Examination: basic vs comprehensive, red flags

What is the purpose of examination

-gather data on which to base dx, prognosis, and plan

-determine nature and extent of main problem

-determine nature and extent of pts disability

-gather baseline data

-ID yellow flags and red flags

-determine if therapist should evaluate and treat, eval and refer or refer

framework of an exam

-hx

-observation

-neuro screen

-function

-palpation

-special test

-joint play assessment

why do a hx

-to determine the thoroughness of the examination

What is involved in a specific hx (12 questions)

-how did it happen

-where does it hurt

-when did it start (onset)

-what's the nature of the pain

-what makes it worse/better (aggs/eases)

-is it worse or better at particular times

-has it happened before

-do you have numbness/weakness/giving way/tingling/nausea

-how has the problem affected you

-what tx has occurred so far

-are you getting worse, better or staying the same

-anything else you'd like to tell me

For whom would you do a basic exam

-pts for whom the dx is known

-condition is uncomplicated

-pts who can't tolerate extended exam

For whom would you do a comprehensive exam

-pts for whom the dx isn't clear

-pts for whom you suspect working dx is inaccurate/incomplete

-pts w/ known dx that have complicating factors

-pts w/ chronic conditions previously non-responsive to PT

what is a red flag

-sign/symptom or collection of signs/symptoms that lead therapist to believe that:

-there may be a condition present that is a true emergency

-the prob may not be MSK condition

-there may be a condition present that renders further exam or tx unsafe

T/F MSK pain is aggravated by mvmt and alleviated at rest

-T

If pain is unchanged with mvmt or rest

-it may not be MSK

Pain may not be MSK if

-not fitting a MSK pattern

-pain wakes pt at night and is unchanged by position

-there's fever of unknown origin

-there are bowel/bladder function chngs

-there is numbness/tingling in saddle shape around groin

-there's weight loss w/o reason

-there's neuro signs or symptoms inconsistent w/ orthopedic condition