Patient Assessment

Question 1

What different components are performed in a patient assessment?

Answer 1

• Hx on File
• Subjective Hx
• Observation
• Muscle Screen (length and strength)
• Sensation
• Reflexes
• Spasticity
• Orofacial Fx
• Cranial Nerves
• Vision
• Balance
• Cognition/Proprioception
• Functional Tests (MAS)

Question 2

What test is used to test light touch sensation?

Answer 2

Using a cotton ball, gently touch the patient’s skin in different places.
- Positive test if sensation is felt

Question 3

What test is used to test sharp/blunt sensation?

Answer 3

Using the sharp/blunt device, touch the patients skin and ask them to tell you if they feel a sharp or blunt sensation
- Positive test id sensation is felt

Question 4

What test is used to test static proprioception?

Answer 4

Therapist puts one clients limbs in a position and ask the patient to match that position with opposing limb

Question 5

What test is used to test dynamic proprioception?

Answer 5

Patient has eyes closed. Therapist moves limb and ask the patient whether they are flexing, extending, moving up or moving down

Question 6

What test is used to test temperature sensation?

Answer 6

Hot/Cold Test

Question 7

How do you test Reflexes?

Answer 7

Therapist uses a reflex hammer to determine if reflexes are present

Question 8

How do you grade reflexes?

Answer 8

A number system:
0 - Absent
1 - Trace
2 - Normal
3 - Brisk
4 - Fatigable Clonus
5 - Sustained Clonus

Question 9

How do you test Patella tendon reflexes?

Answer 9

Note: hammer must hit perpendicular to tendon

Pt. Supine
Knee bent to 90 with PT arm support
PT hits tendon for tendon reflex

Question 10

How do you test Achilles tendon reflexes?

Answer 10

Note: hammer must hit perpendicular to tendon

Pt. Supine
Knee bent w/ hip ER + towel to support under knee
PT holds Pt. foot in neutral
PT hits tendon for tendon reflex

Question 11

How do you test Babinski Reflex?

Answer 11

Using reflex hammer, draw a C shape on pt. foot
PT looking for scrunching of foot

Question 12

How do you test Biceps tendon reflexes?

Answer 12

Note: hammer must hit perpendicular to tendon

PT places pt. arm in slight F
PT places thumb on biceps tendon
Hammer hits PT thumb looking for reflex response

Question 13

How do youngest Triceps tendon reflexes?

Answer 13

Note: hammer must hit perpendicular to tendon

Pt. humerus by side (supported by towel), forearm across chest
PT hits Triceps tendon looking for reflex response

Question 14

What Scale is used for measuring tone?

Answer 14

The Ashworth Scale

Question 15

How is the Ashworth Scale measured?

Answer 15

A numbering system:
0 =
no increase in tone
1 =
slight increase in tone
catch and release
present in end of range
1+ =
slight increase in tone
catch
minimal resistance for less than 1/2 of range
2 =
more marked tone
throughout most of range
3 =
considerable tone increase
through most of range
passive movement difficult
4 =
rigid in flexion or extension

Question 16

What scale is used for measuring spasticity?

Answer 16

The Tardieu Scale

Question 17

How is the Tardieu Scale measured?

Answer 17

Spasticity is Velocity dependent

V1 = PROM measurement
V2 = speed of gravity fall
V3 = fast as possible

Muscle Reaction (X)
0 = no resistance
1 = slight resistance through passive
2 = clear catch, interrupting passive, followed by release
3 = fatiguable clonus (less than 10s)
4 = infatiguable clonus (more than 10s)

Question 18

What do you need to note in terms of Orofacial Fx?

Answer 18

• Changes in taste?
• Changes in hearing?
• Check swallow
• Check motor Fx