in the background information but could in included in the subjective information?

Back 14

1) occupation/leisure activities
2) family history
3) living environment

Front 15

What are the 7 components of the general health checklist for all patients?

Back 15

1) Chills/sweats/fever
2) Fatigue
3) Malaise
4) Weakness
5) Weight loss/gain
6) Change in appetite
7) Nausea

Front 16

What is considered a "significant fever"?

Back 16

99.5 F (or 37.5 C) or higher... for elderly >98.9 F (or 37.2 C)

Front 17

What is considered "significant fatigue"?

Back 17

sense of weariness, loss of energy maked by a change in ability to function at home, work, school, socially

Front 18

What is is considered "significant malaise"

Back 18

feeling "sick"/sense of lethargy, discomfort general weakness, and as of an impending illness

Front 19

What is considered "significant weakness"

Back 19

demonstrable loss of muscular power related to activity/functional abilities

Front 20

When is "weight loss/gain" considered significant

Back 20

5% increase/decrease of body weight, over a 4 week period, unexplained

Front 21

When is a "change in appetite" considered signficant?

Back 21

when its a sustained change from baseline of more than 2-3 weeks

Front 22

What does a decrease in appetite signify?

Back 22

infection, cancer, metabolic disease, toxicities, depression, rhemuatic disorders

Front 23

What does an increase in appetite signify?

Back 23

hyperthyroidism

Front 24

If there is a yes to any of the general health questions what three questions must follow?

Back 24

1) when did it start? is there any explanation for it?
2) Have they mentioned this to a physican?
3) If a physician is aware of it, has it become worse?

Front 25

What is the purpose of the subjective examination?

Back 25

to determine the area, nature, behavior, and chronology of the patient's symptoms and gather other pertinent info on the patient

Front 26

What is a symptom?

Back 26

sensation that the patient perceives and expresses

Front 27

What are the 3 purposes to the subjective examination?

Back 27

1) establish the diagnosis (to guide objective exam)
2) monitor progress
3) helps treatment strategy

Front 28

What are the 9 components of the Subjective exam?

Back 28

1) Chief complaint
2) Condition
3) Occupation(former profession)
4) Social situation
5) General health status
6) Medications
7) Any medical imaging tests been done? and their findings
8) What does this patient feel is the cause of the complaint?
9) patients goals

Front 29

What are the 3 questions asked if patients symptoms are NOT constant?

Back 29

1) when are they present?
2) what brings them on?
3) what helps to ease the pain?

Front 30

In relation to symptom occurance, when are they worrisome?

Back 30

when symptoms are constant and do not fluctuate

Front 31

What questions need to be asked if symptoms are constant and do not vary in intensity?

Back 31

1) what makes them worse?
2) what relieves them?
3) how long do they last?

Front 32

What clarification needs to be made if patient claims symptoms are constant and do not vary intensity

Back 32

it needs to be clarified that nothing makes the symptoms worse, no matter what the patient does

Front 33

what are the clues that help us establish the nature of an injury for one with a "sudden onset"

Back 33

mechanism of injury coupled ith signs and symptoms following the injury

Front 34

what is the focus of the interview for injrues that came on gradually

Back 34

determining the cause of the injury- must address the cauase of injury in order to treat patient

Front 35

what are the three special considerations to keep in mind during an interview

Back 35

1) relate severity of insident to degree of disability
2) consider hx of local pain as well as hx of referred pain
3) other questions that need to be asked depending upon the nature of the condition

Front 36

What are the red flags for pain related to systemic or visceral pathologies

Back 36

1) No cause
2) Sudden onset
3) non-specific location
4) no change in pain behavior with activity, and recurring pain without any identifiable cause
5) relatively normal examination with the inability to successfully provoke any structure
6) systemic S and S (fever, chils, fatigue, night sweats, GI symptoms)
7) patient does not respond to treatment

Front 37

what are the orthopedic red flags

Back 37

Recognize the need for consultation to rule out
1) fractures/lig. tears (traumatic injuries)
2) ortho systemic problems (RA, Lupus)
3) severe neurological condition (cauda equina)
4) obvious neurological or cardiac condition

Front 38

By the end of the subjective exam, the PT should have

Back 38

a good idea about the posisble pathology that the patient is presenting with

Front 39

the first impression (from subjective exam) needs to be ....

Back 39

corroborated by means of the objective evaluation

Front 40

In oder to confirm your impression, what two things must be encorporated in the objective exam

Back 40

1) Tests to confirm clinical impression
2) tests to rule out other possible pathologies

Front 41

what is a limitation of standard lists of items, including the Quebec Pain Disability Scale?

Back 41

items, such as "throw ball" is not usedul for patients who woulud not routinely throw a ball

Front 42

what is the patient-specific functional scale

Back 42

self-report disability measure that is specific to individual patients

Front 43

what is the difference between the original patient-specific functional scale and the revised one?

Back 43

Original had patients specify 5 important tasks they couldnt do and rate them on a 0-10 scale (inability = 10/10)

Revised required patient to specify 3 activities (normal performance = 10/10)

Front 44

what is the reliability for the patient-specific funcitional scale

Back 44

reliable for patients with LBP, neck pain and knee pain

Front 45

what is the validity for the patient-secific functional scale

Back 45

little information regarding this