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MMD > MMD Exam 1 Lab > Flashcards

MMD Exam 1 Lab Flashcards

1
Q

define dermatome

A

an area of skin innervated by sensory fibers from a single spinal nerve

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2
Q

define myotome

A

a group of muscles innervated form a single spinal segment

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3
Q

an area of skin innervated by sensory fibers form a specific peripheral nerve

A

peripheral nerve sensory field

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4
Q

muscles innervated by a specific peripheral nerve

A

peripheral nerve motor innervation

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5
Q

name the DTR, motor innervation, and sensory innervation: C5

A

DTR: biceps
motor: deltoid
sensory: deltoid tuberosity

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6
Q

name the DTR, motor innervation, and sensory innervation: C6

A

DTR: brachioradialis
motor: biceps, wrist ext
sensory: anatomical snuffbox

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7
Q

name the motor innervation and sensory innervation: C3-4

A

motor: upper traps
sensory: upper traps

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8
Q

name the DTR, motor innervation, and sensory innervation: C7

A

DTR: triceps
motor: triceps/wrist flex
sensory: posterior long finger

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9
Q

name the motor innervation and sensory innervation: C8

A

motor: thumb IP extension
sensory: medial border of small finger

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10
Q

name the motor innervation and sensory innervation: T1

A

motor: finger abduction
sensory: medial forearm

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11
Q

name the sensory innervation: T2

A

medial arm

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12
Q

UMN screen consists of:

A

babinski, hoffman’s, clonus, gait, and balance

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13
Q

sensation is screen with light touch; a more thorough exam can include what?

A

2 point discrimination, sharp-dull, and/or monofilament testing

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14
Q

name the condition(s) to the labs: HbA1c

A

diabetes
4- 5.6 = normal, 5.7 – 6.4 = high risk
>6.5 = DM

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15
Q

name the indications/conditions for the labs: rheumatoid factor (RF)

A

multiple joint pain - identifies autoimmune related arthritis
RA, SLE (lupus), some cancers

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16
Q

name the indications/conditions for the labs: creatine phosphokinase (CK/CPK)

A

muscle pain, cardiac problems
MI, myopathy, muscle breakdown, rhabdomyolysis

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17
Q

name the indications/conditions for the labs: erythrocyte sedimentation rate (ESR, “seds”)

A

inflammatory arthritis - nonspecific marker of inflammation
RA, SLE (lupus), severe infection/cancer

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18
Q

name the indications/conditions for the labs: potassium (K+)

A

muscle weakness, kidney disease - can trigger arrhythmia
kidney disease

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19
Q

name the indications/conditions for the labs: cyclic citrullinated protein (CCP)

A

multiple joint pain, inflammation - nonspecific marker of inflammation
RA, SLE (lupus)

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20
Q

name the indications/conditions for the labs: antinuclear antibody (ANA)

A

multiple joint pain, swelling, inflammation - identifies autoimmune related arthritis
RA, SLE (lupus)

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21
Q

which imaging modality?
good appreciation of basic bony anatomy

A

radiography
low radiation

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22
Q

which imaging modality?
excellent demonstration of cortical bone anatomy; high sensitivity to variances in the density of tissues; multiplanar views of anatomy (3D)

A

computed tomography (CT)
*high radiation

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23
Q

which imaging modality?
excellent demonstration of soft tissues and bone marrow; multiplanar views of anatomy (3D); mulitple sequences allowing various tissue characteristics

A

MRI
no radiation

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24
Q

which imaging modality?
good sensitivity to increased metabolic activity/bone turnover

A

bone scan/scintigraphy
moderate radiation

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25
Q

which imaging modality?
good demonstration of soft tissues; allows real-time, dynamic imaging; convenient and cost-effective

A

ultrasound
no radiation

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26
Q

which imaging modality?
simple, quick, accurate, modest cost; suited to serial testing, if same device

A

dual energy x-ray (DEXA)
low radiation

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27
Q

what is front line for conventional musculoskeletal imaging?

A

radiography (x-ray)

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28
Q

x-rays work by _____, a process of reduction in number of x-ray photons in the beam due to tissue densities

A

attenation

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29
Q

radiopaque or radiolucent?
not easily penetrated by x rays
increased radiodensity (more dense)
osteoblastic lesions/metal appears white

A

radiopaque

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30
Q

radiopaque or radiolucent?
easily penetrated by x rays
decreased radiodensity (less dense)
osteoclastic lesions/air appears black

A

radiolucent

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31
Q

order materials on x ray from least to most radiodensity

A

air, fat, fluid, bone, metal

32
Q

“one view is no view” meaning

A

at least 2 images are required to gain 3D perspective of x-ray
combination of the 3 common projections: lateral, AP/PA, oblique

33
Q

describe the ABCS of image interpretation

A

alignment
bone density
cartilage spaces (joints, subchondral bone, growth plates)
soft tissues

34
Q

what is the gold standard for soft tissue imagining (ligament, cartilage, intraosseous abnormalities, bone tumors)?

A

MRI

35
Q

difference between T1 and T2 weighted MRIs

A

T1 lights up for fat - good for bones
T2 lights up for fluid - good for inflammation

36
Q

what are the main benefits and risks of CT?

A

improved ability to identify subtle pathology
differentiates bone/soft tissue well
high doses of radiation

37
Q

bone scan is ____ for bone changes due to fracture, tumor, infection (OA, muscle trauma, metastatic CA)

A

sensitive

38
Q

hallmark signs of OA

A

joint space narrowing
bone spurs
sclerotic borders
subchondral bone cysts

39
Q

progressive, systemic inflammatory CT disease affecting synovial joints
soft tissue changes and joint deformity due to tissue destruction
women 3x more likely than men
peak onset 35-40 y/o

A

RA

40
Q

you identify bilateral erosion on radiograph and suspect RA or OA?

A

RA

41
Q

salter harris (epiphyseal) fracture classes 1-5

A

– GR I: Fx through the physis (growth plate) only
– GR II: Fx through the physis and Metaphysis
– GR III: Fx through the physis and Epiphysis
– GR IV: Fx through the physis, Metaphysis & Epiphysis
– GR V: crush/compression injury to the physis

42
Q

you review the information on the body chart and the documentation on the referral form and use the chart shown to help you develop what 4 hypotheses?

A

a) Formulate an initial HYPOTHESIS
b) Competing MSK Hypothesis
c) Competing MSK referral
d) Competing Non-MSK

43
Q

after you’ve developed your initial hypotheses, you determine the ____ of the condition and plan your ____ ____

A

SINSS (severity, irritability, nature, stage, stability), objective exam

44
Q

a dynamic process in which the physical therapist makes a clinical judgement based on data gathered during the examination

A

evaluation

45
Q

PT diagnosis includes information related to the resulting:

A

impairment (tone), activity limitations (inability to ambulate), and participation restrictions (inability to work) of the pathology or disease identified

46
Q

once you review data collected from your objective exam, your next two steps are to:

A

modify your working hypothesis if needed
develop the problem list

47
Q

the two main components of prognosis

A

level of improvement
amount of time

48
Q

80% of the information needed to determine/make a diagnosis is contained in the ____ exam

A

subjective

49
Q

the main problem in the patient’s own words: body region of symptoms/concerns and activity limitation

A

chief complaint

50
Q

describe the differences between constant and intermittent pain

A

constant, varying with activity = inflammatory and mechanical
constant, nonvarying = acute disease state or serious pathology
intermittent = mechanical

51
Q

at what point of the subjective exam do you ask the patient “what happened” regarding their pain/illness?

A

history of present illness (date of onset, mode of onset, immediate or delayed sxs, have sxs gotten worse/better/same, any treatment to date, effects of past tx)

52
Q

items from history that may suggest serious pathology indicating need for MD referral

A

red flags

53
Q

items from history that indicate a more extensive psychosocial exam may be required; factors that increase the risk of developing or perpetuating long-term disability and work loss

A

yellow flags

54
Q

when planning the objective exam, you must modify the ___ _____ and establish the ____

A

initial hypothesis, SINSS

55
Q

refers to the clinician’s assessment of the intensity of the patient’s symptoms and the patient’s perception of their symptoms as they relate to a functional activity or limitation

A

severity

56
Q

refers to the relationship among the amount of activity required to provoke a patient symptoms, the magnitude of those symptoms and the time it takes for the symptoms to subside to baseline

A

irritability

3 components:
- time or activity to onset
- magnitude of symptoms provoked
- time for symptoms to subside

57
Q

represents the clinician’s assessment of the hypotheses of structures (if appropriate), syndrome/classification or pathoanatomic structures causing symptoms…
AND
…the character of the presenting person or the problem (psychological, personality, ethnic and socioeconomic factors or the patient’s pain tolerance)

A

nature

58
Q

general rehab stage classifications

A

acute - 1 week (7-10 days)
subacute - 2-7 weeks
chronic - 7+ weeks

59
Q

refers to the progression of the patient’s pain (or symptoms) over time; is it getting better, staying the same, or getting worse

A

stability

60
Q

will SINSS limit the examination?

A

yes, determines whether to be gentle or vigorous
severe & irritable: limit exam, don’t make pnt worse
non-severe & irritable: no limit to exam, reproduce symptoms

61
Q

severity ratings

A

minimal: symptoms do not limit or hinder activity
• minimal or no pain with movement
• pain rated at 0-3/10

moderate: pain reduces activity levels to 40-70% of normal
• reports pain or guarding with activity or certain movements
• pain rated at 4-7/10

high: pain symptoms severely reduce or stop activities; ADLs are avoided or severely limited
• pain rated at 8-10/10

62
Q

irritability ratings

A

minimal
• tolerates repetitive or sustained activities
• continues activity after the onset of pain
• pain eases in a short time or position
change

moderate:
• tolerates brief activities or positions < 10min
• continues light activities after the onset of pain
• pain eases in similar time as onset (may be longer)

high
• activity not tolerated – are avoided
• unable to continue activity after pain onset
• pain takes a long time to ease

63
Q

stage ratings

A

General Medical Classification
- Acute pain: Recent onset (0-6 weeks)
- Sub-acute pain: Pain may be due to later stages of tissue healing or early
stages of developing chronic symptoms (6-12 weeks).
- Chronic pain: Longer duration – usually past expected recovery time (> 3 months)

General Rehab Classification
- Acute conditions: 1 week (7-10 days)
- Sub-acute conditions: 2-7 weeks
- Chronic conditions: 7+ weeks

64
Q

stability ratings

A

getting better
staying the same (ISQ)
getting worse

65
Q

if AROM is normal, apply ____ to determine end-feel and assist in clearing the joint

A

overpressure

66
Q

during the objective exam, you are looking for two sets of data:

A

what the patient feels (subjective)
responses that can be measured or found by the clinician (objective)

67
Q

typical sequence of testing position

A

standing - sitting - supine - prone

68
Q

functional quick test

A

movement, activity, or position that reproduces problem

69
Q

selective tissue tension tests allow you to differentiate between:

A

contractile vs. non-contractile origin
AROM, PROM, resisted isometric tests

70
Q

____ tests both contractile and inert structures; ____ tests just inert structures

A

AROM, PROM

71
Q

PROM provides the following

A

range of movement: stability and mobility
capsular vs non-capsular pattern of restriction
end feels

72
Q

____ _____ tests check the status of contractile tissue, neuro deficit, or pain inhibition

A

isometric strength

73
Q

muscle test findings:
strong and painless =
strong and painful =
weak and painless =
weak and painful =

A

strong and painless = normal
strong and painful = minor disorder
weak and painless = neuro deficit, disuse weakness, complete rupture
weak and painful = partial tear

74
Q

when passive movement > active without pain and the resisted test is weak and painless

A

non-contractile neuro findings
neuro weakness limits AROM

75
Q

joint mobility findings:
normal mobility, painless =
normal mobility, painful =
hypomobile, painless =
hypomobile, painful =
hypermobile, painless =
hypermobile, painful =

A

normal mobility, painless = normal
normal mobility, painful = minor sprain
hypomobile, painless = joint contracture, adhesion
hypomobile, painful = acute sprain, guarding
hypermobile, painless = complete rupture
hypermobile, painful = partial tear

76
Q

PT diagnosis is a description of underlying condition with qualifying statements regarding patient’s problem list
must include:

A

suspected patho-anatomical/pathology
impairments
functional limitations
participation restrictions

MMD (4 decks)

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