Neurology objective assessment 2

Question 1

recording abnormal tone

Answer 1

tone diagram, modified Ashworth scale for grading, ROM, muscle strength

Question 2

why wouldn’t you want to test strength?

Answer 2

associated reaction- neuroplasticity, if they have a lot of high tone, then don’t go resistance

Question 3

strength testing- isometric and isotonic

Answer 3

neuro patients may be strong enough to a through full range of in isotonic test, isometric strength may be more appropriate

Question 4

strength testing- psychological effect

Answer 4

if you ask them to do a lot of movements that they can’t do- negative psycho effects

Question 5

strength testing- AROM

Answer 5

can pick up strength through AROM- of tehy can do full AROM- grade 3 oxford scale, could then test resistance.

Question 6

outcome measure- observations and AROM/ PROM, strength

Answer 6

observations- photos, videos- how it changes over time (Progression), AROM- goniometer- can be difficult as examining all joints/ movement, PROM- goniometer, photos, tone- modified ashworth scale
strength- oxford scale

Question 7

why do we asses

Answer 7

essential to identify patients problems from their perspective- participatory and activity problems, essential to understand what led to these problems- impairments
problem lost, goals, treatment plan

Question 8

impairment problems

Answer 8

such as pain, ROM, strength, sensory deficit, coordination issues, tonal changes

Question 9

sensory testing

Answer 9

proprioceptive, sharp/ blunt, 2 point sensation, light and deep, sterogonosis damage can occur anywhere along the sensory pathway

Question 10

how do sensory receptors work

Answer 10

sensory receptors- peripheral sensory pathway (FON), synapse in spinal cord, sensory tract in spinal cord (SON), synapse at the thalamus, sensory tract from thalamus to sensory cortex (TON), synapse at sensory cortex

Question 11

sensory receptors- muscle spindle

Answer 11

responds to quick stretch- causes contraction, assess during quick stretch- PROM needs to be slow and controlled- don’t want to activate spindle, leads to formation of reflex arc

Question 12

sensory receptors- golgi tendon

Answer 12

responds to muscle tension, stimulated during stretching, it relaxes the muscle once stimulated

Question 13

sensory receptors- pancinan corpuscles and free nerve endings

Answer 13

(in muscles and joints) respond to vibrations, pressure and pain (nociceptive)

Question 14

sensory receptors- ruffini ending and golgi tyoe endings

Answer 14

injoints, respond to vibrations, pressure and pain (nociceptive)

Question 15

sensory receptors- in skin

Answer 15

merkel discs and messner corpuscles, ruffini endings, pacinian corpuscles, free nerve endings- respond to mechanic pressure, thermal and nociceptive input

Question 16

what happens when sensory systems are stimulated

Answer 16

to get sensory information to the brain

Question 17

what do the sensation tests test- proprioception

Answer 17

dorsal column crosses in the medulla to thalamus to SC

Question 18

what do the sensation tests test- shar/blunt

Answer 18

lateral spinal thalamic crosses in the spinal cord to thalamus

Question 19

what do the sensation tests test- 2 point sensation

Answer 19

dorsal columns crosses in the medulla to thalamus to SC

Question 20

what do the sensation tests test- light touch

Answer 20

dorsal columns crosses in the medulla to thalamus to SC

Question 21

what do the sensation tests test- stereognosis

Answer 21

dorsal columns and spino-thalamic tracts

Question 22

how do you test dermatomes

Answer 22

test dermatomes- for a SCI and peripheral nerve injury

use fugl-meyer or Nottingham sensory assessment for SVA or TTBI or any CNS problem

Question 23

coordination testing

Answer 23

finger to nose test (FTN) heel to shin test (HTS)

Rapid movements- dysdiadokinesis- parkinsons- lack of intitian leads to lack of rapid movements

Question 24

what does coordination testing test

Answer 24

test cerebellum- uncoordinated movement

Question 25

deep tendon reflexes

Answer 25

elicit with reflex hammer, patient/ muscle both relaxed, tendon is put on slight stretch, adequate stimulus, i.e. brisk tap to tendon. test 3-6 times (diminuation)

Question 26

deep tendon reflexes- high tone and low tone

Answer 26

high tone- hyper reflexive response, low tone patient- reduced reflex

Question 27

what tendons are being tested

Answer 27

bicep brachii, triceps, supinator, brachoradlais, quads, hamstrings, TFL/ glut med, Achilles

Question 28

functional assessment

Answer 28

rolling right to left, lying to sitting, sitting balance, sit to stand, standing balance, gait, steps and stairs, uL function- PADL, DADL

Question 29

Outcome measure- coordination

Answer 29

9-hole peg test, SARA- questionnaire

Question 30

outcome measure- funcional assessment

Answer 30

rolling- video, lying to sitting- video, sitting balance- PASSS, sit to stand- Video, standing balance- 180/ TUSS/ GUAG/ BB, gait 10m/6m/3m/ISWT/6MWT
UL function- timed or video, PADL, DADL