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Lab Practical Exam > Lab Exam > Flashcards

Lab Exam Flashcards

1
Q

Pain Sensation what tool do we use to assess pain, and what manner?

A

Sterilized safety pin.

Alternating randomly between the sharp and dull side of the safety pin.

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2
Q

True or False. Patient sight does not have to be occluded during pain sensation testing?

A

False.

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3
Q

What does a patient have to do to when is being tested for pain sensation?

A

Indicate if it is the sharp or dull following application

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4
Q

Correct response to pain sensation means?

A

intact protective sensation

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5
Q

Incorrect response to pain sensation means?

A

Absent of protective sensation

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6
Q

How do we test for temperature awareness ?

A

Apply rest tubes filled with hot or cold fluid to areas of hand/UE.

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7
Q

What does the patient have to do when is being tested from temperature awareness?

A

Indicate if tube is hot or cold

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8
Q

Correct response to temperature awareness means?

A

Intact temperature awareness

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9
Q

InCorrect response to temperature awareness means?

A

Absent of temperature awareness.

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10
Q

What static two point discrimination test for?

A

Receptors density and mapping for improvement following nerve repair

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11
Q

How do we begin the test for TPD?

A

Test the fingertips with light pressure, stop when skin begins to blanch.
Randomly test one or two points on the radial and ulnar aspects of each digits fro 10 applications.

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12
Q

At what distance btween each pin do we begin with TPD?

A

Begins with distance of 5 mm between testing points

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13
Q

What patient respond should be when testing TPD?

A

Responds with 1 or 2 or I don’t know

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14
Q

True or False.7/10 correct responses at that number of millimeters of distance between 2 points can terminate the test as it normal senation?

A

True

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15
Q

1-5 mm indicates?

A

Normal 2 point

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16
Q

6-10 mm indicates?

A

fair static 2 point

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17
Q

11-15 mm indicates?

A

poor static 2 point

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18
Q

1 point perceived indicates what?

A

Protective sensation only

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19
Q

No point perceived indicates what?

A

Anestheric area.

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20
Q

What do we beging with Moving Two Point testing?

A

Begin with distance of 8 mm between points

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21
Q

Moving Two Point how does testing look like?

A

randomly select 1 or 2 points and move proximal to distal on the distal phalanx parallel to the longitudinal axis of the finger (so adjacent nerves are not stimulated)

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22
Q

Moving Two Point if patient responds correctly what do we do?

A

decrease the distance between points

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23
Q

What responses should be in place during Moving Two Point

A

1, 2, or I dont know

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24
Q

how many times does patient have to respond Moving Two Point to be terminated ?

A

7/10

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25
Q

2-4 mm ages 4-60?

A

normal

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26
Q

4-6mm ages 60+?

A

normal

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27
Q

What does monofilament testing measures?

A

Light and deep touch

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28
Q

Light touch is important for ?

A

fine discriminatory hand use

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29
Q

Deep touch is important for?

A

Protective sensation

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30
Q

With whom is monofilament testing good to use with ?

A

nerve entrampments

31
Q

True or False? Monofilaments come in a set of 20 or a screen kit of 5?

A

Ture

32
Q

Monofilaments are color coded why?

A

To correspond to threshold caregories

33
Q

What Monofilamet should we start with ?

A

1.65

34
Q

What is the procedure of Monofilament testing ?

A

Start with 1.65
apply for 1 - 1.5 sec (it should bend)
Lift for 1 -1.5 sec
Repeat 3 times in the same spot for filaments 1.65 to 4.8
Filaments higher then 4.08 are only applied once
Randomly select areas in the hand to test

35
Q

What should the patient say during monofilament testing?

A

Pt says touch when they feel the monofilament

36
Q

What do you do if patient feels or does not feel the monofilament?

A

Record the number on the ahnd grid if the pt does NOT perceive filament proceed to the next thicker monofilament up to 6.65.

37
Q

Green Indicates?

A

Normal light touch 1.65-2.83

38
Q

Blue Indicates?

A

Diminished light touch 3.22-3.61

39
Q

Purple Indicates?

A

Dminished Protective senstation 3.84-4.31

40
Q

Red Indicates?

A

Loss of protective sensation 4.56-6.65 loss of protective sensation

41
Q

Untestable indicates?

A

inability to feel the largest monofilament.

42
Q

Grip Testing what is the process ?

A

Should be measured with a calibrated dynamometer

Second rung of the dynamometer is used for standard testing (if different used it should be documented)

43
Q

How many trials do we have to have when measuring grip testing?

A

average of 3 trials should be scored (unless painful).

44
Q

Grip Testing How is it calculated ?

A 
Average of 3 trials 
Grip held for 3 seconds 
15 seconds intervals between traisl 
Compare to uninvolved side 
Compare to established norms.
45
Q

What is the standard position during grip testing?

A

Patient seated with arm adducted at side
Elbow flexed to 90, forearm in neutral, wrist at 15-30 of extension and 0-15 ulnar deviation
Patient instructed to squeeze as hard as possible
Therapist gently supports the base of the dynamometer

46
Q

Dynamometer 5 rungs measure?

A

1st measures intrinsics
2nd standard grip
3rd someone has a large hand
4th and 5th rung extrinsic strength.

47
Q

Pinch Testing what are they?

A 
2 point pinch (tip to tip)
3 point pinch (3 jaw chuck)
Lateral pinch (key pinch)
48
Q

Pinch testing position

A

patient seated,
elbow flexed 90 degrees
arm abducted at side
forearm neutral

49
Q

What observation of edema consist of ?

A 
Visualization, color, location 
touch; temperature, rebounding/pitting 
Sings and symptoms of infection 
open areas
scarring
50
Q

What volumetry of edema consist of ?

A

Volumeter, beaker and 500ml graduated cylinder

51
Q

Figure of eigth methods uses what?

A

tape measure

52
Q

Circumferential measurement uses what?

A

Use of tape measure of circumferential measurement device

53
Q

what is going on in the sage of Acute edema?

A

Transudate edema
COnsist of excess H2O and electrolytes
pits and rebounds

54
Q

what is going on in the sage of Sub-Acute edema?

A

Consits of large plasma proteins: is viscous

Slow to rebound after pitting

55
Q

what is going on in the sage of Chronic edema?

A

Indurated edema is hard and nonpitting

Fibrotic - consists of large plasma proteins that have been trapped over time.

56
Q

Figure of Eigth Method ?

A

Begin at the distal wrist crease of the palmar side of the wrist .
Wrap tape measure In an ulnar direction
Bring the tape diagonally across the dorsum of the hand to the 2nd MCP joint
The tape was then wrapped across the ventral surface of the 5th MCP joint
Continure over the palmar crease of the 5th digit brining the tape back across the dorsum surface to the starting point.

57
Q

What factors may influence results of volumetry ?

A

Time of day
Exercise
Forearm position
Water temp

58
Q

Citcumferential measurement consist of?

A

Using flexible tape measure or finger circumference gauge
Wrap tape measure around body part
Use bony landmarks to and document accurately increase retest reliability
Dont allow tape measure to dig into skin

59
Q

What are edema treatments?

A 
Low stretch bandages 
Self-adherent wrap (coban)
Kinesotaping 
Chip bag
Exercise
Edema gloves
Manual edema mobilization
60
Q

Exercises for Edema?

A

Diaphragmatic breathing
Should start at the trunk
low level aerobic exercises
followed by shoulder/elbow ROM, wrist/hand fisting overhead

61
Q

Treatement of Edema; Cold?

A

Initiates vasoconstricion causing decreased outflow.
should not be <59 15C
Percaustions are? nerve damage, impaired sensation, digit replantation

62
Q

Treatement of Edema; Elevation?

A

Decreased outflow via decreasing arterial hydrostatic pressure
Stimulates lymph flow via increasing hydrostatic pressure
Position of hand: Elbow above shoulder, wrist above elbow, hand above wrist, ELbow should not be in extreme flexion
Precautions: digit replantation R side hemiparesis L stroke.

63
Q

What type of compression garment we have?

A

Elastic gloves, stockinette, and coban wrap

64
Q

Treatement of Edema; Compression

A

Light compression increases the absorption of small molecules in fluid
Too tight will restrict fluid flow causing more edema.

65
Q

Treatement of Edema; Chip bag

A

For small localized edema

Compression depends on mix of foam.

66
Q

Treatement of Edema; Retrograde massage

A

Light stokes working distal to proximal

67
Q

Treatement of Edema; Manual Edema Mobilization

A

Used to reduce subacute edema. ONly regular edema in subacure or chronic stage
Light massage is provided to prevent collapse of the lymph pathways

68
Q

What are contradications to Manual Edema Mobilization?

A 
Infections
areas of inflammation 
Hematoma or clot
Active cancer 
CHF, severe cardiac or pulmonary problem 
Renal failure 
Primary lymphedema or lymphedema from mastectomy 
wounds
69
Q

Treatement of Edema; Kinesotape

A

Promotes absorption of large and samll molecules via increasing the available space between skin and connective tissue
Creates a pull on the anchor filaments in the lymphatic system

70
Q

Treatement of Edema; Pump Point Stimulation (MEM)

A

Simultaneous, synchronous movement of therapist two hands in a U pattern over areas of lymph bundles
Therapist does 20-30 U’s in one area before proceeding to the next area of pump points.
NEED TO BE TRAINED

71
Q

U hand movement pattern..

A

Pattern of hand on skin
Very light pressure
Pulls skin lightly distal then circles back up and around

72
Q

Clearing U’s skin Tractioning Pattern

A

Start proximal and moves to the distal part of the limb

Minimum of 5 Us are done in 3 sections to create interstitial pressure changes

73
Q

Flowing U’s Lymp Movement Pattern

A

Distal moves prximal
Moving one U after another from distal to proximal is repeated 5 times
The flowing U pattern is performed all the way to the contralaterl upper quadrant
Followed by active muscle contracion in each segment.

Lab Practical Exam (1 decks)

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