PT Roles and Responsibilities and Recognizing Atypical Symptoms

Flashcards covering PT roles, responsibilities, and atypical symptoms recognition.

Screening in Physical Therapy

Process to identify patients who fall outside the scope of physical therapy practice and need to be referred.

Low Back Pain

The most common reason for people seeking medical care and missing days of work, and represents a large outpatient population.

Screening Considerations for Low Back Pain

Spinal malignancy, Cauda equina syndrome, Spinal infection, and Vertebral compression fracture

Osteoporosis-related Vertebral Compression Fracture

Most common type of vertebral compression fracture, particularly in women, post-menopausal individuals, and older adults.

Patient Health History Categories

Demographics, current conditions, history of illness, mechanism of injury, surgical history, medications, substance use, and family history.

Substance Use (Health History)

Smoking, caffeine intake, and alcohol consumption.

Family History (Health Risk Factors)

Heart disease, breast cancer, and prostate cancer.

Non-mechanical Pain Patterns

Unpredictable and inconsistent pattern of movements, pain all the time and non-positional, worst at night.

Fatigue (Red Flag)

Inability to function at home, work, or school for 2-4+ weeks with no explanation.

Malaise

General discomfort or uneasiness, sense of getting sick, associated with infection and rheumatic disorder.

Fever (Red Flags)

Fever of unknown origin 99.5-101°F for 2-3+ weeks, physician contact 102°F, Elderly 98.9°F concerning and confusion.

Paresthesia (Red Flags)

Glove and stocking distribution in outpatient unusual, area getting larger, pins and needles to numbness, quick changes

Weakness (Red Flags)

Spreading to other muscle groups or extremities, more noticeable with activity, quick progression

Dizzy (Red Flags)

Hearing loss, tinnitus, falls, visual disturbances, hemiparesis, vomiting falls

Palpitations concern

Fluttering, jumping, irregular with chest pain and syncope.

Diaphoresis

Pain with sweats associated with acute myocardial infarction.

Cough

Persistence 3+ weeks with no sickness, sputum red, pink, green, rust, Cough positional in nature

Swallowing difficulties

Dysphagia

Bowel dysfunction

Melena- black stool upper GI bleed Light gray or pale- obstruction jaundice (liver dysfunction)

Color of urine for concern

Bright red

Nocturia

Increase frequency at night

Dysuria

Painful urination at initiation or throughout

Most frequency sites for skin malignancies

Face, ears, neck, hands

ABCDE’s of malignancies

Asymmetric, Borders- irregular indistinct, Colors- multiple shades, black, Diameter >6mm, Elevating or evolving

Weight Changes (Red Flags)

Unexplained weight loss/gain of 10-15 lbs in 2-3 weeks, physician referral if rapid loss with cancer suspicion.

Loss of Appetite (Red Flags)

May indicate cancer, abdominal infection, or liver/pancreatic disease.

Night Pain (Red Flags)

Unrelenting night pain may indicate cancer; pain not relieved by positional changes.

Rest Pain

Pain that is present even when the patient is not moving or active.

Change in Bowel/Bladder Habits (Red Flags)

Incontinence or retention, could indicate cauda equina syndrome or spinal cord compression.

Numbness (Red Flags)

Saddle anesthesia - numbness in the groin/perineal region, indicative of cauda equina lesion.

Age as Risk Factor

Under 20 or over 55 with new onset back pain.

Past Medical History (Red Flag)

History of cancer, recent infection, IV drug use, or immune suppression.