Ruling Out all Serious Pathology

One of the most important roles a physiotherapist can complete; is ensuring to the best of their ability, no serious pathology is present.

Here I will address this from a top down approach:

The Head & Neck:
Cranial Nerves
1. Olfactory (each nostril tested with known odours)
2. Optic (Visual field loss)(CNS)
3. Oculomotor (Diplopia, Strabismus, Ptosis, Mydriasis)
4. Trochlear (Diplopia- superior oblique)
5. Trigeminal (Fascial sensation, Mastication)
6. Abducens (Diplopia- lateral rectus)
7. Fascial (2/3 anterior tongue taste, ear sensation, fascial palsy)
8. Vestibulocochlear (hearing and balance)
9. Glossopharyngeal (uvula deviation, post 1/3 tongue)
10. Vagus (elevated BP and HR, hoarse voice, dysphagia)
11. Accessory (shoulder shrug will induce winging)
12. Hypoglosseal (unable stick tongue straight out -deviation to weaker/damaged side)

5 D’s An 3 N’s
-Drop Attack
— Ataxia
-Numbness (of face)

Cervical Artery Dysfunction
(description not diagnosis, vertebrobasilar Insufficiency (VBI) is old terminology)

The Lumbar spine:
– Cauda Equina

Compartment syndrome

Systemic pathology:
Rheumatoid Arthritis
Steroid meds