Lecture Midterm 1 Flashcards
What does the O stand for in the acronym “OPQRST”?
Onset of injury
What does the P stand for in the acronym “OPQRST”?
Palliative/Provocative
What does the Q stand for in the acronym “OPQRST”?
Quality of pain
What does the R stand for in the acronym “OPQRST”?
Radiation/Referral of pain
What does the S stand for in the acronym “OPQRST”?
Severity of pain
What does the T stand for in the acronym “OPQRST”?
Temporal factors (time of day, days of the week, etc.)
What term describes a neurological loss from spinal nerve root compression or ischemia with numbness and/or weakness?
Radiculopathy
The majority of information needed to make a clinical diagnosis comes from what?
Patient history
What is Dr. Homack’s 1st Law?
The treatment must match the diagnosis
What is Dr. Homack’s 2nd Law?
Every treatment plan has an expiration date
What term describes the list of conditions the patient may have based on the symptoms exhibited and the results of the exam?
Differential diagnosis
What is the presumed cause of the patient’s condition, arrived at by evaluating all assessment information thus far obtained while conducting further diagnostic testing to definitively diagnose the illness?
Working Diagnosis
What is a clinical red flag that you need to be aware of when taking a history?
Thunderclap or sentinel headache
What are the possible symptoms associated with a cerebellar dysfunction?
- Hypotonia
- Dysmetria
- Ataxia
- Pendular reflex
- Disdiadokinesia
- Rebound phenomenon
Why should the patient be in a standing position for cerebellar testing?
- Anterior lobe controls the torso in relation to the lower extremity
- Posterior lobe controls the head relative to the torso
Why should you take a blood pressure on the left side first?
Left side is usually higher due to being closer to the heart
What blood pressure finding may indicate a cerebellar problem?
Difference of 10mmHg or greater BP from one side to the other
Where in the body are the intermediolateral nucleus located?
Between T1-L3 in the lateral horn
What two procedures can you use to test for hypotonia?
Pendular deep tendon reflex and Rag doll posture
A patient is performing the Babinski Weil and drifts to the left going forward and going backwards. Where do you expect the lesion to present?
Left-sided cerebellum lesion
A patient is performing the Babinski Weil and drifts to the left going forward and drifts right going backwards. Where do you expect the lesion to present?
Left CN VIII: Vestibulocochlear nerve
When performing Romberg’s position, how must the patient be set up?
- Eyes open
- Shoes and socks off with feet as close together without touching
- Arms flexed forwards at 90 degrees (palms up)
The ability to perform rapid, alternating movements is termed?
Diadochokinesia
The impaired ability to perform rapid, alternating movements is termed?
Dysdiadochokinesia (DDK)
The complete inability to perform rapid, alternating movements is termed?
Adiadochokinesia
What is the most important thing when testing for DDK?
Test both upper and lower extremity
What tests can be performed to look for DDK?
- Finger tapping (piano playing)
- Alternating hand slaps
- Foot tapping
- Seated marching
A patient complains about reaching out for an object and can never seem to grab the object. What tests can you perform to test for this phenomenon?
- Patient’s finger to own nose
- Patient’s nose to doctor’s finger
- Heel to knee
- Patient’s toe to doctor’s finger
What is important for the patient to do when performing tests for dysmetria?
Patient must move slowly to bring out a positive finding
What is important about a patient that could possibly have Lyme Disease?
False negative on blood tests
What is the most common symptoms of a vertebral artery dissection?
Neck pain and stiffness
What are the 3 most important reasons to perform examinations?
- Document medical necessity to order tests
- Make an accurate diagnosis
- Establish baselines for outcome measures
After a blow to the head, a 42 year old drummer notices his left hand has difficulty maintaining rhythm. This is an example of what condition?
Dysdiadochokinesia
What are some symptoms that are associated with an Upper Motor Neuron Lesion (UMNL)?
- Clonus
- Hypertonia
- Pathological reflexes present
- Absent superficial reflexes
- Clasp-knife spasticity
What are some of the general features of the Dorsal columns?
- Dorsal
- Afferent
- Sensory
- In going
- Posterior
What are some of the general features of the UMN?
- Ventral
- Efferent
- Motor
- Out going
- Anterior
If pressure is being applied to outside lamination of the spinal cord, what part of the body is most affected?
Lower extremity
What two body parts are good to test for clonus?
Wrist or Ankle
What grades on the Weller reflex grading system are always pathological?
4 (transient clonus) and +5 (sustained clonus)
What term describes the use of another motor movement like clenching the jaw to endure a patellar reflex that wasn’t present before?
Jendrassik Maneuver
What pathological reflex would you find present if you perform the Gordon’s test in the upper extremity?
Extension of the fingers
How do you perform Gordon’s test in the upper extremity?
Briskly compress the pisiform
How do you perform Gordon’s test in the lower extremity?
Briskly compress the calf
What pathological reflex would you find present if you perform Gordon’s test in the lower extremity?
Upward toe sign
What pathological reflex would you find present if you perform Chaddock’s test in the upper extremity?
Extension of the fingers
How do you perform Chaddock’s test in the upper extremity?
Briskly compress the anterior surface of the wrist
How do you perform Chaddock’s test in the lower extremity?
Draw a C around the lateral maleolus of the foot
What pathological reflex would you find present if you perform Chaddock’s test in the lower extremity?
Upward toe sign
What pathological reflex would you find present if you perform Rossolimo’s test in the upper extremity?
Flexion of the fingers
How do you perform Rossolimo’s test in the upper extremity?
Quickly taps on the distal end of the 3rd metacarpal on the palmer surface of the hand
How do you perform Rossolimo’s test in the lower extremity?
Quickly tap on the distal end of the 3rd metatarsal on the plantar surface of the foot
What pathological reflex would you find present if you perform Rossolimo’s test on the lower extremity?
Flexion of the toes
What pathological reflex would you find present if you perform Tromner’s test in the upper extremity?
Flexion of the fingers
How do you perform Tromner’s test in the upper extremity?
Support the patient’s hand and briskly strike the distal end of the 3rd and 4th digits into extension
How do you perform Hoffman’s test in the upper extremity?
Support the patient’s hand pronated and flex the distal end of the 3rd digit into flexion and then let it go
What pathological reflex would you find present if you perform Hoffman’s test in the upper extremity?
OK sign
What tests can be performed in the upper extremity to look for pathological reflexes?
- Gorgon’s
- Chaddock’s
- Rossolimo’s
- Tromner’s
- Hoffman’s
What tests can be performed in the lower extremity to look for pathological reflexes?
- Plantar
- Gordon’s
- Chaddock’s
- Oppenheim’s
- Schaefer’s
- Rossolimo’s
How do you perform the Plantar reflex in the lower extremity?
Briskly stroke the lateral side of plantar surface of foot from heel towards the toes and then towards the medial foot
What pathological reflex would you find present if you perform Oppenheim’s test in the lower extremity?
Upgoing toe sign
How do you perform Oppenheim’s test in the lower extremity?
Stroke proximally to distally along the tibia
How do you perform Schaefer’s test in the lower extremity?
Briskly squeeze the Achille’s tendon
What pathological reflex would you find present if you perform Schaefer’s test in the lower extremity?
Upgoing toe sign
What test can be performed to look for pathological reflexes in the face?
- Snout reflex
- Glabellar reflex
- Palmomental reflex
What pathological reflex would you find present if you perform the Snout Reflex?
Curling of the ipsilateal upper lip
How do you perform the Snout reflex?
Briskly tap on the one side of the phrenoulum, then the other