Neuromuscular

Question 1

when you stand on foam or pillow with eyes open, what systems are you relying on and which are you not relying on? Why?

Answer 1

eyes open, the visual system is relied on.
You are also relying on the vestibular system because it is not compromised.
You are NOT relying on proprioceptive because the pillow is allowing too much movement in the ankles and you cannot rely solely on this system.

Question 2

common impairments left vs right side of the brain CVA

Answer 2

left sided: speech issues, language issues, difficulty planning and sequencing, cautious behavior.
right sided: spatial awareness problems, difficulty sustaining movement and impulsive behavior.

Question 3

when learning a new skill… do you want massed or distributed? do you want frequent feedback

Answer 3

distributed, and no, NO frequent feedback.

Question 4

differentiate between spastic and athetoid CP

Answer 4

spastic CP will have increased tone due to the involvement of the cerebrum motor cortex. There will be couched gait (hip flexion, ADD, IR and knee flexion). There will also be contractures and deformities
Athetoid will be a mixed tone condition. There is an issue int he basal ganglion, and there will be slow integrating reflexes and issues with posture. This is known as “floppy baby” or “worm” due to the mixed tones.

Question 5

sustained contractions is indicative of

Answer 5

dystonia

Question 6

chorea is described as

Answer 6

rapid/jerky movements

Question 7

moving the eyeball lateral tests the ___ CN

Answer 7

abducens, 6.

Question 8

how do you test the VOR

Answer 8

rapid, movements of the head with high velocity and high acceleration so the eyes can stay fixed on a target in those conditions.

Question 9

Cremasteric reflex.

Answer 9

For the cremasteric reflex text, the patient lies in supine position while the examiner strokes the inner side of the upper thigh with a pointed object. The test result is negative if the scrotal sac on the tested side pulls up. Unilateral absence of this response indicates a lower motor neuron lesion between L1 and L2.

Question 10

anal sphincter contraction comes from what nerve roots

Answer 10

S2-4

Question 11

Gluteal sensation comes from what nerve roots

Answer 11

L4-5 and S1-3

Question 12

superficial abdominal reflex

Answer 12

Movement of the umbilicus down and toward the area being stroked is due to the superficial abdominal reflex. The examiner uses a pointed object to stroke each quadrant of the abdomen of the supine patient in a triangular fashion around the umbilicus. Absence of the reflex (movement of the skin) indicates an upper motor neuron lesion; unilateral absence indicates a lower motor neuron lesion from T7–L2, depending on where the absence in noted, as a result of segmental innervation.

Question 13

flexion synergy of the UE looks like…

Answer 13

scapular elevation/retraction and hyperextension, shoulder ABD, ER, elbow flexion, forearm supination and finger and wrist flexion.

Question 14

if you nee to mobilize a scapula that is in a flexor synergy, how would you do it

Answer 14

upward rotation and protraction. we want to preserve the subacromial space in there and not cause more damage.

Question 15

difference between decorticate and decerebrate

Answer 15

decorticate is a comatose patient with a lesion above the superior colliculi that will result in UE flexion and LE extension
Decerebrate is a lesion between the superior colliculi and the vestibular nucleus resulting in all extension at the Extremities and trunk and neck.

Question 16

jaw reflex tests tests the integrity of which CN

Answer 16

5- trigeminal

Question 17

what causes central cord syndrome

Answer 17

hyperextension of the neck

Question 18

lump in the throat is indicative of

Answer 18

transverse ligament tear

Question 19

bowel function with the following two conditions:
above S2-4
Below S2-4

Answer 19

above S2-4 spastic bowel with spinal dedication reflexes intact
below flaccid bowel (loss of spinal defecation reflexes)

Question 20

what is the Tinel sign

Answer 20

this is a sign for CTS, where you tap the anterior surface of the wrist from primal to distal.

Question 21

describe the Spurling test

Answer 21

compression of the spine with ipsilateral rotation and extension

Question 22

direct pressure at the base of the thumb with test for

Answer 22

bowlers thumb.

Question 23

do you transfer to the stronger or weaker side

Answer 23

stronger side. example, if you are s/p hip arthroplasty, you will want to transfer to the stronger side and not onto the weaker surgical side.

Question 24

what factor best predicts upper extremity function following a CVA

Answer 24

having active wrist and finger extension

Question 25

Phalen test is for

Answer 25

carpal tunnel, this is when the wrists are together and the fingers are pointing down to the ground.

Question 26

Allen test is for

Answer 26

TOS

Question 27

Froment test is for

Answer 27

ulnar nerve. pinch the paper. A positive test is if the thumb cannot stay flat and straight when gripping the paper, and when there is abnormal flexion in the thumb.

Question 28

piano key test is for

Answer 28

distal radioulnar injury.

Question 29

upbeating vs downbeating nystagmus and determining which canal. then what about right and left torsion.

Answer 29

the upbeating indicates a posterior canal whereas the downbeating indicated an superior canal. right torsion means its the right side, and left is with left.

Question 30

what is the beginning stage of motor learning and what should you do here

Answer 30

cognitive stage, this is where cues, instruction, guidance and demonstration should be used here.

Question 31

Performing a task with little cognitive attention at variable speeds is characteristic of the ___ stage of learning.

Answer 31

autonomous

Question 32

Problem-solving independent from the therapist’s feedback is characteristic of the ___ stage of learning.

Answer 32

associative

Question 33

Exploration of different strategies with little or no input from the therapist is characteristic of the ___ stage of learning.

Answer 33

associative

Question 34

what CN palsy can lead to torticollis in a child

Answer 34

CN 4, trochlear due to a visual deficit in which the eyes cannot move. can cause diplopia, so kids will tilt their head anteriorly and laterally towards the good side.

Question 35

name some contraindications for postural drainage

Answer 35

head trauma
spinal fusions
eye surgeries

Question 36

precautions for postural drainage

Answer 36

pleural effusion

PE

Question 37

chorea is an issue in what structure of the brain

Answer 37

basal ganglia

Question 38

list some components of the DCML

Answer 38

proprioception, discrimination light touch, vibration.

Question 39

what is on the anterolateral tract

Answer 39

distinction between hot and cold and light touch

Question 40

___ ___ grade is an important predictor of motor recovery

Answer 40

Initial paresis

Question 41

cubital tunnel entrapment is the ___ nerve

Answer 41

ulnar nerve

Question 42

what runs through the pronator teres

Answer 42

median nerve

Question 43

FCR, FDS, FPL, FPB are all innervated by

Answer 43

median nerve

Question 44

Bakody sign

Answer 44

TOS

Question 45

agonist reversals will help with what kind of contraction

Answer 45

eccentric (also concentric and isometric too)

Question 46

rhythmic stabilizations help with

Answer 46

isometric contractions

Question 47

rhythmic initiations help with

Answer 47

concentric contractions

Question 48

dynamic reversals only focus on

Answer 48

concentric

Question 49

musculocutaneous nerve innervates the

Answer 49

biceps and brachialis.

Question 50

brachioradialis is innervated by the

Answer 50

radial nerve

Question 51

pronator teres innervated by

Answer 51

median nerve

Question 52

feedback should occur after every __- reps for hard and simple tasks

Answer 52

simple, after 15

hard after 5

Question 53

Which of the following interventions is MOST appropriate to improve stability in long sitting for an individual with a complete T4 spinal cord injury?

Answer 53

stretch hamstrings to 110 degrees SLR to stretch the naturally tight low back.

Question 54

how can you test figure ground discrimination

Answer 54

you can look at the white button on the white shirt. they cannot tell the difference between the object and the background in which it is embedded.

Question 55

Which of the following exercises promotes context-dependent responses in a patient who has Parkinson disease?
swimming
treadmill
walking outside 
stationary bike.

Answer 55

Exercises such as karate and other martial arts, dancing, and walking outdoors promote context-dependent responses and are important to incorporate in treatment of patients who have movement disorders because these exercises require patients to adjust the response to a specific task

Question 56

retention is tested after

Answer 56

a period of no practice.

Question 57

APGAR score looks at

Answer 57

appearance (A), pulse (P), grimace (G), activity (A), and respiration (R)
scored on a scale of 10. because each one is scored out of 2
tests at 1 or 5 minutes. over 7 means the baby is ok.

Question 58

how will reflexes look in MS

Answer 58

hyperreflexive

Question 59

cranial nerves responsible for eye movements

Answer 59

CN III oculomotor: ADD, ELEVATION AND DEPRESSION OF EYE
CN IV: trochlear, depression of an adducted eye
CN VI: abducens: lateral abduction movements of the eye

Question 60

A physical therapist is conducting an initial examination with a patient who has a history of an ASIA Impairment Scale A cervical spinal cord injury. The patient has 5/5 muscle strength in the elbow flexors, elbow extensors, finger flexors, and wrist extensors but 0/5 muscle strength in the finger abductors. What is the patient’s motor level?

Answer 60

C8 because the T1 would be the finger abductors, so the next likely with the 5/5 strength is the finger flexors which is C8.

Question 61

spinothalamic tract relays ___ and ___ information in the spinal cord.

Answer 61

pain and temperature

Question 62

The spinocerebellar tract relays unconscious ___ in the spinal cord.

Answer 62

proprioception

Question 63

the ___ are the key muscle group to facilitate independence in lateral transfers

Answer 63

triceps