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Neuro Diagnosis > Lab Final: Test E > Flashcards

Lab Final: Test E Flashcards

1
Q

Mental Status: Object Reading

A

Read the card.

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2
Q

Mental Status: Recent Alertness

A

Spell STORE, now spell it backwards EROTS.

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3
Q

Sensory Exam: Joint Position Sense

A

“Tell me if your finger is up or down.” MIP, PIP, DIP

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4
Q

Sensory Exam: Displacement Test

A

Touch patient on each side individually, then the same points bilaterally.

One side is felt normally & the other displaced towards midline.

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5
Q

Motor Exam: Passive Cervical Motion

A

Flexion, Extension, Rotations, Lateral Flexions

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6
Q

Motor Exam: Muscle Test Ankle Dorsiflexion

A

“Resist as I push your foot down”

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7
Q

Coordination & Gait: Heel Shin Test

A

Patient seated, run the heel of one foot down the other leg from knee to foot.

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8
Q

Coordination & Gait: Pronation - Supination Test

A

AKA Diadochokinesia

Pronate/supinate palms as fast as possible

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9
Q

Superficial Reflex: Corneal Test

A

Verbal; don’t perform.

Verify no contacts worn, touch cornea w/ cotton wisp

response: blinking and tearing of eye upon touching the cornea w cotton wisp
affernt: trigeminal
integrating: pons
efferent: facial

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10
Q

Visceral Reflex: Indirect Light Test

A

Patients hand knife edges nose, light lateral to medial

response: contralateral pupillary constriction when light is shined in the eye
afferent: optic
integrating: midbrain
efferent: oculomotor

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11
Q

Deep Tendon Reflex: Achilles

A

Flat side of hammer; Tibial nerve.

response: foot plantar flexion
nerve: tibial
integration: S1,2 spinal cord

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12
Q

Pathological: Tromners

A

Hit palmar surface with hammer.

Normal = flexion of thumb

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13
Q

C.N. Exam: A patient complains that his face is dropping on the left side and he is unable to taste anything like sweet tea, lemon ginger herbal tea. He think the loss of taste is related to recent difficulty he has with smelling anything but the strongest scents.

  • STATE THE APPROPRIATE C.N. TO BE TESTED
  • PERFORM ALL PROCEDURES FOR C.N.’S & STATE ALL SENSORY, MOTOR, AND INTEGRATION CENTERS FOR ANY REFLEX PERFORMED
A

(VII) Facial & (I) Olfactory
Facial n.
- inspect for asymmetry
- eyebrows up, close eyes tight, show teeth, puff cheeks, smile, frown
- “any changes in taste of sweet salty or sour on anterior 2/3 of tongue”
Olfactory
-ask ask about disorders of sense of smell
- check for blockages in nose
- occlude 1 nostril at a time, do you smell anything, can you identify the smell?

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14
Q

Nerve Root Eval: A patient complains that he is having difficulty “face-booking” he types with great difficulty due to finger weakness and also notice numbness on the medial surface of his right hand fingers 4 and 5.

  • STATE THE APPROPRIATE NERVE ROOT
  • STATE THE APPROPRIATE DISC LEVEL
  • PERFORM THE RELATED MUSCLE TESTS, (stating muscles and peripheral nerve
    innervations) , DEEP TENDON REFLEX & SENSORY EXAM
A

Nerve root: C8
Disc level: C7

Finger flexion: Flexor Digitorum Superficialis, Flexor Digitorum Profundus, Lumbricals (Median & Ulnar Nerve)

No Reflex

C7, C8, T1: Palm & middle finger, distal/medial forearm w/ digit 4 & 5, medial elbow

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15
Q

Ortho Exam: A patient complains of posterior thigh pain.

  • STATE & PERFORM AN APPROPRIATE ORTHO TEST TO EVALUATE THIS PATIENT TO DIFFERENTIATE B/W SCIATIC RADICULOPATHY & TIGHT HAMSTRINGS
A

Straight leg raise

Radiating pain down the leg or dull posterior thigh pain.

Pain between 30-70* = discogenic sciatic radiculopathy

Pain >70* = tight hamstrings

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16
Q

Ortho Exam: A patient complains of local cervical pain.

- STATE & PERFORM AN APPROPRIATE ORTHO TEST TO EVALUATE THIS PATIENT

A

Foraminal Compression Test
Compress patients skull from behind in neutral, R, L rotation.

Exacerbation of localized cervical pain indicates foraminal encroachment or facet pathology without nerve root compression.

Exacerbation of cervical pain w/ a radicular component indicates foraminal encroachment or facet pathology with nerve root compression.

17
Q

Ortho Exam: A patient has radiating pain from straining.
- STATE & PERFORM AN APPROPRIATE ORTHO TEST TO EVALUATE THIS PATIENT, DIFFERENTIATE A MEDIAL FROM LATERAL DISC LESION.

A

Kemp Test
Patient seated or standing, arms crossed (hands on shoulders), Dr. stands behind patient & stabilizes opposite PSIS, PASSIVELY laterally flex patient and rotate their torso back; “Does this increase your pain?”

Reproduction of sciatic pain while leaning TOWARD the affected side
= LATERAL disc bulge

While leaning AWAY the affected side = MEDIAL disc bulge

Neuro Diagnosis (10 decks)

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