Exam 1 Flashcards
Nerve pain will usually follow what kind of pattern?
dermatomal
Radiating pain would refer to what type of pain?
a. myotomal
b. dermatomal
c. scleratomal
d. myofascial
c
Injuries to ligaments follow what kind of pattern?
sclerotomal pattern
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
c
pain that appears 40% of the time would be consider what type of pain?
a. intermittent
b. occasional
c. frequent
d. constant
B
Radiating, sharp, stabbing, and well demarcated are signs of what kind of pain?
a. Dermatome
b. Myogenous
c. scleratogenous
a. usually attributed to a nerve root
What is an abnormal vascular noise, and during which part of the examination is it normally heard?
bruit, Auscultation
What are the four areas that are measurements of vital signs?
Pulse, respiration, blood pressure, temperature
During the passive range of motion stage of the examine what is the doctor feeling for?
End feel
An intra articular displacement would be indicitive of what type of block?
Springy block
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
c
When a test is preformed, it the patient’s symptoms decrease it is considered a positive test
True
T/F plain x-rays are recommend for routine evaluation of patients with acute low back problems
False
Why is it not a good idea to perform lumbar x-rays?
exposes the male and female reproductive organs
During discography the water soluable imaging material gets injected directly into the…
nucleus pulposus
When grading muscle strength what would mean a movement against gravity plus maximum resistance?
5
Innervated musculature arises bilaterally from the __________ and travel along the ____________ tract
Pre-central gyrus of the cerebral motor cortex; corticobulbar
What is the number one cause of headaches?
Of dizziness?
Cervicogenic pain; Cervicogenic vertigo
A complete loss of smell
anosmia
a decreased sense of smell
hyposmia
an increases sense of smell
hyperosmia
a perversion of smell
parosmia
abnormally disagreeable smell
cacosmia
T/F anosmia is indicative of a cortical lesion
false
The complete loss of the sense of smel is more commonly associated with what?
viral infection, allergic rhinitis, aginig, or head trauma
CSF drainage is known as…
Rhinorrhea
What are common examinations of cranial nerve 1?
- Observation of the nose.
- Test each side with a different scent
- Internal Exam of the nose
What is the most common cause of anosmia?
the common cold
What are some common exams that are used to test cranial nerve II?
- Observation of the eyes
- Test visual acuity (near or far) Snellen’s chart3. Test peripheral vision, AKA-Confrontation
- Pupillary light reflex
5 Ophthalmoscopic exam
What are some causes of papilledema?
increase intracranial pressure due to brain tumor
abscesses
hemorrhage
hypertension
Which is more common with vision loss?
a. papilledema
b. papillitis
b
What is characteristic of glaucoma?
The leading cause of blindness in the United States, increased pressure on the optic nerve due to an increase in pressure inside the eye
What condition is characterized by a decrease in blood flow to the eye?
optic atrophy
What is the difference between papilledema and papillitis?
papillitis is usually associated with pain, it is usually benign and self resolving without apparent cause.
papillitis might predate what condition of the eye?
multiple sclerosis
What condition in the eye will most likely be a sign of diabetes in the patient?
diabetic retinopathy
damage to the retina due to high blood pressure (hypertension)
hypertensive retinopathy
melanoma most likely effects what part of the eye?
choroid
Multiple sclerosis is the most common cause of what?
retrobulbar neuritis
What condition is characterized by unequal pupil size?
anisocoria
deviation of bilateral eye alignment
heterotropia
an outward/lateral deviation of the eye
exotropia
an inward /medial deviation of the eye
esotropia
an upward deviation of the eye
hypertropia
a downward deviation of the eye
hypotropia
peripheral vision exam is accomplished via a technique known as…
confrontation
What are the exams for cranial nerve I?
Cranial Nerve i
What are the examinations for cranial nerve II?
Visual Acuity (Snell’s chart)
Peripheral Vision exam
Pupillary light reflex
Opthalmascope exam
Which of the Cranial nerve II examinations test both CN II, and III?
Pupillary light reflex
What are the two exams that are used to test CN III, IV, VI?
Corneal light reflex
6 Cardinal field of gaze
nystagmus is…
a. voluntary
b. involuntary
b
T/F
Nystagmus at the end point is common
True
a nystagmus that jerks to the left would be considered a..
left nystagmus
Which condition is characterized by tonic pupillary reaction?
Holmes-Adie Syndrome
A pupil that is myotonic with a very slow contraction to light could be an indicator of what condition?
Holmes-Adie syndrome
Which test would you use to test for Argyll Robertson pupil?
Accommodation
T/F
An Argyll Robertson pupil has an direct reaction to light but not an indirect.
False, indirect to both
What is a clinical reason for Ptosis?
Horner’s Syndrome
The paralysis of the superior tarsal muscle is an indicator of what condition?
Ptosis, which is an indicator of Horner’s syndrome
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
c
vasodilatation occurs on ipsilateral side of the face
What side of the face does facial anhydrosis occur on?
What condition is it a sign of?
Occurs on the ipsilateral side of the face
Symptom of Horner’s syndrome
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
b
Ptosis and pupilloconstiction
A lesion on the sympathetic pathway along the external carotid will result in what two conditions?
a. Ptosis
b. Pupilloconstriction
c. vasodilation
d. anhydrosis
c,d
A lesion along the internal carotid will result in a,b
Enophthalmos is described as…
it interferes with what muscle of the eye?
Can be associated with what condition?
sinking of the eyeball
muscle of Muller
Horner’s syndrome
What are the details of the chief complaint?
O- Onset P - Provoking Q - Quality of Pain R - Radiation S - Severity T - Time
What type of questions should a doctor ask?
a. open-ended
b. direct questions
c. leading questions
a
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?
Radiation
schlerotomal
The chief complaint of severity, what are the three pain scales?
Visual analog pain scale
Borg Pain scale
The severity of Pain Grading system
Scleratogenous pain is usually referred to as…
a. Radiating, sharp and stabbing
b. Crawling
c. Dull and achy
c
What direction does the left lateral pterygoid muscle move the jaw?
To the right
cranial nerve 2 covers what 2 dermatomes?
C2, C3
Atrophy of the temporalis and the masseter muscle together with corneal inflammation and ulceration is termed what?
neuroparalytic keratitis
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
Trigeminal Neuralgia
What exams would be run for cranial nerve V?
Inspect muscles
Corneal Blink
Sensory Exam of the Face
Jaw Jerk
What examination for cranial nerve V would be absent in the early cases of multiple sclerosis?
The Corneal blink reflex
Which nerve would you be testing if you are testing the anterior 2/3 of the tongue?
Cranial Nerve VII
Cranial nerve VII is normall spared in unilateral lesions involving _______ pathways
corticobulbar
What are the two divisions of CN VII and where do they divide?
Temporofacial and cervicofacial divisions and they divide at the parotid gland
What muscle does CN VII innervate?
Staedius
Parasympathetic fibers cause an increase in what type of saliva?
a. thin and watery
b. thick and turbid
a
facial paralysis can be what two types?
central and peripheral
what is peripheral facial paralysis commonly called?
prosopoplegia
A patient with indicators of Bell’s Palsy would have lesions in what cranial nerve?
CN VII
What is a key indicator of the difference between Bell’s Palsy and Stroke?
during a stroke the forehead is spared
What is the term for complete loss of taste?
Ageusia
T/F
Central lesions in cranial nerve VII must be proximal to the stylomastoid foramen to affect taste.
False
Peripheral lesions
Involuntary movement may be __________ ____________
normal variants
What are the three types of involuntary movement?
physiological tremor
myclonic jerks
benign fasciculations
The shaking of fingers due to agonists and antagonists is known as?
physiological tremors
startled reactions tha are normal are known as
Myoclonic jerks
Twitches within the muscles often after exercise and are not pathological?
benign fasciculations
What is decreased movement and is seen in depression or parkingsons?
Hypokinesia
What is increased involuntary movement and is exacerbated by emotional stress and decrease with repose?
hyperkinesia
What types of tremors are there?
Emotional familial senile parkinsonian intention postural
What type of emotional tremor worsens with volitional movement?
emotional
what type of tremor is usually affects the hands?
familial
what kind of tremor is similar to familial but is associated with age?
senile
What kind of tremor is characterized by “pill rolling” at rest?
parkingsonian
What kind of tremor worsens with refined movement?
intention
What kind of tremor occuurs during maintenance of an intentinoal posture, disappears with movement?
postural
What kind of involuntary movement is characterized by random, quick movement simulating fragment of normal movements?
nontremorous hypekinesia or chorea
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?
athetosis
What kind of involuntary movement has slow alternating contraction and relaxation of of agonists and antagonists one movement predominating for a long time
dystonia
involuntary movement characterized by violent flinging movement of half the body
hemiballismus
involuntary movements with quick repetitive movements of the face, tongue, or extremities
associated with what kind of stress?
tics
emotional
involuntary movement characterized by motor unrest manifested as continual shifting of posture and/or movement
akathisia
involuntary movement characterized by tonic or clonic spasms of all or part of the body
epilepsy
What is the largest single category of involuntary movement?
Caused from what??
Tardive dyskinesias
neuroleptic agents given for psychotic disorders
Clumsiness and uncertainty are characteristics of what gait, wide base slapping their feet and usually watch their legs?
tabetic or ataxic gait
What gait is characterized by semicircular movement of a leg and semiflexed position of the arm on the ipsilateral side?
hemiplegic gait
What gait is characteristic of spastic paraplegia, the legs are adducted crossing alternately in front of one another with the knees scraping together?
scissors gait
what gait is typically seen in acute alcoholism?
drunken or staggering gait
What gait is characterized by addlng or clumsy gait resulting from dislocated hips, typically from weakness of trunk and pelvic girdle muscles.
waddling or clumsy gait
gait characterized by high knees and foot flopping due to paralysis of the anterior tibial group of muscles
steppage gait
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
cerebellar gait
gait characterized by short shuffling steps beginning slowly at first and then picking up speed?
propulsion or festination gait
What gait is typically seen in patients with Parkinsonism?
propulsion or festination gait
Differ from the organic forms in being more pronounced and complete, with the ability to use the limb in emergencies
hysterical gaits
what gait differs from the organic forms in being more pronounced and complete, with the ability to use the limb in emergencies?
hysterical gaits
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.
Astasia-abasia
gait with fast movement of the affected extremity when it is weight bearing
limpping gait
What is a positive sign for a rusts test?
patient grabs the had with both hands while lying down or raising up
What are some possible interpretations of a positive sign of rust’s test?
severe sprain
rheumatoid arthritis
fracture
severe cervical subluxation
If a rust’s sign is present; the result suggest servere ____________
upper cervical stability
What is a clinical indication of a rust sign?
suggests ligament, muscle damage or possible fracture
what procedure is done by applying pressure to the mastoid processes of the patient till the patient mentions discomfort?
libmans sign
what does a libman sign demonstrate
unuusually low, high or normal threshold for pain
procedure where the patient is in a seated position and will place the hand of the affected extremity on top of their head
bakody
what is the purpose of the bakody sign
indicator of server radicular symptoms
what is the function of bakody sign
decreases the traction of the lower part of the brachial plexus
What is an important finding with a positive bakody sign
the location of the pain will help to identify the etiology of the pain
what occurs with pain during a reverse bakody sign?
the pain of the patient is exacerbated
what does a positive reverse bakody sign mean?
indicates a thoracic outet syndrome from interscalene compression
What test does the patient abduct the shoulder to 90 degrees and then the elbow is put into full extension?
bikele’s sign
What is the purpose of the bikele’s sign?
traction the brachial plexus and its nerve roots
what is the function of bikele’s sign?
stressng the brachial plexus
What procedure is done by asking the patient to abduct both shoulders to 90 and place hands behind the head?
brachial plexus tension test
purpose of the brachial plexus tension test??
traction of the brachial plexus
what is the function of the brachial plexus tension test
stressing the brachial plexus
coughhing, sneezing and straining during defecation may cause aggravation is what sign?
Dejerine’s sign
