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After completion of this chapter, the physical therapist should be able to do the following:

  • List and discuss the basic purposes of a scan exam as outlined in this chapter.

  • Describe how a scan exam is fundamentally different from an algorithm.

  • Discuss the potential role of a prescreening questionnaire in a scan examination.

  • Compare and contrast the basic elements of a scan examination to the “five elements of patient/client management,” that are described in The Guide to Physical Therapy Practice.

  • List the 5 elements of the scan examination outlined in this chapter, and summarize the key information that should be obtained from each of those topic areas.

  • Describe the vital informational elements derived from each of the following items that are part of the patient history portion of the examination:

    • Age

    • Gender

    • Ethnic makeup

    • Morphology

    • Family history

    • Past medical history

    • Medications

    • Mechanism of injury

    • AM/PM pattern of pain

    • Nature of pain

    • Training history

  • Within a scan examination, “clearing tests” are typically used. Explain the role and limitations associated with clearing tests.

  • Explain what is meant by the terms, “yellow flags” and “red flags.” Additionally, when a yellow or red flag finding is identified, discuss the response options available.

Purpose of a Scan Examination

Everyone has a concept in their mind about scanning a given situation. When driving and intersections are encountered, a system is employed that examines what is occurring off in the distance, as well as any potential issues that might be coming from the right and left. Attention is also paid to the existence of signs or traffic lights, any obstacles like parked cars or debris in the roadway, and anything out of the ordinary that could signal high risk, such as children playing with a ball. Additionally, in the back of the driver's mind, factors such as the amount of light available because of the time of day, the condition of the road, weather conditions, and the type of vehicle being driven, are all factored into the mix. With this information, the driver is able to successfully scan the intersection and make all needed adjustments to either stop and respond to a potential emergency or pass through this point in space.

The 2 most important elements that allow the scan described above to work time after time are the employment of a system and experience. When starting to drive, most individuals learn the rules of the road and know to obey traffic lights. When a light turns green, movement into the intersection is started, and, on a rare occasion, the car is broadsided. This accident occurs because even though the driver was obeying the rules of the road, the limited system of the typical neophyte driver does not take the time to additionally check that the other vehicles in their vicinity are also complying with the rules and not trying to push that yellow-red light ...

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