KAAP 619: Injury Evaluation Process

Vocabulary-style practice flashcards covering clinical examination techniques, pain patterns, end feels, MMT grading, and upper/lower quarter neurological screens from the KAAP 619 lecture.

HOPS Method

A systematic evaluation method consisting of History (Hx), Observation, Palpations, and Special Tests.

MAPPSS

An acronym used for taking present medical history, standing for Mechanism of Injury, Acute or Chronic, Pain, Palpation, Sounds, and Signs/Symptoms.

Tissue Creep

Elongation of tissue beyond its intrinsic extensibility, characterized by a daily pain pattern that is worse in the morning and better as the day progresses.

Muscle Fatigue

A physiological state indicated by a daily pain pattern that is better in the morning and worse as the day progresses.

Normal Soft End Feel

A normal barrier to joint motion caused by soft tissue approximation, such as during knee flexion.

Normal Firm End Feel

A normal barrier to joint motion caused by muscular, capsular, or ligamentous stretch, such as in hip flexion with knee extended, MCP joint extension, or forearm supination.

Normal Hard End Feel

A normal barrier to joint motion caused by bone contacting bone, such as during elbow extension.

Abnormal Soft End Feel

An end feel occurring sooner or later in ROM than usual that feels boggy, caused by edema or synovitis.

Abnormal Firm End Feel

An end feel occurring sooner or later in ROM than usual, caused by increased muscle tone or capsular, muscular, or ligamentous shortening.

Abnormal Hard End Feel

An end feel occurring sooner or later in ROM than usual, caused by a bony block, loose bodies, or fracture.

Spasm End Feel

An abnormal barrier where joint motion is stopped by involuntary or voluntary muscle contraction due to inflammation, strain, or joint instability.

Empty End Feel

An abnormal end feel where no end ROM is reached due to pain and guarding, associated with bursitis or fracture.

Resisted Range of Motion (RROM)

An assessment that evaluates strength throughout a muscle's entire range of motion.

Break Test

An isometric manual muscle test performed in the joint's mid-range to assess muscle pathology versus injury to non-contractile structures.

Grade $5/5$ MMT (Normal)

Clinical MMT finding where the patient can resist against maximal pressure and the examiner is unable to break resistance.

Grade $4/5$ MMT (Good)

Clinical MMT finding where the patient can resist against moderate pressure.

Grade $3/5$ MMT (Fair)

Clinical MMT finding where the patient can move the body part against gravity through the full range of motion.

Grade $2/5$ MMT (Poor)

Clinical MMT finding where the patient can move the body part in a gravity-eliminated position through the full range of motion.

Grade $1/5$ MMT (Trace)

Clinical MMT finding where the patient cannot produce movement, but a muscle contraction is palpable.

Grade $0/5$ MMT (Gone)

Clinical MMT finding where no muscle contraction is felt.

Dermatome

An area of skin innervated by a single spinal nerve root.

Myotome

A group of muscles innervated by a specific spinal nerve root.

Two-Point Discrimination

A sensory discrimination test performed bilaterally with eyes closed, measuring sensitivity between two points spaced $4-5\,mm$ apart.

Upper Motor Neuron Lesion

A central nervous system condition indicated during deep tendon reflex testing by an increased response.

Lower Motor Neuron Lesion

A nervous system condition indicated during deep tendon reflex testing by a decreased response.

L4 Nerve Root Testing

Neurological screen testing involving sensory assessment at the medial lower leg, motor assessment via ankle dorsiflexion, and reflex testing at the patellar tendon.

L5 Nerve Root Testing

Neurological screen testing involving sensory assessment at the lateral lower leg and dorsum of foot, and motor assessment via great toe extension.

S1 Nerve Root Testing

Neurological screen testing involving sensory assessment at the lateral plantar aspect of foot, motor assessment via ankle eversion, and reflex testing at the Achilles tendon.

C5 Nerve Root Testing

Neurological screen testing involving sensory assessment at the deltoid, motor assessment via shoulder abduction, and reflex testing at the biceps tendon.

C6 Nerve Root Testing

Neurological screen testing involving sensory assessment at the lateral forearm, thumb, and index finger; motor assessment via elbow flexion and wrist extension; and reflex testing at the brachioradialis tendon.

C7 Nerve Root Testing

Neurological screen testing involving sensory assessment at the middle finger, motor assessment via elbow extension and wrist flexion, and reflex testing at the triceps tendon.