Exam 1: Random in class handouts

Question 1

What is the test called where is the patient rotates the head back and fourth as fast a they can?

Answer 1

Barr’e-Lie’ou test

-If patient experience symptoms at anytime, the test is considered positive

Question 2

What is the purpose of the Barr’e-Lie’ou test?

Answer 2

To rule out vascular insufficiency, cervicogenic vertigo, and possible vestibular apparatus abnormality

Question 3

What are signs of a positive Barr’e-Lie’ou test?

Answer 3

vertigo, dizziness, visual disturbances, nausea, syncope, nystagmus

Question 4

Explain the vertebrobasilar artery functional maneuver.

Answer 4

• auscultates and palpates carotid and subclavian arteries for possible bruits
• if none, patient rotates and extends head and counts backward from 20

Question 5

What is the purpose of the vertebrobasilar artery functional maneuver?

Answer 5

to rule out vascular insuffiecy

Question 6

Explain the DeKleyn’s test.

Answer 6

Patient lays supine and rotates and hyperextends neck and counts down from 20

Question 7

what is the purpose of DeKleyn’s test?

Answer 7

to rule out vascular insufficiency

Question 8

How do you fix benign paroxysmal positional vertigo?

Answer 8

exercises to reposition debris in the canals (eply maneuver)

Question 9

What is an acoustic neuroma?

Answer 9

Hearing loss with dizziness, hearing loss, vertigo, and tints
-Benign schwanoma of CNVIII

Question 10

What does is mean when there is pain before the end range of motion?

Answer 10

actue

Question 11

What does it mean when there is pain as end range approaches?

Answer 11

subacute

Question 12

What does is mean when there is pain after end range?

Answer 12

chronic

Question 13

What tract is light touch?

Answer 13

anterior spinothalamic

Question 14

What tract is sharp pain and temperature?

Answer 14

lateral spinothalamic

Question 15

What tract is deep sensation, deep pain, and proprioception?

Answer 15

dorsal columns

Question 16

What is the highest level of sensation?

Answer 16

multimodal or association cortex sensations

Question 17

Can pain occur without DIRECT nerve compression by a disc protrusion?

Answer 17

YES

Question 18

What is the clinical neuorpathway for a patient to experience pain from a clerical disc bulge/herniation?

Answer 18

The recurrent nerve of luschka, sinuvertebral nerve is considered to convert sensory fibers to PLL, dura, and outer border of the annulus

Question 19

Nerve roots receive stimuli in what type of pattern? peripheral nerves?

Answer 19

NR: dermatomal pattern
PN: peripheral nerve pattern

Question 20

What is cauda equine syndrome?

Answer 20

• bilateral leg pain
• bowel and bladder incontinence
• Sensory exam for S3-5 is decreased of absent
• Medical emergency

Question 21

What is sacral sparing syndrome?

Answer 21

• bilateral leg pain
• normal bowel and bladder function
• Sensory exam fine
• only need to monitor this issue

Question 22

What sensation is lost first?

Answer 22

Autonomic, light touch

Question 23

What sensation is lost second?

Answer 23

pain and temperature

Question 24

What sensation is lost last?

Answer 24

vibration and position sense

Question 25

What is altered sensation called?

Answer 25

paresthesia

Question 26

Is hyperesthesia indicative of nerve compression or irritation? hypoesthesia and anesthesia?

Answer 26

Hyper: irritation Hypo: compression An: compression

Question 27

Where will instrumentation go with nerve compression?

Answer 27

to the same side of compression

Question 28

Where will instrumentation of with nerve irritation?

Answer 28

to the opposite side of irritation

Question 29

What is nerve irritation?

Answer 29

- numbness down extremity | - sensory, motor and deep tendon reflex exam are same

Question 30

What is nerve compression?

Answer 30

- numbness down extremity | - decreased findings in sensory, motor, and reflex exam

Question 31

If the patient does not feel the vibratory sensation equal from side to side assume there is a deficit where?

Answer 31

posterior columns

Question 32

If the patient does not feel the vibratory sensation at all, what should you assume?

Answer 32

possible neuropathy

Question 33

What are the aspects of an UMNL?

Answer 33

spasticity, hypertonia, hyperreflexia, pathological reflexes

Question 34

What are the aspects of LMNL?

Answer 34

Flaccid, hypotonia, hyporeflexia

Question 35

Extra pyramidal syndromes can decrease kinetic power while static remain normal. T/F

Answer 35

True

Question 36

What is wrist drop?

Answer 36

"Saturday night palsy" - radial nerve involved - shoulder dislocation, crutches, humeral fracture

Question 37

What is claw hand?

Answer 37

distal lesion of ulnar nerve

Question 38

Nerve root compression=? | Peripheral nerve compression=?

Answer 38

NRC: radiculopathy PNRC: neuropathy

Question 39

What is bishop's or benediction hand?

Answer 39

proximal lesion of ulnar nerve

Question 40

What is simian hand (ape hand/monkey paw)?

Answer 40

median nerve issue

Question 41

What is era duchenne syndrome?

Answer 41

- upper plexus - C5/6 roots - loss abduction and should and elbow flexion, but hand is functional on its own

Question 42

What is Klumpke paralysis?

Answer 42

- lower plexus - C8-T1 - During falls and grabbing onto something - Hand is not functioning correctly

Question 43

What type of lesion does a subluxation with nerve compression represent?

Answer 43

LMNL

Question 44

What is called when a muscle with normal innervation is passively stretched, its fibers actively resist the stretching and enter into a state of increased and sustained tension?

Answer 44

The stretch reflex

Question 45

What is continued involuntary rapid flexion and extension of a muscle while a joint is under sustained resistance?

Answer 45

Clonus

Question 46

What is clonus due to?

Answer 46

Rapid-fire elicitation of the muscle stretch relfexes