Written exam 4 Study Guide Flashcards

1
Q

If a patient is dragging or circumducting a weak or spastic leg, what is this called?

A

Hemiplegia
usually accompanied by a spastic arm flexed at elbow that crosses abdomen

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2
Q

Which type of walk is typically seen in a patient with parkinson’s?

A

Shuffle- short, hurried steps, head is bowed.

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3
Q

If a patient shuffles into the ER with short, hurried steps, hunched over, which disease might they have?

A

Parkinson’s

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4
Q

If a patient is walking with a wide-based gait, and they stagger side to side, what could be occuring?

A

Cerebellar ataxia (poor muscle control/lack of muscle control)

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5
Q

If a patient is slapping their foot on the floor what is this due to in their gait?

A

Called footdrop-
Due to weakness of dorsiflexers of ankle

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6
Q

If a patient is high-stepping with their gait and their feet slap down firmly, what is this called?

A

Sensory ataxia

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7
Q

Footdrop vs sensory ataxia

A

Footdrop- slapping results from weakness of dorsiflexors
Sensory ataxia- pt doesn’t know where thier feet are so they slap down intentionally

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8
Q

Sensory ataxia vs cerebellar ataxia

A

Sensory- slapping foot down, high steps, pt doesn’t know where their feet are.
Cerebellar ataxia- Pt has wide-based feet that are far apart, staggering from side to side.

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9
Q

What are the 8 dermatomes with their locations?

A

C6- thumb
C7- Middle finger
C8- Little finger
T4- Nipples
T10-Umbilicus
L4-Medial calves
L5-Big toe
S1-little toe

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10
Q

What does babinski sign indicate

A

UMN or LMN lesion in CST
Drag object across foot from heel to ball of foot, present sign is dorsiflexion of big toe and fanning of other toes.

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11
Q

What does a positive kernig sign indicate

A

meningeal infection
Pt lies supine, flex knee and hip to 90 degrees. Fully extend knee. Pain indicates positive

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12
Q

What does a positive brudizinski’s test indicate

A

Supine pt, flex patient’s neck. If causes flexion of patient’s hips and knees, suggests meningeal irritation

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13
Q

What does Hoffman’s sign indicate

A

Cervical spinal lesion
Positive hoffman sign is abduction and flexion of thumb/fingers when you pull on distal middle finger during hand pronation

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14
Q

What is romberg test and what does it indicate

A
  • Have patient stand and extend arms with palms facing up, close eyes, see ability to maintain upright
    Indicates cerebellar dysfunction and ataxia
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15
Q

What is Pronator drift and what does it indicate

A

Patient stands with both arms forward, eyes closed, palms up, abnormal is that arm drifts down
indicates ataxia or stroke

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16
Q

If you have a tremor that has an oscillation of 10-12 cycles per second, what kind of tremor is this?

A

Physiologic

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17
Q

If you have a tremor present at rest but decreased during activity, what kind of tremor is present?

A

Pathologic- slower like parkinson’s disease, 3-6 times a second.

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18
Q

A tremor that is slow, 2-4 times a second, that increases with movement, what type of tremor does your patient have

A

Intentional tremor

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19
Q

Involuntary jerky movements of hands and limbs are called what and are signs of which disease

A

Chorea- Huntington’s disease presents with this.

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20
Q

Where do the cranial nerves attach?

A

1 and 2 to the forebrain, rest to brainstem

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21
Q

Which cranial nerve extends to the abdomen?

A

Vagus nerve

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22
Q

Huntington’s disease presents with which type of a tremor?

A

Chorea- involuntary, jerky movements

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23
Q

Which cranial nerves havve parasympathetic control

A

3 (oculomotor), 7 (facial), 9 (Glosopharyngeal), 10 (vagus).

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24
Q

If you have a patient who comes to a clinic with anosmia, which cranial nerve is implicated?

A

CN 1- olfactory

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25
Q

If you have a patient whose pupils do not respond to light, which nerve is likely implicated?

A

3- oculomotor- parasympathetic response

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26
Q

Which Cranial nerves control eye movements

A

SO4 LR6, All rest 3

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27
Q

If your patient has trouble with mastication, which nerve is implicated?

A

Trigeminal- mandibular branch

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28
Q

If your patient is unable to distinguish light and sharp touches on their face, which cranial nerve is likely implicated?

A

Trigeminal- no sensation

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29
Q

If your patient does not have a corneal reflex, which nerve is likely implicated?

A

Trigeminal- no eye blink reflex= trigeminal not working to blink eyelid/muscle innervation dysfunctioning

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30
Q

Which nerve controls the sensory function for anterior 2/3 of the tongue?

A

7- facial

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31
Q

Which nerve controls the sensory function for posterior 1/3 of the tongue

A

9- glosopharyngeal

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32
Q

If your patient comes in and is not able to make distinct facial expressions, which nerve is likely harmed?

A

Facial- responsible for raising eyebrows, closing eyes, frowning, smiling, etc

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33
Q

If your patient has dry eyes or dry mouth (xerostomia), which nerve could be implicated?

A

Dry eyes= Facial
Dry mouth= Facial or Glosopharyngeal

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34
Q

If your patient has a negative shoulder shrug test, which nerve is dysfunctioning?

A

11- accessory- Innervates Trapezius and SCM

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35
Q

If your patient’s tongue is deviating to the right, which nerve is dysfunctional and on which side of the body?

A

Right hypoglossal nerve
(same side of the body problem and dysfunction)

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36
Q

If a patient’s uvula is pulled to the left side, which nerve is likely dysfunctioning and on which side of the body?

A

Likely glosopharyngeal nerve dysfunction on the Right side of the body
(opposite side dysfunction and sign)

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37
Q

What is the inability to perform a voluntary movement in the absece of deficits?

A

Apraxia

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38
Q

What is the decreased ability to perform a movement?

A

dyspraxia

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39
Q

What is the inability to construct or draw a simple shape or design

A

constructional apraxia

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40
Q

If your patient is weak on the right half of their body, how do you describe this?

A

Right sided hemiperesis

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41
Q

If a patient is paralyzed on the right side of their body, how do you describe this?

A

Hemiplegia

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42
Q

If a patient is paralyzed on their lower extremities, how do you describe this?

A

Paraplegia

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43
Q

What is the corticospinal tract responsible for

A

Voluntary movement, very skilled, discrete, purposful movements

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44
Q

What is the spinothalamic tract responsible for

A

Pain, temperature, and crude touch transmission
Ascending sensory pathway

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45
Q

What is the DCML tract responsible for

A

Transmission of vibrations, proprioception, fine touch
Ascending sensory pathway

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46
Q

When is the Jendrassik meneuver helpful

A

during testing of lower extremity reflexes- distract them

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47
Q

What is the main function of peripheral nerves

A

Send messages to and from the brain, carry motor output to glands or muscles from brain or send sensory input to the brain.

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48
Q

If a patient says they are feeling like the room is moving, how would you classify this feeling?

A

as vertigo- a spinning sensation

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49
Q

If a patient says that they feel like they just stood up too fast and will fall over, how do you classify this feeling?

A

Light-headedness, dizziness

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50
Q

What are the different types of spine deformities

A

Kyphosis, lordosis, scoliosis
Kyphosis= hunchback
Lordosis= stomach sticks out, lumbar pushed anteriorly
Scoliosis= spine is not straight line, curves laterally

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51
Q

What is active range of motion

A

Range of motion a joint can move through while patient uses their own muscles (no assistance)

52
Q

What is PROM

A

Range of motion a joint can move through when an external force moves the joint without assistance

53
Q

What is Assistive range of motion

A

The range a joint can move through with some assistance from an external force or muscle help

54
Q

What are the bones of the ankle joint

A

Tibia, fibula, talus

55
Q

What does articular cartilage do

A

Smooth tissue covering at the ends of bones, helps reduce friction and absorb shock

56
Q

What is the synovial membrane

A

lining inside of joint capsule that produces synovial fluid for lubrication and cartilage nourishment

57
Q

What does the Joint capsule do

A

Fibrous tissue, sourrounds joint and holds it together to provide stability

58
Q

What do ligaments connect

A

Bones to bones

59
Q

What do tendons connect

A

Bones to muscles

60
Q

Primary function of bursae

A

fluid-filled sacs that cushion and reduce friction between tissues

61
Q

Epiphysis vs diaphysis

A

Ephiphysis= long end
Diaphysis= middle part between ends, contains bone marrow

62
Q

Number of vertebrae in each section

A

C= 7
T=12
L= 5
S= 5
Coccyx=4
33 total

63
Q

If your patient is complaining of right knee pain, do you examine their right or left knee first?

A

Examine their left knee first- must look at unaffected side first

64
Q

Varus vs valgus

A

Varus= pointed away from body
Valgus= pointed toward body (Genu valgum is knees bowing in)

65
Q

Where does growth of long bones occur

A

at epiphyses

66
Q

Where does hematopoiesis occur

A

in bone marrow

67
Q

What is genu valgum

A

knock knees (bowing in, varus)

68
Q

Frontal Lobe is responsible for

A

Voluntary skeletal movement, execuitive function, reasoning

69
Q

The Parietal lobe is responsible for

A

Processing sensory data (like touch, vibration, pressure, pain, and 2 point descrimination)

70
Q

The Temporal lobe is responsible for

A

Perception and determination of sound

71
Q

The occipital lobe is responsible for

A

Primary visual center/visual interpretation

72
Q

What is the primary function of the cerebellum

A

maintain balance and proprioception

73
Q

What are the 2 ascending and 1 descending pathway that are relied upon often?

A

DCML and spinothalamic tracts are ascending
Corticospinal tract is descending

74
Q

What are the neurons that are largely related and implicated in reflex arcs

A

Interneurons

75
Q

What is a bundle of neurons that carry either sensory, motor, or mixed fibers called?

A

Nerves

76
Q

_____________ neurons: sensory neurons that carry nerve impulses from sensory stimuli towards the central nervous system and brain.

A

Afferent

77
Q

________________ Neurons carry information from the brain and CNS to the glands and muscles

A

Efferent

78
Q

Contrast nerves and ganglia

A

Nerves are bundles of peripheral axons
Ganglia are bundles of peripheral cell bodies

79
Q

_____ are axon terminals of motor neurons

A

motor endings

80
Q

What do motor endings innervate

A

effectors (muscle fibers and glands)

81
Q

What is the ability to perform a motor activity

A

Praxis

82
Q

What is the inability to perform a voluntary movement

A

Apraxia

83
Q

What is a decreased ability to perform an ability called

A

dyspraxia

84
Q

What is the most common neuro complaint

A

Headache

85
Q

Dizziness must be classified into which 2 categories

A
  1. Vertigo
  2. Light headedness
86
Q

If a patient enters your office with hesitant and labored speech, poor articulation, and unaltered comprehension, what are they experiancing?

A

Expressive aphasia

87
Q

If a patient enters your office with fluent and rapid words, omitting many words and not making sense, unable to comprehend what you ask them, what are they experiancing?

A

Receptive aphasia

88
Q

Is Broca’s aphasia fluent or nonfluent

A

Non-fluent (expressive)

89
Q

Is Wernicke’s aphasia fluent or non fluent

A

Fluent (receptive)

90
Q

An Extrapyramidal gait is related to

A

motor activity descending from the cerebral cortex

91
Q

If your patient is complaining of feeling pins and needles on their leg, what is this condition called?

A

Paresthesias

92
Q

4 common causes of neurological pain

A

Trigeminal Neuralgia
Herpes Zoster
Sciatica
Meningitis

93
Q

If your patient is feeling severe pain in their face and they constantly feel like they have an electric shock on, what are they experiancing?

A

Trigeminal Neuralgia

94
Q

5 clinical levels of consciousness

A
  1. Alertness
  2. Lethargy
  3. Obtundation
  4. Stupor
  5. Coma
95
Q

What is the acronym and check for dementia?

A

OMIJA
Orientation
Memory
Intellect
Judgement
Affect

96
Q

Which cranial nerves connect to the forebrain?

A

1 and 2

97
Q

How do you assess CN 2

A

Acuity- Snellen chart
Visual feild testing
Pupilary response to light

98
Q

The response of pupils to light is controlled by what

A

Afferent nerves that travel with CN 2 and efferent nerves from CN 3 to innervate ciliary muscle which controls pupilary size

99
Q

What are the somatic and visceral motor functions of CN 3

A

Somatic: Innervates all Eye muscles but LR and SO
Visceral: Innervates ciliary muscle and constricts pupil by contracting, controls shape of lens

100
Q

How do you assess CN 4

A

Have the patient look down and in– CN 4 innervates the superior oblique

101
Q

Which cranial nerve division innervates muscles of mastication

A

CNV3- Mandibular division

102
Q

You walk in on a PA student who is stroking a patient’s face with a q-tip, asking the patient to open and close their mouth, and move their jaw from side to side. As a preceptor, you would be concerned, but you know the PA student is checking () nerve, so you are not.

A

Cranial nerve 5- Trigeminal.

103
Q

What is the special sensory function of CN 7

A

taste to anterior 2/3 of tongue

104
Q

What is the parasympathetic function of CN 7

A

innervate lacrimal glands, submandibular glands, sublingual salivary glands

105
Q

What is the sensory function of CN 8

A

hearing and balance

106
Q

What is the special sensory function of CN 9

A

Taste on posterior 1/3 of tongue

107
Q

What is the motor function of CN 9

A

Elevate pharynx during swallowing

108
Q

What is the parasympathetic function of CN 9

A

Innervate parotid and salivary gland
To test, ask about saliva production or dry mouth

109
Q

If (WHIICH NERVE) is not working on the right side, the uvula will be pulled to the left.

A

CN 9

110
Q

Sensory function of CN 10

A

Thoracic and abdominal viscera
Taste buds on epiglottis

111
Q

What is the motor function of CN 10

A

Skeletal muscles of pharynx and larynx

112
Q

What is the parasympathetic function of CN 10

A

Parasympathetic innervation to the heart, lungs, and abdominal viscera

113
Q

With a light touch, you check the inside of the patient’s external ear. What cranial nerve are you checking?

A

Vagus

114
Q

What is the motor function of CN 11

A

SCM and Trapezius innervation

115
Q

What is the motor function of CN 12

A

Innervates tongue muscles

116
Q

If the right sided CN 12 is dysfunctional, is the tongue sticking out to the right or left?

A

To the Right- Same side.

117
Q

What are the 4 qualities of muscle groups

A

Atrophy, symmetry, fasiculations, tone

118
Q

When checking a patient’s gait, which part of the brain are you testing

A

Cerebellar functioning

119
Q

What are the 3 types of joints

A

Synovial- Freely moveable
Cartilagionous- Slightly moveable
Fibrous- Immovable

120
Q

Muscle activation with gravity eliminated, achieving full range of motion, is which classification of muscle strength?

A

2- weak

121
Q

Twitching muscle activation without achieving FROM is which classifcation of muscle strength?

A

1

122
Q

Muscle activation against gravity with FROM is which classification of muscle strength?

A

3- fair

123
Q

Muscle activation against some resistance, FROM is which classification of muscle strength?

A

4

124
Q

Muscle activation against examiner’s resistance with FROM is which classification of muscle strength?

A

5

125
Q

How do you asssess muscle tone

A

Perform PROM (passive ROM)

126
Q
A