Exam 1: Random in class handouts Flashcards
What is the test called where is the patient rotates the head back and fourth as fast a they can?
Barr’e-Lie’ou test
-If patient experience symptoms at anytime, the test is considered positive
What is the purpose of the Barr’e-Lie’ou test?
To rule out vascular insufficiency, cervicogenic vertigo, and possible vestibular apparatus abnormality
What are signs of a positive Barr’e-Lie’ou test?
vertigo, dizziness, visual disturbances, nausea, syncope, nystagmus
Explain the vertebrobasilar artery functional maneuver.
- auscultates and palpates carotid and subclavian arteries for possible bruits
- if none, patient rotates and extends head and counts backward from 20
What is the purpose of the vertebrobasilar artery functional maneuver?
to rule out vascular insuffiecy
Explain the DeKleyn’s test.
Patient lays supine and rotates and hyperextends neck and counts down from 20
what is the purpose of DeKleyn’s test?
to rule out vascular insufficiency
How do you fix benign paroxysmal positional vertigo?
exercises to reposition debris in the canals (eply maneuver)
What is an acoustic neuroma?
Hearing loss with dizziness, hearing loss, vertigo, and tints
-Benign schwanoma of CNVIII
What does is mean when there is pain before the end range of motion?
actue
What does it mean when there is pain as end range approaches?
subacute
What does is mean when there is pain after end range?
chronic
What tract is light touch?
anterior spinothalamic
What tract is sharp pain and temperature?
lateral spinothalamic
What tract is deep sensation, deep pain, and proprioception?
dorsal columns
What is the highest level of sensation?
multimodal or association cortex sensations
Can pain occur without DIRECT nerve compression by a disc protrusion?
YES
What is the clinical neuorpathway for a patient to experience pain from a clerical disc bulge/herniation?
The recurrent nerve of luschka, sinuvertebral nerve is considered to convert sensory fibers to PLL, dura, and outer border of the annulus
Nerve roots receive stimuli in what type of pattern? peripheral nerves?
NR: dermatomal pattern
PN: peripheral nerve pattern
What is cauda equine syndrome?
- bilateral leg pain
- bowel and bladder incontinence
- Sensory exam for S3-5 is decreased of absent
- Medical emergency
What is sacral sparing syndrome?
- bilateral leg pain
- normal bowel and bladder function
- Sensory exam fine
- only need to monitor this issue
What sensation is lost first?
Autonomic, light touch
What sensation is lost second?
pain and temperature
What sensation is lost last?
vibration and position sense
What is altered sensation called?
paresthesia
Is hyperesthesia indicative of nerve compression or irritation? hypoesthesia and anesthesia?
Hyper: irritation
Hypo: compression
An: compression
Where will instrumentation go with nerve compression?
to the same side of compression
Where will instrumentation of with nerve irritation?
to the opposite side of irritation
What is nerve irritation?
- numbness down extremity
- sensory, motor and deep tendon reflex exam are same
What is nerve compression?
- numbness down extremity
- decreased findings in sensory, motor, and reflex exam
If the patient does not feel the vibratory sensation equal from side to side assume there is a deficit where?
posterior columns
If the patient does not feel the vibratory sensation at all, what should you assume?
possible neuropathy
What are the aspects of an UMNL?
spasticity, hypertonia, hyperreflexia, pathological reflexes
What are the aspects of LMNL?
Flaccid, hypotonia, hyporeflexia
Extra pyramidal syndromes can decrease kinetic power while static remain normal. T/F
True
What is wrist drop?
“Saturday night palsy”
- radial nerve involved
- shoulder dislocation, crutches, humeral fracture
What is claw hand?
distal lesion of ulnar nerve
Nerve root compression=?
Peripheral nerve compression=?
NRC: radiculopathy
PNRC: neuropathy
What is bishop’s or benediction hand?
proximal lesion of ulnar nerve
What is simian hand (ape hand/monkey paw)?
median nerve issue
What is era duchenne syndrome?
- upper plexus
- C5/6 roots
- loss abduction and should and elbow flexion, but hand is functional on its own
What is Klumpke paralysis?
- lower plexus
- C8-T1
- During falls and grabbing onto something
- Hand is not functioning correctly
What type of lesion does a subluxation with nerve compression represent?
LMNL
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?
The stretch reflex
What is continued involuntary rapid flexion and extension of a muscle while a joint is under sustained resistance?
Clonus
What is clonus due to?
Rapid-fire elicitation of the muscle stretch relfexes
