Observation and Posture Analysis — Transcript

Full transcript

1. 0:00In this video I’m going to talk about observation and posture analysis.
2. 0:13Observation is the first step of your physical assessment.
3. 0:16During observation you’re trying to see if you can find any structural abnormalities
4. 0:21that you can link to your patient’s complaints.
5. 0:24In order to conduct a good observation, I have to be able to see certain landmarks on the body,
6. 0:30therefore, I’m going to ask my patient to take off their shirt,
7. 0:34to wear shorts and also take off their shoes.
8. 0:37Now, that the patient is properly exposed, we can start with the observation.
9. 0:42I advise the patient to stand upright, looking straight ahead, relax the shoulders
10. 0:47and let the arms hang naturally besides the body.
11. 0:51In the frontal plane, one of the first things I could look at is the line from the tip of the nose
12. 0:57running through the middle of the chin to the manubrium of the sternum.
13. 1:01The head could also be rotated or leaning to one side.
14. 1:05Next, I could compare the level of the shoulders,
15. 1:09assess the angle of both clavicles and see if the nipples are on the same height.
16. 1:14The latter should be disregarded with female patients.
17. 1:18Moving downwards, I can compare both iliac crests
18. 1:21and use the anterior superior iliac spine as another landmark.
19. 1:27The space in-between trunk and arms can also be compared.
20. 1:31Furthermore, arm length differences can be examined, when comparing the level of the fingertips of both hands.
21. 1:38Looking at the knees, I check if the apex of both patellas are levelled
22. 1:42and whether they have an outward, so-called varus position,
23. 1:47or an inward, so-called valgus, position.
24. 1:50At last, I check the level of both medial malleoli.
25. 1:54In the sagittal plane, one of the first things to assess should be the lateral plumb line,
26. 1:59so-called line of Appleton, which is the line running from the earlobe through the humeral head.
27. 2:05Check if the head is excessively positioned anteriorly or posteriorly.
28. 2:11The shoulders might also be pro- or retracted.
29. 2:14When looking at the patient from the side, it’s wise to examine the spine for abnormalities in the lordosis and kyphosis.
30. 2:22On pelvic level, you can check the angle between the anterior superior iliac spine
31. 2:27and the posterior superior iliac spine,
32. 2:30which is usually around 15°.
33. 2:33Lastly, check if the knees are hyperextended.
34. 2:37Now, let’s look at the patient from the back.
35. 2:39Again, check if the head is rotating or leaning to one side.
36. 2:44When examining the spine, you are looking for lateral shifts that could indicate a scoliosis.
37. 2:50Posterior reference points include both acromia,
38. 2:53the scapular spines and both inferior angles of the scapula.
39. 2:57Also check how far away the medial borders of the shoulder blade are from the spine.
40. 3:03Moving downwards, compare both iliac crests and check the posterior superior iliac spine.
41. 3:09The gluteal fold could also be used as a reference point.
42. 3:14On knee level, you could identify valgus or varus positioning,
43. 3:19just like in the frontal plane.
44. 3:21Lastly, compare both medial malleoli
45. 3:24and depending on the number of toes you see next to the achilles tendon,
46. 3:28one leg could be rotated more than the other.
47. 3:31Be aware though, that not everything that you consider abnormal, is also pathological.
48. 3:37Alright, guys, this was the video on observation, I hope you enjoyed it
49. 3:41if you did, make sure to give it a thumbs up and subscribe to our channel if you haven’t.
50. 3:46Also check out our website at www.physiotutors.com
51. 3:51and check out other videos on the side and I’ll see you next time. Bye.