Ortho

• Cardiovascular/pulmonary symptoms may include chest pain, high blood pressure, and edema
• Integumentary assessment involves evaluating skin integrity, pliability (texture), pressure ulcer formation, and skin color
• Cognitive ability assessment includes evaluating memory (short and long term), expected emotional responses, learning barriers, communication skills, and learning preferences
• Information is gathered about other major body systems (e.g., endocrine, gastrointestinal, genitourinary) to determine if referral for additional medical evaluation is needed
• Differentiation of Systemic and Musculoskeletal Pain:

  • Systemic pain may present with jaundice, migratory arthralgias, skin rash, fatigue, weight loss, low-grade fever, generalized weakness, cyclic and progressive symptoms, history of infection, and tumors
  • Musculoskeletal pain characteristics: generally lessens at night, sharp or superficial ache, usually decreases with cessation of activity, usually continuous or intermittent, aggravated by mechanical stress
• Patient management model is crucial in understanding and addressing the needs of patients effectively
• Levels of evidence are important in determining the strength of research findings:

  • They help in evaluating the quality of research studies and their applicability to clinical practice
• Orthopedic assessment involves various components, including:

  • History collection
  • Observation
  • Examination of movement
  • Palpation
• Main points collected in history:

  • Symptoms
  • Onset
  • Location
  • Duration
  • Aggravating or relieving factors
  • Previous treatments
• Main points looked for in observation:

  • Posture
  • Gait
  • Swelling
  • Deformity
  • Skin changes
• Examination of movement includes:

  • Active Range of Motion (AROM)
  • Passive Range of Motion (PROM)
  • Common capsular patterns table for various joints
  • Resisted isometric testing
  • Functional assessment
  • Special tests
  • Joint play movement
• Palpation involves assessing:

  • Swelling
  • Tenderness
• Uses of plain films (x-ray) include:

  • Detecting fractures
  • Assessing joint alignment
  • Monitoring healing progress
• Uses of Computed Tomography Scans:

  • Detailed imaging of bones and soft tissues
  • Useful for diagnosing fractures and tumors
• Uses of MRI:

  • Detailed images of soft tissues
  • Helpful in diagnosing ligament and tendon injuries
• Systems review includes:

  • Musculoskeletal vs Systematic review
  • Meaning of Red and Yellow flags
  • Tables of red and yellow flags
  • Neurological system review
  • Cardiopulmonary system review
• Evaluation and clinical reasoning involve synthesizing examination findings in relation to the International Classification of Function, Disability and Health (ICF)
• Diagnosis in physiotherapy involves identifying impairments of body structure and function that affect human movement
• Plan of care includes determining specific interventions, patient-centered goals, and meaningful, sustainable, and measurable functional outcomes
• Intervention strategies involve coordination of care, progression of care, and discharge planning
• Outcomes in physiotherapy must be functional, meaningful, patient-centered, sustainable, and measurable
• Examples of soft tissue lesions and clinical conditions resulting from tissue pathology are important to understand in orthopedic physiotherapy
• Severity grades of soft tissue injury help in determining the extent of tissue damage
• Table of tissue healing stages provides information on tissue responses characteristics and clinical signs
• Tables of maximum and moderate protection help in understanding contraindications and precautions in different stages of rehabilitation
• Signs of excessive stress of exercise are crucial to recognize to prevent further injury during rehabilitation
• Patient management model includes elements like a comprehensive examination, evaluation of collected data, determination of diagnosis, establishment of prognosis and plan of care, implementation of intervention, and analysis of outcomes

  
• Clinical decision-making involves reasoning and analytical thinking in patient care, influenced by the biopsychosocial framework of the ICF and skill in the analysis of human movement
• Evidence-based practice involves steps like identifying a patient problem, searching for relevant studies, critically analyzing evidence, integrating with clinical expertise, and assessing outcomes
• Principles of orthopedic assessment include a correct diagnosis based on functional anatomy, patient history, observation, and thorough examination
• Orthopedic assessment involves differential diagnosis using clinical features, physical examination, mechanisms of injury, and diagnostic imaging techniques
• Assessment aims to understand the patient's problems from their perspective and the physical basis for symptoms, often documented using SOAP notes
• Inpatient assessment is modified for bedridden patients, comparing normal and abnormal sides of the body, and considering how injuries may affect other joints in the kinetic chain
• Systems review should be considered throughout the assessment process to identify signs of systematic conditions requiring medical consultation or referral
• Patient/client history includes gathering information for a hypothetical diagnosis, noting demographics, social and family history, current condition, mechanism of injury, and more
• Observation in assessment involves looking for visible defects, functional deficits, abnormalities of alignment, skin color and texture, and signs like ecchymosis or trophic changes
• Examination of movement includes active and passive movement testing, observing pain onset, quality of pain, restriction patterns, end feel, and associated joint movements
• Resisted isometric movements are used to determine if contractile tissue is at fault, involving strong, static, voluntary muscle contractions
• Functional assessment helps establish what is important to the patient and their expectations, measuring whole-body task performance ability
• Special tests may be performed after history, observation, and movement evaluation to determine specific diseases, conditions, or injuries in the involved joint