Final Practical

Question 1

Proprioception vs. kinesthesia

Answer 1

Proprioception: awareness of static joint position

Kinesthesia: awareness of dynamic joint positions (involves spindles, ligaments and connective tissue)

Question 2

Modified Ashworth Scale (for muscle tone/spasticity)

Answer 2

0 - no increase in muscle tone
1 - slight increase in muscle tone; minimal resistance at end ROM
1+ - slight increase in muscle tone; catch then minimal resistance throughout the remainder of ROM
2 - increase in muscle tone throughout most of ROM, but limb moves easily
3 - passive movement difficult
4 - rigid

Question 3

DTR rating

Answer 3

0 - absent reflex
1+ - trace or seen only with reinforcement
2+ - normal
3+ - brisk/fast
4+ - non-sustained clonus
5+ - sustained clonus (>10 beats)

Question 4

Up beating vs. down beating nystagmus

Answer 4

Up beating nystagmus: posterior canal

Down beating nystagmus: anterior canal

Question 5

Canalisthiasis vs. cupulolisthiasis

Answer 5

Canalithiasis: crystals are in the semicircular canal (latency within 1-40 secs, lasts short in duration <1 min, nystagmus fluctuates in intensity)

Cupulalithiasis: crystals attached to the cupula (immediate, persistent in duration, no change in nystagmus intensity)

Question 6

How to do loaded dix hallpike test

Answer 6

-unaffected side first
-pt tucks chin, turns head 45 degrees toward affected side and extended
-hold pt in that position for 1 min because it determines if it’s canalithiasis