NM practice test 1/19 Flashcards
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
Guyon’s Canal
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
Cubital Tunnel
dorsal cutaneous branch that innervates the dorsum of the hand
what pathology?
lower motor neuron disease
myelin sheath is destroyed, thus eliminating nerve conduction.
Guillain-Barré syndrome
test CN 12
which side impaired?
patient to stick out the tongue and move it side to side against resistance.
deviate to weak side
pathology in what part of brain?
signs of shakiness, slowness of movement, and rigidity
substantia negra of the basal ganglia
type of gait deviation?
patient lifting the knee higher to compensate for a lack of dorsiflexion
steppage gait
type of gait deviation?
painful gait, which is primarily noted by decreased stance time on the painful LE.
Antalgic
type of gait deviation?
contralateral hip drop during stance phase and is caused by weak hip abductors
Trendelenburg gait
type of gait deviation?
associated with Parkinsonism and is characterized by very small, rapid steps which appear progressively more unsteady
Festinating gait
possible concussion- constant headache, sensitive to light, and feels slightly dizzy. best initial action?
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.
flexor synergy post CVA
scapular retraction, humeral abduction, elbow flexion, wrist supination, and wrist and finger flexion
what pathology?
feeling dizzy and lightheaded upon standing
sudden drop in blood pressure upon standing
orthostatic hypotension
what pathology?
dizziness lasting about 1 minute following head position changes, such as stooping or turning, rolling in bed
treatment?
BPPV
- Ant/Post: (semont liberatory) Epley
- horizontal: (gufoni, casani) BBQ Roll
what pathology?
fluid imbalance in the inner ear.
cause persistent dizziness and lightheadedness.
Meniere’s disease
what pathology?
stroke-like symptoms <24 hours
not related to position changes.
TIA
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.
apraxia
what term?
absence of willpower or an inability to act decisively, as a symptom of mental illness.
abulia
CTSIB condition?
what does it test?
feet together ankles touching, arms crossed, stand 30 sec, 3x
1 - visual and proprioceptive systems.
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
2 and 3- proprioceptive systems.
dome - more accurately resemble movements in a crowd or among moving objects, testing the vestibular system.
CTSIB condition?
what does it test?
stand on 3in foam, arms crossed, feet together, stand 30 sec, 3x
4- visual, vestibular
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
5 and 6 - vestibular
dome - more accurately resemble movements in a crowd or among moving objects, testing the vestibular system.
young patient with ventriculoperitoneal shunt
displays headache, ataxia, and loss of coordination
next step?
refer to physician
what pathology?
Motor loss that is greater in the upper extremities than the lower extremities, with very limited sensory impairments
central cord
- damages the spinothalamic tract, corticospinal tract, and dorsal columns
what pathology?
incomplete lesion that affects pain sensation, proprioception, and two-point discrimination
Posterior Cord Syndrome
what pathology?
injury that occurs below L1 and usually results in loss of bowel or bladder function.
Cauda Equina Syndrome
what motor learning strategy?
primarily postural control activities, movement sequencing, and key therapeutic handling techniques
bobath, NeuroDevelopmental Treatment- control initiation and sequencing control constructs
what motor learning strategy?
balanced control of agonist and antagonist muscles.
Proprioceptive neuromuscular facilitation
what motor learning strategy?
sensory integration to move independent of a reflex stimulus
Rood’s sensorimotor learning
what motor learning strategy?
all motion is hierarchical and that higher centers control or inhibit lower centers
Hierarchical reflex theory
rancho TBI level?
no carry-over of information, but the patient behaves appropriately in familiar settings.
VI is the confused/appropriate
rancho TBI level?
commands are followed, but still not purposeful.
V is the confused/nonagitated
what joint receptors?
vibration and acceleration.
Pacinian corpuscles
what spinal level?
brachioradialis reflex test
biceps reflex test
C5-C6
what spinal level?
triceps reflex test
C6-C7
what part of brain?
thalamus, hypothalamus, posterior pituitary gland, and pineal gland.
Diencephalon
what part of brain?
cerebrum, including the outer lobes of the brain.
Telencephalon
what part of brain?
midbrain, and contains the substantia nigra and other motor control pathways.
Mesencephalon
what part of brain?
pons and cerebellum region of the brain.
Metencephalon
ipsi/contra impairment?
Cerebellar lobe
ipsi
ipsi/contra impairment?
Anterior corticospinal tract
contra
decussates at the spinal level where it exits the spinal cord.
ipsi/contra impairment?
Spinothalamic tract
decussates and courses up the contralateral side.
post CVA pt in extensor synergy best initial intervention for gait
Fit the patient with an ankle-foot orthosis.
allow the patient to begin ambulation and neuromuscular reeducation sooner.
what pathology?
losing strength in his thumb and is unable to perform a “tip to tip pinch grip”
Anterior interosseous nerve syndrome
flexor pollicis longus and lateral flexor digitorum profundus. This results in 1st and 2nd digit paralysis
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.
Post-polio syndrome
affects people who had poliomyelitis approximately 15-30 years earlier.
intervention focus
preteen spina bifida occulta
- bilateral leg weakness and difficulty walking.
- exercises to increase tone in the flaccid legs
- become as independent as possible.
SNS/PNS
dilate branchioles
SNS
SNS/PNS
Constricted pupil size
PNS
SNS/PNS
Increased peristalsis
Decreased renin production
PNS
renin related to vasoconstriction
which balance strategy
static standing in hallway with people
ankle strategy is most used during simple standing activities.
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
Reflex sympathetic dystrophy, chronic regional pain syndrome
what pathology?
- sharp, burning pain or numbness in the ball of the foot or toes.
- between your third and fourth toes
treatment?
morton’s neuroma
treat: arch supports and foot pads, corticosteroid injections, strength exercises, wide-toe shoes, or surgery.
what pathology?
- numbness, tingling, burning pain over the plantar aspect of the foot
- Ankle pain
- worse when standing or during activity.
treatment?
Tarsal tunnel syndrome
treat: avoiding certain activities, orthotics, anti-inflammatory medications. In rare cases, steroid injections can reduce inflammation.
what nerve pathology?
weak wrist extensors and supinators
posterior interosseous nerve
a branch of the radial nerve
