NMR Mastery Quiz Spring 2016 Flashcards
What area all the test/screenings to be covered (9)
Light touch Pain (Sharp/Dull) Temperature Position Sense Passive Movement sense Cerebellar function Isolation of Movement Visual Fields Visual Tracking
Light Touch
Using a cotton swab touch the patient on all surfaces of the skin and have them verbalize when they feel a touch. (eyes closed)
Reason for using light touch screen
They are unable to sense someone tapping them to get their attention
They don’t realize when clothing has been move or abducted on their skin
Superficial pain (sharp vs dull)
Break a tongue depressor using twisting torsion motion. With the patients eyes closed alternate between the dull and sharp side and have them verbalize if it is sharp or dull
Reasons for doing the sharp/dull
When reaching for something they may prick themselves and not realize it until later
Temperature touch
Use two test tubes of water one hot and one cold and see if they can tell the difference. Make. Sure you use the same method to apply the test tube to the skin each time
Reason for temperature test
Sometimes when they are getting into the tub they can not tell how hot it is and cause some irritation or burning of the skin. Also going outside may not notice if a body part is not covered. Want to see if some modalities are appropriate for use in therapy.
Position sense test
Move one joint through chosen range holding a bony landmark. Identify the different positions of end range as up or down. With eyes close work in small alternating ranges and stop to ask them what position they are in.
Reason for position sense test
Sometimes when you are in your wheel chair your arm falls off the arm rest and you do not notice and you banged it against a doorway.
Passive movement sense
Start with the uninvolved or less involved arm and passively move the arm through random motions. Have the patient mirror the motion of the uninvolved extremity with the involved. If they are unable to perform the movements have them verbalize.
What’s another word for passive movement sense
Kinesthesia
Why use the passive movement sense test
Sometimes when you are in your wheel chair your arm falls off the arm rest and you do not notice and you banged it against a doorway.
What are the cerebellar function tests
Dysmetria
Diadokokinesia
Rebound
What is dysmetria
Inability to judge the distance or range of a movement
Overshooting a target
Hypermetria
Undershooting a target
Hypometria
Dymetria test
Finger to nose Finger to finger Finger to PT's finger Opposition of thumb to each finger (eyes open and eyes closed)
What is Diadokokinesia
Inability to complete rapid alternative movements
Diadokokinesia test
Start with nonalternating movements initially and then move to alternating movements
(Eyes open and Eyes closed)
Upper Extremity Diadokokinesia Test Movements
Supination
Probation
Wrist flex/Ext
Hand open/closed
Lower Extremity Diadokokinesia Test Movements
Dosiflexion
Plantar flexion
Knee flexion
Knee extension
What is the rebound phenomenon
Loss of the “check” reflex function to halt forceful movement after resistance has been eliminated
Rebound test
PT applies resistance to a joint in one direction and asks the pt to resist. The PT releases and observes the ability of the pt to dampen the response to the loss of resistance.
1 joint isolation tests
One joint at a time. We are observing to see if they can do the pattern without any synergistic patterns. If there are two movements occurring at the same time they fail the test.
2 joint isolation
Looking at two diffent joints moving at the same time. Each joint that is moving will have to be opposite of the synergy pattern of the other joint which is moving
3 joint synergy
3 joints moving one in one synergy pattern and the other two in a different pattern.
Flexion synergy of the upper extremity
Scapular elevation and addiction GH extension, ER, Abduction Elbow flexion Forearm Supination Wrist flexion Finger flexion
Extension synergy of lower extremity
Hip extension, IR, adduction
Knee extension
Ankle PF and inversion
Extension synergy of upper extremity
Scapular depression and abduction GH minor flexion, IR, adduction Elbow extension Wrist Pronation Wrist flex or extension Fingers flexed
Flexion synergy of lower extremity
Hip flexion, abduction, and ER
Knee flexion
Ankle dorsiflexion
Foot inversion
Strongest components of upper extremity flexion synergy
Shoulder addiction and elbow flexion
Weakest components of upper extremity flexion synergy
Shoulder abduction
Shoulder ER
Strongest component of lower extremity extension
Knee extension
Hip Abduction
Plantar flexion
Weakest components of lower extremity extension
Hip extension
Document superficial sensations testing
Any areas on the body that have decreased or absent sensation (pt was unable to identify soft touch on the anterior surface of the forearm just distal to the elbow joint line)
Document position testing
Patient was unable to identify the position when the elbow was placed in the flexed position showing a lack in proprioceptive awareness in the Right upper extremity
Document dysmetria
Pt demonstrated dysmetria with bilateral finger to nose w/ eyes open and closed
Document Rebound
Pt demonstrated positive rebound in bilateral upper extremities when testing elbow flexors and knee extensors
Temperature range for hot test
104-113
Temperature for cold test
41-50
