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Clinical Skills > SM02 Mini3 > Flashcards

SM02 Mini3 Flashcards

1
Q

anosmia

A

inability to partially or fully detect smell

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2
Q

Snellen equivalents

A

standard visual acuity measurement regardless of actual distance used in testing

20/20 feet for US normal vision

Britain & colonies use 6 meters

continental Europe uses decimal equivalents

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3
Q

hemianopsia

A

decreased vision in 1/2 the visual field

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4
Q

diplopia

A

double vision

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5
Q

convergence of vision

A

test moving finger closer toward patient’s nose in midline

observing for symmetric adduction

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6
Q

consensual reaction

A

aka consensual response or indirect response

constriction of the pupil when the opposite eye is stimulated to constrict

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7
Q

PERRLA

A

pupils are equal, round and reactive to light & accomadation

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8
Q

visual accommodation

A

pupils constrict when gazing at something close to them

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9
Q

how is CN I tested?

A

ensure inhale/exhale thru both nostrils

close eyes

present with common scent (coffee, cinnamon, curry)

proper identification at 10cm

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10
Q

how is CN II tested?

A

visual acuity

visual fields

pupillary action

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11
Q

anisocoria

A

unequal pupil size

often seen w/o underlying pathology

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12
Q

Marcus-Gunn pupil

A
  • ask pt to fix sight on something in distance
  • look for equal pupil size
  • check again w/lights off
  • swing light back & forth
  • affected eye will be slower to constrict or will dilate
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13
Q

Argyll-Robertson pupils

A

no direct pupillary response to light in either eye

accommodation is present

highly suggestive of tertiary neurosyphilis, but could also be diabetic neuropathy

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14
Q

how are CN III, IV, & VI tested?

A

H test & convergence

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15
Q

strabismus

A

eyes do not move together for full excursion

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16
Q

nystagmus

A

eyes make repetitive uncontrolled movements

can be side to side or up and down

can result from: inner ear infection, CNS disorders, severe myopia, alcohol & drug toxicity

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17
Q

how is the motor function of CN V tested?

A

clenched jaw to check for temporalis & masseter bilateral contraction

lateral pterygoids via jaw movement against resistance

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18
Q

how is the sensory function of CN V tested?

A

touch: cotton on either side of the midline on the forehead, cheek, & jaw
temperature: same as touch but with a cold object like a tuning fork

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19
Q

corneal reflex testing

A

usually only done in unconscious or in someon suspected of CN V or VII lesion

afferent by V & efferent by VII

wisp of cotton to sclera for CN V

cotton to cornea for CN VII & blink reflex

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20
Q

trigeminal neuralgia

A

aka tic douloureux

neuropathic pain that affects one or more branches of CN V

causes lancinating & excruciating facial pain

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21
Q

how is CN VII tested?

A

eyebrow raise

clenched eyes→ don’t open w/resistance

smile: look for symmetric nasolabial folds

purse lips: symmetry

puff out cheeks: air leaks from weak side

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22
Q

how is CN VIII tested?

A

rub fingers together close to each ear

with pts eyes shut so they can’t cheat

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23
Q

gag reflex

A

afferent CN IX

efferent CN X

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24
Q

how is CN IX tested?

A

gag reflex

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25
Q

how is CN X tested?

A

gag reflex

or

sustained “ah” for rise of soft palate

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26
Q

how is CN XI tested?

A

trapezii: shrug shoulders against resistance

SCMs: turn head against resistance

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27
Q

fasciculations

A

brief spontaneous twitching/contractions of a small # of muscle fibers

cause flicker of movement under the skin

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28
Q

how is CN XII tested?

A

protruding tongue

should be midline

if deviated, LMN lesion on side that tongue deviates to

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29
Q

what is a pronator drift indicative of?

A

UMN lesion in contralateral primary motor cortex

can also be seen as digiti quinti sign (just the pinky drifts

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30
Q

how is muscle strength graded?

A
  • 0= no movement
  • 1= flicker of movement, not enough to move body part
  • 2= active movement w/no gravity
  • 3= active movement against gravity
  • 4= active movement against some resistance
  • 5= active movement against full resistance
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31
Q

what myotome is tested by elbow flexion?

A

biceps test C5 & C6

32
Q

what myotome is tested by elbow extension?

A

triceps test C6-C8

33
Q

what myotomes are tested via wrist extension?

A

radial nerve

C6-C8

34
Q

Grip tests which myotomes?

A

C7-T1

35
Q

finger abduction tests which myotomes?

A

C8-T1

dorsal interossei

36
Q

what myotomes does thumb opposition test?

A

C8-T1

median nerve

*component of carpal tunnel syndrome*

37
Q

what myotomes are tested via hip flexion?

A

L2-L4

iliopsoas m.

38
Q

what myotome are tested via hip extension?

A

S1

gluteus maximus m.

39
Q

what myotome is tested via hip adduction?

A

L2-L4

adductor mmm./obturator nerve

40
Q

what myotome is tested by hip abduction?

A

L4-S1

gluteus medius & minimus mm.

41
Q

what myotomes are tested by knee extension?

A

L2-L4

quadriceps mm

42
Q

what spinal roots are tested by knee flexion?

A

L4-S2

hamstrings

43
Q

what myotomes are tested by ankle dorsiflexion?

A

L4-L5

tibialis anterior m.

44
Q

what myotome is tested by plantar flexions?

A

S1

gastrocnemius & soleus mm.

45
Q

what myotome is tested by hallicus extension?

A

L5

extensor hallicus longus m.

46
Q

what spinal levels are checked by ankle reflex?

A

S1 & S2

47
Q

what reflex checks C7 & C8?

A

triceps

48
Q

what reflex tests C5 & C6?

A

biceps

49
Q

what spinal levels are checked by the knee jerk reflex?

A

L3 & L4

50
Q

where is C5 dermatome tested?

A

over the deltoid

51
Q

where is C6 dermatome tested?

A

over the thumb (we skipped b/c it is controversal)

52
Q

where is C7 dermatome tested?

A

palmar surface of the middle finger

53
Q

where is C8 dermatome tested?

A

on the pinky finger or the ulnar side of the hand

54
Q

where is L2 dermatome tested?

A

on the anterior thigh

55
Q

where is L4 dermatome tested?

A

on the medial calf

56
Q

where is the L5 dermatome tested?

A

on the lateral calf or dorsum of foot

57
Q

where is S1 dermatome tested?

A

on the lateral foot

58
Q

how is the lateral spinothalamic pathway best tested?

A

with pinprick testing

but we used tuning fork to test with temperature instead

59
Q

what is the specific test for the posterior column/medial lemniscus pathway?

A

vibration with a 128Hz tuning fork

60
Q

where is the tuning fork placed for testing vibration?

A

over the hallix or the DIP joint

61
Q

what should be completed if a patient fails to feel the vibrations of the tuning fork?

A

continue testing more proximal bony protuberances to determine level of sensory impairment

ex. wrist, olecranon process, acromion process OR medial malleolus, patella, anterior superior iliac spine

62
Q

how is proprioception tested?

A

movement of the hallix or middle finger up & down

OR

Romberg test: stand w/feet together and close eyes, + if patient sways or falls over

63
Q

what is a Hoffmann reflex and what does it indicate?

A

pressure or flick on nail bed of middle finger that produces contraction of thimb & index finger

sign of upper motor neuron lesion (often from spinal cord compression)

64
Q

dysmetria

A

missing the mark

tested by finger-to-nose test

65
Q

a right sided cerebellar lesion will cause?

A

a right sided paresis

66
Q

dysdiadochokinesia

A

slow or clumsy movements

67
Q

truncal ataxia

A

loss of coordinated muscle movements for maintaining normal posture of the trunk

68
Q

tandem gait

A

walk heel-to-toe

69
Q

a wide clumsy gait is a sign of?

A

cerebellar ataxia

often in the vermis

70
Q

features of a spastic gait

A

pronation & flesion of affect arm

circumduction of affected leg as wellas medial rotation of that leg

decortic hemiplegic

71
Q

most common peripheral neuropathy of the lower extremity

A

foot drop

caused by peroneal or fibular nerve lesion

gait is high stepping to avoid dragging of the toes as they cannot dorsiflex the foot for swing phase

72
Q

most common peripheral neuropathy of the upper extremity?

A

carpal tunnel syndrome

73
Q

indications of carpal tunnel syndrome

A
  • atrophy of the thenar eminence
    • Tinel’s test
    • Phalen’s test
74
Q

radiculopathy

A

spinal nerve root neuropathy

caused by ruptured spinal disc & compression of nerve root as it leaves the spine

usually unilateral

75
Q

tinnitus, hearing loss, and fullness of the ear are associated with what type of vertigo?

A

peripheral vertigo

more common form

76
Q

what symptoms are associated with central vertigo?

A

cranial neuropathies

disarthria

diplopia

weakness

involves cerebellum or brainstem- less common form

77
Q
A

Clinical Skills (7 decks)

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