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NYCC Patient Assessment 1 > Lecture Midterm 2 > Flashcards

Lecture Midterm 2 Flashcards

1
Q

The cervical plexus makes up what spinal nerves?

A

C1-C4

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2
Q

The brachial plexus makes up what spinal nerves?

A

C5-T1

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3
Q

What are the important details when performing motor tests?

A

Clear explanation to the patient
-Test across one joint
-Steady pressure for a count of 3 with no ballistic stresses

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4
Q

When a person is giving a motor testing grade of 5, what does that mean?

A

Complete range of motion against gravity with full resistance

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5
Q

When a person is given a motor testing grade of 4, what does that mean?

A

Complete range of motion against gravity with some resistance

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6
Q

When a person is given a motor testing grade of 3, what does that mean?

A

Complete range of motion against gravity only

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7
Q

When a person is given a motor testing grade of 2, what does that mean?

A

Complete range of motion with gravity eliminated

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8
Q

Your patient is able to raise their arm into abduction, but cannot resist any over pressure. What is the correct grading for this finding?

A

3/5

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9
Q

Your patient is able to raise their arm into abduction with full resistance. What is the correct grading for this finding?

A

5/5

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10
Q

When a herniated disc is present between C5 and C6, what nerve root is affected?

A

C6

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11
Q

What muscle would you test to examine the C5 nerve root?

A

Deltoid

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12
Q

What muscle would you test to examine the C6 nerve root?

A

Wrist extensors

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13
Q

What muscle would you test to examine the C7 nerve root?

A

Wrist flexors

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14
Q

What muscle would you test to examine the C8 nerve root?

A

Finger flexors

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15
Q

What muscle would you test to examine the T1 nerve root?

A

Interossei

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16
Q

What deep tendon reflex would you use to examine the C5 nerve root?

A

Biceps tendon

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17
Q

What deep tendon reflex would you use to examine the C6 nerve root?

A

Brachioradialis tendon

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18
Q

What deep tendon reflex would you use to examine the C7 nerve root?

A

Triceps tendon

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19
Q

What deep tendon reflex would you use to examine the C8 nerve root?

A

There is no reflex

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20
Q

What deep tendon reflex would you use to examine the T1 nerve root?

A

There is no reflex

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21
Q

What is the sensory dermatome for C5 nerve root?

A

Lateral arm

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22
Q

What is the sensory dermatome for C6 nerve root?

A

Lateral forearm, thumb, and lateral side of 2nd digit

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23
Q

What is the sensory dermatome of C7 nerve root?

A

Medial side of 2nd digit, 3rd digit, and lateral side of 4th digit

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24
Q

What is the sensory dermatome of C8 nerve root?

A

Medial forearm, 5th digit, and medial side of 4th digit

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25
Q

What is the sensory dermatome of T1 nerve root?

A

Medial arm from axilla to elbow

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26
Q

Interosseous wasting is a symptom of what conditions?

A

Apical lung tumor or space occupying lesion on the inferior aspect of the brachial plexus

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27
Q

What deep tendon reflex would you use to examine the Musculocutaneous nerve?

A

Biceps tendon

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28
Q

What deep tendon reflex would you use to examine the Radial nerve?

A

Brachioradialis or Triceps tendon

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29
Q

What is the order of muscle testing needed to assess the axillary nerve motor function?

A
  1. Deltoid
  2. Teres minor
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30
Q

What is the order of muscle testing needed to assess the musculocutaneous nerve motor function?

A
  1. Biceps
  2. Coracobrachialis
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31
Q

What is the order of muscle testing needed to assess the radial nerve motor function?

A
  1. Extensor digitorum
  2. Wrist extensors (extensor carpi radialis longus and brevus)
  3. Brachioradialis
  4. Triceps + Anconeus
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32
Q

What is the order of muscle testing needed to assess the median nerve motor function?

A
  1. Flexor pollicus brevis
  2. Flexor digitorum profundus (2nd and 3rd digit)
  3. Flexor carpi radialis
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33
Q

What is the order of muscle testing needed to assess the ulnar nerve motor function?

A
  1. Adductor pollicus
  2. Flexor digitorum profundus (4th and 5th digit)
  3. Flexor carpi ulnaris
  4. Interossei
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34
Q

What is the largest nerve in the upper extremity?

A

Radial nerve

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35
Q

What is the most commonly entrapped nerve in the body?

A

Median nerve

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36
Q

A patient comes in and complains of weak abduction of their arm. What nerve root or peripheral nerve would you suspect could be an issue?

A

C5 or Axillary nerve

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37
Q

A patient comes in and complains of weak external rotation of their arm. What nerve root or peripheral nerve would you suspect to be an issue?

A

C5 or Axillary nerve

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38
Q

A patient comes in and complains of weak elbow flexion in a supinated position. What nerve root or peripheral nerve would you suspect to be an issue?

A

C5 or Musculocutaneous nerve

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39
Q

A patient comes in and complains of weak wrist extensions. What nerve root or peripheral nerve would you suspect to be an issue?

A

C6 or Radial nerve

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40
Q

A patient comes in and complains of weak elbow extension. What nerve root or peripheral nerve would you suspect to be an issue?

A

C7 or Radial nerve

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41
Q

A patient comes in and complains of weak wrist flexion. What nerve root or peripheral nerve would you suspect to be an issue?

A

C7 or Ulnar and Median nerve

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42
Q

A patient comes in and complains of weak finger flexion. What nerve root or peripheral nerve would you suspect to be an issue?

A

C8 or Median nerve

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43
Q

When performing an orthopedic test, what side of the body should you test first?

A

Asymptomatic side

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44
Q

When charting an orthopedic test, how would you describe the results?

A

Positive or negative

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45
Q

What type of pain follows along nerves and can be described as a sharp, radiating, pins and needles, or numbness?

A

Neurological pain

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46
Q

What type of pain follows the dermatome pattern?

A

Dermatogenous pain

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47
Q

What type of pain is considered a referred pain from sensory irritation to a structure that shared embryological mesodermal innervation and is usually described as burning?

A

Sclerotogenous pain

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48
Q

What type of pain originates within a muscle due to a trigger point referral and is often described as cramping, spasm, or aching?

A

Myotogenous pain

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49
Q

What type of pain is considered a throbbing, pulsating pain?

A

Vascular pain

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50
Q

What test is used to evaluate the patient’s pain threshold by applying firm pressure to the mastoid process?

A

Libman’s sign

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51
Q

How do you perform O’Donaghue’s Maneuver?

A

Have the patient move the affected joint/s actively, against isometric contraction, and passively looking for exacerbation of pain

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52
Q

If a doctor performs O’Donaghue’s Maneuver on a patient and they report pain upon resisted motion, what do you suspect the injury is?

A

Muscle or musculotendinous injury

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53
Q

If a doctor performs O’Donaghue’s Maneuver on a patient and they report pain upon passive motion, what do you suspect the injury is?

A

Ligamentous, capsular, or articular injury

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54
Q

What test is performed by striking the top of the patient’s head through the doctor’s hand and should not be done?

A

Spurling’s test

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55
Q

What is the least invasive test for nerve root encroachment?

A

Neutral Compression Test

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56
Q

What is the positive finding for the Cervical Compression Test?

A

Sharp shooting pain and/or parenthesis down the upper extremity

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57
Q

What is the order from least invasive to most invasive cervical compression tests?

A
  1. Neutral Compression
  2. Lateral Compression (Jackson’s Compression)
  3. Rotary Compression
  4. Hyperextension Compression
  5. Maximal Foraminal Compression
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58
Q

What three motions are used during the Maximal Foraminal Compression test?

A

Lateral flexion, extension, and rotation

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59
Q

When performing Jackson’s Compression or Hyperextension Compression tests, where should your line of drive be?

A

Down the spine (towards the chin)

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60
Q

What are the three positive findings associated with Cervical Distraction Test?

A

-Decrease in symptoms
-Increase in symptoms down the arm
-Well localized cervical pain

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61
Q

If you perform the Cervical Distraction Test and the patient says the symptoms decrease, what do you suspect is going on?

A

Nerve root encroachment

62
Q

If you perform the Cervical Distraction test and the patient says the symptoms down the arm have increased, what do you suspect is going on?

A

-Nerve root adhesions

63
Q

If you perform the Cervical Distraction test and the patient says they have an increased pain in the cervical area, what do you suspect is going on?

A

Capsular inflammation

64
Q

What is the positive finding for Bakody Maneuver?

A

Relief of the upper extremity pain or paresthesia

65
Q

A positive finding to the Shoulder Depression Test indicated what?

A

Radicular/Nerve root adhesions

66
Q

What is the position called when a patient walks into your office holding their neck with both of their hands, and what does it mean?

A

Rust Sign; Instability of neck

67
Q

What tests can be performed if you suspect a Space Occupying Lesion?

A

Triad of Dejerine, Valsalva, and Milgrams

68
Q

What test is performed by asking the patient if coughing, sneezing, or straining of the bowel causes the pain to get worse?

A

Triad of Dejerine

69
Q

What test is performed by having the patient blow on their own thumb to increase intrathecal and intra-abdominal pressure?

A

Valsalva Maneuver

70
Q

What is a positive finding for the Valsalva Maneuver?

A

Pain is worsened

71
Q

What test is performed by having the patient hold their feet 3-6 inches off the table for 15 seconds?

A

Milgram’s Test

72
Q

What space occupying lesion test is considered the least invasive?

A

Triad of Dejerine

73
Q

What space occupying lesion test is considered the most aggressive?

A

Milgram’s Test

74
Q

What test is used to test the arterial filling of the upper extremity?

A

Allen’s test

75
Q

Before tests for thoracic outlet syndrome, what test must be performed first?

A

Allen’s test

76
Q

What is a positive finding when you perform Allen’s Test?

A

Flushing that takes more than 10 seconds

77
Q

A patient complains of pain and numbness down their left arm when they turn to the left. What is one of the possible explanations for this finding?

A

Anterior scalene TOS

78
Q

A patient complains of pain and numbness down their left arm when they turn their head to the right. What is one of the possible explanations for this finding?

A

Middle scalene TOS

79
Q

A patient complains of pain and numbness down their left arm when they are asked to hold their breath. What is one of the possible explanations for this finding?

A

Costoclavicular space or scalenes TOS

80
Q

A patient complains of pain and numbness down their left arm when they try and grab something above their head. What is one of the possible explanations for this finding?

A

Pectoralis minor TOS

81
Q

A patient complains of pain and numbness down their left arm when their neck is tractioned. What is one of the possible explanations for this finding?

A

Cervical rib or elongated TP

82
Q

If you suspect a patient is suffering from anterior scalene TOS, what test would you have them perform?

A

Adson Test

83
Q

What is the positive finding for Adson’s Test?

A

Decrease in pulse volume and/or exacerbation of upper extremity symptoms

84
Q

If you suspect a patient is suffering from middle scalene TOS, what test would you have them perform?

A

Reverse Adson Test

85
Q

If you suspect a patient is suffering from costoclavicular TOS, what test would you have them perform?

A

Eden’s Test or Soldier’s Position

86
Q

What costoclavicular TOS test is performed passively?

A

Soldier’s Position

87
Q

What costoclavicular TOS test is performed actively?

A

Eden’s Test

88
Q

What tests are able to be performed if you suspect hyperabduction syndrome?

A
  1. Roos test
  2. Hostage position
  3. Wright’s test
  4. Reverse Bakody Maneuver
89
Q

What is a positive finding for the Hostage position?

A

Decrease in pulse patency and/or exacerbation of upper extremity symptoms

90
Q

When performing the Wright’s Test, how far do you raise the arm?

A

120 degrees

91
Q

What is a positive finding for the Traction test?

A

Decrease in pulse patency and/or exacerbation of upper extremity symptoms

92
Q

What tests can be performed to test for the integrity of the transverse humeral ligament?

A
  1. Yergason’s Test
  2. Speed’s Test
  3. Abbott-Saunders
93
Q

What are the other possible names for Supraspinatus press test?

A

Jobe Test or Supraspinatus Stress Test

94
Q

What tests can be performed if you suspect a patient has a Supraspinatus strain/tear?

A
  1. Supraspinatus press test
  2. Codman’s Test (Drop arm test)
95
Q

What test can be performed if you suspect a patient has an acute glenohumeral dislocation?

A

Dugas Test

96
Q

What test should not be performed on a patient that has recurrent glenohumeral dislocations?

A

Apprehension Test

97
Q

What test can be performed if you suspect a patient has subacromial bursitis?

A

“Dawbarn’s “Pushbutton” Test”

98
Q

What is the most likely cause of popping, clicking, and pain in the anterior shoulder with motion?

A

Transverse humeral ligament tear

99
Q

What two tests can be performed to test for lateral epicondylitis?

A

Cozen’s Test and Mill’s Test

100
Q

Which of the following is a positive indication for Cozen’s Test?

A

Pain at the lateral epicondyle

101
Q

Which of the following is a positive indication for Mill’s Test?

A

Pain at the lateral epicondyle

102
Q

What test can be performed to test for medial epicondylitis?

A

Golfer’s Elbow Test

103
Q

When performing a Varus Stress test on the elbow, what are we testing for instability?

A

Lateral (radial) collateral ligament

104
Q

When performing a Valgus Stress test on the elbow, what are we testing for instability?

A

Medial (ulnar) collateral ligament

105
Q

When performing any stress test at the elbow, which side of the body should you do first?

A

Well-side first

106
Q

What is a positive finding when you perform Valgus Stress test?

A

Pain or excessive motion at the medial elbow

107
Q

What test can be performed to test for ulnar neuropathy at the elbow joint?

A

Tineal tap at the Elbow

108
Q

What is a positive finding for the Tineal Tap test at the Elbow?

A

Sustained paresthesia along the distribution of the ulnar nerve

109
Q

If a patient complains of numbness and tingling on the 2nd and 3rd digits, what test could be done to examine this?

A

Tineal Tap test at the Wrist

110
Q

What is a positive finding for the Tineal Tap test at the Wrist?

A

Sustained paresthesia into the distal median nerve distribution

111
Q

What is a positive finding for the Tineal Tap at the Tunnel of Guyon?

A

Sustained paresthesia along the distribution of the ulnar nerve

112
Q

What is the positive finding for Carpal tunnel orthopedic tests always?

A

Increased or sustained paresthesia along the (distal) Median N. distribution

113
Q

True or False: Wrist pain is a positive finding for Carpal Tunnel Syndrome?

A

FALSE

114
Q

What forms the borders of the Carpal Tunnel?

A

-Tubercle of Scaphoid
-Pisiform
-Hamulus of Hamate
-Tubercle of Trapezium

115
Q

What structures can be found inside the Carpal Tunnel?

A

-Tendons of Flexor digitorum superficialis & profundus
-Flexor pollicus longus tendon
-Median nerve

116
Q

What tests can be performed to test for Carpal Tunnel Syndrome?

A

-Phalen’s test
-Prayer Sign
-English test
-Tineal tap at the Wrist

117
Q

What is a positive finding when performing the English test?

A

Increased or sustained pain or paresthesia into the median nerve distribution of the hand

118
Q

What are some of the other names for English Test?

A

Sphygmomanometer Test or Tourniquet Test

119
Q

What test can be performed to see if a patient has De Quervain’s syndrome?

A

Finkelstein’s Test

120
Q

What is a positive finding when performing Finkelstein’s Test?

A

Pain at the lateral wrist (radial styloid distally)

121
Q

What is another name for De Quervain’s syndrome?

A

Stenosing tenosynovitis

122
Q

What test can be performed if you suspect a ulnar neuropathy with paresis of the adductor pollicus?

A

Froment’s/Paper Test

123
Q

Nerve entrapment in the cubical fossa will cause symptoms into what part of the upper extremity?

A

Volar surface of the lateral hand and fingers

124
Q

What diagnosis does a 4+J bicep reflex suggest?

A

Corticospinal tract lesion

125
Q

What is the likely diagnosis for a patient that has pain into the right arm when turning the head to the left?

A

Middle scalene TOS

126
Q

A positive finding for cervical capsulitis during the Cervical Distraction test is what?

A

Increased localized posterior-lateral cervical pain

127
Q

A patient sticks their tongue out and it deviates to the left. Where could the lesion be located?

A

CN XII on the left

128
Q

Interosseous wasting may be a sign of what condition?

A

Apical lung tumor

129
Q

Your patient has right medial forearm pain when turning their head to the right. What muscle test is most appropriate?

A

Finger flexors (C8)

130
Q

Your patient has right arm pain extending into the index finger when turning their head to the left. What two tests are most useful to evaluate this patient?

A

Reverse Adson’s and rotary compression test

131
Q

When testing for pallesthesia, what should be used?

A

Using a 128 Hz tuning fork

132
Q

What are some of the positive findings you would see in a patient with a basal ganglia lesion?

A

Resting tremors, Cogwheel or lead pipe rigidity, Pill rolling, Festinating gait

133
Q

A 68-year old woman with pain in her forearm and hand on the left side when she raises her arm to the side. She admits her hand tends to get cold and sometimes her finger turns white. What test you would you want to do first on this patient?

A

Allen’s Test

134
Q

what is the ROM for cervical flexion?

A

60-90*

135
Q

what is the ROM for cervical extension?

A

75-90*

136
Q

what is the ROM for cervical lateral flexion?

A

45-55*

137
Q

what is the ROM for cervical rotation?

A

80-90*

138
Q

what is the ROM for thoracic flexion?

A

25-45*

138
Q

what is the ROM for thoracic extension?

A

25-45*

139
Q

what is the ROM for thoracic lateral flexion?

A

20-40*

140
Q

what is the ROM for thoracic rotation?

A

30-45*

141
Q

what is the ROM for shoulder flexion?

A

180*

142
Q

what is the ROM for shoulder external rotation?

A

90* (w/ ADduction)

143
Q

what is the ROM for shoulder extension?

A

50* (w/ elbow straight)

144
Q

what is the shoulder open-packed position?

A

55* abduction; 30* horizontal adduction

144
Q

what is the ROM for shoulder internal rotation?

A

90* (w/ ABduction)

144
Q

what is the ROM for shoulder ABduction?

A

180*

145
Q

what is the ROM for shoulder ADduction?

A

50*

146
Q

what is the shoulder closed-packed position?

A

abduction + external rotation

147
Q

The median n runs thru ____

A

Cubital Fossa

148
Q

The median n runs thru ____

A

Cubital Fossa

149
Q

The Ulnar n runs thru ____

A

Cubital Tunnel

NYCC Patient Assessment 1 (15 decks)

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