OFF-FIELD CARE (CLINICAL)

Question 1

a patient has trouble with reading words clearly - what CN might be damaged?

Answer 1

CN II - optic - acuity / vision

Question 2

a patient has trouble with their sense of smell - can’t differentiate between coffee and tea - what CN could be damaged?

Answer 2

CN I - olfactory - smell

Question 3

when attempting a smooth pursuit test, a patient has the inability to look outward and down - what CN might be damaged?

Answer 3

CN VI - abducens - abducts the eyes (motor)

Question 4

when testing a patient’s convergence with their eyes - one eye is delayed or they simply cannot perform this movement of the eyes - what CN might be damaged?

Answer 4

CN IV - trochlear - adduction and downward movement of the eye

Question 5

a patient has general difficulty with smooth pursuits and has a hard time tracking a target in front of them - what CN might be damaged?

Answer 5

CN III - oculomotor

Question 6

a patient has difficulty with clenching their teeth together and they also have slt. paraesthesia of their mandible - what CN might be affected?

Answer 6

CN V - trigeminal - sensory and motor functions of mastication

Question 7

a patient has trouble with producing a smile and then a frown and also has a bit of paraesthesia of face) - what CN might be affected?

Answer 7

CN VII - facial - expressions

Question 8

a patient’s balance and sense of hearing has been compromised - when you test them, they can hear from one ear but not the other, what CN could be damaged?

Answer 8

CN VIII - vestibulocochlear

Question 9

a patient has trouble swallowing - what CN might be damaged?

Answer 9

CN IX - glossopharyngeal - gag reflex, swallowing, sensations of tongue

• *possibly CN X - test further
• *possibly CN XII - test further

Question 10

a patient can’t differentiate the difference between saying ‘cah’ and ‘gah’ - what CN might be damaged?

Answer 10

CN X - vagus - swallowing, speech

Question 11

what CN is damaged and what csp nn root is damaged when patient has difficulty shrugging their shoulders?

Answer 11

CN XI - accessory

C4 nn root

Question 12

if you recall the small clip of shakira’s super bowl performance where she had her tongue out - what CN was she using?

Answer 12

CN XII - hypoglossal - tongue movements

Question 13

for deep tendon reflex grading what do the following number indicate?

0
1
2
3
4

Answer 13

0 - no reflex 
1 - reduced reflex (hyporeflexia) 
2 - avg. reflex 
3 - hyperreflexia **may not be pathological 
4 - obvs. over exaggerated reflex

Question 14

what does the absence of a superficial reflex indicate?

Answer 14

lesion in the spinal cord - descending cortical spinal tract

Question 15

what does the presence of a pathological reflex indicate?

Answer 15

lesions in descending upper motor neuron

**absense indicates integrity

Question 16

perform the test for presence of a babinski sign

Answer 16

stroke lateral-plantar aspect of foot

(+) great toe extends and toes splay outward

Question 17

perform the test for the presence of clonus

Answer 17

forceful DF

rhythmical PF of foot

Question 18

perform the test for the presence of the Chaddock reflex

Answer 18

similar to babinski but goes all the way to baby toe

(+) - extension of big toe

Question 19

perform the test for the presence of the Hoffman’s reflex

Answer 19

flick the middle finger of patient

(+) - index and thumb flex together

Question 20

perform the test for the presence of Gordon’s reflex

Answer 20

squeeze calf

(+) - big toe extension and splaying out of toes

Question 21

what two test can help assess lower leg function and spot increased risk of ACL injury?

Answer 21

Landing error scoring system - counts landing errors

tuck jump test - 10 sec (more than 6 flaws - needs technical training)

Question 22

diff between inter-rater and intra-rater reliability? what coefficient is considered very reliable/ not reliable?

Answer 22

inter-rater: extent to where the same examiner can get the same results every-time

intra-rater: extent to where different practitioners can be the same results on the same patient

ideally - 1.0 is reliable

anything below 0.5 isn’t as reliable

Question 23

diagnostic accuracy is compared to what gold standard?

Answer 23

radio-graphic imaging

Question 24

def’n sensitivity

Answer 24

increased sensitivity means that there’s a greater chance that a negative test can rule out an injury

Question 25

def’n specificity

Answer 25

increased specificity means that there’s a greater chance that a positive test can correctly rule in an injury

Question 26

name the 5D’s and 3N

Answer 26

drop attacks - fainting 
dysphagia - trouble swallowing 
dysarthria - trouble speaking 
dizziness 
diplopia - double vision 

Numbness and tingling
nausea
nystagmus