Study sets, textbooks, questions
Upgrade to remove ads
Good Luck! You can do it
Terms in this set (39)
Practice patient interaction FOR ALL STATIONS
WASH YOUR HANDS BEFORE AND AFTER CLIENT INTERACTION
1. Introduce yourself -Hi im Alcina im an OTS; provide explanation of task and what you'll be doing and THANK THE CLIENT AT THE END.
Know how to properly transfer patient from wheelchair or to the wheelchair; don gait belt and know how to use it on client
-what else should you NEVER forget to do when transferring someone to/from wc?
Select appropriante testing procedure, perform the assessment, demonstrate positive response, be safe w/ child, state age of integration and purpose of reflex.
-Landau reflex define and give age of integration.
-Integration at 12-24 months.
-child should be prone in the air (support its abdomen area) and its head movement should match feet movement. If the child has their head in extension then the feet will come up and kick (U shape), but if you push the Childs head down into flexion then the feet will go down as well (n shape).
-purpose is to break up total reflex pattern
Galant reflex define and give integration age
-Integration at 2 months.
-Infant starts in prone and you just stroke their spine from C7 (shoulders) down to hip (iliac crest)
-child should curve towards the side you stroke them on
-purpose is to develop ROM in hip and encourage movement for walking and crawling
Be able to read prompt, state appropriate research design and explain why (pretty sure this will be provided so at least be very familiar with the definitions)
Give type of evidence aka define: level 1A
Randomization only happens in level 1 except 2B which would be like a pilot study!!! Randomization means its well tested. Level A studies are all systematic reviews where they get results from multiple studies whereas all level B studies are its conducting its own study)
1. 1A- systematic review of homogenous randomized controlled trial (i.e., same population, same intervention, etc)- taking multiple studies and getting a conclusion about them about a homogenous population.
2. 1B- randomized controlled trial (RCT)- randomly puts people randomly in experimental or control group to conduct a study
-This is not a pilot or feasibility study =large sample size.
3. 2A- systematic review of cohort studies -Same thing as 2B except you're comparing the tx results from multiple studies.
4. 2B- individual prospective cohort study, low quality RCT (pilot or feasibility because you dont have other info from other studies since it could be an initial study or you just have small sample size); ecological studies; two-group (every individual gets treatment and you're looking at how they are before, during, and after intervention and comparing each person to themselves over period of time aka cohort. If its 2 groups you compare tx to people who have condition and those who dont).
Ex. you're getting some therapeutic tx before, during, and after therapy and you look at their rate of change
5. 3A- systematic review of case-control studies (taking a bunch of studies and comparing the significance of the study of 2 different groups (1 w/ condition 1 w/out and reporting the results)
Give type of evidence for level:
1. 3B- individual retrospective case-control study (comparing 2 groups and conducting its own study (1 w/ condition 1 w/out back in time and throughout time)
Ex- people w/ aids are asked about their medical history and lifestyle choices to study origin of disease)
4. case series - observations made before and after an intervention with no control group. Theres no randomization for this because the people you are picking ppl who all have the same condition/disease.
-Ex. looking at covid in different states.
5. expert opinion or personal observation
For UE ROM/MMT introduce yourself, explain test procedure, use Goni appropriately (alignment of axis, proximal and distal arm, bony landmarks) accurately read Goni, verbalize findings and compare to normative values and explain what that means
Make sure to bring in your gait belt and your goniometer, name badge, pen/pencil and show up at 11:05am. your start time is at 11:10.
1. ATNR (asymmetrical tonic neck reflex) define and integration age
1. Integration at 4-6 months.
-Baby is on the floor in supine and you stand above the baby's head and turn their head to the left/right side. Baby should go into a "fencing position" - so the arm and leg on the side they're facing will extend (jabbing opponent) and their arm and leg on the other side will flex.
-purpose is to provide hand-eye coordination. If they can't do it then they may have trouble with visual tracking or rolling.
MORO define and integration age
-Integration is 5-6 months.
-Child starts in supine position and you bring them down (kinda head first)
-The child should give startle response by bring their hands out and back in when you bring them down at the very end.
-The purpose is to give the child his/her first experience of extension and if they dont give do the reflex then might indicate brain lesion or peripheral nerve problems.
STNR define and integration age
-Integrates 8-12 months
-baby starts in quadruped position on the floor. Support their abdomen. When you push their head into flexion they also flex their arms and the LE extends. When you bring their head into extension the opposite reaction happens so UE will extend and LE will flex. so just think of a natural rocking response.
-purpose is to achieve crawling
Shoulder flexion and Extension ROM
1. shoulder flexion- normal ROM is 165-180 degrees
-patient is in supine position with knees bent. Arm is in neutral and by their side.
-Place fulcrum of Goni over the greater tubercle of humerus (opposite side of head of humerus) or place it at the axis of motion. Make sure you're in the midline of arm and keep it there while the client goes into flexion. Support under the elbow and then move the distal arm of Goni to measure.
2. shoulder extension- ROM 50-60 degrees
-patient is in prone. If there is no face placement (hole) in table then have them turn their head to the side you're not measuring.
-Place fulcrum over lateral greater tubercle and have client go into extension and then move the distal arm of Goni and measure. Support under elbow when measuring.
Shoulder Abduction ROM
1. Shoulder abduction is 170-180 ROM.
-client is in supine. Place fulcrum on anterior acromion process (top of shoulder) and parallel to their body. Have them supinate arm, arm bring their arm out to the side and up like a jumping jack motion. Move the distal arm of goni and measure
2. Shoulder adduction- Not measured since its the starting position
Shoulder medial (internal rotation) and lateral (external) rotation ROM
1. Shoulder internal rotation - 70-90
-client is in supine with a towel under the arm. Place the proximal arm straight out in abduction from body and have forearm straight up (perpendicular to table) in neutral.
-center fulcrum over the olecranon process of the ulna (side of elbow) and have client bring the forearm straight down to the table (flexion motion) and move distal arm of goni and measure. Hold wrist for support.
2. Shoulder external rotation- normal ROM 90-100 degrees
-have client in same position as the shoulder internal rotation but have them move their forearm backward instead. support by the wrist and measure moving distal arm of goni.
Elbow flexion ROM
1. Elbow flexion- normal ROM is 140-150 degrees
-have client in supine and place towel underneath the proximal arm. Center fulcrum over lateral epicondyle of humerus while placing the proximal arm by the humerus and the distal arm by the clients forearm when they're in full arm extension. Have them close to the side of the table so their arm can hang off to make sure their extension is not being limited. Then have client bend their elbow and measure.
2. Elbow extension- ROM is not measured because normal is 0. if they go further its hyperextension.
Forearm pronation and supination ROM
1. Forearm pronation- normal ROM 75-85 degrees
-client in sitting position with elbow flexed to 90 degrees to their side in neutral position. Support their wrist and put smaller half Goni fulcrum over the lateral ulnar styloid process perpendicular to wrist. Have client pronate and move the distal goni arm on top of forearm to measure.
2. Forearm supination- normal ROM is 80-90 degrees. Have client in same position as forearm pronation except put fulcrum of small half Goni on the ulnar styloid process from the medial side of the arm. Have client supinate and move distal arm of Goni over the forearm to measure.
Wrist flexion and extension ROM
1. Wrist flexion- normal ROM is 60-80 degrees.
Have client in sitting position with their hand over the edge of table. Put small half Goni on the lateral aspect of the wrist with the proximal arm parallel to the forearm and the distal arm parallel to the hand. Move client in wrist flexion while stabilizing forearm and use other hand to move the distal arm of the Goni to measure.
2. Wrist extension- normal ROM is 60-75 degrees.
Have client in same position as wrist flexion. put fulcrum of small half Goni on lateral aspect of the hand in the same placements as wrist flexion and just move the client into wrist extension. Measure by moving the distal arm.
Scapular (shoulder) elevation MMT
1. Grade 0- no contraction when palpating
2. Grade 1- have client in prone w/ head turned away from testing side. Stand at side of client putting one hand under the clients shoulder for support and use the other hand to palpate the upper trap at the shoulder where the supraspinatus is (this is where the insertion is).
-client is a grade 1 if muscle tension can be felt.
3. Grade 2- have client in prone position and elevate their shoulders.
-client is grade 2 if they complete full ROM in gravity-minimized position.
4. Grade 3- client is in sitting and is able to elevate shoulders against gravity
5. Grade 4- client is in sitting and is able to elevate shoulders against client pressure for a couple seconds before giving out. Kneel on table behind client and push down on shoulders.
6. Grade 5- client is able to hold test position against max. resistance. Kneel on the table behind client and push down on shoulders.
Wrist ulnar and radial deviation ROM
1. Wrist ulnar deviation- Normal ROM is 30-40 degrees
-Have client in sitting with table to their side and have their arm propped on table. Center the fulcrum over the dorsal aspect of the capitate (middle of wrist. its middle carpal bone). Move distal arm with their wrist and measure. stabilize the lateral forearm.
2. Wrist radial deviation- Normal ROM is 20-25
-Have client in same position as wrist ulnar deviation and measure.
Elbow flexion MMT
Elbow flexion: Client IN SITTING for all grades!!!
1. Grade 0
2. Grade 1- support client under elbow and wrist if necessary and palpate the bicep by the elbow
3. Grade 2- have client bring their arm out in front with their elbow flexed to 90 degrees. Support clients arm proximal to elbow to reach gravity minimized position and support forearm by the wrist and have them flex.
4. Grade 3- stand to side of client and have them bend their elbow. cup the elbow for support.
5. Grade 4- support client elbow and apply pressure over forearm by the wrist
6. Grade 5
Shoulder flexion MMT
1. Grade 0- no discernable palpation
2. Grade 1- client is in side-lying. Stand behind client cradling the test arm at the elbow and putting the other hand on the shoulder. Have client raise arm while palpating the anterior deltoid by the insertion (shoulder).
-if there's contraction felt client is grade 1
3. Grade 2- client is able to flex shoulder to 90 degrees in gravity-minimized position (side-lying)
4. Grade 3- client is in sitting and can raise their full arm (w/ elbows straight) in front of their body against gravity (90 degrees perpendicular to body)
5. Grade 4- place one hand over the client's shoulder and place the other hand over the distal end of the clients proximal arm near the elbow and apply resistance.
-client is a 4 if able to w/stand moderate resistance
6. Grade 5
Shoulder abduction MMT
1. Grade 0
2. Grade 1- stand on opposite side of testing side and palpate middle deltoid
3. Grade 2- client is in supine and complete ROM to 90 degrees in this position or they can't raise shoulder to 90 degrees with elbow straight. stand at opposite side of testing side so client has movement.
4. Grade 3- client is in sitting and completes shoulder abduction to 90 degrees (arm straight out to side)
5. Grade 4- Place one hand on shoulder and apply resistance by the elbow on the proximal arm
6. Grade 5
Shoulder extension MMT
Client is in PRONE FOR ALL GRADES with forearm in supination position (neutral)!!!!
1. Grade 0- no discernable contraction
2. Grade 1- use 2 fingers to palpate the posterior upper arm (posterior deltoid)
3. Grade 2- client has partial ROM in prone position
4. Grade 3
5. Grade 4- Apply resistance over the proximal arm near the elbow
5. Grade 5
For MMT, what should you always have the client do first before deciding whether to apply resistant to the client or have them go in a gravity-minimized position?
Always have the client raise the testing UE first to see whether they are at a grade 3 to orient yourself on how to grade them next.
Shoulder horizontal abduction MMT
1. Grade 0
2. Grade 1- client is in sitting. support forearm and palpate right above the axilla (posterior deltoid)
3. Grade 2- client is in sitting position (gravity minimized). Stand at the testing side supporting the forearm. Client is 2 if they can move through full ROM.
4. Grade 3- client is in prone position. doesn't specify which way the client is facing. Have their shoulder out to 90 degrees w/ forearm hanging off side of table and have them bring arm out for horizontal abduction.
5. Grade 4- place resistance just above the elbow
6. Grade 5
Shoulder horizontal adduction MMT
1. Grade 0
2. Grade 1- palpate pec major by the axilla
3. Grade 2- client is in sitting position with arm supported on a table at their side. shoulder should be 90 degrees in abduction with forearm bent in neutral and is able to complete ROM in this position. support clients forearm if needed by standing on opposite clients testing side.
4. Grade 3- client in supine and starts off with their shoulder in 90 degrees abduction and elbow bent so forearm is pointing towards ceiling. Client can move arm across their chest.
5. Grade 4- support clients forearm by the wrist and use other hadn't to apply resistance right above the elbow in a downward position.
6. Grade 5
Shoulder external rotation MMT
Shoulder internal rotation MMT
1. Grade 0
2. Grade 1- support clients forearm and use other hand to palpate the lower scapula (infraspinatus and teres minor) by the axilla
3. Grade 2- client is sitting facing the table with their forearm supported on it. client completes ROM in this position. Stabilize the elbow if needed.
4. Grade 3- client is in sitting with arms at the side and their elbow flexed to 90 degrees (like an L) and can move JUST their forearm laterally
5. Grade 4- stand in front of the patient and support right below the elbow on the forearm (dont block movement) while using other hand to provide resistance on dorsal forearm.
6. Grade 5
Shoulder internal rotation will be all the same positions except palpate deep in the anterior axilla (subscapularis) and do the opposite motion.
Elbow extension MMT
1. Grade 0
2. Grade 1- support limb under forearm by the wrist and palpate the tricep by the elbow
3. Grade 2- patient in sitting with shoulder out to side with elbow flexed to 45 degrees for gravity minimized position. Support client's arm proximal to elbow and wrist. If they complete ROM they are a 2.
4. Grade 3- client is in prone with arm abducted out to the side of the body and forearm hanging off table. Ask them to straighten the elbow.
5. Grade 4- Provide support under the arm by elbow and apply resistance on the distal forearm by the wrist.
6. Grade 5
Forearm supination MMT
Forearm pronation MMT
Forearm supination: client is in sitting for all positions!!!
1. Grade 0
2. Grade 1- support forearm and palpate the supinator (top of forearm) on lateral aspect. Feel for contraction.
3. Grade 2- completes partial ROM
4. Grade 3- With elbow flexed to 90 degrees and forearm in neutral have them supinate. stand in front of client.
5. Grade 4- support clients elbow and provide resistance on lateral aspect of forearm
6. Grade 5
Forearm pronation is the same but palpate the pronator theres instead (top of forearm on medial side)
Wrist flexion MMT
Wrist extension MMT
Wrist flexion MMT: Client in sitting for all grades!!!
1. Grade 0
2. Grade 1- supinate forearm, support the back of the wrist and have them flex while palpating the flexor tendons on the wrist.
3. Grade 2- client has wrist propped up on table in mid position. Can flex wrist in gravity minimized position.
4. Grade 3- client has forearm propped on table with arm in supination and is able to flex wrist
5. Grade 4- support clients forearm and apply resistance over the palm
6. Grade 5
Same as wrist flexion but reverse. pronate the wrist and palpate extensor tendon at the wrist for grade 1.
Finger PIP and DIP flexion MMT
Isolated PIP and DIP flexion MMT
Client in sitting for all grades with fingers relaxed!!!
3. Grade 2 -Refer to isolated PIP and DIP tests for grade 0-2
4. Grade 3-Ask client to touch their palm with their fingers
5. Grade 4/5- Place one finger in clients palm, have them fold fingers around your finger and pull your finger upward while they resist. Client is able to hold against strong resistance.
For isolated PIP hold down all the fingers and the proximal phalanx of the one being tested to isolate the PIP joint. Do the same for the DIP by holding down the middle phalanx. Repeat for all other fingers.
1. Grade 0
2. Grade 1- palpate flexor at wrist (doesn't clarify whether to be in mid position or go into supination)
3. Grade 2- completes ROM with hand in mid position for gravity minimized
4. Grade 3- completes ROM without resistance
5. Grade 4/5- they're able to hold against strong finger resistance
Finger MCP extension MMT
Client is in sitting for all grades w/ arm propped on table with fingers in relaxed position!!!
1. Grade 0
2. Grade 1-can see tendons moving but no movement happening. no need to palpate here
3. Grade 2- completes ROM with forearm in mid position
4. Grade 3- Place index finger over the back of the proximal phalanx to stabilize and have client straighten their fingers out. Can complete range without resistance.
5. Grade 4/5 -able to hold position with appropriate level of resistance
Finger MCP Flexion MMT
Client is in sitting position with elbow propped on table. Demonstrate the intrinsic plus position.
1. Grade 0
2. Grade 1- minimal motion
3. Grade 2- clients hand is in mid position. Stabilize the hand (metacarpals) and have client go into intrinsic plus so that they're only flexing the MCP. client completes ROM in this position.
4. Grade 3- While client is in intrinsic plus position, stabilize the clients hand and ask client to point the fingers straight up. If this is achieved client is grade 3.
5. Grade 4/5- place resistance over the proximal phalanx one digit at a time.
Finger abduction MMT
Finger adduction MMT
Just have client sitting with hand pronated on table. Have them abduct fingers. If they can do this, they are a grade 3. apply resistance by pushing two fingers close together.
-Grade 2 is they only can do partial ROM.
-Grade 1- the only fingers that can be palpated (interosseous) are the base of the proximal finger and the ulnar border of the hand for the 5th digit.
Finger adduction- client is able to adduct fingers is a grade 3. For a 4/5 use your fingers to try and spread their fingers apart. if they can resist they are a 4/5.
-For grade 2 patient has partial ROM
-Grade 1- palpating is hard but might be detectable if placed on side of base of fingers.
Thumb MCP flexion MMT
Thumb IP flexion MMT
Thumb MCP flexion:
client is sitting with forearm in supination. Stabilize the wrist and have client bend thumb toward palm for grade 3 (completes ROM)
-Grade 4/5- place one finger over the proximal phalanx of thumb and apply resistance. stabilize hand/wrist.
-Grade 2- partial ROM
-Grade 1- palpate thenar eminence (flexor pollicis brevis) for contraction while stabilizing hand
Thumb IP flexion:
client is in same position as thumb MCP flexion. stabilize the MCP thumb joint and have them flex their IP joint (tip of thumb). If ROM is present then grade 3.
-Grade 4/5- stabilize base of thumb (MCP joint) and use two fingers to pinch the tip of the clients flexed thumb and extend it for resistance.
Grade 2- holds test position
Grade 1 and 0- palpate proximal phalanx of the thumb. You can also see flexor tendon in the wrist move.
Thumb MCP and IP extension MMT
Client is sitting with forearm in mid position on table. Ask client to lift thumb straight up. If they can its grade 3.
Grade 4/5- stabilize the wrist and apply 1 finger resistance over back of the distal phalanx.
Grade 2- forearm is in pronation. stabilize clients wrist and have client extend their thumb out. client is able to complete ROM.
Grade 1- palpate anatomical snuffbox (base of MCP)
Grade 0- no contraction
Thumb abduction MMT
Thumb adduction MMT
client has forearm supinated on a table. Ask them to lift their thumb straight up. This is grade 3.
Grade 4/5- Stabilize the metacarpals (hand) on the side of the 4th and 5th digit and apply resistance over the tip of thumb
-Grade 2- partial ROM
-Grade 1- stabilize wrist/other side of hand and palpate base of first metacarpal (abductor pollicis)
Forearm in pronation. stabilize the ulnar hand and have them bring their thumb towards the hand for grade 3.
-Grade 4/5- stabilize ulnar hand and apply resistance on medial proximal phalanx of thumb
-grade 2- forearm in mid position and thumb in abduction, stabilize the client hand and have them bring their thumb toward their hand. Client completes ROM.
-grade 1- palpate the adductor policies by the web of the thumb.
client has forearm in supination supported on table. Ask client to bring little finger towards their thumb, thumb towards little finger, then ask them to go into opposition using thumb and little finger. If range is present grade 3.
-Grade 5- have them go into opposition using thumb and 5th digit and then use two fingers (one on base of each) and pull them away to apply resistance
-Grade 4- holds against moderate resistance
-Grade 2- moves through range when evaluated separately
-Grade 1- palpate OP along the base of the thumb bone. palpate 5th digit along side of hypothenar eminence.
-Grade 0- no contraction
Determine Research Design
Other sets by this creator
FW I -Muscles of the UE
Recommended textbook solutions
Elliot Aronson, Robin M. Akert, Samuel R. Sommers, Timothy D. Wilson
Myers' Psychology for AP
David G Myers
Spencer A. Rathus
Myers' Psychology for the AP Course
C. Nathan DeWall, David G Myers
Other Quizlet sets
Practical Vim Combined
Unit 11- Real Estate Contracts
1. Introduction and legal regulations
MKTG 379 Final Exam