Musculoskeletal and Neurological Systems chapt 30 (645-658) Flashcards
1
Q
The muscles, bones, and joints are all part of what system?
A
musculoskeletal system
2
Q
This part of the musculoskeletal system is assessed for strength, tone, size, symmetry, pain, cramping, and weakness:
A
muscles
3
Q
This part of the musculoskeletal system is assessed for pain, stiffness, swelling, crepitation, heat, redness, limitation of movement:
A
joints
4
Q
This part of the musculoskeletal system is assessed for pain, deformity, and trauma:
A
bones
5
Q
A crackling or grating sound that’s heard from a joint is called:
A
crepitation
6
Q
What part of the musculoskeletal system would you assess for atrophy or hypertrophy?
A
muscles
7
Q
A decrease in size of a muscle is defined as:
A
atrophy
8
Q
An increase in size of a muscle is defined as:
A
hypertrophy
9
Q
You are assessing the musculoskeletal system of your pt and you notice that the L thigh muscle is smaller than the R thigh muscle. This finding is:
A
abnormal and indicative of atrophy
10
Q
An abnormal contraction of a bundle of muscle fibers that presents itself as a twitch is called:
A
fasciculation
11
Q
An involuntary trembling of a limb or body part is defined as:
A
tremor
12
Q
The normal condition of tension or tone of a muscle at rest is defined as:
A
tonicity
13
Q
You’re assessing the musculoskeletal system of your pt and you notice that the R arm is not firm. This finding is:
A
abnormal and indicative of being atonic
14
Q
A muscle that lacks tonicity is defined as:
A
atonic
15
Q
A weakness or laxness in the muscle of a pt upon activity is defined as:
A
flaccidity
16
Q
A sudden involuntary muscle contraction felt upon palpation during activity is defined as:
A
spasticity
17
Q
The muscle strength grading scale is from:
A
0-5
18
Q
What grade of muscle strength depicts 100% of normal strength with normal full movement against gravity & against full resistance:
A
5
19
Q
What grade of muscle strength depicts 50% of normal strength w/normal movement against gravity:
A
3
20
Q
What grade of muscle strength depicts 0% of normal strength w/complete paralysis:
A
0
21
Q
What grade of muscle strength depicts 75% of normal strength w/normal full movement against gravity and against minimal resistance:
A
4
22
Q
What grade of muscle strength depicts 25% of normal strength w/full muscle movement against gravity with support:
A
2
23
Q
What grade of muscle strength depicts 10% of normal strength w/no movement but contraction of muscle is palpable or visible:
A
1
24
Q
You’re assessing the musculoskeletal system of your pt and you notice edema, tenderness, and swelling on the LLE upon palpation. This finding:
A
Abnormal and indicative of fx, neoplasm, or osteoporosis
25
Of the musculoskeletal system, what would you palpate for when inspect swelling of the joints on your pt:
presence of tenderness, crepitation, or nodules
26
What instrument is used to measure the ROM of joints:
goniometer
27
You're assessing the clavicle of a newborn and you notice a mass along with crepitus. This finding is:
abnormal and indicative of a fx due to vaginal delivery
28
You're assessing a 2 year old pt and you notice pronation along w/toeing in of the feet. This finding is:
normal for pts between 12-30 months of age
29
Children age 1 that are bowlegged after learning to walk is defined as:
genu varum and is normal
30
Children in preschool or early school-age that express knock-knee is defined as
genu valgus and is normal
31
Children under 5 years that express swayback is defined:
lordosis and is normal under age 5
32
When should curvature of the spine in children should be referred for further medical evaulation?
a curvature greater than 10%
33
What are the risk factors for girls who participate in extensive strenuous activity?
delayed menses, osteoporosis, and eating disorders
34
What causes the decrease in speed, strength, resistance to fatigue, reaction time, and coordination in older adults:
a decrease in nerve conduction and muscle tone
35
What predisposes the elderly to bone fxs and compressed vertebrae?
fragile bones and osteoporosis
36
The CNS (brain and spinal cord) and the PNS (peripheral nerve)are all part of what system?
neurological system
37
How long does a through neurological examination take:
1-3 hrs
38
What are the three major considerations that determine the extent of a neurological exam?
1: pt's chief complaint, 2: pt's physical condition (i.e., LOC, amb), 3: pt's willingness to participate
39
An assessment of mental status reveals what of the pt's general cerebral functions:
cognitive (intellect) and affective (emotional) functions all reflected in the pt's use of language, memory, orientation.
40
Any defects in the loss of the power to express oneself by speech, writing, or signs, or to comprehend spoken or written language is defined as:
aphasia (can be categorized as either receptive or expressive)
41
You're assessing a pt and you notice that the pt doesn't seem to comprehend either your written or spoken words. This finding is:
abnormal and indicative that the pt has receptive aphasia (can be audio or visual)
42
You're assessing your pt and you notice that the pt can understand you but can't seem to express himself in spoken or written words. This finding is:
abnormal and indicative of expressive aphasia
43
This aspect of assessment determines the pt's ability to recognize person, time, and place:
orientation (usually charted as awake, alert, & oriented x3; AA&Ox3)
44
This aspect of assessment involves the pt's recall of info:
assesses memory
45
You're assessing your pt's memory. You have your pt recall info that you had him remember 15 seconds ago. This is what type of recall:
immediate recall
46
You're assessing your pt's memory. You have your pt recall info that happened earlier in the day during his first examination. This is what type of recall:
recent memory
47
You're assessing your pt's memory. You have your pt recall info that happened to him a few years back. This is what type of recall:
long-term (remote) memory
48
This aspect of assessment determines the pt's ability to focus on a mental task (such as an easy math problem) that's expected to be able to be performed by persons of normal intelligence:
attention span and calculation
49
Though this scale was originally used to predict recovery from head injury, it is now used to assess LOC:
Glasgow Coma Scale
50
The Glasgow Coma Scale test what three areas:
1: eye response, 2: motor response, 3: verbal response An assessment of 15 points indicates that the pt is alert and orientated
51
An automatic response of the body to a stimulus is called:
reflex
52
A DTR (deep tendon reflex) is activated when...
...a tendon is tapped/stimulated and its associated muscles contract
53
Sensory nerve terminals that occur chiefly in the muscles, tendons, joints and internal ear are called:
proprioceptors
54
A neurological assessment of the motor system involves what structures:
Structures involved in proprioception: proprioceptors, posterior column of spinal cord, cerebellum; vestibular apparatus (innervated by cranial 8) of the inner ear
55
What gives information about the position of the body or the body's movements:
stimuli from proprioceptors travel thru posterior columns of the spinal cord
56
What helps to control posture, coordinates body movements with cerebral cortex and controls skeletal muscles to maintain equilibrium?
cerebellum
57
What does a nsg hx focus on when assessing the neurological system?
Orientation, presence of pain (in back, head, or extremities), speech disorder (slurred-indicative of CVA or TIA), LOC
58
A neurological assessment of sensory function involves what structures:
touch, pain, temp, position, and tactile discrimination
59
Lost of sensation upon touch stimuli is defined as:
anesthesia
60
Less than normal sensation upon touch stimuli is defined as:
hypoesthesia
61
More than normal sensation to touch stimuli is defined as:
hyperesthesia
62
You're assessing the sensory function of your pt. Upon touch stimuli to the L cheek, your pt c/o a burning sensation. This finding is:
abnormal and indicative of paresthesia
63
A burning, pain, or electric shock upon touch stimuli is defined as:
paresthesia
64
Because diabetes and arteriosclerotic heart disease can result in the loss of protective sensation of the LE, what program helps to identify pts at increased risks:
LEAP (lower extremity amputation prevention program) requires high risk pts to foot screening 4 times a year
65
The one-two point discrimination, stereognosis, and extinction are all used for...
...tactile discrimination
66
This tactile discrimination tests the ability to sense whether one or two areas of the skin are being stimulated by pressure pins or sharp-dull:
one-two point discrimination
67
This tactile discrimination is the ability to recognize objects by touch or manipulating them:
stereognosis
68
This tactile discrimination is the failure to perceive touch on one side of the body when two symmetric areas of the body are touched simultaneously:
extinction
69
When testing the plantar reflex, a positive Babinski would show:
the toes spread outward and big toe moves upward= abnormal
70
You ask the pt to stand with feet together and arms resting at the sides, first with eyes open then with eyes closed. You're having your pt perform what kind of motor test?
Romberg Test to assess gross motor function
71
You're having your pt perform the Romberg test and you notice that your pt sways slightly but still maintains stance. This finding is:
normal
72
You're having your pt perform the Romberg test and you notice that your pt sways slightly and loses balance with eyes shut. This finding is:
abnormal and indicative of sensory ataxia
73
The lack of coordination of the voluntary muscles is defined as:
sensory ataxia
74
The lack of maintaing balance whether eyes are open or shut is defined:
cerebellar ataxia
75
The finger to nose test, alternating supination and pronation, and finger to thumbs are all assessments of what type of motor functions:
assess fine motor functions
76
You're having your pt perform a gross motor function by having the pt stand on one foot with eyes closed. You notice that the pt loses balance in 3 sec. This finding is:
abnormal. The pt should be able to maintain balance for at least 5 seconds.
77
Stroking the side of the infant's face near mouth and the infant opens mouth while turning head to the side that's stroked is called:
rooting
78
This reflex requires the infant to be supine with head turn to one side with arm on side to which head is turned and the opposite arm should extend.
tonic neck
79
This reflex is done by placing a finger in infants hand and press into palm; the infant curls fingers around.
palmer grasp
80
This reflex is done by holding infant as if weight bearing on surface and watching as infant steps along, one foot at a time
stepping
81
This reflex requires loud noise or unexpected movement; infant spreads arms and legs, extends fingers, flexes and brings hands together; may cry
Moro
82
Most of infant reflexes disappear upon what age:
4-6 months of age
83
You're assessing the Babinski reflex on a three year old. It is positive. This finding is:
abnormal after a child ambulates or at age 2
84
To provide a comprehensive neurological evaluation for children under 5 years of age, what test is performed:
Denver Developmental Screening Test II
85
At what age can we test children using the Romberg Test?
3+
86
Of adults, which sort of memory is affected by age:
short-term memory
87
You are assessing an elderly pt and you've been noticing mood changes, weight loss, anorexia, constipation, and your pt c/o waking up earlier than usual. This finding is:
abnormal and indicative of depression possibly due to loss of support persons (friends family)
88
The stress of being in an unfamiliar situation can cause what in an older adult:
confusion
89
A pt is admitted to ER and you notice a posturing with a flexing out of the limbs. This is called:
Decerebrate rigidity posturing (the worst type of posturing)
90
A pt is admitted to ER and you notice a posturing with limbs very tight against body. This is called:
decorticate rigidity
91
Lifespan Considerations of the Elderly
Short term memory less efficient, unfamiliar situations cause confusion, impulse transmission and reaction time slower, reflexes become less intense; impairment of: hearing, vision, smell, temperature, pain sensation and mental endurance may occur
92
The lack of coordination of the voluntary muscles is defined as:
sensory ataxia
93
The lack of maintaing balance whether eyes are open or shut is defined:
cerebellar ataxia
94
The finger to nose test, alternating supination and pronation, and finger to thumbs are all assessments of what type of motor functions:
assess fine motor functions
95
You're having your pt perform a gross motor function by having the pt stand on one foot with eyes closed. You notice that the pt loses balance in 3 sec. This finding is:
abnormal. The pt should be able to maintain balance for at least 5 seconds.
96
Stroking the side of the infant's face near mouth and the infant opens mouth while turning head to the side that's stroked is called:
rooting
97
This reflex requires the infant to be supine with head turn to one side with arm on side to which head is turned and the opposite arm should extend.
tonic neck
98
This reflex is done by placing a finger in infants hand and press into palm; the infant curls fingers around.
palmer grasp
99
This reflex is done by holding infant as if weight bearing on surface and watching as infant steps along, one foot at a time
stepping
100
This reflex requires loud noise or unexpected movement; infant spreads arms and legs, extends fingers, flexes and brings hands together; may cry
Moro
101
Most of infant reflexes disappear upon what age:
4-6 months of age
102
You're assessing the Babinski reflex on a three year old. It is positive. This finding is:
abnormal after a child ambulates or at age 2
103
To provide a comprehensive neurological evaluation for children under 5 years of age, what test is performed:
Denver Developmental Screening Test II
104
At what age can we test children using the Romberg Test?
3+
105
Of adults, which sort of memory is affected by age:
short-term memory
106
You are assessing an elderly pt and you've been noticing mood changes, weight loss, anorexia, constipation, and your pt c/o waking up earlier than usual. This finding is:
abnormal and indicative of depression possibly due to loss of support persons (friends family)
107
The stress of being in an unfamiliar situation can cause what in an older adult:
confusion
108
A pt is admitted to ER and you notice a posturing with a flexing out of the limbs. This is called:
Decerebrate rigidity posturing (the worst type of posturing)
109
A pt is admitted to ER and you notice a posturing with limbs very tight against body. This is called:
decorticate rigidity
110
Lifespan Considerations of the Elderly
Short term memory less efficient, unfamiliar situations cause confusion, impulse transmission and reaction time slower, reflexes become less intense; impairment of: hearing, vision, smell, temperature, pain sensation and mental endurance may occur
111
The lack of coordination of the voluntary muscles is defined as:
sensory ataxia
112
The lack of maintaing balance whether eyes are open or shut is defined:
cerebellar ataxia
113
The finger to nose test, alternating supination and pronation, and finger to thumbs are all assessments of what type of motor functions:
assess fine motor functions
114
You're having your pt perform a gross motor function by having the pt stand on one foot with eyes closed. You notice that the pt loses balance in 3 sec. This finding is:
abnormal. The pt should be able to maintain balance for at least 5 seconds.
115
Stroking the side of the infant's face near mouth and the infant opens mouth while turning head to the side that's stroked is called:
rooting
116
This reflex requires the infant to be supine with head turn to one side with arm on side to which head is turned and the opposite arm should extend.
tonic neck
117
This reflex is done by placing a finger in infants hand and press into palm; the infant curls fingers around.
palmer grasp
118
This reflex is done by holding infant as if weight bearing on surface and watching as infant steps along, one foot at a time
stepping
119
This reflex requires loud noise or unexpected movement; infant spreads arms and legs, extends fingers, flexes and brings hands together; may cry
It's called Moro
120
Most of infant reflexes disappear upon what age:
4-6 months of age
121
You're assessing the Babinski reflex on a three year old. It is positive. This finding is:
abnormal after a child ambulates or at age 2
122
To provide a comprehensive neurological evaluation for children under 5 years of age, what test is performed:
Denver Developmental Screening Test II
123
At what age can we test children using the Romberg Test?
3+
124
Of adults, which sort of memory is affected by age:
short-term memory
125
You are assessing an elderly pt and you've been noticing mood changes, weight loss, anorexia, constipation, and your pt c/o waking up earlier than usual. This finding is:
abnormal and indicative of depression possibly due to loss of support persons (friends family)
126
The stress of being in an unfamiliar situation can cause what in an older adult:
confusion
127
A pt is admitted to ER and you notice a posturing with a flexing out of the limbs. This is called:
Decerebrate rigidity posturing/or extension posturing (the worst type of posturing)
128
A pt is admitted to ER and you notice a posturing with limbs very tight against body. This is called:
decorticate rigidity/or abnormal flexion
129
Lifespan Considerations of the Elderly
Short term memory less efficient, unfamiliar situations cause confusion, impulse transmission and reaction time slower, reflexes become less intense; impairment of: hearing, vision, smell, temperature, pain sensation and mental endurance may occur
130
What are the usual causes of acute, abrupt-onset mental status changes:
delirium and reversible with TX
131
What are the causes of chronic mental status changes:
dementia and are usually irreversible
132
Your assessing a pt and you notice that your pt has a tremor of the right hand but goes away as she grabs her water glass. This finding is:
Resting tremor: abnormal and maybe indicative of parkinson's
133
You're assessing your pt and you notice that her hand shakes when she grabs her coffee cup but goes away as she puts her hand back on her lap. This finding is:
Intention tremor and abnormal
134
What is used to measure ROM of the joints:
goniometer
