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NMS 1 Diagnosis > Exam 1 > Flashcards

Exam 1 Flashcards

0
Q

Nerve pain will usually follow what kind of pattern?

A

dermatomal

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1
Q

Radiating pain would refer to what type of pain?

a. myotomal
b. dermatomal
c. scleratomal
d. myofascial

A

c

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2
Q

Injuries to ligaments follow what kind of pattern?

A

sclerotomal pattern

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3
Q

A patient has pain but is able to tolerate it but has some impairment to activities. What pain scale most likely describes this?

a. visual analog scale
b. borg pain scale
c. the severity of pain grading system

A

c

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4
Q

pain that appears 40% of the time would be consider what type of pain?

a. intermittent
b. occasional
c. frequent
d. constant

A

B

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5
Q

Radiating, sharp, stabbing, and well demarcated are signs of what kind of pain?

a. Dermatome
b. Myogenous
c. scleratogenous

A

a. usually attributed to a nerve root

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6
Q

What is an abnormal vascular noise, and during which part of the examination is it normally heard?

A

bruit, Auscultation

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7
Q

What are the four areas that are measurements of vital signs?

A

Pulse, respiration, blood pressure, temperature

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8
Q

During the passive range of motion stage of the examine what is the doctor feeling for?

A

End feel

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9
Q

An intra articular displacement would be indicitive of what type of block?

A

Springy block

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10
Q

During a “break method test” a grade 2 strain would be mean what about the muscle?

a. Painless and strong
b. Painful and strong
c. Painful and weak
d. Painless and weak

A

c

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11
Q

When a test is preformed, it the patient’s symptoms decrease it is considered a positive test

A

True

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12
Q

T/F plain x-rays are recommend for routine evaluation of patients with acute low back problems

A

False

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13
Q

Why is it not a good idea to perform lumbar x-rays?

A

exposes the male and female reproductive organs

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14
Q

During discography the water soluable imaging material gets injected directly into the…

A

nucleus pulposus

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15
Q

When grading muscle strength what would mean a movement against gravity plus maximum resistance?

A

5

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16
Q

Innervated musculature arises bilaterally from the __________ and travel along the ____________ tract

A

Pre-central gyrus of the cerebral motor cortex; corticobulbar

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17
Q

What is the number one cause of headaches?

Of dizziness?

A

Cervicogenic pain; Cervicogenic vertigo

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18
Q

A complete loss of smell

A

anosmia

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19
Q

a decreased sense of smell

A

hyposmia

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20
Q

an increases sense of smell

A

hyperosmia

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21
Q

a perversion of smell

A

parosmia

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22
Q

abnormally disagreeable smell

A

cacosmia

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23
Q

T/F anosmia is indicative of a cortical lesion

A

false

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24
Q

The complete loss of the sense of smel is more commonly associated with what?

A

viral infection, allergic rhinitis, aginig, or head trauma

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25
Q

CSF drainage is known as…

A

Rhinorrhea

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26
Q

What are common examinations of cranial nerve 1?

A
  1. Observation of the nose.
    1. Test each side with a different scent
    2. Internal Exam of the nose
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27
Q

What is the most common cause of anosmia?

A

the common cold

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28
Q

What are some common exams that are used to test cranial nerve II?

A
  1. Observation of the eyes
  2. Test visual acuity (near or far) Snellen’s chart3. Test peripheral vision, AKA-Confrontation
  3. Pupillary light reflex
    5 Ophthalmoscopic exam
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29
Q

What are some causes of papilledema?

A

increase intracranial pressure due to brain tumor
abscesses
hemorrhage
hypertension

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30
Q

Which is more common with vision loss?

a. papilledema
b. papillitis

A

b

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31
Q

What is characteristic of glaucoma?

A

The leading cause of blindness in the United States, increased pressure on the optic nerve due to an increase in pressure inside the eye

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32
Q

What condition is characterized by a decrease in blood flow to the eye?

A

optic atrophy

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33
Q

What is the difference between papilledema and papillitis?

A

papillitis is usually associated with pain, it is usually benign and self resolving without apparent cause.

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34
Q

papillitis might predate what condition of the eye?

A

multiple sclerosis

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35
Q

What condition in the eye will most likely be a sign of diabetes in the patient?

A

diabetic retinopathy

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36
Q

damage to the retina due to high blood pressure (hypertension)

A

hypertensive retinopathy

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37
Q

melanoma most likely effects what part of the eye?

A

choroid

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38
Q

Multiple sclerosis is the most common cause of what?

A

retrobulbar neuritis

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39
Q

What condition is characterized by unequal pupil size?

A

anisocoria

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40
Q

deviation of bilateral eye alignment

A

heterotropia

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41
Q

an outward/lateral deviation of the eye

A

exotropia

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42
Q

an inward /medial deviation of the eye

A

esotropia

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43
Q

an upward deviation of the eye

A

hypertropia

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44
Q

a downward deviation of the eye

A

hypotropia

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45
Q

peripheral vision exam is accomplished via a technique known as…

A

confrontation

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46
Q

What are the exams for cranial nerve I?

A

Cranial Nerve i

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47
Q

What are the examinations for cranial nerve II?

A

Visual Acuity (Snell’s chart)
Peripheral Vision exam
Pupillary light reflex
Opthalmascope exam

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48
Q

Which of the Cranial nerve II examinations test both CN II, and III?

A

Pupillary light reflex

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49
Q

What are the two exams that are used to test CN III, IV, VI?

A

Corneal light reflex

6 Cardinal field of gaze

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50
Q

nystagmus is…

a. voluntary
b. involuntary

A

b

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51
Q

T/F

Nystagmus at the end point is common

A

True

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52
Q

a nystagmus that jerks to the left would be considered a..

A

left nystagmus

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53
Q

Which condition is characterized by tonic pupillary reaction?

A

Holmes-Adie Syndrome

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54
Q

A pupil that is myotonic with a very slow contraction to light could be an indicator of what condition?

A

Holmes-Adie syndrome

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55
Q

Which test would you use to test for Argyll Robertson pupil?

A

Accommodation

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56
Q

T/F

An Argyll Robertson pupil has an direct reaction to light but not an indirect.

A

False, indirect to both

57
Q

What is a clinical reason for Ptosis?

A

Horner’s Syndrome

58
Q

The paralysis of the superior tarsal muscle is an indicator of what condition?

A

Ptosis, which is an indicator of Horner’s syndrome

59
Q

Which of the following is not a sign of Horner’s Syndrome?

a. Ptosis
b. Pupilloconstriction
c. Vasoconstriction on ipsilateral side of the face
d. Facial anhydrosis

A

c

vasodilatation occurs on ipsilateral side of the face

60
Q

What side of the face does facial anhydrosis occur on?

What condition is it a sign of?

A

Occurs on the ipsilateral side of the face

Symptom of Horner’s syndrome

61
Q

Lesions along the sympathetic pathway _________ to the bifurcation of the common carotid will result in what two conditions that can be seen during Horner’s syndrome?

a. proximal
b. distal

A

b

Ptosis and pupilloconstiction

62
Q

A lesion on the sympathetic pathway along the external carotid will result in what two conditions?

a. Ptosis
b. Pupilloconstriction
c. vasodilation
d. anhydrosis

A

c,d

A lesion along the internal carotid will result in a,b

63
Q

Enophthalmos is described as…
it interferes with what muscle of the eye?
Can be associated with what condition?

A

sinking of the eyeball
muscle of Muller
Horner’s syndrome

64
Q

What are the details of the chief complaint?

A 
O-  Onset
P - Provoking 
Q - Quality of Pain
R - Radiation
S - Severity
T - Time
65
Q

What type of questions should a doctor ask?

a. open-ended
b. direct questions
c. leading questions

A

a

66
Q

An injury to a ligament would be included in what area of the chief complaint and what type of pain would it be referring to?

A

Radiation

schlerotomal

67
Q

The chief complaint of severity, what are the three pain scales?

A

Visual analog pain scale
Borg Pain scale
The severity of Pain Grading system

68
Q

Scleratogenous pain is usually referred to as…

a. Radiating, sharp and stabbing
b. Crawling
c. Dull and achy

A

c

69
Q

What direction does the left lateral pterygoid muscle move the jaw?

A

To the right

70
Q

cranial nerve 2 covers what 2 dermatomes?

A

C2, C3

71
Q

Atrophy of the temporalis and the masseter muscle together with corneal inflammation and ulceration is termed what?

A

neuroparalytic keratitis

72
Q

An idiopathic condition of Cranial Nerve V characterized by sharp, painful facial sensation in the clear distribution of a certain division of the trigeminal nerve

A

Trigeminal Neuralgia

73
Q

What exams would be run for cranial nerve V?

A

Inspect muscles
Corneal Blink
Sensory Exam of the Face
Jaw Jerk

74
Q

What examination for cranial nerve V would be absent in the early cases of multiple sclerosis?

A

The Corneal blink reflex

75
Q

Which nerve would you be testing if you are testing the anterior 2/3 of the tongue?

A

Cranial Nerve VII

76
Q

Cranial nerve VII is normall spared in unilateral lesions involving _______ pathways

A

corticobulbar

77
Q

What are the two divisions of CN VII and where do they divide?

A

Temporofacial and cervicofacial divisions and they divide at the parotid gland

78
Q

What muscle does CN VII innervate?

A

Staedius

79
Q

Parasympathetic fibers cause an increase in what type of saliva?

a. thin and watery
b. thick and turbid

A

a

80
Q

facial paralysis can be what two types?

A

central and peripheral

81
Q

what is peripheral facial paralysis commonly called?

A

prosopoplegia

82
Q

A patient with indicators of Bell’s Palsy would have lesions in what cranial nerve?

A

CN VII

83
Q

What is a key indicator of the difference between Bell’s Palsy and Stroke?

A

during a stroke the forehead is spared

84
Q

What is the term for complete loss of taste?

A

Ageusia

85
Q

T/F

Central lesions in cranial nerve VII must be proximal to the stylomastoid foramen to affect taste.

A

False

Peripheral lesions

86
Q

Involuntary movement may be __________ ____________

A

normal variants

87
Q

What are the three types of involuntary movement?

A

physiological tremor
myclonic jerks
benign fasciculations

88
Q

The shaking of fingers due to agonists and antagonists is known as?

A

physiological tremors

89
Q

startled reactions tha are normal are known as

A

Myoclonic jerks

90
Q

Twitches within the muscles often after exercise and are not pathological?

A

benign fasciculations

91
Q

What is decreased movement and is seen in depression or parkingsons?

A

Hypokinesia

92
Q

What is increased involuntary movement and is exacerbated by emotional stress and decrease with repose?

A

hyperkinesia

93
Q

What types of tremors are there?

A 
Emotional
familial
senile
parkinsonian
intention
postural
94
Q

What type of emotional tremor worsens with volitional movement?

A

emotional

95
Q

what type of tremor is usually affects the hands?

A

familial

96
Q

what kind of tremor is similar to familial but is associated with age?

A

senile

97
Q

What kind of tremor is characterized by “pill rolling” at rest?

A

parkingsonian

98
Q

What kind of tremor worsens with refined movement?

A

intention

99
Q

What kind of tremor occuurs during maintenance of an intentinoal posture, disappears with movement?

A

postural

100
Q

What kind of involuntary movement is characterized by random, quick movement simulating fragment of normal movements?

A

nontremorous hypekinesia or chorea

101
Q

what kind of involuntary movement is characterized by slow writhing movements of the fingers and extremities that may come and go and are usually associated wit pyramidal tract signs?

A

athetosis

102
Q

What kind of involuntary movement has slow alternating contraction and relaxation of of agonists and antagonists one movement predominating for a long time

A

dystonia

103
Q

involuntary movement characterized by violent flinging movement of half the body

A

hemiballismus

104
Q

involuntary movements with quick repetitive movements of the face, tongue, or extremities

associated with what kind of stress?

A

tics

emotional

105
Q

involuntary movement characterized by motor unrest manifested as continual shifting of posture and/or movement

A

akathisia

106
Q

involuntary movement characterized by tonic or clonic spasms of all or part of the body

A

epilepsy

107
Q

What is the largest single category of involuntary movement?

Caused from what??

A

Tardive dyskinesias

neuroleptic agents given for psychotic disorders

108
Q

Clumsiness and uncertainty are characteristics of what gait, wide base slapping their feet and usually watch their legs?

A

tabetic or ataxic gait

109
Q

What gait is characterized by semicircular movement of a leg and semiflexed position of the arm on the ipsilateral side?

A

hemiplegic gait

110
Q

What gait is characteristic of spastic paraplegia, the legs are adducted crossing alternately in front of one another with the knees scraping together?

A

scissors gait

111
Q

what gait is typically seen in acute alcoholism?

A

drunken or staggering gait

112
Q

What gait is characterized by addlng or clumsy gait resulting from dislocated hips, typically from weakness of trunk and pelvic girdle muscles.

A

waddling or clumsy gait

113
Q

gait characterized by high knees and foot flopping due to paralysis of the anterior tibial group of muscles

A

steppage gait

114
Q

gait characterized by vertigo and a tendency to reel to one side. limb starts advancing slowly but the limb s unexpectedly, erratically and vigorously flung forward

A

cerebellar gait

115
Q

gait characterized by short shuffling steps beginning slowly at first and then picking up speed?

A

propulsion or festination gait

116
Q

What gait is typically seen in patients with Parkinsonism?

A

propulsion or festination gait

117
Q

Differ from the organic forms in being more pronounced and complete, with the ability to use the limb in emergencies

A

hysterical gaits

118
Q

what gait differs from the organic forms in being more pronounced and complete, with the ability to use the limb in emergencies?

A

hysterical gaits

119
Q

type of hysterical gait with such bizarre uncoordinated movements that the patient is unable to stand or to walk, leg works is normal while the patient is sitting or is in bed.

A

Astasia-abasia

120
Q

gait with fast movement of the affected extremity when it is weight bearing

A

limpping gait

121
Q

What is a positive sign for a rusts test?

A

patient grabs the had with both hands while lying down or raising up

122
Q

What are some possible interpretations of a positive sign of rust’s test?

A

severe sprain
rheumatoid arthritis
fracture
severe cervical subluxation

123
Q

If a rust’s sign is present; the result suggest servere ____________

A

upper cervical stability

124
Q

What is a clinical indication of a rust sign?

A

suggests ligament, muscle damage or possible fracture

125
Q

what procedure is done by applying pressure to the mastoid processes of the patient till the patient mentions discomfort?

A

libmans sign

126
Q

what does a libman sign demonstrate

A

unuusually low, high or normal threshold for pain

127
Q

procedure where the patient is in a seated position and will place the hand of the affected extremity on top of their head

A

bakody

128
Q

what is the purpose of the bakody sign

A

indicator of server radicular symptoms

129
Q

what is the function of bakody sign

A

decreases the traction of the lower part of the brachial plexus

130
Q

What is an important finding with a positive bakody sign

A

the location of the pain will help to identify the etiology of the pain

131
Q

what occurs with pain during a reverse bakody sign?

A

the pain of the patient is exacerbated

132
Q

what does a positive reverse bakody sign mean?

A

indicates a thoracic outet syndrome from interscalene compression

133
Q

What test does the patient abduct the shoulder to 90 degrees and then the elbow is put into full extension?

A

bikele’s sign

134
Q

What is the purpose of the bikele’s sign?

A

traction the brachial plexus and its nerve roots

135
Q

what is the function of bikele’s sign?

A

stressng the brachial plexus

136
Q

What procedure is done by asking the patient to abduct both shoulders to 90 and place hands behind the head?

A

brachial plexus tension test

137
Q

purpose of the brachial plexus tension test??

A

traction of the brachial plexus

138
Q

what is the function of the brachial plexus tension test

A

stressing the brachial plexus

139
Q

coughhing, sneezing and straining during defecation may cause aggravation is what sign?

A

Dejerine’s sign

NMS 1 Diagnosis (4 decks)

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