CMC 2 Midterm Flashcards
For a strength exam used in a clinical setting, what is the range of values on the measurement scale?
0-5
During a strength exam, an effort resulting in no movement, but contraction of a muscle would receive what value on the measurement scale?
1
During a strength exam, an effort resulting in active movement of muscle with gravity removed would receive what value on the measurement scale?
2
During a strength exam, an effort resulting in active movement of a muscle against gravity, but not against physical resistance would receive what value on the measurement scale?
3
During a strength exam, an effort resulting in weak movement of muscle against physical resistance would receive what value on the measurement scale?
4
What is the range of values on the scale used to measure reflexes?
0-4+
What value on the scale used to measure reflexes is assigned to a normal reflex?
2+
A hyporeflexic reflex (which may or may not be normal) is assigned what value on the scale used to measure reflexes?
1+
A very brisk reflex (which may or may not be normal) is assigned what value on the scale used to measure reflexes?
3+
A 4+ reflex on the scale is determined by what two characterstics?
hyperreflexic, also with clonus
What are three ROS questions that can be asked about peripheral nervous function?
numbness or tingling
dizziness
headache
What is the normal response in a Babinski test?
downgoing toes (plantar flexion)
T/F: Babinski test results can be described as negative
F: Either absent/present or downgoing/upgoing (upgoing is synonymous with positive)
A “positive” Babinski test may indicate what?
upper motor neuron disease (potential CNS involvement)
Alcohol intoxication
Post-ictal phase after seizure
In what situations may the Babinski test be acceptably abnormal?
In children under 12 months of age
What is indicated by a positive pronater drift test result?
CNS/upper motor neuron disease; more directly it indicates weaker muscles of supination than those of pronation
What is indicated by a positive Romberg test result?
Impaired proprioception from dorsal column disease (vision will normally compensate)
Define paresis:
Impaired strenth or weakness
Define paralysis or plegia:
absent strength
Define neuropathy:
dysfunction of a nerve
Define radiculopathy:
dysfunction of a spinal nerve root (often due to compression)
Define dermatome:
an area of skin innervated by the sensory root of a single spinal nerve
Define hyperesthesia:
abnormally increased sensitivity to a stimuli of a sense (usually touch)
Define hypoethesia:
abnormally diminshed sensitivity to stimuli (usually touch)
Define allodynia:
pain due to a stimulus that normally does not provoke pain
Define proprioception:
awareness of the position and movement of the body in space
What are five potential causes of hyperreflexia?
TBI
spinal cord lesion
stroke
ALS
MS
What are three potential causes of hyporreflexia?
Electrolyte imbalance (also hyperreflexia)
Myopathy
Peripheral neuropathy (GBS, othes)
What are the six links of the chain of infection?
What are the four forms of transmission?
direct contract
indirect contact
droplet
airborne
What is the standard precautions take home message?
If it’s wet and not yours, don’t touch it without PPE
What are two notable precautions taken for airborne transmission diseases?
N95 respirator (requires fit testing)
PAPR
Which three bloodborne pathogens are especially important to avoid for healthcare workers?
Hepatitis B
Hepatitis C
HIV
What figure represents the proportion of patients who have a HAI during a hospital visit?
1/31
What are the five most common HAIs?
-Surgical site infection (SSI)
-Central line associated BSI
-Ventilator associated pneumonia
-C. diff infection
-Catheter associated UTI
Define enthesis:
the insertion points of tendon or ligament to bone
Define enthesitis:
inflammation of the insertion site of ligament/tendon to bone
Define arthritis:
articular swelling or effusion OR 2+ of the following
-limitited ROM
-joint tenderness on palpation
-pain on joint movement
-increased warmth over joint
Define arthralgia:
joint pain
Define myalgia:
muscle pain
Define synovitis:
inflammation of the synovial membrane
Define joint effusion:
increased synovial flud in the synovial cavity of a joint
Define bursitis:
inflammation of the bursa (sacks lined with synovial membrane)
Define crepitus:
A grating/grinding/cracking sound of sensation from two rough surfaces rubbing together
What are the two major distinctions between hand/finger presentation for rheumatoid arthritis and osteoarthritis?
RA: Autoimmune destruction of synovial membranes and tendon disruption leads to abnormal flexion/extension of joints (i.e. boutonniere defornity of thumb, swan-neck deformity of fingers)
OA: swelling/joint enlargement due to osteophyte formation but no abnormal positiong of joints
Define anisotrpy with respect to ultrasound?
the phenomenon responsible for specific items (typically nerves or tendons) appearing hypoechoic due to the angle of the ultrasound probe
How can tendons and nerves be differentiated on ultrasound?
Tendons will change shape during muscle flexion/extension under US, while nerves will not
