Name: Miteshkumar Patel
Assignment week 1
all the five components of the patient management were integrated in the case
Therapist examines patients and found out about onset of sharp pain in buttock,
right testicular pain, which precipitates by prolonged standing and sitting
active movements does not reproduce symptoms, but sharp burning pain with
extension, Negative Babinski, Negative SLR, MMT
within 8 weeks patient able to restore previous functional activity, able to
wear heavy life jacket and stand for long time
passive joint mobilization to T12 spinous process, passive manual hip flexor
pain: mainly comes from muscles, body and joints
be localized, sharp pain. Injury can cause this.
pain: mainly from organs, internal organ
dull and hard to localize, can also felt different location from where actually
it is started.
pain in testicle and buttock but it is not form visceral pain, it originates from
nerve entrapment and causes sharp burning pain
pain; it is a type of pain which can be felt at other place then from origin.
this case study source of pain was from the thoracolumbar junction.
this case patient was having the entrapment from L1-2 nerve roots which
innervates scrotum. This nerve passes through psoas muscle and reaches to
testicle, where that can have entrapped and symptoms found out in testes.
was 12th thoracic and upper 3 lumbar nerves were affected.
is very important as when therapist as a direct access, it is very much
important to first find a cause of problem, which can only possible by proper
knowledge and detailed evaluation pattern. Once, diagnosed properly therapist
can direct appropriate treatment protocol.
FROM BOOK CHAPTER 1 and 2
are three main factors described below for detail and that may the reasons for
effect of medication: Patient is very
often to have side effects of medication, joint pain, other pain and sometime
nausea, vomiting, chest pain. So, it is important to screen to find out the actual
reason which causes a problem to the patient.
morbidities: Now a day, patients are suffering from diabetes, high blood
pressure, osteoporosis, depression, drug abuse and many more. Considering all
these problems, only superficial symptoms explained by patient is not helpful
finding out a problem. At this point, it is very important to screen in depth
and properly to diagnose and then offer treatment. This is very complicated and
difficult to screen but very important.
pain mechanism: it is very common that after physical activity, lot of people feels
like free of symptoms about discomfort, weakness but at one point if it is not
controlled, it can create nutritional compromise and starts with other problems
in body. At this point it is very much necessary to identify possible source
is multiple reason that patient has to be screen
and sicker patient client base.
medical specialist may fail to diagnose problem.
day, health care sector is getting too much complex. Therapist must be alert
for all yellow or red signs. For example, after discharged from hospital, patient
is sending out to rehab. At this point, therapist must have to be alert about
any symptoms that can be red flag, it can be stroke warnings, UTI infection,
and many more. Earlier the identification better the prognosis. Sometime, PT
becomes a first contact. client can get a referral directly from a physician
about PT visit for the same pain that may have occurred in the past. At this
point, therapist should not make a final call based on past, but it is
necessary to screen in detail for clear explanation.
review is a brief, limited examination pattern which provides some of the extra
information to find out diagnosis, prognosis and plan of care. It is also
helpful that any possible health problems require referral to another provider.
of system is a kind of examination pattern that can help getting more
information/history from the patient.
example, if we compare two systems as per system review and review of system.
review: strength, ROM
of system: swelling, crepitus, arthritis
review: skin color, skin texture
of system: pruritus, rashes, wounds
can also be termed as system review may be objective and review of system can
be objective and subjective ways.
Z.G., Jason, M.B., Joel, E.B., Trevor, A.L., Giorgio, Z., Qinglin, P., &
Samuel., S. (2015). Guidelines of a review of systems screening tool for
orthopaedic physical therapist: results from the optimal screening for
prediction of referral and outcome (OSPRO) cohort. Journal of orthopaedic and
sports physical therapy,45(7),512-526.