Lab #1 and #2 Notes - Goniometry and Lower Quarter Screen PDF

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Goniometry and Lower Quarter Screen...

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Lab #1 and #2 – Goniometry and Lower Quarter Screen: Goniometry –  the measurement of angles created at human joints by the bones of the body  may be used to determine both a particular joint position and the total amount of joint motion available  post-operative ROM assessment o total knee arthroplasty (TKA) vs. ACL reconstruction  immobilization  tight musculature Anatomy of the Goniometer – 1. moving arm 2. stationary arm 3. fulcrum Range of Motion –  arc of motion that occurs at a joint or series of joints  the starting position is usually in the anatomical position  the anatomical position is usually termed as 0 degrees o if 0 degrees cannot be reached, note the new starting point and reasoning Positioning –  start with anatomical position when necessary  use the same starting position every time you test that joint or person  the test must be done bilaterally and in both AROM and PROM Alignment –  use body anatomical landmarks to align the arms of the goniometer both proximal and distal  the landmarks are universal and should be used whenever possible  use textbook for landmarks (green boxes)  stationary arm = proximal joint segment  moving arm = distal joint segment  fulcrum = axis of motion Documentation –  patient’s name  date and time  positioning  ROM including beginning and end degrees  normal ROM comparison  active or passive  special notes (differences, noises, end feels, etc.)

Common Mistakes –  fulcrum moves during ROM  inconsistent alignment  reading goniometer incorrectly  sloppy measurements  not documenting your results Lower Quarter Screening –  familiarize yourself with page 26  will practice dermatomes, myotomes, and reflexes in lab Dermatomes from Lumbar and Sacral Plexus –  signs and symptoms: o paresthesia = altered sensation  numbness  tingling  shooting pain  burning  L1-L5  S1 and S2 Two Point Discrimination –  normal is 4-5mm  also assess dull, sharp, and other sensations o pressure o temperature o pain Myotomes Neuro –  table 1.1 - motor: o innervation of all muscles tends to overlap o weakness in motor test screen that is innervated by a specific nerve root, identify another muscle that shares that innervation and perform a manual muscle test o if only one muscle is weak, pathology to the muscle or the peripheral nerve supplying it (if different from the second muscle) should be suspected o if both muscles are weak, then the nerve root or peripheral nerve supplying the muscles is implicated Deep Tendon Reflex (DTR) –  SAD MEV = sensory, afferent, dorsal horn, and motor, efferent, ventral  0 = no response  1 = hyporeflexia

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2 = normal 3 = hyperreflexia 4 = hyperactive clonus L4-L5 S1 and S2

Jendrassik Maneuver –  attempts to relax patient for DTR...