Exam 2 Study Guide (cumulative) Flashcards
Increased muscular resistance felt by the examiner during quick joint movement, quickly fades.
Spasticity
Spasticity is indicative of UMN lesion involving what type of spinal tracts?
Cortical or pyramidal pathway lesions
Involuntary muscular resistance felt when moving a resting joint and persists through the joints entire ROM.
Rigidity
Rigidity is indicative of UMN lesion involving what spinal tract?
Extrapyramidal
Hypotonia (decreased muscle tone) is usually indicative of damage to 1 of what 2 areas?
- -LMN lesion
- -cerebellar disease
What is a loss of normal neurological function (reduction in muscle tone, reflexes, strength, etc.)?
Deficit phenomena
What is an exaggerates or pervert’s normal neurological findings (hyper-reflexia, hypertonia, etc.)?
Release phenomena
Which is an UMN/LMN:
- -Deficit phenomena or
- -Release phenomena
Deficit phenomena = LMN
Release phenomena = UMN
What nerve is associated w/ the muscle stretch reflex of the biceps?
Musculocutaneous N (C5)
What nerve is associated w/ the muscle stretch reflex of Brachioradialis?
Radial (C6)
What nerve is associated w/ the muscle stretch reflex of Triceps?
Radial (C7)
What nerve is associated w/ the muscle stretch reflex of Finger Flexion?
Median, Ulnar (C8)
What nerve is associated w/ the muscle stretch reflex of Patellar?
Femoral (L2-L4)
What nerve is associated w/ the muscle stretch reflex of Achilles?
Tibial (L5-S2)
What nerve is associated w/ the muscle stretch reflex of Adductor?
Obturator (L2-L4)
What nerve is associated w/ the muscle stretch reflex of Internal Hamstrings?
Tibial (L4-S2)
What nerve is associated w/ the muscle stretch reflex of External Hamstrings?
Common Peroneal (L5-S3)
What is a positive Rossolimo sign and what does it mean?
Plantar flexion of toes = UMNL
What is a positive Chaddock sign and what does it mean?
Dorsiflexion = UMNL
What is the afferent and efferent supply for the Pupillary Light Reflex?
Afferent = CN 2
Efferent = CN 3
What is the afferent and efferent for Ciliospinal reflex?
Afferent = CN 5
Efferent = cervical sympathetics
What is the afferent and efferent for Oculocardiac reflex?
Afferent = CN 5
Efferent = CN 10
What is the afferent and efferent for Carotid Sinus reflex?
Afferent = CN 9
Efferent = CN 10
What reflex dysfunction is associated w/:
- -Depressed stretch reflexes
- -Loss of strength
Muscular
What reflex dysfunction is associated w/:
- -Depressed stretch reflex
- -Loss of stretch
Neuromuscular junction
What reflex dysfunction is associated w/:
- -Depressed stretch reflexes
- -Usually out proportion to weakness
Peripheral nerve
What reflex dysfunction is associated w/:
–stretch reflexes hypoactive at level of lesion and hyperactive below level of lesion
Spinal cord and brain stem
What reflex dysfunction is associated w/:
–stretch reflexes hypoactive or visibly abnormal
Cerebellum
What reflex dysfunction is associated w/:
–no consistent deep or superficial reflex changes
Basal ganglia
What reflex dysfunction is associated w/:
- -UMN pattern of weakness on the contralateral side
- -may be a babinski response
Cerebral cortex
Shaking in fingers, due to agonist/antagonist action
Physiological tremors
Startle reactions (usually a normal occurrence between walking and sleeping)
Myoclonic jerks
What are twitches (often after exercise and not pathological)?
Benign fasciculations
What type of tremor presents as:
–Rapid tremor
Emotional
What type of tremor presents as:
–hereditary tremor that affects the hands
Familial
What type of tremor presents as:
–associated w/ aging
Senile
What type of tremor presents as:
–“pin-rolling” at rest, disappears w/ volitional movement (basal ganglion lesion)
Parkinsonian
What type of tremor presents as:
–Tremor worsens w/ volitional movement (cerebellar pathology)
Intention tremor
What type of tremor presents as:
–Tremor w/ intentional posture, decreases w/ movement
Postural tremor
Random, quick movements stimulating normal movements
Chorea
Slow, writhing movements of fingers and extremities that come and go (pyramidal tract signs)
Athetosis
Slow, alternating contraction and relaxation of agonist and antagonists, one usually dominates causing fixed joint contractures.
Dystopia
Violent, flinging movement of half the body
Hemiballismus
Quick, repetitive movements associated w/ emotional stress
Tics
Motor unrest manifested as continual shifting of posture
Akathisia
Involuntary movements of the face, mouth, tongue, and limbs
Tardive dyskinesia
What type of gate is this:
–slap feet on ground w/ wide base and watch steps b/c they cant tell where their body is in space
Ataxic gate
What type of gate is this:
–Affected leg is rigid and swung from hip, toes usually pointed down
Hemiplegic gait
What type of gate is this:
- -Legs adducted, crossing alternately in front of one another
- -short, slow steps that are stiff and jerky
Scissors gait
What type of gate is this:
–High knee action and flopping of the feet, toes tend to drag along the floor
Steppage gait
What type of gate is this:
–forward leaning posture w/ short shuffling steps
Festination gait
What is the problem if their is pain w/ active ROM?
Muscle strain
What is the problem if their is pain w/ passive ROM?
Ligament sprain
What’s the problem:
–Nonspecific neck pain w/ symptoms down one side of neck
Cervical radiculopathy
What’s the problem:
–Neck pain, bilateral upper extremity symptoms, coordination/balance deficits
Cervical myelopathy
What are 5 Cervical Orthopedic Tests for Dural Irritation (Myelopathy)?
- -Brachial Plexus Tension
- -Lhermitte sign
- -Shoulder Depression
- -Kernig-Brudzinski
- -Soto-Hall
What are 4 Cervical Orthopedic Tests for Dural Meningitis?
- -Kernig-Brudzinski
- -Bikele
- -Brachial Plexus Tension
- -Soto-Hall
What would be 3 findings in the history of soft clues that would lead a doctor to test for meningitis?
Fever, headache, stiff neck
What 3 tests are best for identifying myelopathy?
- -Hoffman’s
- -Upper Deep Tendon Reflex
- -Babinski sign
What are 5 tests for IVF encroachment?
- -Distraction
- -Foraminal Compression
- -Jackson’s Compression
- -Maximum Cervical Compression
- -Spurlings
If you suspect a Brachial Plexus Injury, what 4 tests should you perform?
- -Bakody Sign
- -Bikele’s Sign
- -Brachial Plexus Tension Test
- -Brachial Plexus Compression Test
What does a positive Adson’s test indicate?
Anterior scalene hypertrophy
What does a positive Modified Adson’s test indicate?
Middle scale hypertrophy
Doctor occluded jugular vein at clavicles for 10-15 sec and patient is instructed to cough.
Naffzigers test
What does a positive Naffziger’s Test indicate?
Sharp pain = SOL
Patient seated and asked to shake head back and forth as fast as they can
Barr’e-Lie’ou Test
What are positive Barr’e-Lie’ou Test?
Dizziness, vertigo, nausea, fainting, nystagmus
What are 3 DDx’s for Lateral/Anterior shoulder pain w/ overhead activities?
- -Subacromial impingement
- -Tendinitis
- -Bursitis
What are 2 DDx’s for instability, pain w/ action
- -Shoulder instability
- -possible Labrador tear if clicking
What is Dx for patient falls on shoulder?
AC joint sprain
What are the 2 DDx for decreased ROM w/ pain during resistance?
- -Rotator cuff
- -bicep tendon
What is the Dx for pain and weakness w/ muscle loading, night pain?
Rotator cuff
What is the Dx for poorly located pain, may extend into elbow, aggravated by movement?
Adhesive capsulitis
What type of SLAP lesion is this:
–fraying of superior labrum
Type 1 SLAP lesion
What type of SLAP lesion is this:
–fraying of superior labrum also bicep anchor detachment
Type 2 SLAP lesion
What type of SLAP lesion is this:
–bucket tear w/ intact Biceps tendon
Type 3 SLAP lesion
What type of SLAP lesion is this:
–bucket tear of biceps tendon
Type 4 SLAP lesion
What are the 2 DDx for the following symptoms:
–Lateral elbow pain during gripping
- -Lateral epicondylitis
- -Radial tunnel
What is the Dx for the following symptoms:
–Medial elbow pain during wrist flexion
Medial epicondylitis
What is the Dx for the following symptoms:
–Elbow pain w/ numbness in Ulnar nerve
Cubital tunnel syndrome
What is the Dx for the following symptoms:
–Anterior elbow pain and forearm made worse by wrist or elbow flexion
Pronator syndrome
What is the Dx for the following symptoms:
–Sensations of catching or instability
Rotary instability
What is the Dx for the following symptoms:
–Posterior elbow pain during hyperextension
Valgus extension overload syndrome