Name: Miteshkumar Patel Assignment week 1 Answer 1Yes,all the five components of the patient management were integrated in the casestudy.Answer 2Examination:Therapist examines patients and found out about onset of sharp pain in buttock,right testicular pain, which precipitates by prolonged standing and sittingEvaluation:active movements does not reproduce symptoms, but sharp burning pain withextension, Negative Babinski, Negative SLR, MMTDiagnosis:MRIPrognosis:within 8 weeks patient able to restore previous functional activity, able towear heavy life jacket and stand for long timeIntervention:passive joint mobilization to T12 spinous process, passive manual hip flexorstretchingAnswer 3Somaticpain: mainly comes from muscles, body and jointsCanbe localized, sharp pain.

Injury can cause this.Visceralpain: mainly from organs, internal organ Usuallydull and hard to localize, can also felt different location from where actuallyit is started.Answer 4Reportedpain in testicle and buttock but it is not form visceral pain, it originates fromnerve entrapment and causes sharp burning painAnswer 5Referredpain; it is a type of pain which can be felt at other place then from origin.Inthis case study source of pain was from the thoracolumbar junction.Inthis case patient was having the entrapment from L1-2 nerve roots whichinnervates scrotum.

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This nerve passes through psoas muscle and reaches totesticle, where that can have entrapped and symptoms found out in testes.Therewas 12th thoracic and upper 3 lumbar nerves were affected.Answer 6Itis very important as when therapist as a direct access, it is very muchimportant to first find a cause of problem, which can only possible by properknowledge and detailed evaluation pattern.

Once, diagnosed properly therapistcan direct appropriate treatment protocol. FROM BOOK CHAPTER 1 and 2Answer 1Hereare three main factors described below for detail and that may the reasons forscreening needs.Sideeffect of medication:  Patient is veryoften to have side effects of medication, joint pain, other pain and sometimenausea, vomiting, chest pain. So, it is important to screen to find out the actualreason which causes a problem to the patient.Comorbidities: Now a day, patients are suffering from diabetes, high bloodpressure, osteoporosis, depression, drug abuse and many more. Considering allthese problems, only superficial symptoms explained by patient is not helpfulfinding out a problem.

At this point, it is very important to screen in depthand properly to diagnose and then offer treatment. This is very complicated anddifficult to screen but very important.Visceralpain mechanism: it is very common that after physical activity, lot of people feelslike free of symptoms about discomfort, weakness but at one point if it is notcontrolled, it can create nutritional compromise and starts with other problemsin body. At this point it is very much necessary to identify possible sourceand solution.Answer 2Thereis multiple reason that patient has to be screen Directaccess.Quickerand sicker patient client base.Sometimemedical specialist may fail to diagnose problem.Now aday, health care sector is getting too much complex.

Therapist must be alertfor all yellow or red signs. For example, after discharged from hospital, patientis sending out to rehab. At this point, therapist must have to be alert aboutany symptoms that can be red flag, it can be stroke warnings, UTI infection,and many more.

Earlier the identification better the prognosis. Sometime, PTbecomes a first contact. client can get a referral directly from a physicianabout PT visit for the same pain that may have occurred in the past. At thispoint, therapist should not make a final call based on past, but it isnecessary to screen in detail for clear explanation.

Answer 3Systemreview is a brief, limited examination pattern which provides some of the extrainformation to find out diagnosis, prognosis and plan of care. It is alsohelpful that any possible health problems require referral to another provider.Reviewof system is a kind of examination pattern that can help getting moreinformation/history from the patient.Forexample, if we compare two systems as per system review and review of system.MusculoskeletalSystemreview: strength, ROM Reviewof system: swelling, crepitus, arthritisIntegumentarySystemreview: skin color, skin textureReviewof system: pruritus, rashes, woundsItcan also be termed as system review may be objective and review of system canbe objective and subjective ways.

ReferenceSteven,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 fororthopaedic physical therapist: results from the optimal screening forprediction of referral and outcome (OSPRO) cohort. Journal of orthopaedic andsports physical therapy,45(7),512-526.