Lab final: Test A Flashcards
Mental Status Evaluation: Orientation test
Ask patient to recall their NAME, LOCATION, & the DATE.
Mental Status Evaluation: Abstraction test
Ask patient to INTERPRET a proverb or colloquialism:
Happy as a tick on a fat dog.
Sensory Exam: Pain Sensation test
Instruct patient to say “now” when they feel something. Touch 5 points on each extremity with pin of NEUROTIP.
Sensory Exam: Barognosis test
“Can you tell me what the difference is between these two objects?”
Two objects of same size; different weights.
Motor Exam: Passive ankle motion test
Dorsiflexion, Plantarflexion, Inversion, Eversion
Motor Exam: Muscle test Biceps
Push down on forearm, patient resists motion.
Coordination & Gait: Patting test
AKA?
AKA Diadochokinesia:
Patient pats their legs as fast as possible in ALTERNATING, rhythmic movements
Coordination & Gait: Finger nose test
AKA?
AKA Dysmetria:
Patient touches Dr.’s finger then their own nose alternating in ALL FOUR QUADRANTS.
Superficial Reflex: Interscapular
Arching stroke on medial side of each scapula w/ handle of reflex hammer.
response: drawing inward of scapular when skin or interscapular space is irritated
afferent: T2-T7 spinal nerves
integrating: T2-T7 spinal cord
efferent: dorsal scapular N
Visceral Reflex: Cilliospinal
Pinch skin & a little of trapezius over nerve exit area and watch for PUPIL DILATION.
response: pupillary dilation when examiner pinched the base of the neck at the cervical symp chain
afferent: cervical symp chain
integrating: T1-T2 spinal cord
efferent: cervical symp chain
Deep Tendon: Achilles
Strike achilles w/ flat side of hammer.
Patient: 1) Prone with knee bent 90* and slight dorsiflexion.
2) Standing with knee bent on chair.
response: foot plantar flexion
nerve: tibial
integrating center: S1,2 spinal cord
Pathological: Babinski
Scrape sole of foot lateral to medial (starting @ heel) using handle of hammer. Babinski sign present when big toe extends and toes flare into extension.
C.N. Exam: Patient complains of difficulty swallowing and change in ability to taste coffee, beer and dark unsweetened chocolate. At times it seems like the patient’s heart is racing
- STATE THE APPROPRIATE CRANIAL NERVES TO BE TESTED. Perform test.
-STATE ALL SENSORY, MOTOR, AND INTEGRATION COMPONENTS TO C.N.
(IX) Glossopharyngeal and (X)Vagus
- Note any hoarseness of the voice
- Uvula reflex
- Gag reflex
- Have patient swallow while you palpate thyroid cartilage
- carotid sinus reflex = find pulse then put pressure on carotid sinus.
- Ask the patient about change in bitter taste sensation on the posterior third of the tongue
Nerve Root Eval: A patient complains of pain and tingling along the left lateral forearm, thumb, and first finger. He also notices some weakness in elbow flexion and wrist extension.
-STATE APPROPRIATE NERVE ROOT & DISC LEVEL.
-PERFORM ALL RELATED TESTS:
[Muscle Tests (state muscles and peripheral nerve innervations), Deep Tendon Reflex & Sensory Exam.]
Nerve root: C6
Disc level: C5
Wrist Extension: extensor carpi radialis longus & brevis, extensor carpi ulnaris (Radial N.)
Reflex: Brachioradialis (flat side of hammer)
Sensory: C5, C6, C7
Ortho Exam: A patient complains of a headache with neck stiffness and fever.
-STATE & PERFORM AN APPROPRIATE ORTHO TEST TO EVALUATE THIS PATIENT.
Kernig
Patient supine, hip to 90, knee to 90 & extend the leg.
Inability to fully extend the leg and/or pain (usually in the neck region).
Meningeal Irritation/Meningitis
