Module 3

Question 1

What is information from the client is important to tie into your treatment plan? Why?

Answer 1

Hobbies/ Interests

Increases compliance

Question 2

Orientation (name, place, time, circumstance), ability to follow 1-3 step commands, perseveration (patients gets stuck with a certain task or question) and mini-mental status exam are all examples of? Can be difficult if? How should you approach?

Answer 2

All examples of cognitive status assessments

Can be difficult to assess if they have speech issues

Allow them time to answer

Question 3

Cognitive status assessment, emotional and behavioral status assessment, checking of vital signs, assessing any changes to bowel or bladder function, checking the skin for abnormal color, texture or for wounds, checking for signs/ symptoms of DVT, checking sensory integrity, vision and perception testing, and examination of CN integrity are all part of the _ _ and _ _ of _ _ which part of the _ examination.

Answer 3

All part of the systems review and testing measures of Impairment portion of the physical examination.

Question 4

What 3 things should be looked at during the emotional and behavioral status portion of the PE?

Answer 4

ADE

Apathy
Depression
Emotional lability

Question 5

Emotional lability or the _ _ is common in patients with _ CVA

Answer 5

Psuedobulbar affect is common in patients with a left CVA

Question 6

What vital signs is it important to check with examining a stroke patient? (6)

Answer 6

RB H POT

Respiratory rate
Blood pressure
Heart rate
Pain
Oxygen saturation 
Temperature

Question 7

3 pain conditions that can result from stroke: _ _ _ pain which is most common in the _. _ pain and _ which occurs _, _ stimulus.

Answer 7

Central Post Stroke Pain (CPSP) with is most common in the shoulder

Thalamic pain and hyperalgesia which occurs spontaneously without stimulus

Question 8

2 common visual impairments that occur in stroke patients: _ _ which is most common with _ _ brain injuries. _ _ which is where 1/2 of the visual field is absent in both eyes.

Answer 8

Visual neglect, most common in right sided brain injuries

Homonymous hemianopsia

Question 9

/ and / are alterations in tone that affect motor function.

Answer 9

Flaccidity/ hypotonicity

Spasticity/ hypertonicity

Question 10

With increases in the level of spasticity the risk of _ and _ _ also increases

Answer 10

Risk of contracture and skin breakdown also increases

Question 11

How many levels are there in the Brunnstrom stage of motor recovery? Is used to assess? What stage do many patients ‘get stuck’ in?

Answer 11

Level range from 1-6 (in order of decreasing severity)

Used to assess motor function

Many patients get stuck at a level 3

Question 12

What Brunnstrum level is being described: flaccid? Minimal voluntary synergistic movement, spasticity emerges

Answer 12

Level1- flaccid

Level2- minimal voluntary synergistic movement, spasticity emerges

Question 13

What Brunnstrom level is being described: more voluntary synergistic movement, spasticity is maximal

Answer 13

Level 3

Question 14

What Brunnstrom level is being described: some movements out of synergy, spasticity declines

Answer 14

Level 4

Question 15

What Brunnstrom level is being described: synergy patterns lose dominance but there is still some evidence of

Answer 15

Level 5

Question 16

Brunnstrom level 6: _ spasticity, and individual joint movements _

Answer 16

No spasticity, individual joint movements possible

Question 17

What is another common system used to assess motor function? Levels/ range?

Answer 17

Modified Ashworth Scale (MAS)

Scale: 0, 1, 1+, 2, 3, 4
- 0= no increase in muscle tone; 4=rigid

Question 18

_ _ is the ability to plan and execute coordinated movement

Answer 18

Motor praxis

Question 19

2 types of altered motor programming include _ apraxia and _ apraxia. Define each.

Answer 19

Ideational apraxia (inability to perform automatically or on command)

Ideomotor apraxia (can perform automatically but NOT on command)

Question 20

4 types of abnormal (obligatory) synergy patterns

Answer 20

UE flexion and extension patterns

LE flexion and extension patterns

Question 21

Scapular retraction and elevation, shoulder abduction and ER, elbow flexion, forearm supination and wrist and finger flexion are characteristic of a _ _ _ _.

Answer 21

Upper extremity flexion pattern

Question 22

Upper extremity extension pattern has: scapular _, shoulder _ and _ _, elbow _, forearm _ and wrist & finger _.

Answer 22

Scapular protraction, shoulder adduction and internal rotation, elbow extension, forearm pronation, and wrist & finger FLEXION

Question 23

Lower extremity flexion pattern consists of: 
Hip _, _, and _ _
Knee _
Ankle _ and _
Toe _

Answer 23

Hip flexion, abduction, and ER
Knee flexion
Ankle Dorsiflexion and inversion
Toe Dorsiflexion

Question 24

Lower extremity extension pattern includes:
Hip _, _ and _ _
Knee _ 
Ankle _ and _
Toe _

Answer 24

Hip extension, adduction and internal rotation
Knee FLEXION
Ankle plantar flexion and INVERSION
Toe plantar flexion

Question 25

4 examples of abnormal reflexes

Answer 25

H HAT

Hyporeflexia
Hyperreflexia
Associated reactions
Tonic reflexes

Question 26

ATNR and flexor withdrawal are examples of? Clonus, clasp knife response, babinski sign are examples of?

Answer 26

ATNR/ flexor withdrawal: tonic reflexes

Clonus, etc: hyperreflexia

Question 27

Examples of altered coordination and associated area of lesion:
Ataxia?
Bradykinesia?
Choreoathetosis?
Hemiballismus?

Answer 27

Ataxia- cerebellar lesion

Bradykinesia, choreoathetosis, hemiballismus- basil ganglia lesions

Question 28

What is being described: patient’s perception of vertical is absent, therefore they are not aware if they have fallen or if they are standing

Answer 28

Ipsilateral Pushing/ Pusher syndrome

Question 29

Which 6 outcome measures (StrokEDGE) are commonly used to assess function in stroke patients?

Answer 29

BFD 6-10

Berg balance test
Functional reach test
Dynamic gait index

6 minute walk test
10 meter walk test

Question 30

What other outcome measures will we be looking at in this class? (7)

Answer 30

AA F STOP

Action research arm test
Ashworth scale
Fugl-Meyer (motor performance) test

Stroke impact scale
Tardieu spasticity scale
Orpington prognostic scale
Postural assessment scale for stroke

Question 31

Identifying: strength, sensory and perceptual, coordination, and balance impairments is outlined in the? What two parts of the ICF does it address

Answer 31

Guide to physical therapy practice

ICF: activity and participation roles

Question 32

What APTA preferred practice pattern is described and associated with stroke rehab: Impaired function and sensory integrity associated with non-progressive disorders of the CNS- acquired in adolescence or adulthood

Answer 32

Pattern 5D

Question 33

What are the 4 essential elements that must be included when writing patient goals?

Answer 33

Individual (who)
Behavior/ activity (What)
Condition (how)
Time (when/ by)

Question 34

What level of the modified Ashworth scale is being described: Minimal increase in muscle tone at the end of range

Answer 34

1

Question 35

What level of MAS is being described: minimal increase in muscle tone (less than 1/2 PROM)

Answer 35

1+

Question 36

What level of the MAS is being described: more marked increase in muscle tone (most PROM)

Answer 36

2

Question 37

What level of the MAS is being described: considerable increase in muscle tone (PROM difficult)

Answer 37

3

Question 38

What type of abnormal reflex is characteristic of UMN lesions? LMN lesions?

Answer 38

UMN- hyperreflexia

LMN- hyporeflexia