1
Q
What initial questions should you ask in a GALS exam?
A
- do you have any pain or stiffness in any muscles, joints or the back?
- can you completely dress and undress yourself without difficulty?
- are you able to climb up and down stairs without difficulty?
2
Q
What does asking about back and joint pain and stiffness screen for?
A
- RA
- OA
- ankylosing spondylitis
3
Q
Why should you ask about getting dressed?
A
- fine motor impairment
- restriction of joint range of motion
4
Q
Why should you ask about climbing stairs?
A
- impaired gross motor function
5
Q
What should you inspect from the front?
A
- abnormalities in the shoulders, chest, elbows, wrists, hands
- hips, thighs, knees, feet
6
Q
What should you inspect from the side?
A
- normal spinal curvatures
- cervical lordosis
- thoracic kyphosis
- lumbar lordosis
- hip and knee deformities
- knee hyperextension
7
Q
What should you inspect from the back?
A
- abnormalities in the shoulders, spine, paraspinal muscles
- levels of iliac crests, gluteal regions, popliteal fossae, calves, Achilles tendon, hind feet
8
Q
How do you assess gait?
A
- ask patient to walk a few steps, turn and walk back
9
Q
What should you comment on in gait?
A
- arm swing, pelvic tilt, stride length
- ability to turn quickly
- antalgic (painful) gait
- if walking is painful
10
Q
How do you assess the spine?
A
- Place 2 fingers on adjacent lumbar vertebrae, ask pt to bend forward and touch toes
- observe fingers moving apart and back together
- lateral flexion: ear to shoulder and ask if it is painful
11
Q
How do you assess the shoulders?
A
- put hands behind head and push shoulders back
- comment on ROM of shoulder abduction, external rotation and elbow flexion
12
Q
How do you inspect the hands?
A
- arms out, palms down then turn over and palms up
- joint swelling, deformity, loss of contour, muscle wasting, skin/nail changes, nodules in wrists and hands
- squeeze MCP joints
13
Q
What should you observe for in the elbows?
A
- ability to supinate and pronate
- ability to fully straighten the elbow
14
Q
How do you move the hands?
A
- ask patient to make full fist covering nails
- ask patient to squeeze your fingers to assess grip strength
- ask pt to touch each finger to thumb
15
Q
How do you move the legs?
A
- knee to chest and hand over knee to assess for crepitus
- flex hip and knee, move foot for int and ext rotation
- patellar tap: slide hand from mid thigh, tap over patella
16
Q
How do you look at the feet?
A
- inspect soles for swelling, deformity, callosities
- squeeze across MTP joints
17
Q
What is Trendelenburg’s gait?
A
- unilateral weakness of hip abductor muscles
- secondary to superior gluteal nerve lesion or L5 radiculopathy
18
Q
What is waddling gait?
A
- bilateral weakness of hip abductor muscles
Phase 2b
flashcards
Decks in class (17)
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