physical examination

Question 1

what does a physical examination do?

Answer 1

• confirm that it is an MSK dysfunction
• prove or disprove the hypothesis made from subjective exam
• acts as a giude for treatment - pain and movement resppnses to physical tests
• establish baseline data to compare after intervention

Question 2

what are important things to consider for the physical exam?

Answer 2

• consider the severity and irritability of pain - decide what physical tests need to be included
• precautions or contraindications for certain tests or activities
• decide on priority of tests

Question 3

what kind of tests are done in a physical exam of a patient ?

Answer 3

• observation
• functional testing - eg walking or squatting
• ROM-active and passive
• muscles tests - strength, length and control
• accessory movements
• palpation
• special tests - eg testing for achilles tear
• neurological tests
• neurodynamic tests

Question 4

what are different things that can be observed in a physical exam?

Answer 4

• gait - walking
• general build - ie are they over weight etc
• posture type
• bony structure and alignment
• muscle bulk and tone
• skin
• presence of oedema
• obvious deformities

Question 5

what instrument can ROM be measured with?

Answer 5

a goniometer

Question 6

what is a capsular joint pattern?

Answer 6

• proportional motion restriction that indicates iritation of the entire synovial membrane or joint capsule
• can occur with active inflammatory or degenerative joint changes

Question 7

what is a non-capsular joint pattern?

Answer 7

• motion restrictions that occur for reasons that are different to the capsular pattern
  eg involving structures around the joint like soft tissue

Question 8

what are 2 main ways you can test muscle?

Answer 8

• resisted testing - eg using the Oxford scale, 1 rep max / 10 rep max
• muscle control - eg during functional tasks, squatting etc

Question 9

what are the 2 main ways that muscles react to pain or stress?

Answer 9

• spasm / overactivation
• inhibition / underactivity

Question 10

what is the function of a neurological examination?

Answer 10

• to test the conduction and function of the nerve
• to differentiate between a lower and upper motor lesion

Question 11

what is an upper motor lesion?

Answer 11

lesion in the brain or spinal cord

Question 12

what is a lower motor lesion?

Answer 12

• a lesion in the peripheral nerves

Question 13

what are examples of special tests done in a physical exam for hip, knee & ankle?

Answer 13

1. hip - flexion / adduction Scour test
2. knee - Mc murrays meniscal tests
3. ankle - anterior drawer test

Question 14

what are the aims of functional tests?

Answer 14

• observe techniques
• control movement dysfunction
• provoke (stimulate ) pain

Question 15

what are examples of functional tests?

Answer 15

• gait
• running on threadmill
• squatting
• overarm throw
• reaching overhead

Question 16

what is an important point regarding pain and functional test?

Answer 16

• pain must be not severe and not irritable