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Treatments 5 > Final Review > Flashcards

Final Review Flashcards

1
Q

What is the most common type disc herniation?

A

Posterior or posterolateral

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2
Q

Positioning that would provide relief from various facet irritations in the L/S

A
  • Flexion, and contralateral lateral flexion. (moving away from irritation.)
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3
Q

What are the causes and triggers for Primary Raynaud’s?(both are the same)

A

Idiopathic

In secondary Raynauds, it is due to a secondary condition like TOS
Most common cause is Cold and Emotional Stress

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4
Q

What are the aims of treatment and techniques appropriate for a client with Chronic Bronchitis?

A

1) Decrease sympathetic NSF. Encourage diaphragmatic breathing
2) Reduce fascial restrictions
3) Stretch shortened muscles, reduce hypertonicity, reduce trigger points, reduce pain. Increase local circulation to flush out metabolites, mobilize thorax
4) Postural drainage to remove secretions

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5
Q

What are the causes of Varicose Veins?

A

Caused by impaired function of the venous valves

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6
Q

What are the contraindications of Varicose Veins?

A
  • Deep specific techniques
  • Local massage is CI’d for 24 hours after medical treamtnet
  • If Cx is taking Anticoagulant medication modify techniques and pressure
  • MT to the Legs is CI’d with DVT symptoms
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7
Q

List appropriate Homecare for varicosities.

A
  • Compression Stockings to help with the Venous Return o in the legs
  • Care is taken not to scratch the skin over the varicosities to prevent bleeding and ulceration
  • Standing in a cold foot bath, marching in place.
  • Elevated legs and feet at least 3 times a day for about 10 minutes
  • AF ROM like drawing the alphabet with your feet
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8
Q

What are the various degrees/levels of hypertension and what qualifies for each?

A 
Normal: 120/80
Low: 90 or less/60 or less
Pre-hyper: 130-139/85-89
Mild: 140-159/90-99
Moderate: 160-179/100-109
Severe: 180-209/110-119
Very Severe: 210+/120+
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9
Q

What is hypotension?

A

A decrease in the systolic and diastolic blood pressure below normal (90 or less/60 or less)
Following massage a client would be at risk for fainting due to a drop in BP.

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10
Q

What is the approach to treatment for a client who presents with Thrombophlebitis?

A
  • THIS IS NOT SOMETHING WE TREAT, RATHER A CONDITION WE MUST BE AWARE OF TO DETECT AND REFER OUT
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11
Q

What is Neurotmesis and the degrees?

A

3-5 (Poor Recovery - Worst)
- A severance to part or all of a nerve trunk. There are sensory, motor and autonomic losses (degeneration of axons) and it results in degeneration of the nerve. It required surgery and has a poor recovery prognosis. Muscle wasting is usually involved.

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12
Q

What is Axonotmesis and it’s degrees?

A

2 (Good Prognosis - Okay)
- A prolonged, severe compression with which there are sensory, motor and autonomic losses (degeneration of axons). It takes month to recover from this type of injury and no surgical treatment is necessary. There is muscle wasting involved but overall the prognosis is good.

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13
Q

What is Neuropraxia and it’s degrees?

A

1 (Good prognosis - Best)
- A loss of motor function only, but it presents as weakness (no sensory or autonomic involvement). This only happens with compression injuries. There is no structural damage to the nerve – no Wallerian Degeneration(nerve lesions or compression and the nerve distal to compression site degenerates) and it may require weeks to months for recovery but it has a good prognosis. (EX. Sitting on your wallet)

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14
Q

“lightning like”, often throbbing pain. No significant pathological change in the nerve. Characterized by a “trigger zone”, an area that causes attack when stimulated.

A

Neuralgia

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15
Q

What is the most common type of Neuralgia?

A

Trigeminal and Intercostal Neuralgia

Others: Phrenic, Lumbar, Brachial and Sciatic

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16
Q

What is the cause of Neuralgia?

A

Local compression and prolong exposure to cold

Local MT CI’d in Acute

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17
Q

List possible modifications necessary for clients with Klumpke’s Paralysis and for Erb’s Palsy

A

1) When client is in supine, ensure that there is no traction being placed on the nerve.
2) When client is in sidelying, place a pillow under the UNAFFECTED side to help place the head in a more neutral position.

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18
Q

What are the possible causes of Klumpke’s Paralysis

A

1) During birth: forceps or poor positioning – breech or legs first is the most likely cause in children
2) Falling from a height and grabbing onto something most likely cause in adults

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19
Q

What muscles are affected with Klumpke’s Paralysis

A

1) All of the Forearm Flexors
2) Exception of Brachioradialis which is overworked so it is tight
3) Weakness of Forearm Flexors or Atrophy depending on severity
4) Extensors are hypertonic and contractured with TP
* Claw Hand*

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20
Q

What are the possible causes of Erb-Duchenne Palsy?

A

1) Birth trauma: baby is pulled from the birth canal when the neck is extended, rotated and laterally flexed
2) Adults: trauma that violently separates neck & shoulder – shoulder depression with cervical contralateral lateral flexion
- MVA or Motorcycle accident
- Sports injury where person lands on head/shoulders

Chronic Microtrauma: Carrying heavy backpack for long period “Backpacker’s Palsy”

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21
Q

What muscles are affected with Erb-Duchenne Palsy?

A

Muscle wasting and motor dysfunction in all muscles above the elbow, especially abductors, external rotators and extensors as well as elbow flexors and forearm supinators.

1) Upper limb presents with “Waiter’s tip deformity”: (strap em down)
2) Adducted shoulder
3) Medially rotated arm
4) Extended elbow & forearm pronated
5) Wrist & fingers flexed

Tissue edema and dystrophy are not significant Sensory loss in:

  • C5 and C6 dermatome
  • Sensory deficits in the distribution of the axillary, musculocutaneous & radial nerves
  • Lateral aspect of the forearm (lateral antebrachial nerve – continuation of the musculocutaneous nerve
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22
Q

Describe the etiology for Pronator Teres Syndrome

A
  • Repetitive activities that irritate the pronator teres and compress the Median Nerve, like supination to pronation. (EX. Carpenter)
  • Blunt force Trauma to Pronator Teres
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23
Q

Describe the presentation for Pronator Teres Syndrome.

A

1) No nocturnal pain
2) Pain on resisted pronation
3) Tenderness at attachments
4) Pain in anterior forearm rather than wrist
5) Flexor retinaculum and distal is carpal tunnel,
6) Sensory innervation in mid forearm.
7) Carpal tunnel is weakness of thenar eminence

Presentation is similar to Carpel Tunnel Syndrome, the difference occurs not only in the thumb movement but in the wrist, index and middle finger flexion are also compromised as the median nerve innervates Palmaris Longus, Flexor Carpi Radialis and Flexor Digitorum Superficialis.

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24
Q

Sensory innervations/distributions to Sciatic

A

Motor: Hamstrings, Lower Leg and Foot
Sensory: Most of the anterior and posterior lower leg, Foot

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25
Q

Sensory innervations (L4-S2)

A

Sciatic

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26
Q

Motor innervations/distributions to Deep common Fibular/Peroneal

A

Motor: Extensors of the lower leg (Tib Ant, Extensor Digitorum Longus, Extensor Hallicus Longus and Brevis, Peroneus Tertius)

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27
Q

Sensory innervations/distributions to Superficial Common Fibular/Peroneal

A

Motor: Peroneus Longus and Brevis
Sensory: Skin distal to the anterior surface of the leg, most of the dorsum of the foot and toes

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28
Q

Motor innervations/distributions to Tibial

A

Motor: Gastrocnemius, Soleus, Planteris and Popliteus, Tib Post, Flexor Hallicus Longus and Flexor Digitorum Longus.

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29
Q

Sensory innervations/distributions to Sural

A

Sensory: Skin of the lateral and posterior part of the inferior third of the leg and the lateral side of the foot.

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30
Q

Sensory innervations/distributions to Median

A

Motor: Anteromedial compartment of the forearm and hand: Flexor carpi ulnaris, medial ½ flexor digitorum profundus, hypothenar muscles of central compartment (except lumbricals 1&2), adductor pollicis and flexor pollicis brevis (1/2).

Sensory: Anterior and posterior sides of ½ digit #4 and all of digit #5 and palm in line isolated supply = little finger -5th to the wrist.

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31
Q

Sensory innervations/distributions to Radial

A

Motor: Posterior brachium/Posterior antebrachium muscles – Extensors, Abductors and Supinators

Sensory: Posterior skin of the arm/forarm- dorsal surface of digits 1, 2, 3 and the lateral half of digit 4 (excluding the fingertips)

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32
Q

Sensory innervations/distributions to Ulnar

A

Motor: Anterior medial compartment ( flexor cari ulnaris, medial 1/2 flexor digi Profundus, Hypothenar mm

Sensory: Ant/Post side of 1/2 #4 & #5 digit

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33
Q

What muscles are innervated by the Median

A

1) Pronator Teres
2) Flexor Carpi Radialis
3) Flexor Digitorum Superficialis
4) Flexor Digitorum Profundus (radial or lateral half); Innervation is shared with the ulnar nerve
5) Palmaris Longus – this muscle is absent in 20.4 % of the population
6) Flexor Pollicis Longus
7) Pronator Quadratus
8) Thenar Muscles:
- Abductor Pollicis Brevis
- Opponens Pollicis
- Flexor Pollicis Brevis
- First and second Lumbricals

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34
Q

What muscles are innervated by the Ulnar?

A

1) Flexor Carpi Ulnaris
2) Flexor Digitorum Profundus (ulnar or medial half), innervation is shared with the median nerve
3) Hypothenar Muscles:
- Abductor Digiti Minimi
- Flexor Digiti Minimi
- Opponens Digiti Minimi
- Third and fourth Lumbricals
- Palmar and Dorsal Interossei
- Adductor Pollicis
- Flexor Pollicis Brevis (deep head), innervation is shared with the median nerve

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35
Q

What muscles are innervated by the Radial?

A

1) Extensors and Brachioradialis
2) Triceps
3) Anconeus
4) Brachioradialis
5) Extensor Carpi Radialis Longus and Brevis
6) Supinator
7) Extensor Digitorum
8) Extensor Carpi Ulnaris
9) Extensor Digiti Minimi
10) Extensor Pollicis Longus and Brevis
11) Abductor Pollicis Longus
12) Extensor Indicis

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36
Q

Explain the process of differential assessment of Carpal Tunnel versus Pronator Teres Syndrome. (Motor, Sensory, Assessment Findings/Special Tests)

A

Rule out Carpal Tunnel (Negative result)

  • Phalen’s
  • Reverse Phalen’s
  • Tinel’s at the Wrist
  • Pronator Teres Test
    • Carpal Tunnel DOES NOT involve the palm of the hand and the forearm flexors DO NOT exhibit muscle weakness**

Rule out Pronator Teres:

  • Pain over Anterior surface of forearm by repeated elbow/forearm pronation
  • Paresthesia over lateral palm, thumb, index, middle and lateral 1/2 of ring finger
  • Weakness of Pronate group, forearm and finger flexors
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37
Q

Describe the location of the Flexor Retinaculum in both the ankle and wrist

A

From the Hook of Hamate to the tubercle of Trapezium and the Scaphoid to the Pisiform

Foot : posterior from medial malleolus to lateral malleolus.

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38
Q

What is the timeline for nerve regeneration?

A

Regeneration of the nerve occurs at a rate of approximately 1-2mm a day.
28-52mm/month

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39
Q

Review the pathways (general understanding) of the median nerve?

A

Main Significant points that it passes through and under.

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40
Q

At which anatomical location does the Sciatic Nerve bifurcate/branch?

A

The Popliteal Fossa

Common Fibular and the Tibial Nerve

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41
Q

Thumb is in line with the plane of the hand rather than being Abducted. It is associated with Complete Median Nerve Lesions.

A

Ape Hand

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42
Q

Presentation of hand with Ulnar Nerve Lesions.

A

Bishop’s Hand and Claw Hand

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43
Q

person attempts to make a fist. The person cannot perform this
action because only the third and fourth digits can be flexed. There is a loss of
Thenar Flexors and Opponens Pollicis, as well as most of the flexors of the index and
middle fingers. Associated with a complete Median Nerve Leasion.

A

Oath Hand

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44
Q

Associated with Erb’s Palsy.

A

Waiter’s Tip Hand

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45
Q

What is the purpose of Tinel’s at the elbow?

A

Indicates an irritated Ulnar Nerve and indicates how far the nerve has regenerated. You will feel the parenthesis in certain portions. Use it to help confirm Ulnar Nerve Palsy. Sensory is the 5th and medial ½ of the 4th digit.

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46
Q

What is the purpose of Tinel’s at the wrist?

A

Indicates an irritated Median Nerve and Carpel Tunnel Syndrome and represents as a tingling or numbness

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47
Q

What are treatment goals/aims and techniques for flaccid paralysis

A

Treat Contracture of the Opposing Muscles (ex. Flaccid Flexors means Contractured Extensors)

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48
Q

Consider stretching and strengthening for various stages and types of nerve lesions
Radial:

A

Strengthen: Extensors will be weak as well as Brachiradialis
Stretch: Forearm Flexors

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49
Q

Consider stretching and strengthening for various stages and types of nerve lesions Ulnar & Median:

A

Strengthen: Forearm flexors as they will be weak
Stretch: Forearm Extensors

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50
Q

3 kinds of Thoracic Outlet Syndrome

A

1) Pec Minor Syndrome – cause tight pec minor pushing your nerves against the coracoid process
2) Anterior Scalene Syndrome – cause is tight anterior or middle scalene, or both
3) Costoclavicular Syndrome – caused by a tight subclavius or compression by the clavicle

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51
Q

Goals for TOS

A

Decrease Hypertonicity of Muscles that are tight
Decrease Fascial Restrictions
Improve Tissue health

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52
Q

Remedial Exercises for TOS

A
  • Stretch the Scalenes, Pec Minor, Pec Major and Subclavius

- Strengthen the muscles that pull the shoulders back and unround the shoulders

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53
Q

What is the trigger point referral for Gluteus Medius, Quadratus Lumborum, Tensor Fascia Lata and Piriformis Muscles?

A

Glute Med: Pain over the lower back, the SI joint, medial butt and lateral hip and down the leg.

QL: pain in the lateral hip, SI Joint and Inferior portion of the Gluteal area

TFL: refers to the Greater Trochanter into the Iliotibial band

Piriformis: Pain may radiate into SI Joint, over the Butt and hip and may extend over the posterior thigh.

Glute Min: Pseudosciatica Pain over the buttock, down the posterior thigh, past the knee and sometimes the lateral leg to the lateral malleolus.

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54
Q

Pseudosciatica Pain over the buttock, down the posterior thigh, past the knee and sometimes the lateral leg to the lateral malleolus.

A

Glute Min

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55
Q

Describe causes and subjective/ findings for a client with Piriformis Syndrome

A

1) Pain the butt from the lateral border of the sacrum to the Greater Trochanter
2) Sciatic like symptoms right down to the foot
3) Sciatic like symptoms in nerve (tingling and symptoms)

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56
Q

Describe causes and objective findings for a client with Piriformis Syndrome.

A

1) External Rotation of the Femur
2) Not comfortable sitting on affected side
3) Prone to crossing Legs
4) Walk with a limp

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57
Q

What is the isolated sensory area of the radial nerve?

A

The Dorsal web space of the hand between the 1st and 2nd digits

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58
Q

What are the possible causes of Bell’s Palsy? Describe possible subjective/objective findings.
Idiopathic

A

Autoimmune or Edema (compression)
Pregnancy
Hitting your head

Sx & Sx:

  • Issues closing their eye
  • One side of the mouth drops on the same side and the droopy eye
  • Sensory impairment
  • Autonomic Phenomenon with tearing of the eye
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59
Q

What is Trigeminal Neuralgia?

A

Nerve pain of the Trigeminal Nerve
Triggers: Touch to face, eating, food in mouth, heat or cold
People with this condition are often more prone to depression, anxiety and suicidal thoughts

Trigeminal is more pain related versus Bell’s Palsy has more of look of pain

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60
Q

How does Trigeminal Nerve differ from Bells Palsy

A

Trigeminal is more pain related versus Bell’s Palsy has more of look of pain

Bells Palsy Affects the Cranial Nerve 7 (facial Nerve), Trigeminal Neuralgia affects Cranial Nerve 5.

Chovostek’s Test: Tap over the parotid Gland

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61
Q

What nerve roots do the Ulnar, Median, Radial and Sciatic Nerves originate from?

A

Ulnar: C8-T1
Median: C5-C8/T1
Radial: C5-T1
Sciatic: L4-S2

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62
Q

What are Claw Toe and Drop Foot?

A

Drop Foot: A sciatic Nerve involvement, inability to dorsiflex the ankle.
Claw Toe: Hyperextension of the MTP as a result of Tibial Nerve Lesion

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63
Q

What is Intercostal Neuralgia and what causes it?

A

It is Nerve pain in the Intercostal space, usually one space but can be multiple at one time.
Causes:
- Rib subluxations
- Blunt Force Trauma to the thorax
- Shingles (Complication: Pain can remain for up to 2 years known as Post Herpetic Neuralgia)
- Herpes

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64
Q

Gastrocnemius and Soleus muscles are innervated by which nerve(s)?

A

Tibial Nerve

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65
Q

How does DDD/Herniation/Prolapse effect peripheral nerves?

A

Puts Pressure on the Nerve Root

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66
Q

Shingles is most commonly present in which nerve(s)? What nerve is less commonly affected but it can be affected in rare cases? What is a possible complication to Shingles?

A

Most common present in the Intercostal Nerve and Trigeminal Nerve

The Optic Nerve can be Affected in rare cases

Complication: Pain can remain for up to 2 years known as Post Herpetic Neuralgia

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67
Q

Review the Deep Tendon Reflexes.

A

LOOK THESE UP **

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68
Q

A young person who has trigeminal neuralgia may be at risk for what autoimmune condition?

A

Multiple Sclerosis

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69
Q

Review Myotomes and Dermatomes.

A

LOOK THESE UP**

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70
Q

Trigger point (MTP) referral patterns for Scalene?

A

Lateral upper arm/forearm, Extensor surface of thumb and index finger

71
Q

Trigger point (MTP) referral patterns for Brachiallis?

A

Distal Thumb and Wrist

72
Q

Trigger point (MTP) referral patterns for Brachioradialis?

A

Thumb at the web and radial forerarm

73
Q

Trigger point (MTP) referral patterns for Opponens Pollicus?

A

Radial palmar wrist and thumb

74
Q

Trigger point (MTP) referral patterns for Adductor Pollicus?

A

Thumb and Thenar eminence

75
Q

Trigger point (MTP) referral patterns for Palmaris Longus?

A

To the palm

76
Q

Trigger point (MTP) referral patterns for Subscapularis?

A

Palmar and Extensor wrist surface

77
Q

Trigger point (MTP) referral patterns for Flexor Carpi Radialis?

A

Mid-palm and wrist

78
Q

Trigger point (MTP) referral patterns for Pronator Teres?

A

Forearm and Radial Palmar wrist

79
Q

What are Baroreceptors and where are they located?

A

Detect pressure, located in walls of carotid arteries and aorta

80
Q

What are Chemoreceptors and where are they located?

A

Detect chemical changes, located in carotid and aortic bodies

81
Q

Modifications for client with CHF?

A 
No prone for longer than 10 min
Avoid abdominal pillow
Take blood pressure before treatment
No long strokes
Elevate head above heart in supine
82
Q

Which vein is most commonly affected by varicose vein?

A

Great Saphneous

83
Q

What is Raynauds Disease?

A

Arterial spasms and symptoms are similar to Raynauds Phenomena
Idiopathic in nature

84
Q

What causes Raynauds Disease attack?

A

Extreme cold or Emotion

85
Q

Define Raynauds Phenomenon?

A

Peripheral vascular disorder affecting blood vessels outside the heart and throax

86
Q

Raynauds Phenomenon occurs secondary to what?

A

1) Obstructive Arterial Disease
2) Connective Tissue Disorder
3) Drug Side Effects
4) Other vascular disorders

87
Q

What makes up the Upper Resp Tract? Purpose?

A

Nasal cavity and Pharynx

Moisten and warm air

88
Q

What makes up Lower Resp Tract and its purpose?

A

Air into Alveoli

Gas Exchange

89
Q

How many lobes do Left and Right Lung have? Fissures?

A

Left: 2 Lobes, 1 Fissure
Right: 3 Lobes, 2 Fissure

90
Q

Explain position for the 3 postural Drainage?

A

Upper: Seated position
Middle: Supine with right side higher supported by pillow
Lower: Prone, hips raised 45 degree

91
Q

What technique is most beneficial to end treatment for somebody with respiratory condition?

A

Soothing effleurage and stroking to finish or Postural Drainage

92
Q

Homecare Technique for Respiratory Conditon

A
  • Breathing Exercise
  • Stretching to postural muscles
  • Facial Steams
  • DDB
93
Q

List and Describe the 4 Paranasal Sinsuses?

A

1) Ethmoid: Behind the eye
2) Sphenoid: Relatively large, deep behind the eye
3) Frontal: Drain into top of nasal cavity above the nose
4) Maxillary: Present at birth (Largest) - Found in Maxilla

94
Q

How would you perform trans illumination test?

A

Maxillary: Flashlight against roof of the mouth
Frontal: Flashing against Medial aspect of orbital margin (corn of bridge of nose/eyebrow)

95
Q

How does OA, FJI and Disc Herniation become connected?

A

OA leads to FJI due to biomechanics of pain can then lead to poor posture, which leads to DDD

96
Q

What is primary OA?

A

Idiopathic

Due to age, wear and tear, Genetics

97
Q

What is Secondary OA?

A

Identifiable cause such as trauma/pathology leading to degeneration of cartilage

98
Q

What is an Osteophyte?

A

Cartilage becomes ossified become osteophytes/bone spurs

99
Q

What condition of the spine may result from Hyperlordosis?

A

OA

  • Joint in closed pack position (bone on bone)
  • Wear and tear cartilage
  • Higher risk develop FJI and DDD
100
Q

At what age does OA become more common?

A

Over the age of 40

101
Q

What ROM is CI’d with OA?

A

NO PF ROM

102
Q

How does massage therapy help with OA?

A

It won’t stop progression but will help slow it down and relief/keep mobile

103
Q

What grades of joint mobs are CI’d with Osteophyte formation?

A

No grade 3 or 4

104
Q

What is the function of the Zygapophyseal Joint? (Facet Joint)

A

Direct and control the degree of vertebral movement

105
Q

Describe movement of Zygaphopaseal Joints allowed in each section?

A

1) Cervical: Transverse Plane
- High degree of rotation and flexion/extension

2) Thoracic: Coronal Plane
- Rotation is greatest of the movement

3) Lumbar: Sagittal Plane
- Most in Flexion, then Extensions, then Lateral Flexion and then Rotation

106
Q

Describe Function of Spinal Ligaments

A

1) Supraspinous Lig: Runs from each SP on the tip
- Prevents Hyperflexion of spine

2) Interspinous Lig: Betweent he SPs
- Prevents Hyperflexion of spine

3) Nuchal Lig: Inion to C7 in Cervical Spine
- Prevents Hyperflexion of CS

4) Intertransverse Lig: Between TVP’s
- Limits Side Bending and Rotation

5) Ligamentum Flava: Inside Vertebral Canal
- Straightens the spine from flexed position

107
Q

What is the function of the IVD?

A

Supports weight, allows movement

108
Q

Describe the Nucleus pulposus

A

Central core, jelly like core that is shock absorber

109
Q

Describe Annulus Fibrosis

A

Outer ring of fibrous cartilage that surround nucleus pulposus

110
Q

What is the location and function of ALL(Anterior Longitudinal Ligament)

A

Found on anterior surface of Vertebral body

- Prevents hyperextension

111
Q

What is location and function of PLL (Posterior Longitudinal Ligament)

A

Posterior surface of the Vertebral body

- Prevents hyperflexion

112
Q

Define DDD

A

Degeneration of Annulus Fibrosis of IVD

113
Q

Define Disc Prolapse

A

Nucleus pulpous pokes through the Annulus Fibrosis

114
Q

What is Disc Herniation?

A

Annulus Fibrosis tears and the pulposus can leak outside

115
Q

At which level do 98% of low back injuries occur?

A

L4-L5 & S1-S2

Shooting pain down legs

116
Q

What is term for “slipped disc”

A

Herniated Disc

117
Q

What is the most common type (direction) of acute disc Herniation?

A

Or posterior / posteriolateral.Look up***

118
Q

If movement towards painful side increase pain, what is involved?

A

Nerve Root

119
Q

If movement away from painful side increase pain, what is involved?

A

FJI

120
Q

Which position would relieve pain associated with FJI?

A

Flexion and Contralateral Rotation

Extension and Ipsilateral Rotation would irritate it

121
Q

Which nerve root is involved in Bell’s Palsy?

A

Facial Nerve #7

122
Q

What are sx & sx Belly’s Palsy

A

1) Paralysis of eye
2) Can’t blink
3) Can’t do facial expressions
4) Droopy of side of the face
5) “Not painful”

123
Q

What factors can affect prognosis of Bell’s Palsy?

A 
80% chance of recovery in 6 months
Risks: 
1) Age above 55
2) Hypertension
3) Complete Facial Paralyis
4) Crocodile Tears
124
Q

What is Wallerian Degeneration?

A

Axon or myelin degenerates distal to lesion

125
Q

Describe how Before Geniculate Ganglion, Between Ganlion and Stlyomastoid and After Sylomastoid affect Bell’s Palsy

A

1) Before Geniculate Ganglion
- Motor, Sensory and Autonomic function affected

2) Between Ganglion and Stylomastoid Foramen
- Motor loss, and varying degrees of sensory/autonomic loss

3) After Stylomastoid Foramen
- Only motor affected

126
Q

CI’s for Bell’s Palsy

A

1) Prone
2) Don’t touch/poke eye
3) No drag away from lesion
4) Stabilize head w/ pillows

127
Q

What type of hydro is appropriate for Bell’s Palsy

A

Cool wash or warm

No extremes

128
Q

Which direction do you direct pressure during Bell’s Palsy

A

Towards the lesion

129
Q

Describe motor re-education for Bell’s Palsy

A
  • Practice vowels
  • Nostril flaring
  • Help move eye (AA ROM)
130
Q

Compression @ 2 different places @ the same time

A

Double crush syndrome

131
Q

Which nerve roots comprise the brachial plexus

A

C5-T1

132
Q

What is Thoracic Outlet?

A

Condition that involves compression of brachial plexus and accompanying artery

133
Q

Which nerve is compressed with CTS?

A

Median

134
Q

What structures travel through Carpal Tunnel?

A

1) 4 Tendons of Flexor Digitorum Superficiallis
2) 4 Tendons of Flexor Digitorum Profundus
3) Tendon of the Pollicus Longus

135
Q

Compression happen through the Carpal Tunnel how?

A
  • Tunnel decreases

- Structures passing through tunnel increases

136
Q

How does pregnancy increase likelihood of CTS?

A

Higher due to edema and fluid buildup

137
Q

What vitamin deficiency can cause CTS?

A

Vitamin B6

138
Q

Describe 3 possible sites for Pronator Teres Syndrome Compression

A

1) Between 2 heads of Pronator Teres muscle
2) Bicipital Aponeurosis
3) Ligament of Struthers

139
Q

How long after steroid injection should you avoid local massage?

A

10 and 21 days

140
Q

Which peripheral nerve is longest and strongest in the body?

A

Sciatic

141
Q

Which area does Sciatic nerve supply sensory function?

A

Lower Leg (Ant and Post)

142
Q

What is function of the Sural Nerve?

A

Supplies to the Inf 1/3 of Leg and Lateral side of foot

143
Q

2 Branches of Peroneal Nerve?

A

1) Superficial

2) Deep

144
Q

Which muscle are innervated by the Sciatic nerve?

A

Half of the Adductor Magnus

145
Q

Foot drop is present with which nerve lesion?

A

Complete Sciatic Nerve

146
Q

Claw toe is present in which type of nerve lesion?

A

Tibial Nerve

147
Q

What muscle with be weak with AR ROM in Sciatic, Tibial and Peroneal?

A

Sciatic: Hamstring
Tibial: Plantarflexor, Invertor
Peroneal: Dorsiflexion, Evertor

148
Q

Compression of Sciatic nerve surrounding Piriformis muscle

A

Piriformis Syndrome

149
Q

Prolonged initiation of damage of Sciatic Nerve resulting in inflammation of nerve

A

True Sciatic

150
Q

Occupations likely to develop Piriformis

A

1) Sitting long periods (Truck driver, office worker)

2) Dancers who are externally rotated

151
Q

Causes of Peripheral Nerve Lesion

A

1) Compression
2) Trauma
3) Systemic Disorder
4) Systemic Edema

152
Q

Inflammation of Nerve, constant pain

A

Neuritis

153
Q

Burnin sensation/pain

A

Causalgia

154
Q

Spontaneous burning pain syndrome affecting the limb beyond the nerve injury caused by trauma/surgery

A

Reflex Sympathetic Dystrophy

155
Q

Motor supply of Radial Nerve

A

Posterior Brachium - Posterior Antebrachium

Extensors, Supinators

156
Q

Sensory supply of Radial Nerve

A

Posterior skin of Arm/forearm

- Dorsal side of digits 1,2,3 and lateral 1/2 4th

157
Q

Wrist drop is present in what nerve lesion?

A

Radial nerve lesion

158
Q

Motor supply of Ulnar Nerve

A

Anteromedial compartment

- Flexors, Hypothenar Eminence

159
Q

Sensory supply of Ulnar Nerve

A

Ant/Post side of 1/2 digit #4 and all 5th

160
Q

Isolated supply of Ulnar Nerve

A

5th finger to wrist

161
Q

Claw Hand is present in what nerve lesion?

A

Ulnar Nerve lesion

162
Q

What nerve roots make up Median Nerve

A

Median: C8-T1
Lateral: C5-C7

163
Q

Motor supply of Median Nerve

A 
Anterior Antebrachium (Anterolateral)
- Thenar Eminence, Lumbrical #1 & 2
164
Q

Sensory supply of Median Nerve

A

Palmer surface of digits 1,2,3, and 1/2 4th

165
Q

Isolate supply of Median Nerve

A

Distal to 2nd & 3rd fingers

166
Q

Ape Hand/Oath Hand present in what nerve lesion?

A

Median Nerve Lesion

167
Q

Nerve’s affected with Klumpke’s

A

C8-T1

168
Q

Complication of Klumpkes that are affected on the same side, contraction of pupil, droopy eyelid and eye socket can sink in

A

Horner’s syndrome

169
Q

What is presentation of Klumpke’s paralysis

A

Claw Hand

170
Q

What nerve is affected by Erb-Duchenne

A

C5-C6

171
Q

Which Cranial Nerve is affected by TN?

A

Nerve #5

172
Q

What 4 Foramen does TN pass through?

A

1) Supraortibal Notch
2) Infraorbital
3) Zygomatic Facial
4) Mental

173
Q

How long can Intercostal Neuralgia last?

A

Up to 2 years

Treatments 5 (2 decks)

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