Week 10 - musculoskeletal and neuro

Question 1

Pronator Drift test is one of the most sensitive tests for

Answer 1

upper extremity weakness

Question 2

Abnormal finding with pronator drift

Answer 2

arms drop down very quickly

Question 3

What can a positive Straight Leg Raise test (Laségue Test) indicate?

Answer 3

when there is pain, the test is positive and can indicate HERNIATED lumbar disc and nerve irritation/pressure

Question 4

Phalen’s Sign

Answer 4

Inverted prayer - there should be no pain or discomfort (assesses for carpel tunnel)

Question 5

Positive Tinel’s Sign

Answer 5

Pain when tapping medial nerve (assesses for carpel tunnel)

Question 6

What is the #1 predictor of falls in the elderly?

Answer 6

history of falls!

Question 7

What is the only movable joint in the head?

Answer 7

temperomandibular joint (TMJ)
Can move vertically, laterally, protrusion (in/out)

Question 8

Alexander technique

Answer 8

through voice and gentle touch, participants led through movements to improve posture during sitting, standing, and walking

Question 9

Traeger Therapy

Answer 9

goal is to provide deep relaxation and increase mobility

Question 10

Feldenkrais technique

Answer 10

Participants are led by verbal suggestion through an exploratory movement process
Focuses on improving functional awareness and expanding the repertoire of movement patterns

Question 11

Neuro health history ?’s

Answer 11

Hx of seizure disorder, TIA, stroke, fainting, blackouts, meningitis, alcoholism, myasthenia gravis, multiple sclerosis, mental health dysfunction

Question 12

Romberg test

Answer 12

stand w/ feet together, close eyes. Slight swaying is normal.
Falling can occur in PTs w/ MS, drunk, loss of vestibular function

Question 13

Tandem walking

Answer 13

PT walks in straight line, heel to toe (accentuates gait problems)

Question 14

increased touch sensation

Answer 14

hyperesthesia

Question 15

reduced touch sensation

Answer 15

hypoesthesia

Question 16

absent touch sensation

Answer 16

anesthesia

Question 17

Stereognosis (evaluates cortical sensory function)

Answer 17

place a familiar object in the patient’s palm (e.g. paper clip) ask PT to identify it

Question 18

Graphesthesia (evaluates cortical sensory function)

Answer 18

trace a # on PT’s palm w/ a blunt object (e.g. finger) and ask PT to identify number

Question 19

inability to identify objects correctly

Answer 19

astereognosis

Question 20

headache history- what are signs of increased ICP

Answer 20

pain worse in the AM on awakening & pain precipitated by straining/sneezing

Question 21

Cogwheel rigidity

Answer 21

small, regular jerks during rotating movements of wrist and hand (parkinson’s)

Question 22

indicative of UPPER motor neuron lesions (from strokes, tumors)

Answer 22

hyperreflexia

Question 23

indicative of LOWER motor neuron lesions (from spinal cord injury)

Answer 23

hyporeflexia

Question 24

Stroke recognition FAST

Answer 24

F- face (ask person to smile, look for droopiness)
A-arms (raise both arms, does one drift)
S- speech (is speech slurred?)
T-time (call 911 if you observe these signs!)

Question 25

What's always the 1st step when there's a musculoskeletal injury?

Answer 25

compare L and R for symmetry

Question 26

Phalen and Tinel tests can test for

Answer 26

carpel tunnel syndrome

Question 27

Bulge and ballottement tests look for

Answer 27

effusion in the knee joint

Question 28

McMurray test assesses for

Answer 28

meniscus tears in the knee

Question 29

The Thomas Test is used to identify

Answer 29

flexion contracture of the hip

Question 30

The Drawer test is for

Answer 30

knee injury

Question 31

Trendelenberg test is for

Answer 31

hip disease (lift one leg and see if you tip to side)

Question 32

When doing an assessment of the spine of an older adult, you can expect to see which variation?

Answer 32

Kyphosis (hunchback)

Question 33

fasciculation

Answer 33

involuntary twitching

Question 34

tremors

Answer 34

involuntary contractions of muscles

Question 35

atony

Answer 35

lack of tone or strength

Question 36

spasticity

Answer 36

muscle tone is hypertonic so the muscles are stiff and movements awkward

Question 37

Post hip replacement, which assessment technique should you avoid?

Answer 37

adduction (could cause fake hip to dislocate)

Question 38

1,200 mg of calcium

Answer 38

recommended daily amt to consume for bone health

Question 39

What 3 functions are assessed on the glasgow coma scale?

Answer 39

verbal response, eye opening, and motor response 15: best 3 or less: totally unresponsive

Question 40

Innervation of the arm roughly correlates with which parts of the spinal cord?

Answer 40

C5 to T1

Question 41

Innervation of the chest correlates with:

Answer 41

T1 to T8

Question 42

Innervation of the abdomen corresponds with

Answer 42

T9 to T12

Question 43

Innervation of the legs corresponds with

Answer 43

L1 to S1

Question 44

When discussing care for a patient with back pain, the nurse should particularly alert the assistant to watch for

Answer 44

bowel/bladder incontinence (can occur with spinal cord injury at any level)

Question 45

Cluster headache

Answer 45

pain is usually on one side of head with lacrimation and nasal congestion

Question 46

Tension headache

Answer 46

typically mild or moderate, often bilateral, "pressing" or "tightening" pain (not sharp)

Question 47

Crepitation

Answer 47

dry, crackling sound or sensation that occurs with joint movement

Question 48

Muscle strength grading

Answer 48

● 0 = no evidence of contractility ● 1 = slight evidence of contractility ● 2 = ROM with gravity eliminated ● 3 = ROM with gravity ● 4 = ROM against gravity with some resistance ● 5 = ROM against gravity with full resistance

Question 49

common symptoms associated with neuro system include

Answer 49

headace, weakness, blurred vision, impaired motor function, and impaired speech

Question 50

Clinical situations that require urgent communication of neurological assessment findings include

Answer 50

a change in LOC, pupillary reaction, and verbal or motor response.

Question 51

Cranial nerves 1, 2, 3:

Answer 51

○ I: Olfactory - smell ○ II: Optic - visual acuity, visual fields, ocular fundi, pupillary reactions ○ III: Oculomotor - pupillary reactions, extraocular movements (including opening of the eyes)

Question 52

Cranial nerves 4, 5, 6

Answer 52

○ IV: Trochlear - extraocular movements ○ V: Trigeminal - facial sensation, movements of the jaw, corneal reflexes, voice and speech ○ VI: Abducens - extraocular movements

Question 53

Cranial nerves 7, 8, 9

Answer 53

○ VII: Facial - facial movements and gustation, voice and speech ○ VIII: Vestibulocochlear - hearing and balance ○ IX: Glossopharyngeal - swallowing, elevation of the palate, gag reflex, gustation

Question 54

Cranial nerves 10, 11, 12

Answer 54

○ X: Vagus - swallowing, elevation of the palate, gag reflex, gustation, voice and speech ○ XI: Accessory - shrugging shoulders and turning head ○ XII: Hypoglossal - movement and protrusion of tongue, voice and speech

Question 55

Cerebellar function

Answer 55

movement, coordination, balance

Question 56

Grading scale of Deep tendon reflexes (DTRs)

Answer 56

``` ● 0 - no response ● 1+ - diminished, low normal ● 2+ - average, normal ● 3+ - brisker than average, high normal ● 4+ - hyperactive with clonus ```

Question 57

Clonus

Answer 57

repeated muscular movements (jerking)

Question 58

Intention tremor

Answer 58

absent at rest and increases with movement

Question 59

babinski reflex

Answer 59

toes should fan out when testing plantar reflex

Question 60

migraine aura

Answer 60

indicates either cortical or brainstem dysfunction

Question 61

migraine headaces

Answer 61

typically last 4-72 hours and are accompanied by at least one of the following: nausea, vomiting, phonophobia, or photophobia

Question 62

the PT with a head injury and increasing ICP is likely to have which assessment findings?

Answer 62

decreased LOC and sluggish pupil