Complexity and MSK Reasoning Process

Vocabulary flashcards covering MSK clinical reasoning, the International Classification of Functioning (ICF) model, neurophysiology of pain, subjective assessments, red/yellow flags, and objective musculoskeletal tests.

Clinical Reasoning

A context-dependent way of thinking that is influenced and shaped by everyone's individual experiences.

Patient Centered Care

An approach grounded in the principle that every patient's experience is unique and should be treated individually.

Pain

Loudness perception on sensation caused by actual or potential tissue injury.

Homeostatic Emotion

A function of pain that serves to maintain equilibrium and balance within the body.

Nociceptor

A high-threshold sensory neuron of the peripheral nervous system (PNS) capable of transducing and encoding noxious stimuli.

Primary Hyperalgesia Area

The primary, central area of pain located directly at the site of tissue injury.

Secondary Hyperalgesia Area

The area surrounding an injury that becomes protectively painful as neighboring nociceptors are activated and become more prominent through peripheral sensitisation.

A-delta and C-fibers

Afferent high-threshold primary sensory nerve fibers that transmit noxious messages (hot/cold, mechanical, and chemical) to the spinal cord and trigger inflammatory responses.

A-beta Fibers

Low-threshold primary sensory nerve fibers that respond to non-noxious stimuli (moderate temperature, mechanical stimuli) and transmit signals to the spinal cord.

Pain Gate Theory

The concept that incoming noxious input can be modulated and regulated by bombarding the dorsal horn synaptic center with non-noxious sensory input.

Mechanical Pain

Pain commonly described by patients as sharp, dull, or achey.

Nerve Pain

Pain characteristically described by patients using terms such as burning, sharp, or electric.

SOAP Framework

A clinical reasoning documentation format consisting of Subjective (patient story/ideas), Objective (tests seen/performed), Analysis (defining the problem/agreeing on treatment), and Plan (treatment action).

S.I.N. Factor

A clinical assessment acronym standing for Severity (scale/level to determine treatment starting point), Irritability (what helps or aggravates), and Nature (type of tissue involved).

Myogenic

A nature classification referring to pain or pathology originating from muscle and soft tissue.

Arthogenic

A nature classification referring to joints, bones, ligaments, and any structures directly affecting joints and skeletal articulations.

Neurogenic

A nature classification referring to symptoms or pathology arising from neurology and the nervous system.

Red Flags

Clinical warning indicators that signal serious underlying medical pathology, including DVT, unremitting cancer pain, infection, thoracic pain, cauda equina syndrome, and low back swelling.

Yellow Flags

Psychosocial risk factors (categorized by A, B, C, D, E, F, W) indicating potential obstacles or barriers to rehabilitation.

Cauda Equina Symptoms

A critical lower limb red flag presentation characterized by saddle anaesthesia along with bladder or bowel changes.

The 5 D's

Special upper limb screening questions for serious neurovascular pathology: Dizziness, Drop attacks, Diplopia (diplopa), Dysarthria, and Dysphagia.

AROM (Active Range of Motion)

An objective assessment movement used specifically to place stress on myogenic structures.

PROM (Passive Range of Motion)

An objective assessment movement utilized to place greater stress on arthogenic and neurogenic structures.

PAM

Passive accessory movement tests used during an objective assessment to evaluate ligaments.

Impairments (ICF)

Problems in body structure, cognition, and function, requiring consideration of physical, mental, and cognitive components such as patient beliefs.

Activity Limitations (ICF)

Specific difficulties an individual encounters when attempting to execute everyday tasks and actions.

Participation (ICF)

Problems an individual may encounter in being involved in broader life situations and social roles.

Environmental Factors (ICF)

The physical, social, and attitudinal context and environment in which individuals conduct their lives.

Personal Factors (ICF)

Background factors of an individual's life that are not part of the primary presenting health condition.