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PT fundamentals > Week 4 > Flashcards

Week 4 Flashcards

1
Q

What is the purpose of a neuromuscular(neurologic) screening exam?

A

It identifies or rules out signs consistent with lower neuron pathology and upper motor neuron pathology

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2
Q

A lower motor neuron pathology is classified as a ____

A

Radiculopathy

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3
Q

Examples of an upper motor neuron pathology

A

Stroke, spinal cord compression, TBI

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4
Q

____ uses sensory, motor, and reflex testing to determine the source and location of a neurological dysfunction. It also assist in differential diagnosis of these conditions

A

A neuromuscular screen

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5
Q

What are the components of a basic neurological screening examination?

A

Motor testing, Somatosensory/sensory testing, reflex testing, central nervous system screen.

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6
Q

What are the things to look for in a functional motor observation/ myotome testing?

A
  • Can the patient do what we want them to and how does it relate to their function?
  • Issues with tremors
  • Fasciculations in muscles
  • Atrophy
  • 1 vs multiple testing to test performance
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7
Q

Functional myotomal assessment assesses which ability?

A

Step up (quads)

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8
Q

Functional myotomal assessment L4-5 assesses which ability?

A

Heel walking

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9
Q

Functional myotomal assessment L5-S1 assesses which ability?

A

Toe walking/ toe raise

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10
Q

UE myotome C1-2 assesses which ability?

A

Neck flexion

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11
Q

UE myotome C3 assesses which ability?

A

Neck sidebending

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12
Q

UE myotome C4 assesses which ability?

A

Shoulder elevation

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13
Q

UE myotome C5 assesses which ability?

A

Shoulder abduction

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14
Q

UE myotome C6 assesses which ability?

A

Elbow flexion

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15
Q

UE myotome C7 assesses which ability?

A

Elbow extension

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16
Q

UE myotome C8 assesses which ability?

A

Thumb abduction

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17
Q

UE myotome T1 assesses which ability?

A

Finger abduction

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18
Q

LQ myotome L2-3 assesses which ability?

A

Hip flexion

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19
Q

LQ myotome L3-4 assesses which ability?

A

Knee extensors

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20
Q

LQ myotome L4 assesses which ability?

A

Ankle dorsiflexors

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21
Q

LQ myotome L5 assesses which ability?

A

Hallux extension

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22
Q

LQ myotome S1 assesses which ability?

A

Ankle plantar flexors

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23
Q

What position are motor screening typically done?

A

In a sitting position

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24
Q

What is positive finding?

A

Significant weakness or diminished resistance relative to the opposite side

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25
Q

UQ dermatome C5

A

Mid deltoid

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26
Q

UQ dermatome C6

A

Radial aspect of 2nd metacarpal

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27
Q

UQ dermatome C7

A

Dorsal aspect of middle finger

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28
Q

UQ dermatome C8

A

Ulna aspect of 5th metacarpal

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29
Q

UQ dermatome T1

A

Medial forearm

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30
Q

LQ dermatome L1

A

Inguinal area

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31
Q

LQ dermatome L2

A

Anterior mid thigh

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32
Q

LQ dermatome L3

A

Medial knee

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33
Q

LQ dermatome L4

A

Medial malleolus

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34
Q

LQ dermatome L5

A

Distal medial dorsum of foot

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35
Q

LQ dermatome S1

A

Lateral border of foot

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36
Q

LQ dermatome S2

A

Medial/ posterior calcaneus

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37
Q

A monosynaptic reflex automatically regulates ____

A

Muscle length

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38
Q

In a monosynaptic reflex, tapping of tendon places a quick stretch on muscle and activates _____

A

Muscle spindle

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39
Q

What does the activation of a muscle spindle result in?

A

Results in contraction of stretched muscle

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40
Q

What will tapping a muscle 5-6 times reveal?

A

Any fatigue or fading response

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41
Q

What is an hypo-reflexive reflex show?

A

Lower motor neuron (possible nerve root compression or neuropathy)

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42
Q

What is an hyper-reflexive reflex show?

A

Upper motor neuron (possible CNS pathology)

43
Q

UQ reflex: C5

A

Biceps brachii

44
Q

UQ reflex: C6

A

Brachioradialis

45
Q

UQ reflex: C7

A

Triceps

46
Q

Positive finding reflex found to be diminished or absent can be correlated with the dermatome and myotome assessment to…?

A

Determine the presence of nerve root pathology

47
Q

What may hyperactive/reflexive findings indicate?

A

Upper motor neuron pathology

48
Q

LQ reflex: L2-4

A

Patellar reflex

49
Q

LQ reflex: S1-2

A

Achilles reflex

50
Q

What is the response of LQ reflex grade 4+?

A

Very brisk response; associated with clonus

51
Q

What is the response of LQ reflex grade 3+?

A

Brisk response; possibly hyper reflexive

52
Q

What is the response of LQ reflex grade 2+?

A

Normal, average response

53
Q

What is the response of LQ reflex grade 1+?

A

Low-normal response

54
Q

What is the response of LQ reflex grade 0?

A

No response

55
Q

What is the response of LQ reflex grade 1+(R)?

A

Absent response which appears with reinforecement

56
Q

What is the response of LQ reflex grade 0(R)?

A

No response even with reinforcement

57
Q

Example of a reinforcement technique (R)

A

Jendrassik maneuver

58
Q

How is the jendrassik maneuver done?

A

Patient is told to clasps hands together and asked to pull then apart without doing so, while looking away.

59
Q

What does the jendrassik manuever do to the nervous system?

A

Ramps up the nervous system

60
Q

What is clonus?

A

A series of involuntary muscular contractions due to sudden stretching of the muscle (reflex response)

61
Q

___ is normally one little jolt, while _____ continually contracts

A

Clonus is normally one little jolt, while colonus continually contracts

62
Q

Clonus is a ______ system disorder

A

CNS disorder.

63
Q

_____ are specifically diseases or disorders that damage the upper motor neuronsor associated tracts

A

Clonus

64
Q

Clonus most commonly testing in the ___

A

Ankle and wrist

65
Q

What clonus is considered abnormal?

A

Sustained clonus (5 beats or more)

66
Q

How is the Babinski CNS screen done?

A
  • Drag something on the bottom of the foot.
  • Normal response- toes flex
  • Babinski response
67
Q

What is the babinski response?

A

The hallux extends and toes fan out

68
Q

What is the hoffman’s reflex?

A
  • When you flick distal IP joint of middle finger

- Looking for the index finger and thumb flexion

69
Q

What is the inverted supinator sign?

A

There will be either a pronation of the forearm of a clasp/flexion of the fingers in a pathologic case

70
Q

What lesion is weakness a sign of?

A

Upper and lower motor neuron lesion

71
Q

What lesion is atrophy a sign of?

A

Lower motor neuron lesion and mild atrophy in the upper motor neuron may develop due to disuse over time, but ultimately no

72
Q

What lesion is fasciculations a sign of?

A

Lower motor neuron lesion

73
Q

What lesion is reflex a sign of?

A
  • Increased in an upper motor neuron lesion

- Decreased in a lower motor neuron lesion

74
Q

What lesion is MM tone a sign of?

A
  • Increased in an upper motor neuron lesion

- Decreased in a lower motor neuron lesion

75
Q

Why do we take a patient’s vitals?

A
  • Essential component of every new patient as documented in the Guide to PT practice
  • Responsible for screening patients for conditions that may negatively impact their response to our interventions
76
Q

A patient may have abnormal vitals, yet be ___

A

A patient may have abnormal vitals, yet be asymptomatic

77
Q

Types of vital signs

A
  • Traditional and modern/updated
78
Q

Types of traditional vital signs?

A
  • Heart rate
  • Blood pressure
  • Respiration rate
  • Body temperature
79
Q

Characteristics of heart rate vital sign

A
  • Generally normal range is between 60-100 beats per minute (BPM)
  • Can take brachial, radial, carotid, femoral or dorsalis pedis pulses
  • May do manually or with a pulse oximeter (pulse ox)
80
Q

Characteristics of BP vital sign

A

o Set up done right: cuff shouldn’t go around clothing

o No reading

o Leg not crossed

o Leaning upright

o Used the bathroom

o No talking

81
Q

What is a normal BP?

A

Systolic: less than 120
and
Diastolic: less than 80

82
Q

What is an elevated BP?

A

Systolic: 120-129
and
Diastolic: less than 80

83
Q

What is an hypertension stage 1 BP?

A

Systolic: 130-139
or
Diastolic: 80-89

84
Q

What is an hypertension stage 2 BP?

A

Systolic: greater than or equal to 140
or
Diastolic: greater than or equal to 90

85
Q

What is an hypertensive crisis BP?

A

Systolic: greater than or equal to 180
and/or
Systolic: greater than or equal to 120

86
Q

Types of a modern/updated vitals

A
  • Gait speed

- Waist circumference/ BMI

87
Q

According to white paper, ____ is the 6th vital sign

A

Walking/gait speed

88
Q

Characteristics of gait speed vital sign

A

o 20-meter distance

o First 5-meter accelerating

o Time over 10 meters

o Last 5-meter deceleration

89
Q

What is the range of a hazard gait speed?

A

0-0.6 m/s

90
Q

What is the range of a normal gait speed?

A

0.6-1m/s

91
Q

What is the range of an above risk gait speed?

A

1- 1.4 m/s

92
Q

Where is the position for waist circumference measurement?

A

Waist/abdominal. (above iliac crest). Around the umbilicus

93
Q

What is the measurement is an high risk of a metabolic disorder/cardiovascular disease for men?

A

Over 40in

94
Q

What is the measurement is an high risk of a metabolic disorder/cardiovascular disease for women?

A

Over 35in

95
Q

What does BMI stand for and what is it?

A

Body mass index. A number calculated from a person’s weight and height

96
Q

What group of people is BMI not overly accurate for?

A

Those who are frail or overly muscular

97
Q

Why is BMI not overly accurate for a muscular person?

A

Because muscle is more dense and it brings more weight

98
Q

BMI of an underweight person

A

less than 18.5

99
Q

BMI of normal weight

A

18.5-24.9

100
Q
  • BMI of overweight
  • Disease risk with optimal waist
  • Disease risk w/o optimal waist
A
  • 25 -29.9
  • Increased
  • High
101
Q
  • BMI of obesity class 1
  • Disease risk with optimal waist
  • Disease risk w/o optimal waist
A
  • 30- 34.9
  • High
  • Very high
102
Q
  • BMI of obesity class 2
  • Disease risk with optimal waist
  • Disease risk w/o optimal waist
A
  • 35- 39.9
  • Very high
  • Very high
103
Q
  • BMI of obesity class 3
  • Disease risk with optimal waist
  • Disease risk w/o optimal waist
A
  • Greater than or = to 40
  • Extremely high
  • Extremely high
104
Q

____ is still possible even though a person has a low BMI, but are no active

A

Cardiovascular mortality

PT fundamentals (8 decks)

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