Final Exam Flashcards by Michelle Era

What are the Superficial Sensory Tests?

Pain
Light Touch
Pressure
Temperature

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How do you perform a sensory test for pain?

Poke the pt. in random spots on the skin with a sharp and dull object. E.g. sharp and dull side of a paper clip.
Can pt. distinguish between sharp and dull or feel either of the 2 objects at all

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How do you perform a sensory test for light touch?

Tap pt. with cotton ball on random spots of the skin (do not wipe)
Can pt. feel the light touch

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How do you perform a sensory test for pressure?

Firmly press the pt. on random spots of the skin with finger or thumb
Can pt. feel the pressure

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How do you perform a sensory test for temperature?

Tap pt.s with 2 test tubes (one filled with hot water and the other filled with cold water), on random parts of the skin
Can pt. distinguish between hot and cold or feel either of the 2 tubes at all

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Which type of test is used for loss of protective sensation in diabetic patients and those at risk for developing neuropathic fool ulcers?

Myofilament Testing

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What are the Deep Sensation Tests?

Proprioception
Kinesthesia
Vibration

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What does Proprioception testing test for?

Can the pt. distinguish which position a joint is in without looking?

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What are the Cortical Stimulations sensory tests?

Steriognosis
Two-Point Descrimination
Graphesthesia

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What can you have your pt. do before reflex testing to have them relax?

Clench teeth

- Jendrassik Maneuver (interlock fingers together in front of face and pull apart)

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What does a reflex score of 0 mean?

No response

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What does a reflex score of 1+ mean?

Minimal response, no joint movement

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What does a reflex score of 2+ mean?

Normal response

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What does a reflex score of 3+ mean?

Brisk response

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What does a reflex scort of 4+ mean?

Hyperactive response/clonus

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What does a reflex score of 5+ mean?

Sustained clonus

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What are the different reflex tests?

Biceps
Brachioradialis
Triceps
Quadriceps
Achilles

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What response does the Biceps Reflex test give and which nerve root innervates this muscle?

Elbow Flexion

- C5

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What response does the Brachioradialis Reflex test give and which nerve root innervates this muscle?

Elbow Flexion

- C6

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What response does the Triceps Reflex test give and which nerve root innervates this muscle?

Elbow Extension

- C7

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What response does the Quadriceps Reflex test give and which nerve root innervates this muscle?

Knee Extension

- L4

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What response does the Achilles Reflex test give and which nerve root innervates this muscle?

Ankle Plantarflexion

- S1

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What is the term used to describe a group of muscles that one spinal nerve innervates?

A Myotome

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What is the term used to describee the skin area that is supplied by the sensory fibers of a spinal nerve?

A Dermatome

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In terms of myotomes, what is the action and muscle innervated by C5?

"Stay alive" - Shoulder Abduction - Deltoid

In terms of myotomes, what is the action and muscle innervated by C5, C6?

"Pick up Sticks" - Elbow Flexion - Biceps

In terms of myotomes, what is the action and muscle innervated by C7?

"Up to heaven" - Elbow Extension - Triceps

In terms of myotomes, what is the action and muscle innervated by C8?

"Ulnar Deviate" - Ulnar Deviation - Flexor & Extensor Carpi Ulnaris

In terms of myotomes, what is the action and muscle innervated by L1, L2?

"Lift up your shoe" - Hip Flexion - Iliopsoas

In terms of myotomes, what is the action and muscle innervated by L3, L4?

"Kick the door" - Knee Extension - Quadriceps

In terms of myotomes, what is the action and muscle innervated by L4, L5?

"Up to the sky" - L4: Ankle Dorsiflexion: Anterior Tibialis - L5: Toe Extension: Extensor Hallicus Longus

In terms of myotomes, what is the action and muscle innervated by S1?

"The race has just begun" - Plantar Flexion/Eversion - Gastrocnemius

Which Dermatomes are on the UEs and where do they start and end?

- C5-T2 - C5 is on the lateral aspect of the humerus - T2 is on the medial aspect of the humerus

Where is the Dermatome for C7 located?

The 3rd digit up to the wrist

Which Dermatomes are on the LEs and where do they start and end?

- L2-S2 - L2 is on the anterior aspect of most of the lateral thigh and a third of the medial thigh - S2 is on the posterior aspect of the thigh

Where is the Dermatome for L3 located?

The Knees

Where is the Dermatome for L4 located?

The medial surface of the foreleg

Where is the Dermatome for L5 located?

The lateral surface of the foreleg to the first 3 toes

What is the ABC Scale?

- Activities-Specific Balance Confidence Scale | - It's a 16 question questionaire which measures your fall risk

What does a balance grade of Normal in Static mean?

Pt. is able to maintain balance with no support

What does a balance grade of Good in Static mean?

Pt. is able to maintain balance with no support, limited postural sway noted

What does a balance grade of Fair in Static mean?

Pt. is able to maintain balance with hand held support

What does a balance grade of Poor in Static mean?

Pt. requires support to maintain balance

What does a balance grade of Zero in Static mean?

Pt. requires Max Assistance to maintain balance

What does a balance grade of Normal in Dynamic mean?

Pt. accepts Maximal challenge and can shift weight in all directions

What does a balance grade of Good in Dynamic mean?

Pt. accepts Moderate challenge, can shift weight (although limitations are evident), and can reach to floor within BOS

What does a balance grade of Fair in Dynamic mean?

Pt. can tolerate only Minimal challenge, cannot maintain balance while weight shifting, but can rotate head L/R

What does the therapist look for when conducting coordination tests?

- Are the movements direct, precise, and easily reversed? - Do the movements occur in a reasonable amount of time? - Does speed affect the quality of the movement? - Is there extraneous movement, swaying, or oscillations?

What is Dysmetria?

The inability to jude distance

What is Dysdiadochokinesia?

The inability to perform rapidly alternating movement (supination/pronation)

What is a Tremor?

Involuntary oscillating movement

What is Akinesia?

The inability to initiate movement

What does a coordination test grade of WNL mean?

Pt.s actions are smooth and controlled

What does a coordination test grade of Impaired mean?

Pt.s actions are slow/jerky

What does a coordination test grade of Absent mean?

Pt. was unable to perform action

What does Reliability in terms of goniometry mean?

Does the instrument yeild the same results on repeated uses by either the same operator or different operators

What does Validity in terms of goniometry mean?

Does the tool measure what it's supposed to measure

What are the landmarks for measuring C-Spine Flexion/Extension with a tape measure?

From the chin to the suprasternal notch

What are the landmarks for measuring C-Spine Lateral Rotation with a tape measure?

From the Mastoid to the Acromion Process

What are the landmarks for measuring C-Spine Rotation with a tape measure?

From the Chin to the Lateral aspect of the Acromion Process

What are the landmarks for measuring L-Spine Flexion/Extension with a tape measure and what is another name for this method?

- From S2 to 15cm above | - The Schober Method

What are the landmarks for measuring Trunk Lateral Flexion with a tape measure?

- From the tip of the third finger to the floor - The difference in the tip of the third finger while standing upright and the tip of the third finger while laterally flexed

What are the landmarks for measuring Trunk Rotation with a tape measure?

From the Acromion to the Upper Iliac Crest in Midaxillary Line

What are the normal AROM measurements for the shoulder?

``` Flexion=180 Extension=60 Abduction=180 Adduction=0 Int Rot=70 Ext Rot=90 Hori Abd=45 Hori Add=135 ```

What are the normal AROM measurements for the elbow?

Flexion=150 | Extension=0

What are the normal AROM measurements for the forearm?

Supination/Pronation=80-90

What are the normal AROM measurements for the wrist?

Flexion=80 Extension=70 Radial Dev=20 Ulnar Dev=30

What are the normal AROM measurements for the hip?

``` Flexion=120 Extension=30 Abduction=45 Adduction=30 Inter Rot=45 Ext Rot=45 ```

What are the normal AROM measurements for the knee?

Flexion=135 | Extension=0

What are the normal AROM measurements for the ankle?

Dorsiflexion=20 Plantar Flexion=50 Inversion=5 Eversion=5

What are the normal AROM measurements for the TMJ?

Depression=35-50cm Occlusion=0 Protrusion=3-7mm Retrusion=10-15mm

What are the landmarks for measuring Trunk Flexion with 2 Inclinometers?

C7 and S2