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Differential Diagnosis for Physical Therapy: Introduction: Summary
Comparison of Systemic Versus Musculoskeletal Pain Pattern Systemic Musculoskeletal Does not present as observed for
○ Hypertension: >140/>90
• Pulse Oximetry:
○ Optimal - 95% to 100% ○ Referral is advised when resting saturation levels fall below 90% ■ Exception -clients with a history of tobacco use and/or COPD ■ COPD could have resting saturations below 90 at baseline
May be sudden or gradual, depending on the history: • Sudden : acute overload stress, traumatic event, repetitive motion; can occur as a side effect of some medications (statins) • Gradual : Secondary to chronic overload of the affected part; may be present off and on for years
years without progression of symptoms
• Pain (“5th vital sign”) • Respirations (adults)
○ Optimal: 15 to 20 breaths per minute ○ < 12 or > 25 breaths per minute abnormal
Walking Speed • Assessed best with 10-meter walk test Body Mass Index (BMI) Weight Categories BMI (kg/m²) Underweight <18.5 Healthy Weight 18.5 - 24.9 Overweight 25 - 29.9 Obese 30 - 34.9 Severely Obese 35 - 39.9 Morbidly Obese >40 Integumentary Screening • Examine for changes in texture, color, temperature, clubbing, capillary filling, and edema • Vitiligo skin condition is associated with areas of hypopigmentation • Skin mobility and turgor affected by fluid status of the client ○ Turgor Assessment:
Unilateral or bilateral
Usually unilateral
Knife-like quality of stabbing from the inside out, boring, deep aching
May be stiff after prolonged rest, but pain level decreases
Cutting, gnawing, Throbbing
Local tenderness to pressure is present
Mild to Severe
Maybe Mild to Severe
Recent/sudden Red Flags for Pain 1. Sweats (night or day) 2. Nausea/Vomiting 3. Diarrhea 4. Pallor 5. Dizziness/syncope 6. Fatigue
7. Weight loss 8. Pain at night Vitals • Pulse (beats per minute BPM): ○ Optimal: 60 to 100 BPM
○ Over 100 bpm - tachycardia ○ Below 60 bpm - bradycardia ○ Optimal: <120/<80 ○ Pre-hypertension: 120-139/80-89
• Blood pressure:
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