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USA Term 2 > AA2 Final > Flashcards

AA2 Final Flashcards

1
Q

When grading/documenting dermatomes and you give the patient a 0, what does this mean?

A

The sensation is absent

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2
Q

When grading/documenting dermatomes and you give the patient a 1, what does this mean?

A

The sensation is diminished

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3
Q

When grading/documenting dermatomes and you give the patient a 2, what does this mean?

A

The sensation is normal

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4
Q

When grading/documenting dermatomes and you give the patient NT, what does this mean?

A

It was Not Tested

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5
Q

What is the sensory distribution of L1 Dermatome?

A

Anterior Pelvis/Thigh

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6
Q

What is the sensory distribution of L2 Dermatome?

A

Upper Medial Thigh

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7
Q

What is the sensory distribution of L3 Dermatome?

A

Medial Knee

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8
Q

What is the sensory distribution of L4 Dermatome?

A

Medial Malleolus/Medial Lower Leg

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9
Q

What is the sensory distribution of L5 Dermatome?

A

Dorsal Midline of foot/Dorsal webspace of toes 2 and 4

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10
Q

What is the sensory distribution of S1 Dermatome?

A

Lateral Malleolus

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11
Q

What is the sensory distribution of S2 Dermatome?

A

Plantar heel/Posterior Medial knee

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12
Q

What is the sensory distribution of S3/S4 Dermatome?

A

Questioning about saddle paresthesia

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13
Q

For Myotomes, If you are checking Hip Flexion, and Psoas Major, Iliacus, and Pectineus muscles, which spinal nerve(s) are you testing?

A

L1/L2

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14
Q

For Myotomes, if you are checking Knee Extension, and Quad. muscles, which spinal nerve(s) are you testing?

A

L3

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15
Q

For Myotomes, if you are checking Ankle Dorsiflexion and Tibialis Anterior, which spinal nerve(s) are you testing?

A

L4

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16
Q

For Myotomes, if you are checking Hallux Extension and Extensor Hallucis Longus, which spinal nerve(s) are you testing?

A

L5

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17
Q

For Myotomes, if you are checking Ankle Eversion/Plantarflextion and Gastrocnemius-Soleus, and Fibularis Longus and Brevis, which spinal nerve(s) are you testing?

A

S1

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18
Q

For Myotomes, if you are checking Knee Flexion and the Hamstings, which spinal nerve(s) are you testing?

A

S2

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19
Q

What spinal nerve(s) are tested in a Patellar Tendon DTR? What action are you looking for?

A

Testing L3 and L4

  • Looking knee extension
    (Patient is seated)
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20
Q

What spinal nerve(s) are tested in Achilles Tendon DTR? What action are you looking for?

A

Testing L5 and S1

  • Looking for Ankle Platarflexion
    (Patient can be seated or prone)
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21
Q

What spinal nerve(s) are tested in Bicep femoris Tendon? What action are you looking for?

A

Testing S2

  • Looking for Knee Flexion
    (Patient is prone)
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22
Q

What is the Clonus Stretch Test?

A

A quick stretch that is applied to the ankle plantarflexors, if the stretch reflex is triggered excessively, clonus occurs.

(One-Two or Three beats of clonus may be considered normal in presence of symmetrical findings and otherwise normal examination)

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23
Q

What is the Babinski Reflex?

A

Its a reflex that is inhibited with involuntary control of the toes.

  • The test consist of a quick stimulus/stroke of the lateral foot towards the toes. If the Babinski is present, the hallux will extend while the smaller toes flex.
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24
Q

What is the Normal ROM for Knee Flexion? What is the endfeel?

A

Normal ROM = 135 - 150°

Soft End-Feel

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25
Q

When measuring for Knee Flexion, what is the Axis, Stationary and Moving arm?

A

Axis: Lateral Epicondyle of femur

Stationary Arm: Lateral midline of femur towards greater trochanter

Moving Arm: Lateral midline of fibula, in line with fibular head and lateral malleolus

Patient is in supine position w/ towel under ankle

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26
Q

What is the Normal ROM for Knee Extension? What is the End-Feel?

A

Normal ROM = 0°
(Can range from -2 to 5°)

Firm Capsular End-Feel

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27
Q

When measuring for Knee Extension, what is the Axis, Stationary and Moving arm?

A

(Same as Flexion)

Axis: Lateral Epicondyle of femur

Stationary Arm: Lateral midline of femur towards greater trochanter

Moving Arm: Lateral midline of fibula, in line with fibular head and lateral malleolus

Patient is in supine position w/ towel under ankle

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28
Q

What is the procedure for Knee Flexion (All Hamstrings) MMT?

A

Patient is prone, ask patient to flex leg and ask them to hold knee in 45°of knee flexion and add resistance (“Don’t let me break you”)

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29
Q

What is the procedure for Knee Flexion (Medial Hamstring Test) MMT?

A

Patient is prone, ask patient to flex leg and ask them to hold at 45° of knee flexion and their leg is in internal rotation (Toes point in). Add resistance down and outward

30
Q

What is the procedure for Knee Flexion (Bicep Femoris) MMT?

A

Patient is prone, ask patient to flex leg and ask them to hold at 45° of knee flexion and their leg is in external rotation (Toes point out). Add resistance down and inward

31
Q

What do you do under a grade 3 for Knee Flexion MMT?

A
  • Grade 2: Patient is in sidelying and testing limb is supported by therapist, instruct patient to flex their knee
  • Pt. is able to complete available ROM in sidelying with gravity min.

Grade 1 and 0:
Patient is prone, knee is partially flexed and the ankle is supported by therapist

G1: Tendons become prominent, bit no visible movement
G0: No contraction and tendons do not stand out

32
Q

What is the procedure for Knee Extension (Quads) MMT?

A

Patient is in short-sitting with a towel rolled under the distal thigh, ask the patient to extend their knee, then apply resistance

33
Q

What do you do below grade 3 for Knee Extension MMT?

A

Pt. is in sidelying and the knee is in about 90°of flexion, the therapist should support the limb, and ask the patient to straighten their knee
Grade 2: They complete the available ROM

Grade 1 and 0:
- Patient is in supine and therapist is palpating the quad tendon.
- Instruct patient to “push back of knee down into table or tighten your kneecap”

G1: No joint movement, but contraction can be palpated through the tendon
G0: No contraction or movement

34
Q

What is the procedure for Rectus Femoris MLT or Ely’s Test? What is considered normal?

A

Patient is prone and the therapist passively flexes the knee and looks for compensation at the pelvis.
- Normal test is the knee passing 90°without compensation and feel the firm end-feel

35
Q

What is the Normal ROM of Ankle Dorsiflexion? What is the End-Feel?

A

Normal - 10-25°

Firm Capsular End-Feel

36
Q

When measuring Ankle Dorsiflexion what is the Axis, Stationary and Moving arm?

A

Axis: Lateral Malleolus

Stationary Arm: In line with the fibular head

Moving Arm: Parallel with the 5th metatarsal

PT. is supine, put gastroc in slack with pillows, foot off table, and stabilize distal tibia/fibula joint

37
Q

What is the Normal ROM of Ankle Plantarflexion? What is the End-Feel?

A

Normal = 40-65°

Firm Capsular End-Feel

38
Q

When measuring Ankle Plantarflexion what is the Axis, Stationary and Moving arm?

A

Axis: Lateral Malleolus

Stationary Arm: In line with the fibular head

Moving Arm: Parallel with the 5th metatarsal

Pt. is supine, towel/pillow under distal tib/fib joint, foot off table

39
Q

What is the Normal ROM of Ankle/Foot Supination? What is the End-Feel?

A

Normal = 30-50°

Firm Capsular End-Feel

40
Q

When measuring Ankle/Foot Supination, what is the Axis, Stationary and Moving arm?

A

Axis: Anterior aspect of Talocrural Joint

Stationary Arm: Anterior Midline of tibia, in line with Tibial Crest

Moving Arm: Anterior Midline of second Metatarsal

Pt. is supine, towel under distal tib/fib joint, move distal segment and moving arm into inversion

41
Q

What is the Normal ROM of Ankle/Foot Pronation? What is the End-Feel?

A

Normal = 5 to 30°

Firm Capsular End-Feel (can be a hard end-feel)

42
Q

When measuring Ankle/Foot Pronation, what is the Axis, Stationary and Moving arm?

A

Axis: Anterior Aspect of Talocrural Joint

Stationary Arm: Anterior Midline of tibia, in line with the tibial crest

Moving Arm: Anterior Midline of second Metatarsal

Pt. is supine, towel under distal tib/fib joint, move distal segment and moving arm into eversion

43
Q

What is the Normal ROM of Ankle Subtalar Inversion? What is the End-Feel?

A

There is no normal ROM

Firm Capsular End-Feel

44
Q

When measuring Ankle Subtalar Inversion, what is the Axis, Stationary and Moving arm?

A

Axis: Over Calcaneal Tendon in line with Malleoli

Stationary Arm: Bisects the posterior calf/middle lower leg

Moving Arm: Posterior Midline of Calcaneus

Pt. is prone, foot is off table, Find subtalar neutral, cup calcaneus and move into inversion

45
Q

What is the Normal ROM of Ankle Subtalar Inversion? What is the End-Feel?

A

There is no normal ROM

Firm Capsular End-Feel

46
Q

When measuring Ankle Subtalar Eversion, what is the Axis, Stationary and Moving arm?

A

Axis: Over Calcaneal Tendon in line with Malleoli

Stationary Arm: Bisects the posterior calf/middle lower leg

Moving Arm: Posterior Midline of Calcaneus

Pt. is prone, foot is off table, Find subtalar neutral, cup calcaneus and move into Eversion

47
Q

What is the Normal ROM of First MTP Flexion? What is the End-Feel?

A

Normal = 30-45°

Firm Capsular End-Feel

48
Q

When measuring First MTP Flexion, what is the Axis, Stationary and Moving arm?

A

Axis: Medial Aspect of 1st MTP joint

Stationary Arm: Medial Midline of 1st Metatarsal

Moving Arm: Medial Midline of Proximal Phalanx of Great toe

Pt. is supine, find subtalar neural

49
Q

What is the Normal ROM of First MTP Extension? What is the End-Feel?

A

Normal ROM = 80 to 95°

Firm Capsular End-Feel

50
Q

When measuring First MTP Extensions, what is the Axis, Stationary and Moving arm?

A

Axis: Medial Aspect of 1st MTP joint

Stationary Arm: Medial Midline of 1st Metatarsal

Moving Arm: Medial Midline of Proximal Phalanx of Great toe

Pt. is supine, find subtalar neural

51
Q

What is the procedure for Ankle Plantar Flexion (Gastroc and Soleus) MMT?
And grades 5-3?

A

The Patient stands on one leg and does “Heel Raises” repeatedly

G5: Pt. completes 25 heel raises through full ROM without rest

G4: Pt. completes 2 to 24 heel raises

G3: Able to hold up BW, unable to raise BW more than one time

52
Q

What do you do below grade 3 for Ankle Plantar Flexion (Gastroc and Soleus)?

A

Pt. is prone with feet off the table and plantar flexes ankle against manual resistance

G2: Holds test position against Max. manual resistance, (Doesn’t break)

G1: Pt. moves through partial ROM without resistance and palpate gastroc for contraction

G0: No contraction or movement

53
Q

What is the procedure for Ankle Dorsiflexion and Inversion (Tibialis Anterior) MMT?

A

Pt. can be supine or sitting (Book recommends supine). Pt. then dorsiflexes and inverts foot and therapist applies resistance into plantarflexion and eversion.

54
Q

What do you do below grade 3 for Foot Dorsiflexion and Inversion (Tib. Anterior)?

A

Pt. is still in supine position

G2: Completes partial ROM

G1: Therapist will detect contraction or the tendon will stand out, no joint movement

G0: No contraction or movement

55
Q

What is the procedure for Foot Inversion (Tibialis Posterior) MMT?

A

Patient is sitting, ask the patient to move the foot down and in. Therapist applies resistance into eversion.

56
Q

What do you do below Grade 3 for Foot Inversion (Tibialis Posterior)?

A

G2: Pt. is in same position and only performs partial ROM.

Pt. is either in sitting (same position )or supine
G1: The Tibialis Posterior will stand out if there is contraction in the muscle but no movement will occur

G0: No movement or contraction

57
Q

What is the procedure for Foot Eversion and Plantarflexion (Fibularis Longus and Brevis) MMT?

A

Pt. is sitting with the ankle in neutral position. (Test can also be in supine). Ask the patient to move their foot down and out. Therapist applies resistance into inversion and slight dorsiflexion.

58
Q

What do you do below Grade 3 for Foot Eversion and Plantarflexion (Fibularis Longus and Brevis)?

A

G2: Pt. is in same position and only performs partial ROM

Pt. is either in sitting (same position )or supine
G1: Both Fibularis longus and brevis will stand out with contraction but no movement will occur

G0: No movement or contraction

59
Q

What is the procedure for Hallux and Toe MP Flexion (Lumbricals and Flexor Hallicus Brevis)?

A

Pt. is in supine (Can be sitting also), ask the pt. to bend their great toe, therapist applies resistance into extension. After ask the Pt. to bend their toes, then therapist applies resistance into extension.

(These are done separately, but have the same grading)

60
Q

What do you do below Grade 3 for Hallux and Toe MP Flexion (Lumbricals and Flexor Hallicus Brevis)?

A

Patient is in the same position throughout the whole test.

G2: Pt. completes partial ROM
G1: Therapist palpates for contraction but no movement
G0: No movement or contraction

61
Q

What is the procedure for Hallux and Toe DIP and PIP Flexion (Flexor Digitorum Longus and Brevis, and Flexor Hallucis Longus)?

A

Pt. is sitting (Can be supine also), ask Pt. to curl toes, then place fingers under PIP and DIP of toes then ask to curl the IP of big toe, Then apply resistance going into extension. (Resistance will be minimal)

(These are done separately, but have the same grading)

62
Q

What do you do below Grade 3 for Hallux and Toe DIP and PIP Flexion (Flexor Digitorum Longus and Brevis, and Flexor Hallucis Longus)?

A

Patient is in the same position throughout the whole test.

G2: Completes partial ROM
G1: Therapist palpates for contraction but no movement
G0: No movement or contraction

63
Q

What is the procedure for Hallux and Toe MP and IP Extension (Extensor Digitorum Longus/Brevis, Extensor Hallicus Longus)?

A

Pt. is sitting (Can be supine also), ask Pt. to straighten the big toe, then extend the other toes. Therapist will apply resistance in flexion.

(These are done separately, but have same grading)

64
Q

What do you do below Grade 3 for Hallux and Toe MP and IP Extension (Extensor Digitorum Longus/Brevis, Extensor Hallicus Longus)?

A

Patient is in the same position throughout the whole test.

G2: Completes partial ROM
G1: Therapist palpates for contraction but no movement
G0: No movement or contraction

65
Q

When the opposing muscle is stretched to a point where it can no longer lengthen and allow further movement, what type of insufficiency?

A

Passive Insufficiency

66
Q

Occurs when the muscle produces simultaneous movement at all the joints it crosses and reaches such a shortened position that it no longer has the ability to develop effective tension, is what type of insufficiency?

A

Active Insufficiency

67
Q

What is Standard Deviation (SEM)?

A

Amount of error one consider measurement error

68
Q

What is minimal detectable change (MDC)?

A

The minimum amount of change that is not considered measurement error

69
Q

What is Reliability?

A

The consistency of measurements

It will produce similar results across various conditions including different testers and different environments

  • Intra-rater: Examiner is able to reproduce his findings overtime
  • Inter-rater: Two or more examiners can reproduce their results overtime
70
Q

What is Validity?

A

Each time a test/measure is performed we must understand how the result of the test compare with the truth

71
Q

What happens if a test is high in sensitivity?

A

Test with high sensitivity when negative Rules Out condition. Rarely misses true positives

SNOUT

(S)ensitivity (N)egative finding rules (OUT)

72
Q

What happens if a test is high in Specificity?

A

Test with high specificity when positive Rules In a condition. Rarely misses true negative

SPIN

(S)pecific (P)ositive finding rules (IN)

USA Term 2 (46 decks)

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