EEO Midterm- Lab info, Special Tests, ROM values Flashcards
1
Q
Shoulder Flexion
A
180
2
Q
GH flexion
A
120
3
Q
Shoulder Extension
A
60
4
Q
GH extension
A
20
5
Q
Shoulder Abduction
A
180
6
Q
GH Abduction
A
100-130
7
Q
Shoulder IR
A
70
8
Q
Shoulder ER
A
90
9
Q
GH IR
A
50-60
10
Q
GH ER
A
90
11
Q
Elbow flexion and extension
What are the end feels?
A
0-150
Flexion: soft end feel
Extension: hard end feel
12
Q
Forearm pronation
A
90
13
Q
Forearm supination
A
80
14
Q
Wrist flexion
A
80
15
Q
Wrist extension
A
70
16
Q
Wrist radial deviation
A
20, hard end feel
17
Q
MCP flexion
A
90, hard or firm end feel
18
Q
MCP extension
A
45
19
Q
MCP abduction
A
20
20
Q
PIP flexion
A
100
21
Q
PIP extension
A
0
22
Q
DIP flesion
A
90
23
Q
DIP extension
A
0-5
24
Q
Thumb CMC flexion
A
15, soft or firm end feel
25
Thumb CMC extension
20
26
Thumb CMC abduction
40
27
Thumb CMC adduction
0
28
Thumb MCP flexion
50, hard or firm end feel
29
Thumb MCP extension
0
30
Thumb IP flexion
80, hard or firm end feel
31
Thumb IP extension
20
32
C spine flexion
40
33
C spine extension
50
34
C spine lateral flexion
22
35
C spine rotation
50
36
T and L spine flexion
60
37
T and L spine extension
25
38
T and L spine lateral felxion
35
39
T and L spine roation
45
40
See other set for dermatomes, myotomes, and reflexes
:)
41
Tests for DCML
Position sense, mirror one side with other, 2 point, light touch, sterognosis, graphesthesia, vibration
42
reflex grading
```
4+ = very brisk hyperactive with clonus
3+ = brisker than average, possibly but not necessarily indicative of disease
2+ = average/normal
1+ = somewhat diminished; low normal
0 = no response
(know difference between 3+ and 4+)
```
43
When should you test temperature sense?
When pain is not intact
| Have pt answer hot or cold
44
Semmes-Weinstein monofilament test
Find the monofilament the pt can feel on a particular spot
To test for LE neuropathy
Filament touched to patient with enough force to bend it
45
Monofilament for protective sensation
5.07
46
Mean threshold for the bottom of the foot in monofilament test
3.63
47
Proprioception and kinesthesia testing
Make small and large arcs starting distally and moving proximally, stabilize bone more proximally
ask pt if position (proprioception) or movement (kinesthesia) is up or down
48
Vibration testing
Palpate bone
128 hz tuning fork stem applied to bony prominence
Commonly test: IP or MCO/MTP of thumb and big toe, also maleoli, patella, acromion, olecranon
49
FInger tips should have what 2 point discrimination
2-5 mm
50
Babinski reflex
stroke lateral foot and MT heads on both sides
Toe fanning is UMN lesion if over 2
Unilateral indicates lesion on opposite side
Bilateral indicates spinal cord lesion
ALso + if withdraw LE
51
Clonus
Repeated beating of ankle following sudden, sustained dorsiflexion that lasts for more than 2 beats
52
Hoffman test
Flick the 3rd finger
| If the 1st and second fingers make an ok sign, there is a lesion
53
Dysmetria tests
Heel to shin
| Finger to nose
54
DDK tests
rapid finder or toe taps, supination and pronation rapidly
55
Ataxia test
Opposition
Romberg stance
Tandem Stance
56
Uvula deviation indicates
Vagus nerve injury
57
Weber test
Tuning fork on top of head, should be heard in both ears equally
58
Rhine test
Tuning fork on mastoid process until bony conduction ceases then in air until air conduction ceases
59
Consensual pupillary light reflex tests
Optic nerve because it sends the sensation in
60
Ipsilateral pupillary light reflex is for
The occulomotor nerve
61
What is included in review of systems?
Musculoskeletal, communication, integumentary, cardiopulmonary, and neuromuscular
62
ICD 10 codes are...
diagnosis codes for billing, can have more than one
63
Clinical impression
summary of impairments to body structure and function, activity limitations, and participation restrictions and why someone is coming to PT
64
Statement or rehab potential
Prognosis and environmental factors from subjective history that affect prognosis
65
ICF model
Health condition creates body structure and function impairments, activity limitations, and participation restrictions, these are influenced by environmental factors and personal factors
66
Body structure and function impairmnets
These are the basics, ROM, strength, reflexes, sensation, gait patter, pain, dizziness
67
Activity limitations
Includes things that are combinations of the basics
68
Participation restrictions
These are specific to the patient- job, hobby, personal role, IADLs (chores, household things)
69
Goal writing tips
- consistent with original measure
- not double barreled
- one activity
- not for DTRs or sensory
- link to safety and decreased falls when applicable
These should be related to documented impairments and things in the problems list
70
Plan
Related to problems and goals
Includes frequency and duration of treatment
Includes treatment performed that day
71
Ways to measure hand edema
Wrist circumference
Figure 8
Volumetry
72
Wrist circumference
at radial and ulnar styloids
73
Figure 8
starting at radial styloid, go across to ulnar styloid then cross dorsally to the 2nd MC head then parlmarly across the MC heads to the 5th and back to the radial styloid
Cross is on the dorsum of the hand
74
Volumetry
Used to measure edema by measuring water displaced from a container
75
FDP and FDS flexibility test
Extend the wrist with MCPs and IPs in extension
If finger position causes the wrist PROM extension to be limited, the muscles are short
If the range is limited regardless of wrist position, there is a bony, capsular, or ligamentous cause
Start with elbow extended, forearm in pronation and neutral, and stabilize forearm
76
ED, EI, and EDM flexibility tests
Flex wrist with MCP and IPs in flexion
| Start with elbow extended, forearm in pronation and neutral, and stabilize forearm
77
Lumbircals and interossei flexibility test
Stabilize at wrist and carpals
Start with flexed MCP, PIP, and DIP and wrist and forearm in neutral
Extend MCP jt while keeping PIP and DIP flexed
78
Bunnel-littler test
This is another test for the length of the lumbricals and interossei
1st, position MCP in slight extension and passively flex the PIP, if it is limited continue
2nd, flex MCP slighlty (slackens test muscles) and see if PIP flexion increases
79
Retinacular test
Start with forearm and wrist in neutral
1st, hold MCP and PIP in neutral and flex DIP, if it is limited, continue
2nd, fkex PIP slightly to slacken the retinaculum and see if this increases DIP flexion (indicating the retinaculum is tight)
80
Allen test
Tests blood supply of radial and ulnar arteries
Have pt open and close fist a few times then tightly hold fist closed
Occlude both arteries and have pt open hand
Release 2 artery
Hand should flush all the way in 5 seconds or less
81
Modified allen test
Same as allen test but occluding arteries on either side of a finger
82
Tinels sign at the wrist
for medial nerve and carpal tunnel
Tap over volar carpal ligement
Pain/paresthesia reproduction indicates median nerve issue
Can also do at the elbow
83
Phalens test
Tests for carpal tunnel syndrome
Press backs of hands together with wrist flexion
This will reproduce pain and paresthesias if median nerve problem
84
Reverse phalens test
Prayer hands to reproduce carpal tunnel syndrome pain
This is faster than phanel's because it increases pressure in the carpal tunnel more
85
Finkelstein test
For dequervain's syndrome (tenosynovitis of abductor pollicis longus and extensor pollicis brevis)
Make thumb with thumb tucked in fist and ulnarly deviate
reproduces shrp pain
arthritis can cause bony block
86
Capsular pattern of the GH joint
Restrictions greatest in ER>AB>IR
87
Capsular pattern of the elbow joint
flexion more limited than extension
88
Capsular pattern of the PRUJ and DRUJ
supination more limited than pronation
89
biceps brachii muscle flexibility test
it will limit elbow extension and forearm pronation when shoulder is extended
pt supine at edge of plinth
90
triceps brachii muscle flexibility test
limits elbow flexion and forearm supinated when shoulder is flexed
pt supine at edge of plinth
91
Lats and teres major muscle flexibility test
note a lack of shoulder ER
shoulder flexion in hooklying should be able to reach the ears- measure lacking distance from ears for lat tightness
If flexion is not limited, the ER limitation may be due to the ER
92
pec minor muscle flexibility test
Pt in supine with towels to elevate the elbows slightly
should be no more than 2 inches from posterior acromion to the plinth
Arms in touch down position above head- measure lack of motion above mat
93
Pec major muscle flexibility test
Pt in supine with arms in horizontal abduction, ER, and elbow extended and should reach mat
Clavicular head- abduction to 90
Sternoclavicular heads- abducted to 135 degrees
94
pectoralis muscle flexibility test as a group
in supine
| hands loosely interlaced behind head and allow elbows to fall behind head
95
Shoulder and wrist elevation test
Test of flexibility and strength
prone with arms shoulder width apart
raise arms as high as possible while keeping chin on ground
96
Static flexibility test of shoulder
Hold a rope in front of chest with hads 4 inches apart
Go from flexion and ER to extension and IR by moving arms overhead and behind back
Measure how much the hands slide on the rope and compare to the width of the shoulders
Subtract shoulder distance from thumb distance
97
Median nerve tension test
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scapular depression
shoulder abduction
shoulder ER
forearm supination
wrist and finger extension
elbow extension
ipsilateral cervical side flexion
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98
Ulnar nerve tension test
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scapular depression
Shoulder abduction
shoulder ER
forearm pronation
wrist and finger extension
elbox flexion
ipsilateral cervical side flexion
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99
Radial nerve tension test
```
scapular depression
elbow extension
shoulder IR
forearm pronation
Wrist and finger flexion
shoulder abduction
cervical side flexion ipsilaterally
```
100
Pronator drift
pt hold B UE in 90 degrees flexion and supination for 20-30 seconds
+ if one or both arms droops from flexion and moves into pronation
More severe lesion indicated by finger or elbow flexion
101
Shimizu reflex
hammer tap on shoulder spine down to acromion
| + if scapular elevation or humeral abduction
102
Order for sensation testing
Test face first with eyes open and closed for comparison
Compare sensation in extremities to face with eyes open
Dermatome screen with eyes closed
Test any deficit to determine dermatome v peripheral nerve
Check opposite spinal tract sensation also
document __/10 correct
103
Suggested testing order
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Dermatome screen
Dermatome v peripheral nerve prn
confirm findings with opposite tract
Myotome
reflex
ROM screen
ROM test
MMT prn
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