Skill Check 2 Flashcards

Question

Where to palpate triquetrum

Answer 1

-posterior side by capitate/slightly below - Radially deviate wrist and palpate just distal to the ulnar styloid process

Answer 2

hook on palmar medial side below and attached to the top of triquetrum (anterior)

Answer 3

right below capitate (posterior)

Answer 4

large and on palmar side right by lunate and below trapezium

Answer 5

– Between pisiform and hook of hamate – Passage of ulnar nerve and ulnar artery to the hand

Answer 6

Ulnar deviate

Answer 7

Make into snuff box (radial styloid)

Answer 8

Flexion/extend wrist

Answer 9

-In full forearm supination and elbow extension, place opposite hand over the forearm with the thenar eminence over the medial epicondyle – Allow the fingers to spread over the forearm * Pronator teres: thumb * Flexor carpi radialis: index finger * Palmaris longus: middle finger * Flexor carpi ulnaris: ring finger

Answer 10

– Brachioradialis: lateral supracondylar ridge to distal lateral radius at the styloid process (functionally elbow flexor) – Extensor carpi radialis longus: radial supracondylar ridge to the base 2nd MC – Extensor carpi radialis brevis: lateral epicondyle to the base of the 3rd MC

Answer 11

-Carpal tunnel area – Attached laterally to the tubercle of scaphoid and tubercle of trapezium – Attached medially to pisiform and hook of hamate

Answer 12

Thumb abduction resistance

Answer 13

– Resist wrist flexion and ulnar deviation – Feel the tendon as it attaches to the pisiform and then proceeds on to the hamate bone as the pisihamate and pisometacarpal ligament

Answer 14

– Abductor digiti minimi (superficial) – Opponens digiti (middle) – Flexor digiti minimi (deep)

Answer 15

– Just lateral to the flexor carpi ulnaris in the wrist

Answer 16

Just lateral to flexor carpi radialis in wrist

Answer 17

– Abductor pollicis brevis (superficial) – Opponens pollicis (middle) – Flexor pollicis brevis (deep)

Answer 18

-Flexion -Extension -Pronation -Supination

Answer 19

-Flexion -Extension -Pronation -Supination -Radial/ulnar deviation

Answer 20

Have them hold a pen in hand sideways get them to twist arm either way measuring with the goniometer where the ben goes NOTE: PROM -> have their arm lie on corner of bed, twist the arm and push the goniometer with your thumb

Answer 21

Line up goniometer with the top of the hand and move the hand left and right

Answer 22

Have patient raise both arms to 90 degrees and press down

Answer 23

Assess: 1) biceps brachii: have elbows flexed at 90 degrees and supinated. Ask patient to resist force applied 2) Wrist extensors: place pronated forearm on table, have their fist closed and apply a force against half extended wrist

Answer 24

Assess: 1) triceps brachii: Flex patients elbow to 90 degrees and perform resisted extension 2) wrist flexors: place supinated forearm on table, have their fist closed and apply a force against have flexed wrist

Answer 25

Assess the abductor pollicis brevis by have the patients arm on its side, pinky side down, with wrist at edge of table and ask patient to resist thumb adduction

Answer 26

Assess the first dorsal interosseus by separating the last 3 digits and apply an adduction force against the index finger

Answer 27

-Tests extensibility of dura (Slow gentle progressive “winding up” of dura). -Patient seated at side of bed with feet unsupported and hands clasped behind back. -Test is performed actively with input to patient. -Normal responses include central T8-9 pain when neck flexion is added. -Most patients will be unable to completely straighten knee because of stretch in posterior thigh and knee area. Thoracic flexion : Ask patient to slump or “sag in the middle” but do not allow pelvis to rotate backwards. Neck flexion: “Chin to chest” (with gentle hold). Knee extension (asymptomatic side first, ankle stays relaxed). Record angle of knee extension and any symptoms produced. - have arm and hand on neck

Answer 28

Without chin tuck = lower l-spine

Answer 29

Flex neck away from arm (lateral)

Answer 30

1) Have eyes closed 2) Test smell in one nostril at a time using non-irritants (coffee, lemon, mint)

Answer 31

1. Check pupil size and symmetry 2. Assess visual field by having one finger on each hand in place where only one eye sees one finger. Move fingers and ask which side the fingers are moving on (right or left)

Answer 32

1. Pupillary light reflex: bring light from side to eye and shine light in the eye to assess constriction 2. Assess eye movement (inferior oblique, superior, medial and inferior rectus) by drawing the letter "H" -> only do one eye at a time and head must be stationary 3. Accommodation reflex: Move fingers close to nose until it becomes blurry (patient should be cross eyed)

Answer 33

Assess eye movement using the letter H while head is stationary and they follow finger with one eye (superior oblique muscle)

Answer 34

Ask patient to: 1. Clench teeth 2. Protrude jaw 3. Protrude jaw and move side to side 4. Jaw reflex (using reflex hammer)

Answer 35

Make sure to assess both sides of face separately, but test using pin prick/light tough on the: 1. Ophthalmic branch (blue) 2. Maxillary branch (red) 3. Mandibular branch (yellow)

Answer 36

Lateral rectus muscle, but using letter H with head stationary and one eye at a time like 3 and 4 cranial; nerves

Answer 37

1. Lift brows 2. Close eyes tightly 3. Show teeth 4. Frown 5. Whistle 6. Smile

Answer 38

Test each side of tongue separately by applying sugar or salt to anterior 2/3 of tongue NOTE: Dampen q-tip and have them drink water between each taste

Answer 39

Vestibular: Test balance and check for nystagmus Cochlear: Test hearing by rubbing on side of ears with fingers

Answer 40

1. Check ability to swallow 2. Test gag reflex by pressing q-tip to back of throat on posterior pharynx

Answer 41

Test each side of tongue and place sugar or salt on q-tip on posterior 1/3 NOTE: Make sure they drink water in between and dampen q-tip to pick up sugar or salt

Answer 42

Motor: 1. Gag Reflex: Touch one side of posterior pharynx with tongue depressor or q-tip (test each side separately) 2. Palatal reflex: Touch one side of uvula at time and it should elevate OR ask to say "ahhhhh" and if deviation = abnormality NOTE: Sensory is tested with the other tasting ones with salt/sugar

Answer 43

1. Examine muscle bulk 2. Assess trap via resisted shoulder elevation 3. Assess SCM via resisted cervical rotation

Answer 44

1. Assess tongue movements (protrude and retract) 2. Push tongue against cheek and apply resistance to outside of cheek 3. Ask to say "la,t,d" NOTE: Jaw and tongue deviate TOWARDS affected side while uvula deviates AWAY from affected side

Answer 45

Place hands on side of hip and will feel the shelf

Answer 46

Come down anteriorly off iliac crests and it lies in the same vertical plane as symphysis pubis and horizontal plane as PSIS and S2 (most prominent bone on the front)

Answer 47

Approximately two thumb widths below and slightly medial to ASIS: Resist extension and hand on top of ankle and ask to kick out against hand -> rectus femoris muscle is what will pop up

Answer 48

NOTE: Should feel hard bone and its really low

Answer 49

It is level with center of hip joint, confirm with hip internal/external rotation (should feel where hip joint turns on side of hip)

Answer 50

Find the 2 PSIS posteriorly and run across = S2 then move up thumb lengths to find L5/L4 NOTE: big space between S1 and L5 so count 2 thumb lengths for this space -L5 often small, short and deep -L4 is large and ridged sagitally

Answer 51

The lie level with interspace between spinous processes and are large at L3 than they are at lower or upper L-spine NOTE: You want to find L4/L5 and move 2 thumb lengths over and dig gradually in a circular motion deeper and deeper until you feel a bony prominence

Answer 52

Lie on either side of the lower 1/3 of the L-spine spinous process. Facets lie 3-5 cm below surface of skin so dig deep

Answer 53

2 bony landmarks on each side of spine that corresponds directly to S2 (directly under dimples at S2 level)

Answer 54

2 thumb lengths lower and 1 thumb length lateral from PSIS (will feel sensitive) NOTE: At S2 level so will palpate at upper level of buttock

Answer 55

Between psis and s2

Answer 56

Go up hamstring with heel of hand until you feel a bony shelf (will be on butt)

Answer 57

confirm with resisted adduction but this muscle in abduction has a distinct ridge running from symphysis pubis to mid-thigh

Answer 58

Uses resisted adduction and extension (inserts distally to adductor tubercle) -Will be just below adductor longus

Answer 59

Palpate inferior to ASIS and determine through resisted hip flexion, abduction, or external rotation

Answer 60

Palpate a few cm distal to pubic insertion on medial surface and confirm with resisted adduction

Answer 61

Start palpation below AIIS until insertion at quadriceps tendon and confirm by asking client to perform isometric quadricep contraction (resisted extension)

Answer 62

Found from ASIS to superior tubercle. Palpate medial to ASIS

Answer 63

Attaches from 12th rib to L1-L5 attaches to transverse processes (so palpate around there) until you get to iliac crest

Answer 64

Find PSIS and find ischial tuberosity (in between two is the sciatic nerve) find the greater trochanter and the piriformis will be in between the sciatic nerve, the shelf and the greater trochanter

Answer 65

1. Find the inferior aspect of the ischial tuberosity and then drop directly distal off of it and you will be on the common proximal attachment of the hamstring group. 2. Place your hand on the posterior thigh between the buttocks and knee, and ask the partner to flex the knee, holding the foot off the table, exploring mass and width as hamstrings contract. Locate the ischial tuberosity, slide fingertips distally in. and strum across the large solid tendon of the hamstrings. (Make sure they active flex)

Answer 66

Lies near the highest point of the butt and attaches from lateral border of sacrum to ischial tuberosity

Answer 67

Palpate the inguinal ligament, the sartorius, and the adductor longus muscles

Answer 68

1. Flexion 2. Extension 3. Rotation 4. Side Bending

Answer 69

Have clients arms crossed, apply hands to side of hip and support lower back

Answer 70

Have arms crossed and apply hands to arms on front and back Measuring tape: put on s2 and mark line 15 cm above and then measure in flexion

Answer 71

Have clients arms crossed and support both sides (1 lower hand and 1 upper hand)

Answer 72

Support both sides with hands (1 lower hand and 1 upper hand)

Answer 73

1. Flexion 2. Extension 3. IR 4. ER 5. Abd 6. Add

Answer 74

Have leg fully extended With gravity: Side lying Without: Lying supine Strength: Apply pressure on abduction/adduction

Answer 75

With: Have lying prone with leg slightly bent (foot on shoulder and hand on hip ) Without: Side lying Strength: Apply resistance to extension

Answer 76

With: Have lying supine with leg slightly bent Without: Side lying Strength: Apply pressure against flexion

Answer 77

With: Side lying -> cross one leg and have leg on bottom push up for external rotation at knee, then have legs on side with knees touching and have upper leg push out for internal rotation at knee Without: Lift leg up supporting ankle and one hand under knee and have rotate in (external) and out (internal) (laying supine) -> 90 degrees NOTE: MAKE SURE TO HAVE BED AT LINE OF DRIVE WITH ARM FOR HIP (HAVE BED AT LEVEL WITH ARM TO HELP GENERATE FORCE)

Answer 78

Note: Wont have to do mechanical transfer

Answer 79

NOTE: Wont perform 2 person transfers on skills check

Answer 80

Supervision: 1. Cue client to get at 45 degree angle with bed and have them apply their brakes 2. Instruct client to remove foot plates and have swing the foot rest farthest away from the bed out of the way 3. Instruct client to put arms on arm rest, lean forward and push themselves out of wheel chair and into standing 4. Instruct to pivot back facing bed and have one hand on wheel chair arm rest and then put one hand behind to feel the bed and use arm and wheel chair arm to lower Minimal Assistance: 1. Therapist applies brakes and aligns at 45 degree angle with bed 2. Place transfer belt around client 3. Remove foot rests and foot plates 4. Place transfer disc under clients feet 5. Therapist puts knees around clients knees 6. Instruct client to move head over shoulder towards movement and ask client to place hands on therapists hips 7. Therapist grabs transfer belt and moves up on 1,2,3 stand 8. turn client to bed ask to place hands on bed and say 1,2,3 sit and client sits down

Answer 81

REMEMBER 1/3 RULE 1. Position client at 45 degree angle and put on brakes and transfer belt 2. Remove foot rests and arm rest between client and bed 3. Ask client to lean away from be gently so you can slide transfer board under the butt closest to bed (press the board down and into the seat away from clients skin) 4. Instruct client to place hand on board but away from edge so fingers do not get crushed 5. Cue client to user upper body to move themselves along the board during the transfer 6. Therapist puts knees around patients knees and hands on transfer belt and moves client to bed

Answer 82

1. reposition bed to align with waist and remove bed rails that are needed for task 2. Instruct client to bend far knee placing foot on bed 3. Have client grab bed rail with opposite arm and have them raise arm above head (dont have to do this second part) 4. Place hands on scapula and waist and ask to roll on 1,2,3 5. Lower arm rail 6. Have client bend both knees and line them on edge of bed and brace arm that was on rail on the bed on the bed 7. Therapist supports shoulder girdle with one hand and other hand on waist and on 1,2,3 sit bring client into seated position 8. Make sure to move client forward if feet are not in contact with ground

Answer 83

1. Ask client to shift up the bed to ensure head hits pillow 2. Ask client to place hands on bed while therapist swings feet onto bed (1,2,3 lie) 3. Client should be positioned in supine 4. Ensure bed rails and call bell are in place and client is comfortable

Answer 84

Measures for cervical radiculopathy

Answer 85

See if it reproduces symptoms by compressing nerve root

Answer 86

To test the dura and can wind up system by plantar flexing and wind down system by lifting head up. Test is positive if it produces typical symptoms. If neck extension doesn’t get rid of pain = hamstring

Answer 87

It can diagnose spinal disorders in meningitis if it reproduces typical pain

Answer 88

To check for cervical radiculopathy. If it produces typical symptoms then thats what it is. Cervical radiculopathy is when a nerve in the cervical region is irritated causing pain.

Answer 89

Helps require a skill or retain old skills lost by impairments

Answer 90

Determines level of independence for transferring

Answer 91

Stretch them

Answer 92

Strengthen them

Skill Check 2 Flashcards

(150 cards)