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Home / Uncategorized / Physical Therapy Differential Diagnosis Module 3: Screening for Lower Quadrant, Chest, Breast, Ribs, and Extremities

Physical Therapy Differential Diagnosis Module 3: Screening for Lower Quadrant, Chest, Breast, Ribs, and Extremities

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Physical Therapy Differential Diagnosis Module 3: Screening for Lower Quadrant, Chest, Breast, Ribs, and Extremities

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Course Description

Course Description:

The causes of lower quadrant pain or dysfunction vary widely; presentation of symptoms is equally wide ranging. Vascular conditions (e.g., arterial insufficiency, abdominal aneurysm), infectious or inflammatory conditions, gastrointestinal (GI) disease, and gynecologic and male reproductive systems may cause symptoms in the lower quadrant and lower extremity,1 including the pelvis, buttock, hip, groin, thigh, and knee. Some overlap may occur, but unique differences exist.  

When screening is called for, the therapist looks at the client’s personal and family history, clinical presentation, and associated signs and symptoms. Knowledge of problems that can affect the lower quadrant, along with the likely history, pain patterns, and associated signs and symptoms, should guide the therapist with regard to the steps they should follow during screening. 

The therapist must especially know how and what to look for to screen for cancer, cancer recurrence, and/or the delayed effects of cancer treatment. Cancer can present as primary chest pain with or without accompanying neck, shoulder, and/or upper back pain/symptoms. Basic principles of cancer screening are presented in Chapter 13; specific clues related to the chest, breast, and ribs will be discussed in this chapter. Breast cancer is always a consideration with upper quadrant pain or dysfunction. 

In this chapter, we explore systemic and viscerogenic causes of shoulder and arm pain and take a look at each system that can refer pain or symptoms to the shoulder. This will include vascular, pulmonary, renal, gastrointestinal (GI), and gynecologic causes of shoulder and upper extremity pain and dysfunction. Primary or metastatic cancer as an underlying cause of shoulder pain also is included. The therapist must know how and what to look for to screen for cancer. 

Contact Hours: 10
Text Course Format: Text
Target Audience:
Instructional Level: Intermediate BOC Level of Difficulty: Advanced

Accreditation Information:

StateDisciplineApproval StatusProvider CodeExpiration Date

Course Outline:

  • Chapter 16- Screening the Lower Quadrant: Buttock, Hip, Groin, Thigh, and Leg 
  • Chapter 17- Screening the Chest, Breasts, and Ribs 
  • Chapter 18- Screening the Shoulder and Upper Extremity 

 

Course Goals & Objectives:

Professional Objectives:

At the end of this course the professional will be able to:

  1. Recognize 7 signs of the “Sign of the Buttock.”
  2. List 6 systemic/medical causes of thigh pain.
  3. Identify symptoms of true nerve root irritation.
  4. Identify 6 causes of psoas abscess.
  5. Define insufficiency fractures.
  6. List 3 physical signs of sacroiliitis.
  7. Recognize 4 signs of sciatic neuropathy.
  8. Identify 9 signs and symptoms of osteonecrosis.
  9. Define ascites.
  10. List 4 screening tests for liver impairment.
  11. Identify 3 clinical signs and symptoms of cardiac arrest.
  12. List 11 clinical signs and symptoms of breast cancer.
  13. Identify 5 guidelines for breast cancer screenings.
  14. Recognize 9 clinical signs and symptoms of chest pain caused by anxiety.
  15. Identify which ribs are affected by costochondritis.
  16. Recognize 4 clinical signs and symptoms of Herpes zoster.
  17. Identify 4 neurologic clinical signs and symptoms of thoracic outlet syndrome.
  18. Recognize 8 risk factor populations more likely to develop pulmonary tuberculosis.
  19. Define Kehr’s sign.
  20. Identify 3 stages of CRPS (Type 1).
  21. List 7 clinical signs and symptoms of upper extremity deep venous thrombosis.

Disclosures:

Contact Hours: 10

Target Audience: Physical Therapists, Physical Therapist Assistants, Certified Athletic Trainers

Instructional Level: Intermediate

Criteria for Completion: Criteria for Completion: A score of 70% or more is considered passing. Scores of less than 70% indicate a failure to understand the material and the test will need to be taken again until a passing score has been achieved

Personnel Disclosure:

Financial –Elsevier - Course content is provided via a royalty based financial arrangement between the parties, Elsevier Inc. & Rocky Mountain Publishing, LLC, d/b/a HomeCEUConnection.com 

Nonfinancial - no relevant nonfinancial relationship exists.

Content Disclosure: This course does not focus solely on any specific product or service

Cancellation Policy: For activity cancellation, returns, or complaint resolution, please contact Anne Osborn by email Anne@HomeCEU or by phone at 1.800.55.4CEUS (2387). We have a 100% satisfaction guarantee. Refunds will be issued for courses that have not been completed (exam not taken), or for any course that has been rejected by your board of approval. Webinar attendance must be canceled 24 hours before the scheduled start time.

Authors:

Catherine Cavallaro Goodman, MBA, PT, CBP

Since first grade when I became friends with a classmate who had polio, I wanted to be a physical therapist. Though I did not know the name of my intended profession at that young age (not until we were required in 9th grade to write about our future), I have now lived my destiny for 40+ years. 

Every experience as a physical therapist has been wonderful. I have never wished to be anything else. Over the decades, I have had the opportunity to work with thousands of individuals in a wide variety of clinical and educational settings.  

My professional history includes: pediatrics, oncology, military service (orthopedic PT), hand therapy, inpatient/outpatient therapy, home health, nursing home (back in the day when they were called NHs!), university professor, medical writer, textbook author, conference speaker, and most recently using energy medicine as a physical therapy modality. 

My main interest now is clinical practice to connect with people in need of a helping hand, a healing touch, a physical therapist’s expertise. I enjoy all aspects of clinical practice using a wide array of approaches including the Gillespie cranio-fascial sacral therapy, myofascial release, BodyTalk™, Reiki, hands on healing, as well as some of the more traditional physical therapy manual therapy and pediatric techniques. 

This practice allows me to address the physical, emotional, psychologic, and spiritual aspects of life and end-of-life situations for all individuals (and their families/support team). I have assisted many people with cancer and older adults in end-of-life care, especially using neurofeedback to moderate pain, anxiety, depression, and emotional distress. 

Most recently, I have focused specifically on the problems that come with peripheral neuropathies, balance impairments, and traumatic brain injuries. 

John Heick, PT, PhD, DPT

Dr. Heick has three professional certifications (orthopaedics, neurology, and sports) through the American Board of Physical Therapy Specialties. Dr. Heick’s is interested in differential diagnosis across multiple areas within physical therapy to include concussion assessment, orthopaedics, sports, neurology, and vestibular rehabilitation. Dr. Heick is the President of the Arizona Chapter of the American Physical Therapy Association (effective January 2017).

Rolando T. Lazaro, PT, PhD, DPT, MS

Rolando Lazaro PT, PhD, DPT, GCS is an Associate Professor in the Department of Physical Therapy. Dr. Lazaro obtained his PhD in Health Science from Touro University in 2011, Doctor of Physical Therapy from Creighton University in 2001, Master of Science Physical Therapy from the University of the Pacific in 1997, and Bachelor of Science in Physical Therapy from the University of the Philippines in 1986. He is a board-certified clinical specialist in geriatric physical therapy by the American Board of Physical Therapy Specialties (ABPTS). Dr. Lazaro’s research interests include the investigation of interventions aimed at improving balance and mobility in older adults and the development and validation of models of Community-Based Rehabilitation (CBR). He also has research lines related to biophysical and electrotherapeutic agents, use of imaging in physical therapy practice, and cultural competence in physical therapy education. In 2013, Dr. Lazaro was awarded a Fulbright Senior Scholarship to study community-based rehabilitation models in the Philippines.

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