NM practice test 1/19 Flashcards by Chris M

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

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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

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

Guillain-Barré syndrome

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test CN 12

which side impaired?

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

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pathology in what part of brain?

signs of shakiness, slowness of movement, and rigidity

substantia negra of the basal ganglia

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type of gait deviation?

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

steppage gait

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type of gait deviation?

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

Antalgic

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type of gait deviation?

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

Trendelenburg gait

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type of gait deviation?

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

Festinating gait

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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.

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flexor synergy post CVA

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

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

orthostatic hypotension

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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

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

Meniere’s disease

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

TIA

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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

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what term?

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

abulia

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

1 - visual and proprioceptive systems.

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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.

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

4- visual, vestibular

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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.

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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