NM practice test 1/19 Flashcards

1
Q

where is nerve entrapment?

  • numbness and tingling on the 4th and 5th fingers of the left hand
  • normal sensation on the hypothenar eminence of the hand
  • altered sensation on the 4th and 5th digits
A

Guyon’s Canal

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2
Q

where is nerve entrapment?

  • numbness and tingling on the 4th and 5th fingers of the left hand
  • dorsum hand altered sensation
  • Flexor carpi ulnaris and medial half FDP weak
A

Cubital Tunnel

dorsal cutaneous branch that innervates the dorsum of the hand

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3
Q

what pathology?
lower motor neuron disease
myelin sheath is destroyed, thus eliminating nerve conduction.

A

Guillain-Barré syndrome

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4
Q

test CN 12

which side impaired?

A

patient to stick out the tongue and move it side to side against resistance.
deviate to weak side

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5
Q

pathology in what part of brain?

signs of shakiness, slowness of movement, and rigidity

A

substantia negra of the basal ganglia

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6
Q

type of gait deviation?

patient lifting the knee higher to compensate for a lack of dorsiflexion

A

steppage gait

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7
Q

type of gait deviation?

painful gait, which is primarily noted by decreased stance time on the painful LE.

A

Antalgic

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8
Q

type of gait deviation?

contralateral hip drop during stance phase and is caused by weak hip abductors

A

Trendelenburg gait

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9
Q

type of gait deviation?

associated with Parkinsonism and is characterized by very small, rapid steps which appear progressively more unsteady

A

Festinating gait

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10
Q
possible concussion- 
constant headache, 
sensitive to light, and 
feels slightly dizzy.
best initial action?
A

Assess symptoms and perform cognitive and balance testing.

  • should not return to play the same day if he has had a concussion.
  • symptoms monitored for several hours after returning home to insure there is no intracranial bleeding
  • determine the severity of the signs/symptoms before making a referral.
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11
Q

flexor synergy post CVA

A

scapular retraction, humeral abduction, elbow flexion, wrist supination, and wrist and finger flexion

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12
Q

what pathology?
feeling dizzy and lightheaded upon standing
sudden drop in blood pressure upon standing

A

orthostatic hypotension

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13
Q

what pathology?
dizziness lasting about 1 minute following head position changes, such as stooping or turning, rolling in bed
treatment?

A

BPPV

  • Ant/Post: (semont liberatory) Epley
  • horizontal: (gufoni, casani) BBQ Roll
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14
Q

what pathology?
fluid imbalance in the inner ear.
cause persistent dizziness and lightheadedness.

A

Meniere’s disease

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15
Q

what pathology?
stroke-like symptoms <24 hours
not related to position changes.

A

TIA

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16
Q

what term?
lack of the ability to carry out purposeful movement. This is commonly manifested by the confusion of objects with their purposes, such as the described brush example.

A

apraxia

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17
Q

what term?

absence of willpower or an inability to act decisively, as a symptom of mental illness.

A

abulia

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18
Q

CTSIB condition?
what does it test?
feet together ankles touching, arms crossed, stand 30 sec, 3x

A

1 - visual and proprioceptive systems.

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19
Q

CTSIB condition?
what does it test?
- feet together ankles touching, arms crossed, eyes closed, stand 30 sec, 3x
- feet together ankles touching, arms crossed, visual conflict dome, stand 30 sec, 3x

A

2 and 3- proprioceptive systems.

dome - more accurately resemble movements in a crowd or among moving objects, testing the vestibular system.

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20
Q

CTSIB condition?
what does it test?
stand on 3in foam, arms crossed, feet together, stand 30 sec, 3x

A

4- visual, vestibular

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21
Q

CTSIB condition?
what does it test?
- stand on 3in foam, arms crossed, feet together, eyes closed, stand 30 sec, 3x
- stand on 3in foam, arms crossed, feet together, visual conflict dome, stand 30 sec, 3x

A

5 and 6 - vestibular

dome - more accurately resemble movements in a crowd or among moving objects, testing the vestibular system.

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22
Q

young patient with ventriculoperitoneal shunt
displays headache, ataxia, and loss of coordination
next step?

A

refer to physician

23
Q

what pathology?

Motor loss that is greater in the upper extremities than the lower extremities, with very limited sensory impairments

A

central cord

- damages the spinothalamic tract, corticospinal tract, and dorsal columns

24
Q

what pathology?

incomplete lesion that affects pain sensation, proprioception, and two-point discrimination

A

Posterior Cord Syndrome

25
Q

what pathology?

injury that occurs below L1 and usually results in loss of bowel or bladder function.

A

Cauda Equina Syndrome

26
Q

what motor learning strategy?

primarily postural control activities, movement sequencing, and key therapeutic handling techniques

A

bobath, NeuroDevelopmental Treatment- control initiation and sequencing control constructs

27
Q

what motor learning strategy?

balanced control of agonist and antagonist muscles.

A

Proprioceptive neuromuscular facilitation

28
Q

what motor learning strategy?

sensory integration to move independent of a reflex stimulus

A

Rood’s sensorimotor learning

29
Q

what motor learning strategy?

all motion is hierarchical and that higher centers control or inhibit lower centers

A

Hierarchical reflex theory

30
Q

rancho TBI level?

no carry-over of information, but the patient behaves appropriately in familiar settings.

A

VI is the confused/appropriate

31
Q

rancho TBI level?

commands are followed, but still not purposeful.

A

V is the confused/nonagitated

32
Q

what joint receptors?

vibration and acceleration.

A

Pacinian corpuscles

33
Q

what spinal level?
brachioradialis reflex test
biceps reflex test

A

C5-C6

34
Q

what spinal level?

triceps reflex test

A

C6-C7

35
Q

what part of brain?

thalamus, hypothalamus, posterior pituitary gland, and pineal gland.

A

Diencephalon

36
Q

what part of brain?

cerebrum, including the outer lobes of the brain.

A

Telencephalon

37
Q

what part of brain?

midbrain, and contains the substantia nigra and other motor control pathways.

A

Mesencephalon

38
Q

what part of brain?

pons and cerebellum region of the brain.

A

Metencephalon

39
Q

ipsi/contra impairment?

Cerebellar lobe

A

ipsi

40
Q

ipsi/contra impairment?

Anterior corticospinal tract

A

contra

decussates at the spinal level where it exits the spinal cord.

41
Q

ipsi/contra impairment?

Spinothalamic tract

A

decussates and courses up the contralateral side.

42
Q

post CVA pt in extensor synergy best initial intervention for gait

A

Fit the patient with an ankle-foot orthosis.

allow the patient to begin ambulation and neuromuscular reeducation sooner.

43
Q

what pathology?

losing strength in his thumb and is unable to perform a “tip to tip pinch grip”

A

Anterior interosseous nerve syndrome

flexor pollicis longus and lateral flexor digitorum profundus. This results in 1st and 2nd digit paralysis

44
Q

what pathology?

  • progressive weakness and fatigue, onset 1 yr ago
  • increasing fatigue, diminished muscle mass, and generalized muscle pain
  • There are no lab tests or imaging to confirm this diagnosis.
A

Post-polio syndrome

affects people who had poliomyelitis approximately 15-30 years earlier.

45
Q

intervention focus
preteen spina bifida occulta
- bilateral leg weakness and difficulty walking.

A
  • exercises to increase tone in the flaccid legs

- become as independent as possible.

46
Q

SNS/PNS

dilate branchioles

A

SNS

47
Q

SNS/PNS

Constricted pupil size

A

PNS

48
Q

SNS/PNS
Increased peristalsis
Decreased renin production

A

PNS

renin related to vasoconstriction

49
Q

which balance strategy

static standing in hallway with people

A

ankle strategy is most used during simple standing activities.

50
Q

what pathology?

  • women 35-50 years old
  • great increase in pain in her left arm, describes as an “intense burning.
  • swells, turns slightly blue, and is extremely sensitive
  • persistent several days
A

Reflex sympathetic dystrophy, chronic regional pain syndrome

51
Q

what pathology?
- sharp, burning pain or numbness in the ball of the foot or toes.
- between your third and fourth toes
treatment?

A

morton’s neuroma

treat: arch supports and foot pads, corticosteroid injections, strength exercises, wide-toe shoes, or surgery.

52
Q

what pathology?
- numbness, tingling, burning pain over the plantar aspect of the foot
- Ankle pain
- worse when standing or during activity.
treatment?

A

Tarsal tunnel syndrome
treat: avoiding certain activities, orthotics, anti-inflammatory medications. In rare cases, steroid injections can reduce inflammation.

53
Q

what nerve pathology?

weak wrist extensors and supinators

A

posterior interosseous nerve

a branch of the radial nerve