Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
1193 Cards in this Set
- Front
- Back
Iliopsoas |
Which muscle test for the following movement|- hip flexion
|
|
Sartorius
|
Which muscle test for the following movement|- hip flexion, abduction, lateral rotation (sitting with legs crossed)
|
|
quads
|
Which muscle test for the following movement|- knee extension
|
|
pectineus, adductor longus/brevis, gracilis
|
Which muscle test for the following movement|- hip adduction
|
|
gluteus medius,minimus
|
Which muscle test for the following movement|- hip abduction,flexion, medial rotation
|
|
tensor fascia lata
|
Which muscle test for the following movement|- hip flexion, abduction, medial rotation
|
|
piriformis, obturator internus, gamelli, guadratus femoris
|
Which muscle(s) test for the following movement|- hip lateral rotation
|
|
gluteus maximus
|
Which muscle test for the following movement|- hip extension, lateral rotation
|
|
biceps femoris
|
Which muscle test for the following movement|- hip extension,knee flexion,leg lateral rotation
|
|
semitendinosus
|
Which muscle test for the following movement|- hip extension,knee flexion
|
|
semimembranosus, popliteus
|
Which muscle(s)test for the following movement|- leg medial rotation
|
|
Which muscle test for the following movement|- ankle dorsiflexion
|
tibialis anterior
|
|
Which muscle test for the following movement|- 2nd - 5th digit MTP extension
|
extensor digitorum longus
|
|
Which muscle test for the following movement|- great toe MTP extension
|
extensor hallucis longus
|
|
Which muscle test for the following movement|- foot eversion
|
peroneus longus/brevis
|
|
Which muscle test for the following movement|- foot inversion
|
tibialis posterior
|
|
Which muscle test for the following movement|- ankle plantarflexion
|
gastrocnemius, soleus
|
|
Which muscle test for the following movement|- 2nd-5th digit DIP flexion
|
flexor digitorum longus
|
|
Which muscle test for the following movement|- great toe IP flexion
|
flexor hallucis longus
|
|
Which muscle test for the following movement|- 2nd-5th digit PIP flexion
|
flexor digitorum brevis
|
|
Which muscle test for the following movement|- great toe MTP flexion
|
flexor hallucis brevis
|
|
Which muscle test for the following movement|- toe adduction/abduction
|
dorsal/plantar interossei
|
|
Which muscle test for the following movement|- pelvic floor control
|
perineals and sphincters
|
|
Which nerve innervates this muscle|- iliopsoas
|
femoral
|
|
Which nerve innervates this muscle|- sartorius
|
femoral
|
|
Which nerve innervates this muscle|- quadriceps femoris
|
femoral
|
|
Which nerve innervates this muscle|- pectineus
|
obturator
|
|
Which nerve innervates this muscle|- adductor longus/brevis
|
obturator
|
|
Which nerve innervates this muscle|- gracilis
|
obturator
|
|
Which nerve innervates this muscle|- gluteus medius,minimus
|
superior gluteal
|
|
Which nerve innervates this muscle|- tensor facia lata
|
superior gluteal
|
|
Which nerve innervates this muscle|- piriformis
|
superior gluteal
|
|
Which nerve innervates this muscle|- gluteus maximus
|
inferior gluteal
|
|
Which nerve innervates this muscle|- obturator internus
|
sacral plexus
|
|
Which nerve innervates this muscle|- gamelli, guadratus femoris
|
sacral plexus
|
|
Which nerve innervates this muscle|- hamstrings (biceps femoris, semitendinosus, semimembrenosus)
|
tibial
|
|
Which nerve innervates this muscle|- tibialis anterior
|
deep peroneal
|
|
Which nerve innervates this muscle|- extensor digitorum longus
|
deep peroneal
|
|
Which nerve innervates this muscle|- extensor hallucis longus
|
deep peroneal
|
|
Which nerve innervates this muscle|- peroneus longus/brevis
|
superficial peroneal
|
|
Which nerve innervates this muscle|- popliteus
|
tibial
|
|
Which nerve innervates this muscle|- tibialis posterior
|
tibial
|
|
Which nerve innervates this muscle|- gastrocnemius, soleus
|
tibial
|
|
Which nerve innervates this muscle|- flexor digitorum longus
|
tibial
|
|
Which nerve innervates this muscle|- flexor hallucis longus
|
tibial
|
|
Which nerve innervates this muscle|- flexor digitorum brevis
|
medial plantar
|
|
Which nerve innervates this muscle|- flexor hallucis brevis
|
medial plantar
|
|
Which nerve innervates this muscle|- dorsal/plantar interossei
|
lateral plantar
|
|
Which nerve innervates this muscle|- perineals and sphincters
|
prudendal
|
|
Gillet's test
|
asseses posterior movement of the ilium relative to the sacrum
|
|
Gillet's test
|
Patient is standing. Place your thumb of your hand under PSIS of limb to be tested and place your other thumb on center of sacrum at same level as thumb under PSIS.|Ask patient to FLEX hip and knee of limb being tested as if bringing their knee to chest.|Assess movement of PSIS via comparison of positions of your thumbs. Make sure your eyes are level with your thumbs. |PSIS should move in an INFERIOR direction|(+) TEST: no identified movement of PSIS as compared to sacrum
|
|
Ipsilateral anterior rotation test
|
assess anterior movement of ilium relative to sacrum
|
|
Ipsilateral anterior rotation test
|
Place thumb of your hand under PSIS of limb to be tested and place your other thumb on center of sacrum at same level as thumb under PSIS.|Ask patient to EXTEND hip of limb being tested.|Assess movement of PSIS via comparison of positions of your thumbs. Make sure your eyes are level with your thumbs. |PSIS should move in a SUPERIOR direction|(+) TEST: no identified movement of PSIS as compared to sacrum
|
|
Gaenslen's test
|
identifies sacroiliac joint dysfunction
|
|
Gaenslen's test
|
Patient sidelying at edge of table while holding bottom leg in maximal hip and knee flexion (knee to chest).|Stand behind the patient and passively extend hip of upper most limb. This places stress on SIJ associated with upper most limb.|(+) TEST: pain in SIJ
|
|
Long sitting or supine to sit test
|
identifies dysfunction of SIJ that may be cause of functional leg length discrepancy
|
|
Long sitting or supine to sit test
|
Patient supine with correct alignment of trunk, pelvis, and lower limbs. YOU stand at edge of table by patient's feet palpating the medial malleoli to assess symmetry (one longer than other).|Have patient come into long sitting position and once again assess their leg length making a comparison between supine and long sitting|(+) TEST: abnormal finding is reversal in limb length between supine as compared to long sit
|
|
Goldthwait's test
|
differentiates between dysfunction in lumbar spine vs SIJ
|
|
Goldthwait's test
|
Patient supine with your fingers in between spinous of lumbar spine. With your other hand, passively perform a straight leg raise (SLR)|(+) TEST: if pain presents prior to palpation of movement in lumbar segments, dysfunction is related to SIJ
|
|
TMJ compression
|
Evaluates for pain with compression of the retrodiscal tissues
|
|
TMJ compression
|
Patient sitting or supine. Support/stabilize patients head with one hand and with other hand push mandible superior causing a compressive load to the TMJ|(+) TEST: pain in TMJ
|
|
Anterior innominate
|
Apparent leg shortening occurs as the malleolus moves from a longer position to a shorter one
|
|
Posterior innominate
|
Apparent leg lengthening occurs as the malleolus moves from a shorter postion to a longer one
|
|
Lasegue's test or Straight leg raising test
|
identifies dysfunction of neurological structures that supply lower limb
|
|
Lasegue's test or Straight leg raising test
|
Patient supine with legs resting on table. Passively flex hip of one leg with knee extended until patient complains of shootingpain into lower limb.|Slowly lower limb until pain subsides then passively dorsiflex foot|(+) TEST: reproduction of pathological, neurological symptoms when foot is dorsiflexed
|
|
Femoral nerve traction test
|
identifies compression of femoralnerve anywhere along its course
|
|
Femoral nerve traction test
|
Patient lies on non-painful side with trunk in neutral, head flexed slightly, and lower limb's hip and knee flexed.|Passively extend hip while knee of painful limb is in extension. |if no reproduction of symptoms flex knee of painful leg|(+) neurological pain in anterior thigh
|
|
Valsalva's maneuver
|
identifies a space-occupying lesion.
|
|
Valsalva's maneuver
|
Patient sitting. Instruct patient to take a deep breath and hold while they "bare down" as if having a bowel movement.|(+) TEST: increasing low back pain or neurological symptoms into lower extremity
|
|
Babinski's test
|
identifies upper motor neuron lesion.
|
|
Babinski's test
|
Patient supine or sitting.|Glide bottom end of a standard reflex hammer along plantar surface of patient's foot.|(+) TEST: extension of big toe and splaying (abduction) of other toes
|
|
Quadrant test
|
identifies compression of neural structures at the intervertebral foramen and facet dysfunction.
|
|
Quadrant test
|
INTERVERTEBRAL FORAMEN: (L = left, R = right)|Patient is standing, cue patient into:|- side bending L, rotation L, and extension to maximally close intervertebral foramen on the L|-Repeat to other side|FACET DYSFUNCTION:|Patient is standing, cue patient into:|- side bending L, rotation R, and extension to maximally compress facet joint on L|- Repeat to other side|(+) TEST: pain and/or paresthesia in the dermatomal patern for the involved nerve root or localized pain if facet dysfunction
|
|
Stork standing test
|
identifies spondylolisthesis
|
|
Stork standing test
|
Patient standing on one leg. Cue patient into trunk extension.|Repeat with opposite leg on ground|(+) TEST: pain in low back with ipsilateral leg on ground
|
|
McKenzie's side glide test
|
Differentiate between scoliotic curvature vs. neurlogical dysfunction causing abnormal curvature (lateral shift) of trunk.
|
|
McKenzie's side glide test
|
Test is perfromed if "lateral shift" of trunk is noted.|Patient is standing. Stand on side of patient that upper trunk is shifted toward.|Place your shoulders into patient's upper trunk and wrap your arms around patient's pelvis. |Stabilize upper trunk and pull pelvis to bring pelvis and trunk into proper alignment|(+) TEST: reproduction of neurological symptoms as alignment of trunk is corrected
|
|
Bicycle (van Gelderen's) test
|
differentiates between intermittent claudication and spinal stenosis
|
|
Bicycle (van Gelderen's) test
|
Patient seated on stationary bicycle, and rides the bike while sitting erect and time how long patient can ride at a set pace/speed. After a sufficient rest period, have patient ride the bike at the same speed while in a slumped position.|Determination based on length of time patient can ride bike in sitting upright vs. sitting slumped|(+) TEST: Pain related to spinal stenosis, should be able to ride bike longer while slumped.
|
|
Rib springing
|
evaluates rib mobility
|
|
Rib springing
|
Patient prone. Begin at upper ribs applying a posterior to anterior force through each rib progressively working through entire rib cage.|Following prone test, Position patient in sidelying and repeat.|BE CAREFUL with springing the 11th and 12th ribs since they have no anterior attachment and therefore are less stable|(+) TEST: pain, excessive motion of rib or restriction of rib
|
|
Thoracic springing
|
evaluate intervertebral joint mobility in thoracic spine
|
|
Thoracic springing
|
Patient prone. Apply posterior to anterior glides/spring to transverse process of thoracic vertebra.|Remember that the spinous process and transverse process of the same vertebra may not be at the same level in the thoracic region.|(+) TEST: pain, excessive movement, and/or restricted movement
|
|
Slump test
|
identifies dysfunction of neurological structures supplying the lower limb
|
|
Slump test
|
Patient is sitting on edge of table with knee flexed.|Patient slumps sits while maintaining neutral postion of head and neck.|Follow this progression after:|1.- Passively flex patient's head and neck. If no reproduction of symptoms, move on to next step.|2.- Passively extend one of patient's knees. If no reproduction of symptoms, move on to the next step|3.- Passively dorsiflex ankle of limb with extended knee|4.- Repeat steps 1-3 with opposite leg|(+) TEST: reproduction of pathological neurological symptoms
|
|
Vertebral artery test
|
identifies the integrity of the vertebrobasilar vascular system
|
|
Vertebral artery test
|
Patient supine with head supported on table (follow the progression)|1.- Extend head and neck for 30 sec. if no change in symptoms, progress to next step|2.- Extend head and neck with rotation left, then right for 30 seconds, if no change in symptoms progress to next step|3.- With head being cradled off table, extend head and neck for 30 seconds. If no change in symptoms, progress to next step|4.- With head being cradled off table, extend head and neck with rotation left for 30 seconds, and then right|(+) TEST: dizziness, visual distribuances, disorientation, blurred speech, nausea/vomiting
|
|
Hautant's test
|
differentiates between vascular vs vestibular causes of dizziness/vertigo
|
|
Hautant's test
|
Part 1|Patient sitting with shoulder at 90° of flexion, and palms up.|Have patient close eyes and remain in this position for 30 seconds. |(+) TEST: If arm lose their position , there may be a vestibular condition, there may be a vestibular condition|Part 2|Patient sitting with shoulder at 90° of flexion and palms up.|Have patient close eyes and cue patient into head and neck extension with rotation right and left remaining in each position for 30 seconds|(+) TEST: If arm lose their position, the condition may be vascular in nature.
|
|
Vestibular condition
|
A PT performs a Hautant's on a patient. Patient is sitting with shoulder at 90° of flexion. PT ask patient to close his/her eyes and remain in this position for 30 seconds. PT observes that his arms lose their position. This is likely due to a:___________
|
|
Vascular condition
|
A PT performs a Hautant's on a patient. Patient is sitting with shoulder at 90° of flexion. PT ask patient to close his/her eyes and to extend his/her head and neck with rotation to the right and then left with 30 seconds holds each. PT observes that arms lose their position. This is likely due to a:_________
|
|
Transverse ligament stress test
|
tests integrity of transverse ligament
|
|
Transverse ligament stress test
|
Patient supine with head supported on table.|Glide C1 anterior. Should be firm end feel|(+) TEST: findings i.e.. soft end feel, dizziness, nystagmus, a lump sensation in throat, nausea
|
|
Anterior shear test
|
assesses integrity of upper cervical spine ligaments and capsules
|
|
Anterior shear test
|
Patient supine with head supported on table|Glide C2-C7 anterior. Should be firm end feel|(+) TEST: laxity of ligaments , also, dizziness, nystagmus, a lump sensation in the throat, nausea
|
|
Foraminal compression (Spurling's) test
|
identifies dysfunction (typically compression) of cervical nerve root
|
|
Foraminal Compression (Spurling's) test
|
Patient sitting with head side bent toward uninvolved side.|Apply pressure through head straight down.|Repeat with head side bent toward involved side|(+) TEST: Pain and/or paresthesia in dermatomal pattern for involved nerve root
|
|
Maximum cervical compression test
|
identifies compression of neural structures at intervertebral foramen and/or facet dysfunction
|
|
Maximum cervical compression test
|
Patient in sitting. Passively move head into side bending and rotation towards the non-painful side followed by extension.|Repeat this step towards the painful side.|(Be careful since this test is very similar to vertebral artery test)|(+) TEST: pain and/or paresthesia in dermatomal pattern for involved nerve root or localized pain in neck if facet dysfunction
|
|
Distraction test
|
indicates compression of neural structures at the intervertebral foramen or facet dysfunction
|
|
Distraction test
|
Patient sitting and head is passively distracted|(+) TEST: finding: |- A decrease in symptoms in neck (facet dysfunction)|- A decrease in upper limb pain (neurological condition)
|
|
Shoulder abduction test
|
indicates compression of neural structures within intervertebral foramen
|
|
Shoulder abduction test
|
Patient is sitting and asked to place one hand on top of their head. Repeat this step with the opposite hand.|(+) TEST: findings, A decrease in symptoms into upper limb
|
|
Lhermitte's sign
|
identifies dysfunction of spinal cord and/or an upper motor neuron lesion.
|
|
Lhermitte's sign
|
Patient is long sitting on table. |Passively flex patient's head and one hip while keeping knee in extension. Repeat this step with other hip|(+) TEST: pain down the spine and into the UE or LE
|
|
Romberg's test
|
identifies upper motor neuron lesion
|
|
Romberg's test
|
Patient is standing and closes eyes for 30 seconds.|(+) TEST: Excessive swaying during test indicates
|
|
Neutral subtalar positioning
|
examination to determine if abnormal rearfoot to forefoot positioning exists
|
|
Neutral subtalar positioning
|
Patient in prone with foot over edge of table. Palpate dorsal aspect of talus on both sides with one hand and grasp lateral forefoot with other hand.|Gently dorsiflex foot until resistance is felt then gently move foot through arc of supination and pronation|Neutral position is point at which you feel foot fall off easier to one side or other. At this point, compare : rearfoot to forefoot, and rearfoot to leg
|
|
Anterior drawer test
|
identifies ligamentous instability (particularly, anterior talofibular ligament).
|
|
Anterior drawer test
|
Patient supine with heel just off edge of table in 20° of plantarflexion.|Stabilize lower leg and grasp foot. Pull talus anterior.|(+) TEST: if talus has excessive anterior glide and/or pain is noted
|
|
Talar tilt
|
identifies ligamentous instability (particularly calcaneofibular ligament)
|
|
Talar tilt
|
Patient sidelying with knee slightly flexed and ankle in neutral.|Move foot into adduction testing for calcaneofibular ligament.|Move foot into abduction testing for deltoid ligament|(+) TEST: if excessive adduction or abduction occurs and/or pain is noted
|
|
Thompson's test
|
evaluates the integrity of the Achilles' tendon
|
|
Thompson's test
|
Patient prone with foot off edge of table. Squeeze calf muscles|(+) TEST: No movement of foot while squeezing calf.
|
|
Tinel's sign
|
identifies dysfunction of posterior tibial nerve, posterior to the medial malleolus or deep fibular anterior to talocrural joint
|
|
Tinel's sign
|
Patient supine with foot supported on the table.|Tap over region of posterior tibial nerve as it passes posterior to medial malleolus.|Tap over region of deep fibular nerve as it passess under dorsal retinaculum (anterior to ankle joint)|(+) TEST: Reproduces tingling and/or paresthesia into the respective nerve distribution
|
|
Morton's test
|
identifies stress fracture or neuroma in forefoot
|
|
Morton's test
|
Patient supine with foot supported on table|Grasp around metatarsal heads and squeeze|(+) TEST: if finding pain in forefoot
|
|
Collateral ligament instability test
|
Testing for medial and lateral knee ligaments, identifies laxity or restriction
|
|
Collateral ligament instability test
|
Patient is supine. Entire lower limb is supported and stabilized and knee placed in 20°-30° of flexion.|Valgus/Varus force are placed through the knee to tests for medial/lateral collateral ligaments|(+) TEST: finding laxity, but pain may be noted as well
|
|
Lachman's stress test
|
indicates integrity of ACL
|
|
Lachman's stress test
|
Patient is supine with testing knee flexed to 20°-30°.|Stablize femur and passively try to glide tibia anterior|(+) TEST: finding excessive anterior glide of tibia
|
|
Pivot shift
|
indicates integrity of ACL
|
|
Pivot shift
|
Patient is supine with testing knee in extension, hip flexed and abducted to 30° with slight internal rotation.|Hold knee with one hand and foot with other hand.|Place valgus force through knee and flex knee.|(+) TEST: finding ligament laxity as indicated by tibia relocating during the test. As knee is being flexed, the tibia clunks backward at approximately 30°-40°. The tibia at begining of test was subluxed and then was reduced by pull of ilitobial band as knee was being flexed.
|
|
Posterior sag test
|
indicates integrity of PCL
|
|
Posterior sag test
|
Patient supine and testing hip flexed to 45° and knee to 90° |Observe to see if tibia "sags" posteriorly while in this position|(+) TEST: finding is sag of tibia relative to femur
|
|
Posterior drawer test
|
indicates integrity of PCL
|
|
Posterior drawer test
|
Patient is supine ,+testing hip flexed to 45°,+ knee flexed to 90°.|Passively glide tibia posteriorly following the joint plane.|(+) TEST: finding is excessive posterior glide
|
|
Reverse Lachman
|
indicates integrity of PCL
|
|
Reverse Lachman
|
Patient is prone with knees flexed to 30°|stabilize femur and passively try to glide tibia posterior|(+) TEST: ligament laxity
|
|
McMurray's test
|
identifies meniscal tears
|
|
McMurray's test
|
patient supine with testing knee in maximal flexion.|Passively:|- internally rotate and extend the knee (for lateral meniscus)|- externally rotate and extend the knee (for medial meniscus)|(+) TEST: reproduction of click and/or pain in knee joint
|
|
Apley test
|
helps differentiate between meniscal tears and ligamentous lesions.
|
|
Apley test
|
patient prone with testing knee flexed to 90°.|stabilized patient's thigh to table with your knee.|Passively :|-distract the knee joint and rotate tibia internally/externally slowly. THEN|-apply a compressive load to knee joint and rotate int/ext to tibia slowly|(+) TEST:|- pain or decreased motion during compression = mensical dysfunction|- pain or decreased motion during distraction = ligamentous dysfunction
|
|
meniscal dysfunction
|
Patient is being evaluated by a PT for knee pain. the PT suspects the problems might either be mensical or ligamentous. the Apley test is performed and the patient reported pain or decreased motion with compression. this is most likely due to:______________________
|
|
ligamentous dysfunction
|
Patient is being evaluated by a PT for knee pain. the PT suspects the problems might either be mensical or ligamentous. the Apley test is performed and the patient reported pain or decreased motion with distraction. this is most likely due to:______________________
|
|
Hughston's plica test
|
identifies dysfunction of the plica
|
|
Hughston's plica test
|
Patient is supine, and testing knee is flexed with tibia in int. rot.|Passively glide the patella medially while palpating the medial femoral condyle. Feel for "popping" as you passively flex and extend the knee|(+) TEST: pain and/or popping noted during test
|
|
Patellar apprehension test
|
indicates history of patella dislocation
|
|
Patellar apprehension test
|
Patient is supine and patella is passively glide laterally.|Patient does not allow and/or does not like patella to move in lateral direction to simulate subluxation/dislocation
|
|
Clarke's sign
|
indicates patellofemoral dysfunction
|
|
Clarke's sign
|
Patient supine with knee in extension resting on the table|push posterior on superior pole of patella then ask the patient to perform an active contraction of the quads mucles.|(+) TEST: pain is produced in knee as a result of the test
|
|
Ballotable patella (Patellar tap test)
|
indicates infrapatellar effusion
|
|
Ballotable patella (Patellar tap test)
|
Patient supine with knee in extension resting on the table|apply a soft tap over the central patella|(+) TEST: perception of the patella floating ("dancing patella" sign)
|
|
Fluctuation test
|
indicates knee joint effusion
|
|
Fluctuation test
|
Patient supine with knee in extension resting on the table.|Place one hand over suprapatellar pouch and other over anterior aspcect of kne joint.|Alternate pushing down with one hand at a time|(+) TEST: finding is fluctuation (movement) of fluid noted during test.
|
|
Q angle measurements
|
measurement of angle between the quadriceps muscle and the patellar tendon|Normal for men = 13°; Normal for women = 18°|angles < or > of normal, may indicate knee dysfunction and/or biomechanical dysfunctions within the lower limb
|
|
Noble compression test
|
identifies if Distal iliotibial band (Distal IT band) friction syndrome is present
|
|
Noble compression test
|
patient supine with hip flexed to 45° and knee flexed to 90°|Apply pressure to lateral femoral epicondyle then extend knee|(+) TEST: Reproduces same pain over the lateral femoral condyle. Patient will complain of pain over lateral femoral epicondyle at ≈ 30° flexion
|
|
Tinel's sign
|
identifies dysfunction of common fibular nerve posterior to fibula head
|
|
Tinel's sign
|
Tap region where common fibular nerve passes through posterior to fibula head|(+) TEST: Reproduces tingling and/or paresthesia into leg following common fibular nerve distribution
|
|
Patrick's (FABER) test
|
Patient lies supine. Passively flex, abduct and externally rotate test leg so that foot is resting just above knee on opposite leg. Slowly lower testing leg down toward table surface|(+) TEST: when involved knee is unable to assume relaxed position and/or reproduction of painful symptoms
|
|
Patrick's (FABER) test
|
identifies dysfunction of hip such as mobility restriction
|
|
Grind (Scouring) test
|
Identifies DJD of hip joint
|
|
Grind (Scouring) test
|
Patient supine with hip in 90° flexion and knee maximally flexed.|Place compressive load into femur via knee joint therefore loading hip joint
|
|
Trendelenburg's sign
|
identifies weakness of gluteus medius or unstable hip
|
|
Trendelenburg's sign
|
Patient standing and asked to stand on one leg (flex opposite knee).|Observe pelvis of stance leg|(+) TEST: when ipsilateral pelvis drops when lower limb support is removed while standing.
|
|
negative test
|
Patient is being evaluated, PT asked the patient to balance on one leg. the examiner looks closely and observe that the pelvis on the nonstance leg rises. The trendelenburg's sign is considered a:___________
|
|
positive test
|
Patient is being evaluated, PT asked the patient to balance on one leg. the examiner looks closely and observe that the pelvis on the nonstance falls. The trendelenburg's sign is considered a:___________
|
|
Thomas' test
|
identifies tightness of hip flexors
|
|
Thomas' test
|
Patient supine and one hip and knee are maximally flexed to chest and held there. Opposite limb is kept straight on table.|(+) TEST: Hip flexion occurs or limb is unable to remain flat on the table on the straight leg as the opposite limb is flexed.
|
|
Ober's test
|
identifies tightness of tensor fascia latae and/or iliotibial band tightness
|
|
Ober's test
|
Patient lying on side with lower limb flexed at hip and knee.|Passively extend and abduct testing hip with knee flexed to 90°.|Slowly lower uppermost limb observe if it reaches table|(+) TEST: if uppermost limb is unable to come to rest on table
|
|
Ely's test
|
identifies tightness of rectus femoris
|
|
Ely's test
|
Patient prone and knee of testing limb is flexed|Observe hip of testing limb|(+) TEST: if hip of testing limb flexes
|
|
90-90 hamstring test
|
identifies tightness of hamstrings
|
|
90-90 hamstring test
|
patient supine and hip and knee of testing limb is supported in 90° flexion. |Passively extend knee of testing limb until a barrier is encountered|(+) TEST: if knee is unable to reach 10° from neutral position (lacking 10° of extension)
|
|
Piriformis test
|
identifies piriformis syndrome
|
|
Piriformis test
|
Patient supine and foot of test leg is passively placed lateral to opposite limb's knee.|Testing hip is adducted. Observe position of testing knee relative to opposite knee|(+) TEST: if testing knee is unable to pass over the resting knee and/or reproduction of pain in buttock and/or along sciatic nerve distribution
|
|
Leg length test
|
identifies true leg length discrepancy
|
|
Leg length test
|
patient is supine and pelvis is balanced/aligned with lower limbs and trunk.|Measure the distance from ASIS to lateral malleoulus on each limb several tiems for consistency and compaire results|A difference in lengths between two limbs is noted identifying a true leg length discrepancy
|
|
Craig's test
|
identifies abnormal femoral antetorsion angle
|
|
Craig's test
|
patient prone with knee flexed to 90° palpate greater trochanter and slowly move hip through internal/external rotation. |when greater trochanter feels most lateral stop, and measure the angle of leg relative to a line perpendicular with table surface|Normal angle = 8°-15° hip internal rotation|< 8° = retroverted hip; > 15° = anteverted hip
|
|
Finkelstein's test
|
Patient makes a fist with thumb within confines of fingers.|Passively move wrist into ulnar deviation|Reproduces pain in wrist. Often painful with no pathology, so compare to uninvolved side
|
|
Finkelstein's test
|
identifies deQuervain's tenosynovitis (parentendonitis of abductor pollicis longus and/or extensor pollicis brevis (AbPL + EPB)
|
|
Bunnel-Littler test
|
The MCP joint is stablized in slight extension while PIP joint is flexed. Differentiates between a tight capsule and tight intrinsic muscles. (all passive movements)| - IF MCP joint is slightly extended + PIP joint = no flexion = Tight intrinsic muscles|- IF MCP joint is slightly flexed + PIP joint = FULL flexion = Tight intrinsic muscles|- IF MCP joint is slightly flexed + PIP joint = LITTLE flexion = Capsular tightness
|
|
Intrinsic muscle tightness
|
A PT performs the Bunnel-Litter test on a patient with finger ROM restrictions. The PT holds MCP in slight extension and attempts to flex the PIP joint but it is unable to. The PT then holds the MCP in slight flexion and the PIP flexes fully. |This is due to:______________
|
|
Capsule tightness
|
An PT performs the Bunnel-Littler test on a patient with finger ROM restrictions. the PT holds the MCP joint in slight extension, and attempts to flex the PIP joint but is unable to, then, PT then holds the MCP joint in slight flexion, but the PIP joint either flexes minimally or no at all.| This is due to: _________
|
|
Tight retinacular test
|
This test differentiates between a tightness in the capsule and tight rectinacular ligaments.
|
|
Tight retinacular test
|
PIP is stabilized in neutral while DIP is flexed. Then PIP is flexed and DIP is flexed|IF DIP flexion is limited with PIP in held in neutral = capsule is tight|IF DIP flexion is greater with PIP held in flexion = retinacular ligaments tightness
|
|
Capsular tightness
|
A PT is performing the Tight retinacular test. He holds the PIP joint in neutral while DIP is passively flexed, but is unable to. then the he holds the PIP joint in slight flexion and DIP flexion is limited. this is due to: __________
|
|
Retinacular ligament tightness
|
A PT is performing the Tight retinacular test. He holds the PIP joint in neutral while DIP is flexed, but is unable to or flexion is minimal. then he holds the PIP joint in slight flexion, and the DIP flexion is greater. This is due to:___________
|
|
Ligamentous instability tests
|
Fingers are supported and stabilized.|Valgus and Varus forces are applied to PIP joints all digits, and the same is repeated at the DIP joints.|(+) TEST: finds laxity either medial or collateral ligaments or both
|
|
Froment's sign
|
Patient graps paper between 1st. and 2nd. digits of hand. Pull paper out and look for IP flexion of thumb, which is compensation due to weakness of adductor pollicis |Indication of ulnar nerve dysfunction: = Patient is unable to perform test without compensation. what's the name of this test?
|
|
Tinel's sign
|
Tap region where median nerve passes through carpal tunnel.|Reproduces tingling and/or paresthesia into hand following median nerve distribution. |Identifies carpal tunnel compression of median nerve
|
|
Phalen's test
|
Patient maximally flexes both wrist holding them against each other for 1 minute.|(+) TEST: Reproduces tingling and/or paresthesia into hand following median nerve distribution
|
|
Two point discrimination test
|
identifies the level of sensory innervation within hand which correlates with functional ability to perform certain tasks involving grasp.
|
|
Two point discrimination test
|
patient sitting with hand stabilized. Using a caliper, two point discriminator, or paper clip apply device to palmar aspect of fingers to assess patients ability to distinguish between two points of testing device.|Record smallest difference that patient can sense two separate points.|Normal amount that can be discriminated is generally < 6 mm
|
|
Allen's test
|
Identifies vascular compromise. identifies radial and ulnar arteries at wrist.
|
|
Allen's test
|
Have patient open/close fingers quickly several times, and then make a closed fist.|Using your thumb, occlude the ulnar artery and have patient open hand. Observe palm of hand and then release the compression on artery and observe for vascular filling. Perform same procedure with radial artery.|Under normal circumstances there is a change in color from white to normal appearance on palm of hand
|
|
Adductor pollicis
|
A patient graps paper between 1st. and 2nd. digits of hand. the PT pulls the paper out and patient compensates by flexing the IP joint of thumb. What muscle is weak on this test?
|
|
ulnar nerve
|
A patient graps paper between 1st. and 2nd. digits of hand. the PT pulls the paper out and observes IP flexion of thumb which is a compensatory technique. Since patient was not able to perform test without compensation. What nerve is affected?
|
|
Ligament instability test
|
Patient is sitting or supine. Entire UE is supported and stabilized and elbow placed in 20°-30° of flexion.|Valgus force placed through elbow tests UCL|Varus force placed through elbow tests RCL|(+) TEST: laxity, but pain may be noted as well
|
|
Lateral epicondylitis test
|
Patient is sitting, elbow flexed to 90° and supported/stabilized.|RESIST: wrist extension, radial deviation and forearm pronation with fingers fully flexed (fist) simultaneously.|(+) TEST: Pain in lateral epicondyle
|
|
Medial epicondylitis test
|
Patient is sitting, elbow flexed to 90° and supported/stabilized.|Passively supinate forearm, extend elbow, and extend wrist|(+) TEST: Reproduces pain at medial epicondyle
|
|
Tinel's sign
|
Tap region where the ulnar passes through cubital tunnel|Reproduces a tingling sensation in ulnar distribution
|
|
Pronator teres syndrome test
|
Patient is sitting, elbow flexed to 90° and supported/stabilized.|RESIST: forearm pronation and elbow extension simultaneously|(+) TEST: Reproduces a tingling sensation or paresthesia within median nerve distribution
|
|
Yergason's test
|
Patient is sitting with shoulder in neutral, stabilized against the trunk, elbow = 90°, and forearm pronated.|RESIST: supination of forearm and external rotation of shoulder|WILL NOTE: that tendon of biceps long head will "POP OUT" of groove. |May also reproduce pain in long head of biceps tendon
|
|
Speed's test
|
(Biceps straight arm).|(1) Patient is sitting or standing with upper limb in full extension, and forearm supinated.|RESIST: shoulder flexion|(2) May also place shoulder in 90° flexion, and PUSH upper limb into extension causing an eccentric contraction of biceps|WILL reproduce symptoms (pain) in long head of biceps tendon
|
|
Neer's impingement test
|
Patient sitting and shoulder is passively internally rotated then fully abducted|WILL reproduce symptoms of pain within shoulder region
|
|
Supraspinatus test (empty can)
|
Patient sitting with shoulder at 90° and no rotation|RESIST: shoulder abduction, THEN place shoulder in "empty can" position [internal rotation and 30° forward (horizontal adduction)]|RESIST: Abduction. |Differentiate if pain present between two positions|(+) TEST: Reproduces pain in supraspinatus tendon and/or weakness while in "empty can" position
|
|
Drop arm test
|
Patient sitting with shoulder passively abducted to 120°. |Patient is instructed to slowly to bring arm down to side.|Guard the patient's arm from falling in case it gives way.|(+) TEST: Patient is unable to lower arm back down to side
|
|
Posterior internal impingement test
|
Patient supine and move shoulder into 90° abduction, maximum external rotation and 15°-20° horizontal adduction|(+) TEST: Reproduction of pain in posterior shoulder during test
|
|
Clunk test
|
Patient supine with shoulder in full abduction.|PUSH humeral head anteriorly while rotating humerus externally|(+) TEST: Audible "clunk" is heard while performing the test
|
|
Anterior apprehension sign
|
Patient supine with shoulder in 90° abduction.|Slowly take shoulder into external rotation|(+) TEST: Patient does not allow and/or does not like shoulder to move in direction to simulate anterior dislocation
|
|
Posterior apprehension sign
|
Patient supine with shoulder in 90°abduction (in plane of scapula) with scapula stabilized by table.|Place a posterior force through shoulder via force on patient's elbow while simultaneously moving shoulder into medial rotation and horizontal adduction|(+) TEST: Patient does not allow and/or does not like shoulder to move in direction to stimulate posterior dislocation
|
|
Acromiocalvicular (AC) shear test
|
Patient sitting with arm resting at side, examiner clasps hands and places heel of one hand on spine of scapula and heel of other hand on clavicle. Squeeze hands together causing compression of AC joint.|(+) TEST: Reproduces pain in AC joint
|
|
Adson's test
|
Patient is sitting, find radial pulse of UE being tested. Rotate head towards the UE being tested, then extend + ext. rotate the shoulder while extending the head|(+) TEST: Disappearance of pulse will be reproduced in UE
|
|
Costoclavicular syndrome (military brace) test
|
Patient is sitting, find radial pulse of UE being tested.|Move involved shoulder down + back|(+) TEST: Disappearance of pulse will be reproduced in UE.
|
|
Wright (hyperabduction) test
|
Patient is sitting, find radial pulse of UE being tested.|Move involved shoulder into MAX abduction + Ext. Rot.|Take a deep breath, + rotate head opposite to side being tested|(+) TEST: Disappearance of pulse will be reproduced in UE.
|
|
Roos elevated arm test
|
Patient is standing with shoulders full ext. Rot, 90° abducted, and slightly horizontally abducted. Elbow flexed to 90°.|Patient opens/closes hands for 3 minutes SLOWLY|(+) TEST: Disappearance of pulse will be reproduced in UE
|
|
Yergason's test
|
shoulder special test
|
|
speed's test
|
shoulder special test
|
|
Neer's impingement test
|
shoulder special test
|
|
supraspinatus test
|
shoulder special test
|
|
drop arm test
|
shoulder special test
|
|
posterior impingement test
|
shoulder special test
|
|
clunk test
|
shoulder special test
|
|
anterior apprehension sign
|
shoulder special test
|
|
posterior apprehension sign
|
shoulder special test
|
|
acromioclavicular shear test
|
shoulder special test
|
|
Adson's test
|
shoulder special test, thoracic outlet syndrome
|
|
Costoclavicular syndrome (military brace) test
|
shoulder special test, thoracic outlet syndrome
|
|
Wright (hyperabduction) test
|
shoulder special test, thoracic outlet syndrome
|
|
Roos elevated arm test
|
shoulder special test, thoracic outlet syndrome
|
|
upper limb tension test
|
shoulder special test
|
|
lateral epicondylitis
|
elbow special test (tennis elbow)
|
|
medial epicondylitis
|
elbow special test (golfer's elbow)
|
|
pronator teres syndrome
|
elbow special test
|
|
Finkelstein's test
|
wrist special test
|
|
Bunnel-Litter test
|
wrist special test
|
|
tight retinacular test
|
wrist special test
|
|
froment's sign
|
wrist special test
|
|
phalen's test
|
wrist special test
|
|
allen's test
|
wrist special test (vascular)
|
|
Patrick's (FABER) test
|
hip special test
|
|
grind (scouring) test
|
hip special test (for DJD)
|
|
trendelenburg's sign
|
hip special test
|
|
thomas' test
|
hip special test
|
|
ober's test
|
hip special test
|
|
ely's test
|
hip special test
|
|
90-90 hamstring test
|
hip special test
|
|
piriformis test
|
hip special test
|
|
leg length test
|
hip special test
|
|
craig's test
|
hip special test
|
|
lachman's test
|
knee special test
|
|
pivot shift
|
knee special test
|
|
posterior sag test
|
knee special test
|
|
posterior drawer test
|
knee special test
|
|
reverse lachman
|
knee special test
|
|
mcmurray
|
knee special test
|
|
apley test
|
knee special test
|
|
hughston plica test
|
knee special test
|
|
patellar apprehension test
|
knee special test
|
|
Clarke's sign
|
knee special test
|
|
Ballotable patella (patellar tap test)
|
knee special test
|
|
fluctuation test
|
knee special test
|
|
noble compression test
|
knee special test
|
|
anterior drawer test
|
ankle/foot special test
|
|
talar tilt
|
ankle/foot special test
|
|
thompson's test
|
ankle/foot special test
|
|
morton's test
|
ankle/foot special test
|
|
vertebral artery test
|
cervical special test
|
|
hautant's test
|
cervical special test
|
|
transverse ligament stress test
|
cervical special test
|
|
anterior shear test
|
cervical special test
|
|
foraminal compression (spurling's) test
|
cervical special test
|
|
maximum cervical compression test
|
cervical special test
|
|
distraction test
|
cervical special test
|
|
shoulder abduction test
|
cervical special test
|
|
Lhermitte's sign
|
cervical special test
|
|
romberg's test
|
cervical special test
|
|
rib springing test
|
thoracic special test
|
|
thoracic springing test
|
thoracic special test
|
|
slump test
|
thoracic special test
|
|
Lasegue's test
|
lumbar special test
|
|
femoral nerve traction test
|
lumbar special test
|
|
valsalva's maneuver
|
lumbar special test
|
|
babinski's test
|
lumbar special test
|
|
quadrant test
|
lumbar special test
|
|
stork standing test
|
lumbar special test
|
|
mckenzie side glide test
|
lumbar special test
|
|
bicycle (van gelderen's) test
|
lumbar special test
|
|
Gillet's test
|
SIJ
|
|
ipsilateral anterior rotation test
|
SIJ
|
|
Gaenslen's test
|
SIJ
|
|
long sitting (supine to sit) test
|
SIJ
|
|
Goldthwait's test
|
SIJ
|
|
Gillet's test
|
asseses posterior movement of the ilium relative to the sacrum
|
|
Ipsilateral anterior rotation test
|
assess anterior movement of the ilium relative to the sacrum
|
|
Gaenslen's test
|
identifies sacroiliac joint dysfunction
|
|
Long sitting or supine to sit test
|
identifies dysfunction of SI joint that may be cause of functional leg length discrepancy
|
|
Goldthwait's test
|
differentiates between dysfunction in lumbar spine vs SI joint
|
|
TMJ Special test
|
evaluates for pain with compression of the retrodiscal tissues
|
|
Lasegue's test or straight leg raising
|
identifies dysfunction of neurological structures that supply the lower limb
|
|
Femoral nerve traction test
|
identifies compression of femoral nerve anywhere along its course
|
|
Bicycle van Gelderen's test
|
differentiates between intermittent claudication and spinal stenosis
|
|
Quadrant test
|
Identifies compression of neural structures at the intervertebral foramen and facet dysfunction
|
|
Stork standing test
|
Identifies Spondylolisthesis
|
|
Spondylolisthesis
|
The actual anterior or posterior slippage of one vertebra on another following bilateral fracture of pars interarticularis
|
|
Spondylolysis
|
It is a fracture of the parts interarticularis with postive "scotty dog" sign on oblique radiographic view of spine
|
|
Rib spring test
|
evaluates ribs mobility
|
|
Thoracic springing
|
evaluates interverebral joint mobility in thoracic spine
|
|
Slump test
|
identifies dysfunction of neurological structures supplying the lower limb
|
|
Vertebral artery test
|
assesses the integrity of the vertebrobasilar vascular system
|
|
Hautant's test
|
differentiates vascular vs vestibular causes of dizziness/vertigo
|
|
Transverse ligament stress test
|
tests integrity of transverse ligament
|
|
Anterior shear test
|
assesses integrity of upper cervical spine ligaments and capsules
|
|
Foraminal compression (Spurling's) test
|
identifies dysfunction (typically compression of cervical nerve root)
|
|
Maximum cervical compression test
|
identifies compression of neural structues at intervertebral foramen and/or facet dysfunction.|Careful this test is similar to vertebral artery test
|
|
Distraction test
|
indicates compression of neural structures at the intervertebral foramen or facet joint dysfunction
|
|
Shoulder abduction test
|
indicates compression of neural structures within intervertebral foramen
|
|
Lhermitte's sign
|
identifies dysfunction of spinal cord and/or an upper motor neuron lesion
|
|
Romberg's test
|
identifies upper motor neuron lesion
|
|
Neutral subtalar positioning
|
examination to determine if abnormal rearfoot to forefoot positioning exists
|
|
Anterior drawer test
|
identifies ligamentous instability (particularly anterior talofibular ligament)
|
|
Talar tilt test
|
identifies ligamentous instability (particularly calcaneofibular ligament)
|
|
Thompson's test
|
evalutates the integrity of the achilles' tendon
|
|
Tinel's sign
|
identifies dysfunction of posterior tibial nerve, posterior nerve anterior to talocrural joint
|
|
Morton's test
|
identifies stress fracture or neuroma in forefoot
|
|
Collateral ligament instability tests
|
identifies laxity or restrictions (medial & lateral stability)
|
|
Lachman's stress test
|
indicates integrity of anterior cruciate ligament (ACL)
|
|
pivot shift test
|
identifies anterior cruciate ligmament instability|(anterolateral rotary instability)
|
|
Posterior sag test
|
indicates integrity of posterior cruciate ligament
|
|
Posterior drawer test
|
indicates integrity of posterior cruciate ligament
|
|
Reverse lachman
|
indicates integrity of posterior cruciate ligament
|
|
McMurray's test
|
identifies meniscal tears
|
|
Apley test
|
helps to differentiate between meniscal tears and ligamentous lesions
|
|
Hughston's plica test
|
identifies dysfunction of the plica
|
|
Patellar apprehension test
|
indicates past history of patela dislocation
|
|
Clarke's sign
|
indicates patellofemoral dysfunction
|
|
Ballotable patella (patellar tap test)
|
indicates infrapatella effusion
|
|
Fluctuation test
|
indicates knee joint effusion
|
|
Q-angle measurement
|
measurement of angle between the quadriceps mucle and the patellar tendon
|
|
Noble compression test
|
identifies if distal iliotibial (IT) band friction syndrome is present
|
|
Tinel's sign
|
identifies dysfunction of common fibular nerve posterior to fibula head
|
|
Patrick's (FABER) test
|
identifies dysfunction of hip such as mobility restriction
|
|
Grind (scouring) test
|
identifies degenerative joint disease (DJD) of hip joint
|
|
Trendelenburg's sign
|
identifies weakness of gluteus medius or unstable hip
|
|
Thomas' test
|
identifies tightness of hip flexors
|
|
Ober's test
|
identifies tightness of tensor fascia latae and/or iliotibial band
|
|
Ely's test
|
identifies tightness of rectus femoris
|
|
90 - 90 Hamstring test
|
identifies tightness of hamstrings
|
|
Piriformis test
|
Identifies piriformis syndrome
|
|
Leg length test
|
identifies true leg length discrepancy
|
|
Craig's test
|
identifies abnormal femoral antetorsion angle
|
|
Finkelstein's test
|
identifies deQuervain's tenosynovitis (paratendonitis of the abductor pollicis longus and/or extensor pollicis brevis (AbPL & EPB)
|
|
Bunnel-Littler test
|
identifies tightness in structures surrounding the MCP joints
|
|
Tight retinacular test
|
identifies tightness around proximal interphalangeal joint
|
|
Ligamentous instability tests
|
identifies ligament laxity or restrictions (medial & lateral stability)
|
|
Froment's sign
|
identifies ulnar nerve dysfunction
|
|
Tinel's sign
|
identifies carpal tunnel compression of median nerve
|
|
Phalen's test
|
identifies carpal tunnel compression of median nerve
|
|
Two point discrimination test
|
identifies level of sensory innervation
|
|
Allen's test
|
identifies vascular compromise. |identifies radial and ulnar arteries at wrist
|
|
Lateral epicondylitis test
|
identifies lateral epicondylitis aka tennis elbow
|
|
Medial epicondylitis test
|
identifies medial epicondylitis aka golfer's elbow
|
|
Tinel's sign
|
identifies dysfunction of ulnar nerve at olecranon
|
|
Pronator teres syndrome test
|
identifies a median nerve entrapment within pronator teres
|
|
Yergason's test
|
Tests for the integrity of transvere ligament and may also identify bicipital tendonitis
|
|
Speed's test
|
identifies bicipital tendonitis or tendonosis
|
|
Neer's impingement test
|
for impingement of soft tissue structures of shoulder complex (long head of biceps and supraspinatus)
|
|
Supraspinatus test
|
identifies tear and/or impingement of supraspinatus tendon or possible suprascapular nerve neuropathy
|
|
Drop arm test
|
identifies tear and/or full rupture of rotator cuff
|
|
Posterior internal impingement test
|
identifies an impingement between rotator cuff and greater tuberosity or posterior glenoid labrum
|
|
Clunk test
|
identifies a glenoid labrum tear
|
|
Anterior apprehension sign
|
identifies past history of anterior shoulder dislocation
|
|
Posterior apprehension sign
|
identifies past history of posterior shoulder dislocation
|
|
Acromioclavicular (AC) shear test
|
identifies dysfunction of AC joint such as : arthritis, separation
|
|
Adson's test
|
identifies pathology of structures that pass through thoracic inlet
|
|
Costoclavicular syndrome (military brace) test
|
identifies pathology of structures that pass through thoracic inlet
|
|
Wright (hyperabduction) test
|
identifies pathology of structures that pass through thoracic inlet
|
|
Upper limb tension test (ULTTs)
|
evaluation of peripheral nerve compression
|
|
ULTT1
|
nerve bias|- Median nerve|- Anterior interosseous nerve|- C5,6,7
|
|
ULTT2
|
nerve bias|- Median nerve|- Musculocutaneous nerve|- Axillary nerve
|
|
ULTT3
|
nerve bias|- Radial nerve
|
|
ULTT4
|
nerve bias|- Ulnar nerve|- C8 and T1 nerve roots
|
|
ULTT1
|
Shoulder = Depression and Abduction to 110°|Elbow = extension|Forearm = supination|Wrist = extension |Finger & Thumb = extension|Shoulder (n/a)|Cervical spine = Contralateral side flexion
|
|
ULTT2
|
Shoulder = Depression and Abduction to 10°|Elbow = extension|Forearm = supination|Wrist = extension |Finger & Thumb = extension|Shoulder = lateral rotation|Cervical spine = Contralateral side flexion
|
|
ULTT3
|
Shoulder = Depression and Abduction to 10°|Elbow = extension|Forearm = pronation|Wrist = flexion and ulnar deviation|Finger & Thumb = flexion|Shoulder = medial rotation|Cervical spine = Contralateral side flexion
|
|
ULTT4
|
Shoulder = Depression and Abduction to 10° - 90°|Elbow = flexion|Forearm = supination|Wrist = extension and radial deviation|Finger & Thumb = extension |Shoulder = lateral rotation|Cervical Spine = Contralateral side flexion
|
|
Evaluation of peripheral nerve compression
|
What's the purpose of Upper limb tension tests?
|
|
80-90
|
Normal cervical flexion ROM (degrees)
|
|
70
|
Normal cervical extension ROM (degrees)
|
|
20-45
|
Normal cervical side-bending ROM (degrees)
|
|
70-90
|
Normal Cervical Rotation ROM (degrees)
|
|
20-45
|
Normal thoracic flexion ROM (degrees)
|
|
20-45
|
Normal thoracic extension ROM (degrees)
|
|
20-40
|
Normal thoracic side-bending ROM (degrees)
|
|
35-50
|
Normal thoracic rotation ROM (degrees)
|
|
40-60
|
Normal lumbar flexion ROM (degrees)
|
|
20-35
|
Normal lumbar extension ROM (degrees)
|
|
15-20
|
Normal lumbar side-bending ROM (degrees)
|
|
3-18
|
Normal Lumbar rotation ROM (degrees)
|
|
35-50mm
|
Normal TMJ ROM, mouth opening in mm
|
|
3-6mm
|
Normal TMJ ROM protrusion in mm
|
|
3-4mm
|
Normal TMJ ROM retrusion in mm
|
|
10-15mm
|
Normal TMJ ROM on lateral deviation mm
|
|
spinal accessory
|
Which nerve innervates this muscle|- sternocleidomastoid, trapezius and other deep neck muscles
|
|
spinal accessory
|
Which nerve innervates this muscle|- upper trapezius
|
|
medial and lateral pectoral
|
Which nerve innervates this muscle|- pectoralis major/minor
|
|
medial pectoral
|
Which nerve innervates this muscle|- pectoralis minor
|
|
long thoracic nerve
|
Which nerve innervates this muscle|- serratus anterior
|
|
dorsal scapular
|
Which nerve innervates this muscle|- levator scapula
|
|
dorsal scapular
|
Which nerve innervates this muscle|- rhomboids
|
|
suprascapular
|
Which nerve innervates this muscle|- supraspinatus
|
|
suprascapular
|
Which nerve innervates this muscle|- infraspinatus
|
|
thoracodorsal
|
Which nerve innervates this muscle|- latissumus dorsi
|
|
subscapular
|
Which nerve innervates this muscle|- teres major
|
|
subscapular
|
Which nerve innervates this muscle|- subscapularis
|
|
axillary
|
Which nerve innervates this muscle|- deltoid
|
|
axillary
|
Which nerve innervates this muscle|-teres minor
|
|
musculocutaneous
|
Which nerve innervates this muscle|-biceps brachii
|
|
musculocutaneous
|
Which nerve innervates this muscle|-coracobrachialis
|
|
musculocutaneous
|
Which nerve innervates this muscle|-brachialis
|
|
ulnar
|
Which nerve innervates this muscle|-flexor digitorum profundus (ulnar part)
|
|
ulnar
|
Which nerve innervates this muscle|-flexor carpi ulnaris
|
|
ulnar
|
Which nerve innervates this muscle|-adductor pollicis
|
|
ulnar
|
Which nerve innervates this muscle|-abductor digiti quinti
|
|
ulnar
|
Which nerve innervates this muscle|-opponens digiti quinti
|
|
ulnar
|
Which nerve innervates this muscle|-flexor digitiquinti brevis
|
|
ulnar
|
Which nerve innervates this muscle|-interossei
|
|
median
|
Which nerve innervates this muscle|-pronator teres
|
|
median
|
Which nerve innervates this muscle|-pronator quadratus
|
|
median
|
Which nerve innervates this muscle|-flexor carpi radialis
|
|
median
|
Which nerve innervates this muscle|-palmaris longus
|
|
median
|
Which nerve innervates this muscle|-flexor digitorum superficialis
|
|
median
|
Which nerve innervates this muscle|-flexor pollicis longus
|
|
median
|
Which nerve innervates this muscle|-flexor digitorum profundus (radial part)
|
|
median
|
Which nerve innervates this muscle|-abductor pollicis brevis
|
|
median/ulnar
|
Which nerve innervates this muscle|-flexor pollicis brevis
|
|
median
|
Which nerve innervates this muscle|-opponens pollicis
|
|
median/ulnar
|
Which nerve innervates this muscle|-lumbricals
|
|
radial
|
Which nerve innervates this muscle|-brachioradialis
|
|
radial
|
Which nerve innervates this muscle|-triceps brachii
|
|
radial
|
Which nerve innervates this muscle|-anconeus
|
|
radial
|
Which nerve innervates this muscle|-extensor carpi radialis
|
|
radial
|
Which nerve innervates this muscle|-extensor digitorum communis
|
|
radial
|
Which nerve innervates this muscle|-extensor digit quinti proprius
|
|
radial
|
Which nerve innervates this muscle|-extensor carpi ulnaris
|
|
radial
|
Which nerve innervates this muscle|-supinator
|
|
radial
|
Which nerve innervates this muscle|-abductor pollicis longus
|
|
radial
|
Which nerve innervates this muscle|-extensor pollicis longus/brevis
|
|
radial
|
Which nerve innervates this muscle|-extensor indicis proprius
|
|
Sterncleidomastoid
|
Actions to be tested (Identify which muscle)|- Neck Flexion
|
|
Trapezius
|
Actions to be tested (Identify which muscle)|- Neck Extension
|
|
Upper trapezius
|
Actions to be tested (Identify which muscle)|- Shoulder shrug, scapular upward rotation
|
|
Pectoralis major/minor
|
Actions to be tested (Identify which muscle)|- Shoulder horizontal adduction
|
|
Serratus anterior
|
Actions to be tested (Identify which muscle)|- Shoulder protraction, scapular upward rotation
|
|
levator scapula
|
Actions to be tested (Identify which muscle)|- scapular elevation, downward rotation
|
|
rhomboids
|
Actions to be tested (Identify which muscle)|- scapular adduction, elevation and downward rotation
|
|
Supraspinatus
|
Actions to be tested (Identify which muscle)|- shoulder abduction
|
|
Infraspinatus
|
Actions to be tested (Identify which muscle)|- shoulder lateral rotation
|
|
Latissimus Dorsi,Teres major and subscapularis
|
Actions to be tested (Identify which muscle)|- Shoulder medial rotation and adduction
|
|
Anterior deltoid
|
Actions to be tested (Identify which muscle)|- Shoulder flexion
|
|
middle deltoid
|
Actions to be tested (Identify which muscle)|- Shoulder abduction
|
|
Posterior deltoid
|
Actions to be tested (Identify which muscle)|- shoulder extension
|
|
Teres minor
|
Actions to be tested (Identify which muscle)|- Shoulder lateral rotation
|
|
Biceps brachii
|
Actions to be tested (Identify which muscle)|- elbow flexion, forearm supination
|
|
coracobrachialis
|
Actions to be tested (Identify which muscle)|- shoulder flexion, adduction
|
|
brachialis
|
Actions to be tested (Identify which muscle)|- elbow flexion
|
|
Flexor digitorum profundus (ulnar part)
|
Actions to be tested (Identify which muscle)|- 4th and 5th digit DIP flexion
|
|
Flexor digitorum profundus (radial part)
|
Actions to be tested (Identify which muscle)|- 2nd and 3rd digit DIP flexion
|
|
flexor carpi ulnaris
|
Actions to be tested (Identify which muscle)|- wrist ulnar flexion
|
|
adductor pollicis
|
Actions to be tested (Identify which muscle)|- thumb adduction
|
|
abductor digiti quinti
|
Actions to be tested (Identify which muscle)|- 5th digit abduction
|
|
opponens digiti quinti
|
Actions to be tested (Identify which muscle)|- 5th digit opposition
|
|
flexor digiti quinti brevis
|
Actions to be tested (Identify which muscle)|- 5th digit MCP flexion
|
|
Interossei
|
Actions to be tested (Identify which muscle)|- 2nd - 5th digit MCP flexion, adduction, abduction
|
|
pronator teres, pronator quadratus
|
Actions to be tested (Identify which muscle)|- forearm pronation
|
|
flexor carpi radialis
|
Actions to be tested (Identify which muscle)|- wrist radial flexion
|
|
palmaris longus
|
Actions to be tested (Identify which muscle)|- wrist flexion
|
|
flexor digitorum superficialis
|
Actions to be tested (Identify which muscle)|- 2nd - 5th digit PIP flexion
|
|
Flexor pollicis longus
|
Actions to be tested (Identify which muscle)|- thumb IP flexion
|
|
abductor pollicis brevis
|
Actions to be tested (Identify which muscle)|- thumb abduction
|
|
abductor pollicis longus
|
Actions to be tested (Identify which muscle)|- thumb MCP abduction
|
|
extensor pollicis longus and brevis
|
Actions to be tested (Identify which muscle)|- thumb extension
|
|
flexor pollicis brevis
|
Actions to be tested (Identify which muscle)|- thumb MCP flexion
|
|
opponens pollicis
|
Actions to be tested (Identify which muscle)|- thumb opposition
|
|
lumbricals
|
Actions to be tested (Identify which muscle)|- 2nd - 5th digit MCP flexion,IP extension
|
|
brachioradialis
|
Actions to be tested (Identify which muscle)|- elbow flexion
|
|
triceps brachii, anconeus
|
Actions to be tested (Identify which muscle)|- elbow extension
|
|
extensor carpi radialis
|
Actions to be tested (Identify which muscle)|- wrist radial extension
|
|
extensor digitorum communis, extensor digiti quinti proprius
|
Actions to be tested (Identify which muscle)|- 2nd - 5th digit MCP, IP extension
|
|
extensor carpi ulnaris
|
Actions to be tested (Identify which muscle)|- wrist ulnar extension
|
|
supinator
|
Actions to be tested (Identify which muscle)|- forearm supination
|
|
extensor indicis proprius
|
Actions to be tested (Identify which muscle)|- 2nd digit extension
|
|
Glasgow coma scale
|
This scale relates to consciousness to three elements of response: eye, motor response and verbal response. This scale is called?
|
|
Mini-mental status examination (MMSE)
|
This test is a brief screening test for cognitive dysfunction
|
|
Balance and gait
|
What does the Performance Oriented Mobility Assessment (POMA, Tinetti) examines?
|
|
Functional Balance
|
What does the Berg Balance Scales examines?
|
|
Functional balance during rise from a chair
|
Timed up and Go test what does it examines?
|
|
Examines maximal distance a person can reach forward beyond's arm length
|
Functional reach test what does examines?
|
|
Examines maximal distance a person can reach in all directions
|
Multidirectional Reach test what does it examines?
|
|
measures repeated chair sit to stand rises
|
Short physical performance battery (SPPB) what does it measures?
|
|
A timed measures of walking using 5 environments challenges (floor, carpet, up and go, obstacles, stairs)
|
What does Modified Emory Functional Ambulation Profile Scale measures?
|
|
stroke patients
|
In which population is this test used|- Fugl-Meyer Assessment of Physical Performance
|
|
stroke patients
|
In which population is this test used|- Stroke impact scale
|
|
CVAs,TBIs, SCIs
|
In which population are these tests used|- Functional Independence Measure (FIM)|- Functional Assessment Measure (FAM)
|
|
Fugl-Meyer Assessment of Physical Performance (FMA)
|
Identify the test based on the content description|- Provides objective criteria for scoring of movements (0 = cannot perform, to 2 = fully performed) Includes subtests for UEs + LEs functions, balance, sensation, ROM and pain
|
|
TBI
|
Which patient population is more likely to use this standardized test?|- Glasgow Coma Scale
|
|
TBI
|
Which patient population is more likely to use this standardized test?|- Rancho Los Amigos Levels of Cognitive Functioning (LOCF)
|
|
TBI
|
Which patient population is more likely to use this standardized test?|- Rappaport's Disability Rating Scale (DRS)
|
|
Rappaport's Disability Rating Scale (DRS)
|
Identify the test based on following description?|- Classifies levels of disability using a wide range of functional behaviors
|
|
TBI
|
Which patient population is more likely to use this standardized test?|- Glasgow Outcome Scale
|
|
Glasgow Outcome Scale
|
Based on description identify the following scale|- Expands on the original Glasgow Coma Scale; includes major disability categories for outcome assessment
|
|
TBI
|
Which patient population is more likely to use this standardized test?|- High Level Mobility Assessment Tool (HI-MATP)
|
|
Multiple Sclerosis
|
Which population is likely to use the following standardized tests for examination?|- Expanded Disability Status Scale (EDSS)|- Minimum Record of Disability (MRD)|- Modified Fatigue Impact Scale
|
|
Parkinson's disease
|
Which population is likely to use the following standardized tests for examination?|- Unified Rating Scale for Parkinsonism documents (UPDRS)|- The Parkinson's Disease Questionnaire (PDQ-39)
|
|
CVAs
|
Which population is likely to use the following test for examination?|- Barthel Index
|
|
Barthel Index
|
Identify the following test based on the description|- An ordinal scale used to measure performance in activities of daily living (ADL). |- Each performance item is rated on this scale with a given number of points assigned to each level or ranking.|- It uses ten variables describing ADL and mobility. A higher number is = greater likelihood of being able to live at home with a degree of independence following discharge from hospital.|Items tested are:|- Bowel, bladder,grooming, toilet use, feeding|- Transfer, mobility, dressing,stairs, bathing
|
|
Iontophoresis
|
the process by which medications are induced through the skin into the body by means of continuous direct current
|
|
acidic reaction
|
sclerotic in nature and can cause hardening of the skin over time
|
|
alkaline reaction
|
sclerotic in nature and can soften the skin over time, exposing it to the risk of irritation and burn during further treatment
|
|
Buffering
|
a technique used to stabilize the pH of the skin during iontophoresis by placing buffering agents into the electrode pads that cover the designated drug reservoir area within the electrode
|
|
Positive
|
What is the polarity of the following ion?|lidocaine
|
|
positive
|
What is the polarity of the following ion?|lithium
|
|
Positive
|
What is the polarity of the following ion?|histamine
|
|
positive
|
What is the polarity of the following ion?|hydrocortisone
|
|
positive
|
What is the polarity of the following ion?|magnesium
|
|
positive
|
What is the polarity of the following ion?|zinc
|
|
negative
|
What is the polarity of the following ion?|acetate
|
|
negative
|
What is the polarity of the following ion?|dexamethasone
|
|
negative
|
What is the polarity of the following ion?|salicylate
|
|
negative
|
What is the polarity of the following ion?|chlorine
|
|
either positive or negative
|
What is the polarity of the following ion?|tap water
|
|
Positive
|
What is the polarity of the following ion?|hyaluronidase
|
|
lidocaine, xylocaine,salicylate
|
Three ions indicated for analgesia
|
|
acetate
|
indicated for calcium deposits
|
|
zinc
|
indicated for dermal ulcers
|
|
hyaluronidase
|
indicated for fungal infections
|
|
water
|
indicated for hyperdidrosis
|
|
calcium, magnesium
|
Two ions indicated for muscle spasms
|
|
dexamethasone
|
indicated for musculoskeletal
|
|
hydrocortisone
|
indicated for inflammatory conditions
|
|
Paget's Disease
|
what is a slowly-progressing disorder that involves accelerated and abnormal bone remodeling (osteoblast)
|
|
Paget's Disease
|
what affects approx 10% of people over 70 yrs old
|
|
Paget's Disease
|
what has bones become enlarged, but weakened and mainly affects the skull, spine & pelvis
|
|
Deep ache that is worse at night
|
what is the most common symptom of Paget's Disease
|
|
Headaches, tinnitus, vertigo or hearing loss
|
if the skull is involved with Paget's Disease what are symptoms
|
|
Fractures and osteogenic sarcoma
|
with Paget's Disease pt's have increased risk of what
|
|
Delerium
|
what disorder usually has an acute onset and is reversible
|
|
Delerium
|
what disorder is caused by toxic or metabolic abnormalties
|
|
Alcohol, Analgesics, OTC meds, HTN meds, Heart meds
|
what are things that cause delerium
|
|
Parkinson's meds, Seizure meds, Antidepr meds, Liver/kidney failure
|
what are things that cause delerium
|
|
Pulmonary failure, Hypoglycemia, Hyponatremia (sodium), Hypocalemia (calcium)
|
what are things that cause delerium
|
|
Hypothermia, Hypothyroidism
|
what are things that cause delerium
|
|
Dementia
|
what is a slow onset of increasing intellectual impairment
|
|
Alzheimer's and multi-farct dementia (left-side brain lesion)
|
what is the most common causes of Dementia
|
|
Alzheimer's
|
what disorder affects 10% of people > 65 yrs old and 50% of people > 85 yrs old
|
|
Alzheimer's
|
what disorder is the 4th leading cause of death related to environmental factors such as poor nutrition and exposure to toxins
|
|
No cure
|
what is the cure for Alzheimer's
|
|
Cell death and atrophy of the cerebral cortex which causes accumulation of "senile plaque" (amyloid)
|
what happens with Alzheimer's
|
|
Several yrs
|
pathological changes with Alzheimer's begins how long before symptoms appear
|
|
7-11 yrs
|
with Alzheimer's death usually occurs when after onset of symptoms and is often due to infection or dehydration
|
|
The inability to learn new information
|
what are the first signs and symptoms of Alzheimer's
|
|
Progressive dementia & Motor function affected
|
what are signs and symptoms of Alzheimer's
|
|
Personality changes & Visuospatial deficits (affect ability to navigate the environment and perform household duties)
|
what are signs and symptoms of Alzheimer's
|
|
Huntington's Disease
|
what disorder affects 6-7 per 1,000,000 people
|
|
Huntington's Disease
|
what disorder may have an onset that occurs during childhood but usually starts in middle age
|
|
Basal ganglia
|
with Huntington's Disease atrophy happens where
|
|
Rigidity and bradykinesia
|
with Huntington's Disease what type of movements happens
|
|
No cure
|
with Huntington's Disease what is the cure
|
|
15-20 yrs
|
with Huntington's Disease death usually occurs when after onset and often due to infection
|
|
Ataxic gait, Chorea, Personality disorder, Dementia Deterioration of writing and speech
|
what are signs and symptoms of Huntington's Disease
|
|
Dysphagia, Urinary incontinence, Sleep disorders, Abnormalities of eye movement (problems with fixation & saccadic movements), Depression (25%) with attempt suicide
|
what are signs and symptoms of Huntington's Disease
|
|
Parkinson's Disease
|
what disorder affects an estimated 1 in 3 people over age 85
|
|
50 and 80
|
with Parkinson's Disease majority of cases are diagnosed between what ages, but 10% of cases deveolp before age 40
|
|
Basal ganglia
|
with Parkinson's Disease part of the what is affected and these cells are responsible for producing DOPAMINE, a neurotransmitter
|
|
Unknown and no cure
|
with Parkinson's Disease what is the cause and what is the cure
|
|
Resting tremors (starts in one limb and spreads to others), Pill roll tremors, Rigidity, Loss of facial expression
|
what are signs and symptoms of Parkinson's Disease
|
|
Dysarthria & Dysphagia, Micrographia (small writing), Dementia, Balance and gait changes
|
what are signs and symptoms of Parkinson's Disease
|
|
Impaired balance: decreased righting and equilibrium responses
|
with Parkinson's Disease what are balance and gait changes
|
|
Shuffling/festinating gait: shortened stride, decreased speed, increased cadence, decreased arm swing and trunk rotation
|
with Parkinson's Disease what are balance and gait changes
|
|
Stooped posture, Difficulty initiating and stopping movement
|
with Parkinson's Disease what are balance and gait changes
|
|
Difficulty changing direction, Bradykinesia
|
with Parkinson's Disease what are balance and gait changes
|
|
Levadopa which is precursor to dopamine
|
what is a drug used with Parkinson's Disease
|
|
When the patient confuses the order of letters
|
A therapist is testing for attention by asking a patient to spell short words such as bottle,garden, fork etc.. (this task can be made progressively more difficult by adding longer words; Individuals with high attention span will be able to perform this task). When attention deficits it will be apparent to the therapist?
|
|
Anterior (ventral) spinothalamic tract
|
Among the three major tracts of the spinothalamic system, which is the one concern with crude localized touch and pressure?
|
|
Lateral spinothalamic tract
|
Among the three major tracts of the spinothalamic system, which one carries pain and temperature sensations?
|
|
Spinoreticular tract
|
Among the three major tracts of the spinothalamic system, which is involved with diffuse pain sensations?
|
|
Tactile localization
|
Defined as the ability to localize touch sensation on the skin. It examines the ability to identify the specific point of application of a touch (e.g., tip of ring finger, lateral malleolus, etc..)
|
|
Two point discrimination
|
This test determines the ability to perceive two points applied to the skin simultaneously. It is a measure of the smallest distance between two stimuli (applied simultaneously and with equal pressure) that can still be perceived as two distinct stimuli. This is a practical test for cutaneous sensation
|
|
Barognosis
|
It is the recognition of weight. A set of small objects of the same size and shape but different weight. two objects of different or equal weights are given to the patient. the patient is asked to identify which is heavier or lighter
|
|
UMN
|
Identy if the following signs & symptoms are either Upper Motor Neuron syndrome (UMN) or Lower Motor Neuron syndrome (LMN)|- Hyperactive stretch reflexes|- Involuntary flexor or extensor spasms|- clonus|- Babinski's sign|- Exagerated cutaneous reflexes|- Loss of precise autonomic
|
|
LMN
|
Identy if the following signs & symptoms are either Upper Motor Neuron syndrome (UMN) or Lower Motor Neuron syndrome (LMN)|- Decreased or absent tone|- Decreased or absent reflexes|- Paresis|- Muscle fasciculations and fibrillations with denervation|- Neurogenic atrophy
|
|
Decorticate rigidity
|
Abnormal flexor response. It refers to sustained contraction and posturing of the upper limbs in flexion and the lower limbs in extension. The elbows, rist and fingers are held in flexion with shoulder adducted tightly to the sides while the legs are held in extension, internal rotation and plantarflexion. This condition is called?
|
|
Decerebrate rigidity
|
Abnormal extensor response. Refers to sustained contraction and posturing of the trunk and limbs in a position of full extension. The elbows are extended with shoulders adducted, forearms pronated, and wrist and finger flexed. The legs are held in stiff extension with plantaflexion.
|
|
Grade 0
|
Modified Ashworth Scale for grading spascity|No increase in muscle tone
|
|
Grade 1
|
Modified Ashworth Scale for grading spascity|Slight increase in muscle tone, minimal resistance at the end of ROM
|
|
Grade 1+
|
Modified Ashworth Scale for grading spascity|Slight increase in muscle tone, miminal resistance through less than half of ROM
|
|
Grade 2
|
Modified Ashworth Scale for grading spascity|Marked increase in muscle tone through most of ROM, affected part moved easily
|
|
Grade 3
|
Modified Ashworth Scale for grading spascity|Considerable increase in muscle tone, passive movement difficult
|
|
Grade 4
|
Modified Ashworth Scale for grading spascity|Affected part rigid in flexion or extension
|
|
Grade 0
|
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Flaccidity, no response
|
|
Grade 1+
|
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Decreased response (hypotonia)
|
|
Grade 2+
|
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Normal response
|
|
Grade 3+
|
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Exaggerated response (mild to moderate hypertonia)
|
|
Grade 4+
|
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Sustained response (severe hypertonia)
|
|
Grade 0
|
Reflexes are graded on a 0 - 4+. What grade?|- No response
|
|
Grade 1+
|
Reflexes are graded on a 0 - 4+. What grade?|- Present but depressed, low normal
|
|
Grade 2+
|
Reflexes are graded on a 0 - 4+. What grade?|- Average, normal
|
|
Grade 3+
|
Reflexes are graded on a 0 - 4+. What grade?|- Increased, brisker than average, possibley but not necessarily abnormal
|
|
Grade 4+
|
Reflexes are graded on a 0 - 4+. What grade?|- Very brisk, hyperactive, with clonus; abnormal
|
|
Flexor withdrawal
|
Identify the type of primitive/spinal reflex being tested?|- Noxious stimulus (pinprick) to sole of foot. (tested in supine or sitting position)|- Response: Toes extend, foot dorsiflexes, entire LE flexes uncontrollably.|Onset: 28 weeks of gestation|Integraded: 1-2 months
|
|
Crossed extension
|
Identify the type of primitive/spinal reflex being tested?|- Noxious stimulus to ball of foot of LE fixed in extension. Tested in supine position.|Response: Opposite LE flexes, then adducts and extends.|Onset: 28 weeks of gestation|Integraded: 1-2 months
|
|
Traction
|
Identify the type of primitive/spinal reflex being tested?|- Grasp forearm and pull up from supine position|- Response: Grasp and total flexion of the UE.|Onset: 28 weeks of gestation|Integraded: 2-5 months
|
|
Moro
|
Identify the type of primitive/spinal reflex being tested?|- Sudden change in position of head in relation to trunk; drop patient backward from sitting position|- Response: Extension, abduction of UEs, hand opening, and crying followed by flexion, adduction of arms across chest.|Onset: 28 weeks of gestation|Integraded: 5-6 months
|
|
Startle
|
Identify the type of primitive/spinal reflex being tested?|- Sudden loud or harsh noise|- Response: Sudden extension or abduction of UEs, crying|Onset: birth|Integraded: persists.
|
|
Grasp
|
Identify the type of primitive/spinal reflex being tested?|- Maintained pressure to palm of hand (palmar grasp) or to ball of foot under toes (plantar grasp)|- Response: Maintained flexion of fingers or toes|Onset: palmar, birth; plantar, 28 weeks gestation.|Integraded: palmar =, 4 - 6 months and plantar, 9 months
|
|
Asymmetrical tonic neck reflex (ATNR)
|
Identify the type of tonic/brainstem reflexes being tested?|- Rotation of the head to one side|- Response: flexion of skull limbs, extension of the jaw limbs; bow and arrow or fencing posture. When the face is turned to one side, the arm and leg on the side to which the face is turned extend and the arm and leg on the opposite side flex.
|
|
Symmetrical tonic reflex (STNR)
|
Identify the type of tonic/brainstem reflexes being tested?|- Flexion or extension of the head|- Response: with head FLEXION: flexion of UEs, extension of LEs. -- with head EXTENSION: extension of UEs, and flexion of LEs.|Onset: 4 -6 months|Integrade: 8-12 months.
|
|
Symmetrical tonic labyrinthine (STLR)
|
Identify the type of tonic/brainstem reflexes being tested?|- Prone or supine position|- Response: with PRONE position: Increased flexor tone/flexion of all limbs; -- with SUPINE: Increased extensor tone/extension of all limbs
|
|
Postive supporting
|
Identify the type of tonic/brainstem reflexes being tested?|- Contact to the ball of the foot in upright standing position.|- Response: Rigid extension (co-contraction) of the LEs|Onset: birth|Integraded: 6 months
|
|
Associated reactions
|
Identify the type of tonic/brainstem reflexes being tested?|- Resisted voluntary movement in any part of the body|- Response: Involuntary movement in a resting extremity|Onset: birth - 3 months|Integraded: 8 - 9 years
|
|
Diplopia
|
Double vision. It is often present following brain change. The patient sees two of the entire environment. This condition is usually a result of defective function of extraocular muscles in which both eyes used but not in focus. Treatment involves, exercise for eye muscles, and patching of the other eye until condition clears. This condition is called?
|
|
patch the other eye
|
Diplopia or double vision.It is often present following brain change. The patient sees two of the entire environment. treatment involves exercises for eye muscles and?
|
|
Homonymous hemianopsia
|
The most common visual field affecting patients with hemiplegia, and occurs most frequently following damage to the middle cerebral artery near the internal capsule. This visual field deficit is called?
|
|
Turn the head to the affected side
|
The presence of a visual field cut may inhibit performance in many ADLs. The patient is usually unaware of the condition does not automatically conpensate by turning the head. The patient should be then instructed specifically to:__________ to compensate for visual field deficits.
|
|
Immediate recall
|
A therapist gives a patient instructions of what do next in the therapy session. after a few seconds the patient does not remember what the instructions were. This is a clinical example of what kind of memory deficit?
|
|
Short term memory
|
In a clinical setting, a patient with memory deficits a therapist teaches him/her how to perform a new transfer technique. Next day, the therapists asks the patient to performed the new learned technique,but the patient does not remember the steps. This is an example of what kind of memory deficit?
|
|
Long term memory
|
A patient experience difficulty recalling events from many years ago such a child's birth, work experience. What kind of memory deficit?
|
|
Body image
|
Defined as a visual and mental image of one's body that includes feelings about one's body, especially in relation to health and disease.
|
|
Body scheme
|
Refers to a postural model of the body, including the relationship of body parts to each other and the relationship of the body to the environment. the acquisition of an internal awareness of the body and the relationship of body parts to one another.
|
|
Unilateral neglect
|
A patient with body scheme and body image disorders, appears to be totally indifferent to the left side of the body and environment. When he dresses, he ignores the left side when putting on pants, or shaves only the right side ignoring the left. This condition is called?
|
|
Behavioral Inattention Test (BIT)
|
Which test can be useful to examine for unilateral neglect?
|
|
Anosognosia
|
Defined as a severe condition including denial and lack of awareness of te presence or severity of one's paralysis. It is a lack of awareness or denial of a paretic extremity as belonging to the person, or a lack of insight concerning or denial of paralysis. The presence of this disability may compromise rehabilitation potential greatly, because it limits the patient's ability to recognize the need for, and thus to use, compensatory techniques.
|
|
Anosognosia
|
This is a clinical example of what condition?|- Typically the patient maintains that there is nothing wrong and may disown the paralyzed limbs and refuse to accept responsibility for them.|- The patient may say " the limb has a mind of its own or that it was left at home or in a closet"
|
|
Anosognosia
|
A therapist asks the patient the following questions|- What happened to the arm, leg etc..|- Do you think it is paralyzed, and how the limb feels, and why it cannot be moved.|The patient responds by denying paralysis, stated that is of no concern, and begins to fabricate reasons why the limb does not move the way it should.|This patient is presenting with what kind of body image/scheme impairment?
|
|
Somatoagnosia
|
Derive from the words somato- body; a = no; gnosia = knowldege. It is a lack of wareness of the body structure and the relationship of the body parts to onselft or to others. The patient may have difficulties performing transfer activities because he/she does not perceive the meaning of the terms related to body parts.
|
|
Somatoagnosia
|
This is a clinical example of what condition|- A therapist asks a patient to "Pivot on your leg, and reach for the armrest with your hand". The patient presents with difficulty performing the task.|- Patients may have a hard time participating in exercises that require somebody part to be moved in relation to the other body parts. For example, "Bring your arm across your chest and touch your soulder"
|
|
Somatognosia
|
A therapist asks a patient the following questions|- Can you point to your shoulder, nose, Can you point to my(the therapist) shoulder, forehead|- From a picture, puzzle of a human figure, can you point to (any part named by therapist)|- Show me your chin, point to your back|(do not use the word Right or left , patient may have right-left discrimination deficits and may lead to inaccurate diagnosis)|This patient is presenting with what kind of body image/scheme impairment?
|
|
Somatognosia
|
A patient is asked to rub with a rough cloth to body parts named by the therapist. This is a tx suggestion for what condition?
|
|
Right-left discrimination disorder
|
Defined as the inability to identify the RIGHT - LEFT sides of one's own body or the examiners. This includes the inability to execute movements in response to verbal commands that include the terms "RIGHT" or "LEFT"
|
|
Right-left discrimination disorder
|
Which body image/scheme impairment is being tested?|- A therapist ask a patient to: Point to your RIGHT shoulder, LEFT hand, knee, RIGHT ear etc..|Six responses should be elicited on the patient's body, therapists and on a model or picture of human body to rule out somatoagnosia. The patient should be tested first without using the words "right" or "left"
|
|
Figure ground discrimination
|
Defined as the inability to visually distinguish a figure from the background in which it is embedded. Functionally, it interferes with the patient's ability to locate important objects that are not prominent in a visual array.
|
|
Figure ground discrimination
|
This is a clinical example of what kind of spatial relation disorders?|- The patient cannot locate items in a pocketbook or drawer, locate buttons on a shirt, or distinguish the armhole from the remainder of a solid-colored shirt|- The patient may not be able to tell when one step ends and another begins on a flight of stairs, especially when decending.
|
|
The Ayres Figure-Ground Test
|
Whihc is appropriate for Figure-ground discrimination disorder?
|
|
Figure ground discrimination
|
For the following functional test, identify which condition is being assessed?|- A white towel can be placed on a white sheet, and the patient is asked to find the towel.
|
|
Figure ground discrimination
|
For the following functional test, identify which condition is being assessed?|- The patient can be asked to point out the sleeve, buttons, and collar of a white shirt, or to pick out a spoon from an unsorted array of eating utensils.|(it is necessary to rule out poor eyesight, hemianopsia,visual agnosia, and poor comprehension to improve the validity of these testing techniques)
|
|
Form discrimination disorder
|
Defined as the inability to perceive or attend to subtle differences in form and shape. The patient is likely to confuse objects of similar shape or not to recognize and object placed in an unusual position.
|
|
Form discrimination disorder
|
This is a clinical example of what kind of spatial relations disorders?|- Patient confuses a pen with a toothbrush|- Patient confuses a vase with a water pitcher|- Patient confuses a cane with a crutch
|
|
Form discrimination disorder
|
Which spatial relations disorders is being tested?|A therapist gather a number of items similar and different in shape and size. A set contains a pencil, pen, straw, toothbrush, watch, and the other set contains a key, paper clip,coins, and a ring. Each object is presented in different positions (e.g., up sidedown). Visual object agnosia MUST be ruled out as a cause for poor performance by first presenting objects separately and asking the patient to identify them or to demonstrate how they are used)
|
|
Spatial relations disorder
|
aka spatial disorientation, is the inability to perceive the relationship of one object in space to another, or to one self. This may lead to or compound, problems in constructional tasks. Crossing midline may be a problem with patients with this condition, it is require to manage most ADLs
|
|
Spatial relations disorder
|
This is a clinical example of what condition?|- Patient may find it difficult to place cutlery, plate, and spoon in the proper position when setting the table.
|
|
Spatial relations disorder
|
This is a clinical example of what condition?|- The patient may be unable to tell the time from a clock because of difficulty in perceiving the relative postions of the hands.
|
|
Spatial relations disorder
|
This is a clinical example of what condition?|- The patient may have difficulty learning to position his/her arms, legs and trunk in relation to the wheelchair to prepare for transferring.
|
|
Rivermead Perceptual Assessment Battery (RPAB), Arnadottir OT-ADL, and Neurobehavioral Evaluation ( A-ONE)
|
What tests are recommended for spatial relations disorder or spatial disorientation?
|
|
Position in space impairment
|
Defined as the inability to perceive and to interpret spatial concepts such as up, down, under, in, out, in front of, and behind.
|
|
Position in space impairment
|
This is a clinical example of what condition?|- If the patient is asked to raise the arm "above" the head during ROM activities or is asked to place the feet "on" the footrest, the patient may behave as if he/she does not know what to do.
|
|
Position in space impairment
|
What spatial relations disorders is being tested?|A therapist is testing function for this condition|- Two objects are used, such as a shoe and a shoebox; for example, in the box, on top of the box, or next to the box|Alternatively, the patient is presented with two objects and asked to describe their relationship; for example, a toothbrush can be placed in a cup, under a cup, etc.., and the patient is then asked to indicate the location of the toothbrush.
|
|
Position in space impairment
|
What spatial relations disorders is being tested?|- Have the patient copy therapist's minipulation with an identical set of objects. For example, the therapist hands the patient a comb and a brush. The therapist then takes an identical set and places the comb on top of the brush. The patient is requested to arrage his/her comb and brush in the same way.
|
|
Topographic disorientation
|
Defined as the difficulty in understanding and remebering the relationship of one location to another. As a result, the patient is unable to get from one place to another, with, or without a map
|
|
Topographic disorientation
|
This is a clinical example of what condition?|- The patient cannot find the way from his/her room to the physical therapy clinic despite of being shown repeatedly.|- The patient cannot describe the spatial characteristics of familiar surroundings such as the layout of his/her bedroom at home.
|
|
Topographic disorientation
|
What condition is being tested?|- The patient is asked to describe or to draw a familiar route, such as te block on which he/she lives, the layout of his/her house, or a major neighborhood intersection. An impaired patient will be unable to succeed in this task.
|
|
Depth and distance perception
|
This patient experience inaccurate judgement of direction, distance, and depth. Spatial disorientation may be a contributing factor in faulty distance perception
|
|
Depth and distance perception
|
This is a clinical example of what condition?|- The patient may have diffculty navigating stairs, may miss the chair when attempting to sit or may continue pouring juice once a glass is filled.
|
|
Depth and distance perception
|
What condition is being tested?|- for a functional test a patient is asked to take or grasp an object that has been placed on a table. The object may held in front of , in the air, and the patient will overshoot or undershoot (dysmetria)|- The patient can be asked to fill a glass of water. A patient with this condition may continue poruing once the glass is filled
|
|
Vertical disorientation
|
Refers to a distorted perception of what is vertical. Displacement of the vertical position can contribute to disturbance of motor performance, both in posture and gait
|
|
Visual Agnosia
|
This is a clinical example of what condition?|A patient cannot recognize an given object despite normal function of the yes and optic tracts. However, patient recognizes it when the object is handled (stereognosis). The patient may not recognize people, possessions, and common objects.
|
|
Auditory agnosia
|
Refers to the inability to recognize non-speech sounds or to discriminate betwen them.
|
|
Auditory agnosia
|
This is a clinical example of what condition?|- The patient cannot tell, for example, the difference beteen the ring of a doorbell and that of a telephone or between a dog barking or a thunder
|
|
Astereognosis
|
Defined as inability to detect objects by touch with vision occluded
|
|
Astereognosis
|
This is a clinical example of what condition?|- A patient is handed an object e.g., a key, with vision occluded and fails to recognize it.
|
|
Apraxia
|
Impairment of voluntary skilled learned movement. It is characterized by inability to perform purposeful movments which cannot be accounted for by inadequate strength, loss of coordination, impaired sensation, attentional difficulties, abnormal tone, movement disorders,intellectual deterioration, poor comprehension or uncooperativeness
|
|
Ideomotor apraxia
|
Refers to a breakdown between concept and performance. There is a disconnection between the idea of a movement and its motor execution. The patient is able to carry out habitual tasks automatically and describe how they are done but is unable to imitate gestures or perform on command. Patient with this condition often perseverate, that is they repeat an activity or a segment of a task over, and over , even if it is no longer necessary or appropriate.
|
|
Ideomotor apraxia
|
This is a clinical example of what condition?|- The patient is unable to "blow" on command;however, if presented with a bubble wand, the patient will spontaneously blow bubbles.
|
|
Ideomotor apraxia
|
This is a clinical example of what condition?|- The patient is asked to walk to the other end of the room, but the patient is unable to perform on command.;however, another therapist places a cup of coffee on the table tells patient "please have coffee", and the patient walks towards the other end to get it.
|
|
Ideomotor apraxia
|
This is a clinical example of what condition?|- A male patient is asked to comb his hair. The patient is able to identify the object, and describe what is it used for, but will not use it when it is handed to him. Despite this observation, his wife reports that he spontaneously comb his hair every morning.
|
|
Ideomotor apraxia
|
This is a clinical example of what condition?|- A female is handed a dynamometer and is asked to squeeze it. She knows what it is for, and the task has been demonstrated, but she is unable to squeeze the hand dynamometer on command.
|
|
Ideational apraxia
|
Defined as a failure in the conceptualization of a task. It is an inability to perform a purposeful motor act, either automatically or on command. The patient can perform isolated components of a task, but cannot combine them into a complete act. The patient cannot verbally describe the process of performing an activity, describe the function of objects, or use them appropriately
|
|
Ideational apraxia
|
This is a clinical example of what condition?|- The patient is presented a toothbrush and toothpaste and told to brush the teeth, the patient may put the tube of toothpaste in the mouth, or try to put toothpaste on the toothbrush without removing the cap. The patient is unable to describe verbally how a toothbrush is done. This will be evident in all aspect of ADLs (e.g., washing, meal preparation etc..)
|
|
Neurogenic injury
|
A patient who presents with persistent fasciculations (Involuntary contractions or twitchings of groups of muscle fibers), suggests what kind of injury?
|
|
Leadpipe
|
Rigidity that is seen in basal ganglia nigrostriatal disorders are increased resistance to PROM in agonist and antagonist muscle. Rigidity that is uniform throughout the range is called?
|
|
Cogwheel
|
Rigidity that is seen in basal ganglia nigrostriatal disorders are increased resistance to PROM in agonist and antagonist muscle. Rigidity that is interrupted by a series of jerks during PROM is called?
|
|
Anterior cerebral artery Syndrome
|
This artery supplies the anterior 2/3 (67%) of the medial cerebral cortex. Occulusions produces:|- Contralateral sensory loss and hemiparesis, with leg more involved than arm (Leg > Arm)
|
|
Circle of willis
|
Occlusions proximal to the anterior communicating artery produce minimal deficits owing to collateral circulation of?
|
|
A
|
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Complete, no motor or sensory function is preserved in the sacral segments S4-S5
|
|
B
|
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Incomplete: Sensory, but NO motor function is preserved below the neurological level and includes the sacral segments S4-S5
|
|
C
|
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Incomplete: Motor function is preserved below the neurological level, and most key muscles below the neurological level have a muscle grade < 3
|
|
D
|
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Incomplete: Motor function is preserved below the neurological level, and most key muscles below the neurological level have a muscle grade ≥ 3
|
|
E
|
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Normal: Motor and sensory function is normal
|
|
Anterior Cord
|
Identify the following spinal cord syndrome|- Mechanism of injury: hyperflexion, acute large disc herniation or as a result of anterior spinal artery injury|- This lesion damages: Anterolateral spinothalamic tract, cortical spinal tract, anterior horn (gray matter). |- Typically presents BILATERAL loss of pain and temperature sensation and motor function with PRESERVATION of light touch, proprioception (position sense) and vibration sense.
|
|
Brown Sequard
|
Identify the following spinal cord syndrome|- Mechanism of injury: Penetrating spinal trauma (e.g., Stab wound) epidural hematoma, spinal arteriovenous malformation, cervical spondylosis, or unilateral articular process fracture or dislocation.|- Lesion of 1/2 of the spinal cord; typically presents with:|- IPSILATERAL loss of touch, proprioception, and vibration sense|- IPSILATERAL motor paresis (weakness) or paralysis|- CONTRALATERAL loss of pain, and temperature sensation a few segments below the level of lesion.
|
|
Central cord
|
Identify the following spinal cord syndrome|- Usually occurs at the cervical level.|- Mechanism of injury: hyperextension injuries where the spinal cord is squeezed or pinched between anterior cervical spondylotic bone spurs and the posterior intraspinal canal ligament, the ligamentum flavum. or as a result of tumor, rheumatoid arthritis or syringomyelia [(the development of a fluid-filled cyst (syrinx) within your spinal cord. Over time, the cyst may enlarge, damaging your spinal cord and causing pain, weakness and stiffness, among other symptoms)]|This lesion exerts pressure on anterior horn cells, and typically presents with:|- BILATERAL motor paralysis or UEs > LEs, variable sensory deficits, and possible bowel/bladder dysfunction
|
|
Cauda equina
|
Identify the following spinal cord syndrome|- Indicates damage to the lumbar (below L1) and/or sacral spinal roots (LMN), causing sensory impairment and flaccid paresis (weakness) or paralysis of lower limb muscles, bladder and bowels. Some capacity for regeneration; LMN, autonomous or non-reflex bladder. |- Muscle hypertonia and hyperreflexia do not occur because the upper motor neurons are intact.
|
|
Emergency medical referral
|
If a patient presents to the clinic with low back pain and/or sciatica COMBINED with bladder or bowel retention or incontinence, knowing that cauda equina syndrome may progress to paraplegia and/or to permanent problems with bladder and/or bowel control, the patient needs?
|
|
Posterior cord
|
Identify the following spinal cord syndrome|- Condition caused by lesion of the posterior portion of the spinal cord. It can be caused by an interruption to the posterior spinal artery. rare condition|- Presents with loss of proprioception, discriminative touch information, vibration sense
|
|
Sacral sparing
|
Identify the following spinal cord syndrome|- Sparing of tracts to sacral segments, with preservation of perianal sensation, rectal sphincter tone, or active toe flexion
|
|
C1 - C4 lesions
|
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patients requires an electric wheelchair with:|- tilt-in-space or reclining seat back|- micro switch or puff and sip controls|- portable respirator may be attached
|
|
C5
|
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patients with cervical lesions, shoulder function and elbow flexion|- can use manual wheelchair with propulsion aids (i.e., projections)|- independent for short distance on smooth , flat surfaces|- may choose and electric wheelchair for longer distances and energy conservation
|
|
C6
|
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patients with cervical lesions , radial wrist extensors
|
|
C6
|
Identify the spinal cord level for the following description for appropriate wheelchair prescription|May use a manual wheelchair with friction surface and hand rims; independent.
|
|
C6
|
Identify the spinal cord level for the following description for appropriate wheelchair prescription|The highest SCI level that has the ability to drive a car independently with adaptive equipment
|
|
C7
|
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patients with cervical lesions and triceps function (elbow extension)
|
|
C7
|
Identify the spinal cord level for the following description for appropriate wheelchair prescription|may use manual wheelchair with friction surface hand rims independently, but with increased propulsion
|
|
C8 - T1
|
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patient with hand function and below
|
|
C8 - T1
|
Identify the spinal cord level for the following description for appropriate wheelchair prescription|May use manual wheelchair with standard hand rims
|
|
Midthoracic lesions ( T6-9)
|
Appropriate orthotic prescription/ambulation training. What lesion level?|- Supervised ambulation for short distances (physiological, limited household ambulator); requires bilateral knee-ankle-foot orthoses (KAFOs) and crutches, swing-to gait pattern; requires assistance; may prefer standing devices/standing wheelchairs for physiological standing
|
|
Swing to gait pattern
|
For a patient with midthoracic lesions (T6-9), what appropriate gait pattern will be recomended?
|
|
High lumbar lesions (T12-L3)
|
Appropriate orthotic prescription/ambulation training. What lesion level?|- Can be independent in ambulation all surfaces and stairs; using a swing-through or four point gait pattern and bilateral KAFOs and crutches.|- Patients may also use reciprocating gait orthoses (RGO) with walker with or without FES system.|- Typically independent household ambulators; wheelchair use for community ambulation.
|
|
Low lumbar lesions (L4-5)
|
Appropriate orthotic prescription/ambulation training. What lesion level?|- Can be independent with bilateral AFOs and crutches or canes.|- Typically independent community; may still use wheelchair for activities with high-endurance requirements.
|
|
Absolute contraindication
|
Do no harm. Identify based on ACSM guidelines if the following condition is an absolute contraindication or not for exercise testing and training of individuals with SCI.|- Autonomic dysreflexia
|
|
Absolute contraindication
|
Do no harm. Identify based on ACSM guidelines if the following condition is an absolute contraindication or not for exercise testing and training of individuals with SCI.|- Severe or infected skin on weight bearing surfaces
|
|
Absolute contraindication
|
Do no harm. Identify based on ACSM guidelines if the following condition is an absolute contraindication or not for exercise testing and training of individuals with SCI.|- Symptomatic hypotension
|
|
Absolute contraindication
|
Do no harm. Identify based on ACSM guidelines if the following conditions are absolute contraindications or not for exercise testing and training of individuals with SCI.|- Urinary tract infection|- Uncontrolled spasticity or pain|- Uncontrolled hot and humid environments
|
|
Absolute contraindication
|
Do no harm. Identify based on ACSM guidelines if the following conditions are absolute contraindications or not for exercise testing and training of individuals with SCI.|- Unstable fracture|- Insufficient ROM to perform exercise task
|
|
Postural stress syndrome
|
Defined as postural malalignment that produces chronic muslce lengthening and/or shortening and stress to soft tissues.
|
|
Myofascial pain syndrome
|
Defined as persistent, deep aching pain in muscle, nonarticular in origin;characterized by well-defined, highly sensitive tender spots (trigger points)
|
|
Fibromyalgia
|
Defined as widespread pain accompanied by tenderness of muscles and adjacents soft tissues, a non-articular rheumatic disease of unknown origin.
|
|
Approximation
|
The proprioceptive element that applies compression force to the joints;stimulates afferent nerve endings,and facilitates EXTENSOR muscles, mobilizaing patterns is called?
|
|
Traction
|
The proprioceptive element that applies a distraction force to the joints;stimulates afferent nerve endings and facilitates FLEXOR
|
|
Rhythmic initiation
|
Voluntary relaxation follwed by passive movements through increasing ROM, followed by AAROM, progressing to RROM; the patient finishes with AROM. |Indications:|- Inability to iniate movement (apraxia)|- Uncoordinated motion (rigidty, ataxia)|- General tension or tonal impairment (hypertonic muscles)|- Motor learning deficits;communication deficits (aphasia)
|
|
Rhythmic rotation
|
Voluntary relaxation combined with slow, passive, rhythmic rotations of the body or body parts;focus is on gaining ROM. Active holding in the new range is then stressed|Indications:|- General tension or hypertonica with limitations in function or ROM (hypertonic muscles)
|
|
Stabilizing reversals (alternating isometrics)
|
Isometric holding is facilitated first on one side of the joint,followed by alternate holding of the antagonist muscle groups. May be applied in any direction (anterior-posterior, medial lateral, diagonal)|Indications:|- Decreases stability|- Poor antigravity control|- Weakness
|
|
Rhythmic stabilization (RS)
|
Simultaneous isometric contractions of both agonist and antagonist muscles (co-contraction) performed without relaxation using carful grading of resistance; RS emphasizes rotational stability control.|Indications:|- Decreased stability in weight bearing and holding|- Poor antigravity control|- Weakness|- Ataxia|- Limitations in ROM caused by muscle tightness, painful muscle splinting.
|
|
Dynamic reversals (Slow reversals)
|
Slow isotonic contractions of first agonist,then antagonist patterns using careful grading of resistance and optimal facilitation;reversal of antagonist without relaxation or pause.|An isometric hold can be added at the end of the ROM at a point of weakness (hold can be added in both directions or only in one direction|Indications:|- Decreased AROM|- Weakness of antagonistic muscle|- Decreased reciprocal control|- Hypertonic muscle groups
|
|
Combination of isotonics (agonist reversals)
|
Combines concentric, eccentric, and isometric contractions of one muscle group. e.g., agonists: a slow isotonic,shortening contraction through the range followed by an isometric hold, and then, an eccentric, lengthening contraction using the same muscle group.|Indications:|- Weak postural muscles|- Inability to eccentrically control body weight during movement transistions; e.g., sitting down|- Decreased AROM , control and weakness.
|
|
Replication (hold relax - Active motion
|
An isometric contraction performed in the MID to SHORTENED range follwed by voluntary relaxation and passive movement into te lengthened range, and resistance to an isotonic contraction through the range.|Indications:|- Inability to iniate movements|- Hypotonia|- Weakness
|
|
Contract-relax
|
A relaxation technique usually performed at a point of limited ROM in the agonist pattern: isotonic movement in rotation is performed follwed by an isometric hold of the range-limiting muscles in the antagonist pattern against slowly increasing resistance, then voluntary relaxation, and active contraction (CRAC) into the newly gained range of the agonist pattern.|Indication:|- Limitations in ROM caused by muscle tightness, spasticity
|
|
Hold-relax
|
A relaxation technique usually performed at the point of limited ROM in the agonist pattern; isometric contraction of te range-limiting antagonist pattern is performed against slowly increasing resistance, followed by voluntary relaxation , and passive movement into the newly gained range of the agonist pattern.|Active contraction (HRAC) into the newly gained range of the agonist pattern can also be performed and serves to maintain the inhibitory effects through reciprocal inhibition.|Indications:|- Limitations in ROM caused by muscle tightness, muscle spasms, and pain
|
|
Repeated stretch (repeated contractions)
|
Repeated stretch linked to voluntary effort to contract stretched muscles;may be repeated, without stopping, as soon as the contraction weaknes or stops.|Indications:|- Weakness|- Fatigue|- Decreased ability to perform the desired pattern
|
|
Parkinson's
|
Identify the disease based on description|- A progressive neurodegenerative disorder associated with a loss of pigmented dopaminergic nigostriatal neurons in the substantia nigra and the presence of lewy bodies. This disorder is produced by abnormalities of basal ganglia function.|- three cardinal signs of this disorder are resting tremor,rigidity, and bradykinesia
|
|
Multiple Sclerosis
|
Identify the disease based on description|- A chronic progressive demyelinating disease of the CNS affecting mostly young adults|- fatigue pattern: early afternoon fatigue and exhaustion common with high energy periods in early morning, and some recovery in early evening.
|
|
Guillain-Barre Syndrome
|
Identify the disease based on description|- A heterogeneous grouping of immune-mediated processes generally characterized by motor, sensory, and autonomic dysfunction. It is an acute inflammatory demyelinating polyneuropathy characterized by progressive symmetric ascending muscle weakness, paralysis and hyporeflexia with/without sensory or autonomic symptoms.
|
|
Amyotrophic Lateral Sclerosis
|
Identify the disease based on description|- aka Lou Gehrig's disease. it is characterized by slowly progressive degeneration of upper and lower motor neurons
|
|
Bell's palsy
|
Identify the condition based on description|- A facial paralysis a LMN lesion involving CN VII (facial nerve), resulting in unilateral facial paralysis
|
|
Frontal lobe
|
Precentral gyrus: |- Primary motor cortex for voluntary muscle activation|- Prefrontal cortex: Controls emotions and judgement|- Broca's area: Control motor aspect of speech
|
|
Parietal lobe
|
Post central gyrus:|- primary sensory cortex for integration of sensation|- Receives fibers conveying touch, proprioceptive, pain, and temperature sensations from opposite side of body
|
|
Temporal lobe
|
Primary auditory cortex: receives/processess auditory stimuli|Associative auditory cortex: process auditory stimuli|Wernicke's area: language comprehension
|
|
Occipital lobe
|
Primary visual cortex: receives/processes visual stimuli|Visual association cortex: process visual stimuli
|
|
Limbic system
|
Part of the brain concerned with:|- instincts and emotions contributing to preservation of the individual.|- basic functions inlcude: feeding, aggression, emotions, and endocrine aspects of sexual response
|
|
Cheyne-Stokes respiration
|
A period of apnea lasting for 10 - 60 seconds followed by gradually increasing depth and frequency of respirations.|Accompanies depression of FRONTAL LOBE and diencephalic dysfunction
|
|
Primary motor cortex
|
This area is part of the frontal lobe of the brain and is concerned with voluntary muscle activations
|
|
Prefrontal corex
|
This area is part of the frontal lobe of the brain for control of emotions and judgements
|
|
Broca's area
|
This area of the brain controls the motor aspect of speech
|
|
Primary sensory cortex
|
This area is part of the parietal lobe of the brain and is responsible for integration of sensation. it receives fibers conveying touch, proprioception, pain, and temperature sensation from opposite side of body
|
|
Primary auditory cortex
|
This area of the temporal lobe that receives/processes auditory stimuli
|
|
Wernicke's area
|
Area of the temporal lobe of the brain reponsible for language comprehension
|
|
Primary visual cortex
|
Located in the occipital lobe, it receives/process visual stimuli
|
|
Insula
|
Located deep within lateral sulcus, it is associated with visceral functions
|
|
White Matter
|
Myelinated nerve fibers located centrally. This is called?
|
|
Transverse commissural fibers
|
This fibers interconnect two hemispheres, including the corpus callosum (the largest), anterior commissure, and hipocampal comissure
|
|
Basal Ganglia
|
Which part of the brain is this?|Masses of gray matter deep within the cerebral hemispheres including:|- the corpus striatum (caudate nucleus and lenticular nuclei|- amygdalid nucleus, and claustrum|- lenticular nuclei are further divided into the putamen and globus pallidus|Forms an associated motor system (extrapyramidal system) with other nuclei in the subthalmus and midbrain
|
|
occulomotor circuit
|
Caudate loop: originate in frontal and supplementary motor eye fields, projects to caudate functions with saccadic eye movements
|
|
Skeletomotor circuit
|
Putamen loop: Originates in precentral motor and postcentral somatosensory areas;|- projects to putamen functions to scale amplitude and velocity of movements|- reinforces selected pattern, supresses conflicting patterns; preparatory for movement (i.e. motor set, anticipatory movement)
|
|
Limbic circuit
|
Originates in prefrontal and limbic areas of cortex to Basal Ganglia, to prefrontal cortex|functions to organize behaviors (executive functions, problem solving, motivation) and for procedural learning (repeating a complex activity over and over again until all of the relevant neural systems work together to automatically produce the activity).
|
|
Archicerebellum
|
(flocculonodular lob) connects with vestibular system and is concerned with equillibrium and regulation of muscle tone helps coordinate vestibulo-occular reflex
|
|
Spinocerebellum
|
Receives input from proprioceptive pathways and is concerned with modifying muscle tone and synergistic actions of muscles|It is important in maintenance of posture and voluntary movement control
|
|
Neocerebellum
|
Receives input from corticopontecerebellar tracts and olivocerebellar fibers|-It is concerned with the soomth coordination of voluntary movements, ensures accurate force, direction and extent of movement|- Important for motor learning sequencing of movements, and visually triggered movements|- May have a role in assisting cognitive function and mental imagery
|
|
Anterior horn cells
|
It contains cell bodies that give rise efferent (motor) neurons: Alpha motor neurons to effect muscles and gamma motor neurons to muscle spindles.
|
|
Posterior horn cells
|
It contain afferent (sensory) neurons with cell bodies located in the dorsal root ganglia.
|
|
Fasciculus cuneatus
|
Ascending fibers systems (sensory pathways)|Dorsal columns/medial lemniscal system (Upper extremity tracts, laterally located) convey sensations of proprioception, vibration and tactile discrimination
|
|
Fasciculus gracilis
|
Ascending fibers systems (sensory pathways)|Dorsal columns/medial lemniscal system (Lower extremity tracts, medially located) convey sensations of proprioception, vibration and tactile discrimination
|
|
Lateral spinothalamic tract
|
Ascending tract (sensory pathways) that convey sensations of pain and temperature
|
|
Anterior spinothalamic tract
|
Ascending tract (sensory pathways) that convey crude touch
|
|
Spinocerebellar tracts
|
Ascending tract (sensory pathways) that convey proprioception information from muscle spindles, golgi tendon organs, and touch and pressure receptors to cerebellum for control of voluntary movements
|
|
Spinoreticular tratcs
|
Ascending tract (sensory pathways) that convey deep ande chronic pain to reticular formation of brainstem via diffuse polysynaptic pathways
|
|
Corticospinal tracts
|
Descending fiber systems (motor pathways)|Arise from primary motor cortex, descend in brainstem, cross in medulla (pyramidal decussation)|- Important for voluntary motor control
|
|
Vestibulospinal tract
|
Descending fiber systems (motor pathways)|Important for control of muscle tone, antigravity muscles, and postural reflexes.
|
|
Rubrospinal tract
|
Descending fiber systems (motor pathways)|Assist in motor function
|
|
Reticulospinal system
|
Descending fiber systems (motor pathways)|Arises in the reticular formation of the brainstem and descends (crossed and uncrossed) in ventral and lateral columns, terminates both on dorsal gray (modifies transmission of sensation, especially pain) and on ventral gray (influences gamma motor neurons and spinal reflexes)
|
|
Tectospinal tract
|
Descending fiber systems (motor pathways)|Arises from superior colliculus (midbrain) and descends to ventral gray; Assists in head-turning responses to visual stimuli
|
|
Neuroglia
|
Supports cells that do not transmit signals; important for myelin and neuron production;maintenance of K+ levels and reuptake of neurotransmitters after neural transmission at synapses
|
|
-70mV
|
Resting membrane potential: positive on outside, and negative on the inside. What is the value of the resting membrane potential on the inside?
|
|
Saltatory conduction
|
Myelinated axons, are axons overed with myelin with small gaps called nodes of Ranvier where myelin is absent. Myelin functions to increase speed of conduction and conserve energy. The action potential jumps from one node to the next. This type of conductions where the action potential jump from one node to the next is called?
|
|
A fiber
|
There are several different nerve fiber types, A, B and C fibers. This type of nerve fiber is large, myelinated and fast conducting. Which nerve fiber type is?
|
|
B fiber
|
There are several different nerve fiber types, A, B and C fibers. This type of nerve fiber is small, myelinated and conduct less rapidly; preganglionic autonomic. Which nerve fiber type is?
|
|
C fiber
|
There are several different nerve fiber types, A, B and C fibers. This type of nerve fiber is the smallest, unmyelinated, slowest conducting fiber. Which nerve fiber type is?
|
|
Alpha
|
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for proprioception, somatic motor?
|
|
Beta
|
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for touch and pressure?
|
|
Gamma
|
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for motor to muscle spindles?
|
|
Delta
|
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for pain, temperature and touch?
|
|
Dorsal root
|
C fibers are the smallest, unmyelinated, slowest conducting fibers, Whic type of C fiber is responsible for pain and reflex responses?
|
|
Motor (efferent) fibers
|
These fibers originate from motor nuclei (cranial nerves) or anteior horn cells (spinal nerves). These are?
|
|
Sensory (afferent) fibers
|
These fibers originate in cells outside of the brainstem or spina cord with sensory ganglia (cranial nerves) or dorsal root ganglia (spinal nerves).
|
|
Alert
|
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient responds appropriately, can open eyes, look at the examiner, respond fully and appropriately to stimuli. Patient is completely awake, aware of all stimuli and able to interact meaningfully with clinician.|Based on the above description, Identify which level of consciouness it represents?
|
|
Lethargy
|
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient appears drowsy; can open eyes and look at exminer, respond to questions, but fall asleep easily. Arousal with stimuli, that is falls asleep when not stimulated. Decreased awareness, loss of train of thought.|Based on the above description, Identify which level of consciouness it represents?
|
|
Obtundation
|
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient can open eyes, look at examiner, but responds slowly and is confused; demonstrates decreased alertness and interest in environment. Difficult to arouse, requires CONSTANT stimulation for all activities.|Based on the above description, Identify which level of consciouness it represents?
|
|
Stupor
|
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient can be aroused from sleep ONLY with PAINFUL or VIGOROUS stimuli; verbal responses are slow or absent; patient returns to unresponsiveness state when stimuli are removed. Demonstrates minimal awareness of self and environment. Unable to complete mental status examination because responses are usually incomprehensible words.|Based on the above description, Identify which level of consciouness it represents?
|
|
Coma
|
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient cannot be aroused, eyes remain closed; no response to external stimuli or environment. Patient is unrousable and non-verbal.|Based on the above description, Identify which level of consciouness it represents?
|
|
daiylight, radio or television sound, or a cold cloth on the forehead
|
Changes in body position, especially the transition from a recumbent position to a sitting position often stimulate increased alertness. Other stimuli that can be used to stimulate alertness include:?
|
|
Glasgow coma scale
|
It is a widely accepted measure of level of consciouness and responsiveness. It relates consciousness to three elements or response. Eye opening (E) with a max possible score = 4, Motor response (M) with a max possible score = 6, and verbal response (V) with a max possible score = 5. |Score = (E+M+V)|Max score = 15 and lowest score = 3. |A score of ≤ 8 signifies coma or severe brain injury
|
|
Minor brain injury
|
Using the glasgow coma scale. A score between 13 - 15 signifies what?
|
|
Moderate brain injury
|
Using the glasgow coma scale. A score between 9 - 12 signifies what?
|
|
Severe brain injury or coma
|
Using the glasgow coma scale. A score ≤ 8 signifies what?
|
|
Attention
|
As part of neurological examination, testing of cognitive function is important to assess attention, orientation, memory, abstract thought, and the ability to perform calculations or construct figures. |Bases on definition and task,what cognitive function is being assess?|- It is defined as the ability to attend to a specific stimulus or task. The patient is asked to repeat a series of numbers or letters, spelling words forward and backward
|
|
Orientation
|
Bases on definition and task,what cognitive function is being assess?|- It is defined as the ability to orient to person, place and time|- Identify name, age, current date, and season, birth date, present location, town etc...
|
|
Immediate recall
|
Bases on definition and task,what type of memory (cognitive function) is being assess?|- Name three items previously presented after a brief interval (a few seconds to a few minutes)|for example, the patient repeats, a red car, black pants, green tomatoes.
|
|
Short-term memory
|
Bases on definition and task,what type of memory (cognitive function) is being assess?|- Recounts words (after a few minutes) or recall recent events (i.e., What did you have for breakfast?)
|
|
Long-term memory
|
Bases on definition and task,what type of memory (cognitive function) is being assess?|- Recount past events (i.e., Where were you born?; Where did you grow up?)
|
|
Calculation
|
Bases on definition and task,what type of cognitive function is being assess?|- Defined as the ability to perform verbal or written mathematical problems (add,substract,multiply or divide whole numbers). i.e., 8 ÷ 4 =?; 7+5 =? etc..
|
|
Construction
|
Bases on definition and task,what type of cognitive function is being assess?|- Defined as the ability to construct a 2D or 3D figure or shape. i.e., Draw a figure after a verbal command or reproduce a figure from a picture
|
|
Calculation
|
A physical therapist asks a patient to perform the following mathematical operations. 9+3 =?; 4+7=? 8 ÷ 4 =?; 7 - 4 =? etc... Also the therapist aske to count backward from 100 by 7s. What cognitive function is being tested?
|
|
Construction
|
A physical therapist ask a patient (verbal command) to draw house and tree next to it. Also the therapist shows a picture of a red barn with white fences around it, and ask can you draw this picture in the best possible way you could? What cognitive function is being tested?
|
|
Abstraction
|
Bases on definition and task,what type of cognitive function is being assess?|- Defined as the ability to reason in an abstract rather than a literal or concrete fashion. i.e., discuss how two objects are similar or different
|
|
Abstraction
|
A therapist shows a patient a two cans of sodas. A can of regular Coca-Cola and a can of regular Pepsi. The therapis asks the patient what are the differences and similarities between the two objects. What cognitive function is being tested?
|
|
Jugdement
|
Bases on definition and task,what type of cognitive function is being assess?|- Defined as the ability to reason (according to age and lifestyle). Demonstrate common sense and safety.
|
|
Attention
|
A therapist ask a patient to recall up to seven numbers in order presented. | Then asks, can you spell backwards bottle, then fork, garden (using small words, and then ask progressively longer words) What cognitive function is being tested?
|
|
Sustained attention
|
In testing cognitive function, attention can be subdivided into sustained attention, divided attention, and focused attention. |Defined as the ability to attend to a task without redirection. As therapists determine time on task, and frequency of redirection. Based on definition this is called?
|
|
Divided attention
|
In testing cognitive function, attention can be subdivided into sustained attention, divided attention, and focused attention. |- Defined as the ability to shift attention from one task to another. As therapists, assess ability of dual taks control. (i.e., can the patient perform two activities simultaneously?) Also assess for perseveration (mental inertia) getting stuck on a task.
|
|
Focused attention
|
In testing cognitive function, attention can be subdivided into sustained attention, divided attention, and focused attention. |- Defined as the ability to stay on a task in presence of detractors. As therapists assess impact of environmental vs. internal detractors. This cognitive function is called?
|
|
Mini-mental status examination
|
Produced by Folstein, Folstein, and McHugh, in 1975. aka as Folstein test. It is a brief 30-point questionnaire test that is used to screen for cognitive impairment. Includes screenings items for orientation, registration, attention, calculation, recall and language. The max possible score is 30 points, and a score ≤ 15 indicates severe impairment. This test is called
|
|
No cognitive impairment
|
Mini-mental status examination or MMSE. A score ≥ 25 indicates?
|
|
Mild cognitive impairment
|
Mini-mental status examination or MMSE. A score between 21 - 24 indicates?
|
|
Moderate cognitive impairment
|
Mini-mental status examination or MMSE. A score between 16 - 20 indicates?
|
|
Severe cognitive impairment
|
Mini-mental status examination or MMSE. A score ≤ 15 Indicates?
|
|
Levels I
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the no response level?
|
|
Levels II, III
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the decreased response levels?
|
|
Levels IV, V, VI
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the confused levels?
|
|
Level VII
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the automatic appropriate level?
|
|
Level VIII
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the purposeful appropriate level?
|
|
I. No Response
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). |- Patient appears to be in a deep sleep and is completely unresponsive to any stimuli.|Based on the above description, This patient is said to be at what level/category?
|
|
II. Generalized Response
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient reacts inconsistently and non-purposefully to stimuli in a nonspecific manner.|- Responses are limited and often the same regardless of stimulus. |- Responses may be physiological changes, gross body movements, and/or vocalization.|Based on the above description, This patient is said to be at what level/category?
|
|
III. Localized Response
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient reacts specifically but inconsistently to stimuli.|- Responses are directly related to the type of stimulus presented. |- May follow simple commands such as closing the eyes or squeezing the hand in an inconsistent, delayed manner.|Based on the above description, This patient is said to be at what level/category?
|
|
IV. Confused-Agitated
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient is in a heightened state of activity.|- Behavior is bizarre and non-purposeful relative to the immediate environment. |- Does not discriminate among persons or objects; is unable to cooperate directly with treatment efforts. |- Verbalizations frequently are incoherent and/or innappropriate to the environment; confabulation may be present. |- Gross attention to environment to very brief; selective attention is often nonexistent. Patient lacks short and long-term recall.|Based on the above description, This patient is said to be at what level/category?
|
|
V. Confused-Inappropriate
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient is able to respond to simple commands fairly consistently. However, with increased complexity of commands or lack of any external structure, responses are non-purposeful, random, or fragmented. |- Demonstrates gross attention to the environment but is highly distractible and lacks the ability to focus attention on a specific task. With structure, may be able to converse on a social automatic level for short periods of time. |- Verbalization is often inappropriate and confabulatory. |- Memory is severly impaired; often shows inappropriate use of objects; |- May perform previously learned tasks with structure, but is unable to learn new information.|Based on the above description, This patient is said to be at what level/category?
|
|
VI. Confused-Appropriate
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient shows goal-directed behavior, but is dependent on external input or direction. |- Follows simple directions consistently and shows carryover for relearned tasks such as self-care. |- Responses may be incorrect due to memory problems, but they are appropriate to the situation. |- Past memories show more depth and detail than recent memory.|Based on the above description, This patient is said to be at what level/category?
|
|
VII. Automatic-Appropriate
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient appears appropriate and oriented within the hospital and home settings; goes gthrough daily routine automatically, but frequently robot-like. |- Patient shows minimal to no confusion and has shallow recall of activities.|- Shows carryover for new learning, but at a decreased rate. With structure is able to initiate social or recreational activities; judgment remains impaired.|Based on the above description, This patient is said to be at what level/category?
|
|
VII. Purposeful-Appropriate
|
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient is able to recall and integrate past and recent events and is aware of and responsive to environment. |-Shows carryover for new learning and needs no supervision once activities are learned.|- May continue to show a decreased ability relative to premorbid abilities, abstract reasoning, tolerance for stress, and judgment in emergencies or unusual circumstances.|Based on the above description, This patient is said to be at what level/category?
|
|
Broca's motor aphasia
|
Part of the neurological examination, is the assessment of speech and language. Aphasias can be divided into fluent aphasias and non-fluent aphasias. It is a central language disorder in which speech is typically awkward, restricted, interrupted, and produced with effort. Typically the result of a lesion involving the 3rd. frontal convolution of the left hemisphere. |Example of a normal speech: It's been 5 years since I have the stroke. I feel fine now, I am able to drive my car to the store, and to my relatives' house.|Speech impairment: ah...man..strooke.. uh..I.. geez. ... Drive car... uhh........I.. five yearshh.....housess...|This type of speech impairment is called?
|
|
Apraxia
|
Comes from the greek word praxis = work, act, deed. A = no. It is characterized by loss of the ability to execute or carry out learned purposeful movements, despite having the desire and the physical ability to perform the movements. Another definition: It is a disorder of the brain and nervous system in which a person is unable to perform tasks or movements when asked, even though:|- The request or command is understood|- They are willing to perform the task|- The muscles needed to perform the task work properly|- The task may have already been learned
|
|
Verbal apraxia
|
Impairment of volitional articulatory control secondary to a cortical, dominant hemisphere lesion. A person has trouble saying what he or she wants to say correctly and consistently, and it is not related to facial muscle weakness.
|
|
Dysarthria
|
Dys = having problem with; Arthr = articulating|Impairment of speech production, in the CNS/PNS mechanisms that control respiration, articulation, phonation, and movements of jaw and tongue. It is a condition in which problems occur with the muscles that help you talk; this makes it very difficult to pronounce words. It is unrelated to any problem with understanding cognitive language.Patient may present with a "slur speech", or speak softly or barely able to whisper.|This condition is called?
|
|
Wernicke's aphasia
|
A type of aphasia considered to be a fluent aphasia, receptive aphasia. It is central language disorder in which spontaneous speech is preserved and flows smoothly, while auditory comprehension is impaired. It is the result of a lesion in the posterior first temporal gyrus of the left hemisphere.| Individuals with this type of aphasia have difficulty understanding spoken language but are able to produce sounds, phrases, and word sequences. While these utterances have the same rhythm as normal speech, they are not language because no information is conveyed.|This is called?
|
|
Global aphasia
|
A severe form of aphasia characterized by marked impairments in comprehension and production of language
|
|
Olfactory (CN I)
|
Which cranial nerve is responsible for sense of smell
|
|
Olfactory (CN I)
|
Which cranial nerve is being tested in the following example?|- Have the patient close one nostril, and ask him/her to sniff a mils smelling substance and identify it. (e.g., coffee, vanilla etc.)
|
|
Anosmia
|
This condition is characterized by inability to detect smells. It is seen with frontal lobe lesions of patients with dysfunction of impairment of the CN I (Olfactory)
|
|
Olfactory (CN I)
|
A patient at a rehab center was told at a request of a therapist to use deodorant before the coming to therapy session. The patient replied to the therapist " I am sorry, I did not I had a strong smell, I could not smell at all anything". Which cranial nerve is being affected?
|
|
Anosmia
|
A patient at a rehab center was told at a request of a therapist to use deodorant before the coming to therapy session. The patient replied to the therapist " I am sorry, I did not I had a strong smell, I could not smell at all anything". This condition of inability to detect smells is called?
|
|
Optic (CN II)
|
Which cranial nerve for central and peripheral vision?
|
|
Optic (CN II)
|
Which cranial nerve is being tested?|- Acuity: Have patient cover one eye, and ask patient to read a visual chart (snellen eye chart)|- Fields: Have patient cover one eye, and hold an object (e.g., pen cap) at arm's length from the patient in his or her peripheral field. Hold the patient's head steady. Slowly move the object centrally, and ask the patient to state when he or she first sees the object. Repeat the process in all quadrants
|
|
Blindness, myopia, presbyopia, homonymous hemianopsia
|
Possible dysfunction or impairments of cranial nerve II (optic nerve) include?
|
|
Myopia
|
Defined as impaired far vision
|
|
Presbyopia
|
Defined as impaired near vision
|
|
Homonymouse hemianopsia
|
Defined as the loss of half of the field of view on the same side in both eyes. i.e., the patient cannot see from the left half of the left and right eye.
|
|
Occulomotor (CN III)
|
Which cranial nerve is responsible for eyelid elevation, pupil constriction (pupillary reflexes), visual focusing, upward, downward inward and infero-medial eye movement?
|
|
Occulomotor (CN III)
|
Which cranial nerve is being tested?|- Pupil reaction to light: Shine a flashlight into one eye and observe bilateral pupil reaction. Normal is bilateral pupil constriction occurs with flashing into one eye. Also hold an object about 10 cm from the patient's eye and ask him/her to look at the near object and to look off into the distance. Watch for pupil constriction with near object and pupil dilation with distance objects.
|
|
Occulomotor (CN III)
|
Which cranial nerve is being tested?|- Gaze: Hold objects (e.g., pen) at arm's length from the patient, and hold the patient's head steady. Ask the patient to follow the object with a full horizontal, vertical and diagonal gaze.
|
|
Occulomotor (CN III)
|
If a patient is exhibiting absence of pupillary constriction, Ptosis (drooping of eyelid), unequal pupils; Horner's syndrome this condition is likely to be an impairment of which cranial nerve?
|
|
Horner's syndrome
|
This condition is not a disease itself, but rather, it's a sign of another medical problem — such as a stroke, tumor or spinal cord injury. Typically involves, miosis (constriction of pupil), Ptosis (drooping of eyelid), and decreased sweating of the face on the same side.
|
|
Anisocoria
|
Condition defined as unequal pupils
|
|
Trochlear (CN IV)
|
Which cranial nerve is responsible for infero-lateral (downward and lateral) eye movement?
|
|
Trochlear (CN IV)
|
Which cranial nerve is being tested?|- Patient follows with eyes,(head steady) downward, lateral gaze
|
|
Strabismus
|
Condition where eyes deviate from normal conjugate position i.e., eyes are not properly aligned with each other. one eye might be aligned while the other is either up (hypertropia), down (hypotropia), inward (esotropia), and outward (exotropia). This is called?
|
|
Trigeminal (CN V)
|
Which cranial nerve is responsible for sensation of face, cornea and for mastication (motor: temporal and masseter muscles)?
|
|
Wisp of cotton on the patient's cornea
|
How would you test for cornea reflex?
|
|
Trigeminal (CN V)
|
If a patient lost his/her corneal reflex ipsilaterally (involuntary blinking in response to corneal touch), which cranial nerve is involved?
|
|
Trigeminal (CN V)
|
If a patient lost his/her facial sensation, or has numbness, which cranial nerve is involved?
|
|
Trigeminal (CN V)
|
A patient demosntrates weakness of muscles of mastication (temporal and masseter muscles). When asked to open his mouth, the jaw not the tongue deviates ipsilaterally. Which cranial nerve is involved?
|
|
Abducens (CN VI)
|
Which cranial nerve is responsible for lateral eye movement and proprioception?
|
|
Abducens (CN VI)
|
Inability to turn eye out is an impairment of which cranial nerve?
|
|
Facial (VII)
|
Which cranial nerve is responsible for Facial expressions, autonomic innervation of lacrimal and salivary glands, and sense of taste of anterior 2/3 of the tongue?
|
|
Facial (VII)
|
A therapist asks a patient to: smile, show your teeth,frown,raise eyebrows, wrinkle brows, purse lips, puff out both cheeks and close eyes tightly. Which cranial nerve is being tested?
|
|
Facial (VII)
|
A therapist asks a patient to smile, show your teeth,frown,raise eyebrows, wrinkle brows, purse lips, puff out both cheeks and close eyes tightly; however, he is unable to control the facial muscles which produce the above movements on the right side, but no problem with his left side. Which cranial nerve is impaired?
|
|
Bell's palsy
|
A therapist asks a patient to smile, show your teeth,frown,raise eyebrows, wrinkle brows, purse lips, puff out both cheeks and close eyes tightly; however, he is unable to control the facial muscles which produce the above movements on the right side, but no problem with his left side. As a result of this paralysis, the patient's face looks and feels stiff or pulled to one side. He also presents with drooling and drooping of the face, such as the eyelid or corner of the mouth. has trouble closing one eye. In addition other symptoms that this patient presents are: Dry eye or mouth, headache,loss of sense of taste(anterior 2/3 of tongue),sound that is louder in one ear (hyperacusis),twitching in face. The patient's wife added that he has difficulty eating and drinking, and that food falls out of one side of the mouth. Based on the above description, the patient's condition is called?
|
|
Facial (VII)
|
Bell's palsy is a condition where facial muscles are paralyzed on the affected side. This is due to a dysfunction of which cranial nerve?
|
|
Facial (VII)
|
A patient presents with ipsilateral paralysis of upper and lower facial muscles, loss of lacrimation, dry mouth, loss of taste of anterior 2/3 of the tongue on the ipsilateral side. Which cranial nerve is affected?
|
|
Vestibulocochlear (CN VIII)
|
Which cranial nerve is responsible for sense of equilibrium (vestibular branch) and a sense of hearing (cochlear branch)?
|
|
Vestibulocochlear (CN VIII)
|
Which cranial nerve is reponsible for gaze stability with head rotations?
|
|
Vestibulocochlear (CN VIII)
|
Testing of the vestibular branch involves the occulocephalic reflex aka Doll's eyes, or vestibular-occular reflex. It is a reflex that is tested by turning the patient's head from side to side, adn watch for eye movement. The eyes movement should be opposite to the direction of the head. Which cranial nerve is being tested?
|
|
Vestibulocochlear (CN VIII)
|
Vertigo, dysequilibrium,nystagmus, neural deafness, impaired hearing, tinnitus, unilateral conductive loss: sound lateralized to impaired ear, conductive loss: sound heard through bone = or longer than air, sensorineural loss: Sound heard in good ear, sound heard longer through air. All of above conditions are the result of which cranial nerve impairment?
|
|
Vestibulocochlear (CN VIII)
|
A therapist is testing for lateralization (weber's test). a vibrating tunning fork is placed on top of the head, mid position. The sound of the tunning fork is checked to see if it is heard in one ear or equally in both. This is testing for which cranial nerve impairment?
|
|
Weber's test
|
A therapist places a vibrating tunning fork on top of the head, mid forehead, and ask the patient if sound is heard equally (normal) or if it is heard louder in one ear (lateralized;the defective ear). This test is called?
|
|
Rinne's test
|
This test compares air and bone conduction. Place a vibrating tunning fork on the mastoid process, then close to ear canal; sound heard longer through air than bone. (+) test = sound heard on bone longer than air. This test is called?
|
|
Glossopharyngeal (IX)
|
Which cranial nerve is responsible for gag reflex, motor and proprioception of superior pharyngeal muscle, Autonomic innervation of salivary gland, Taste (posterior 1/3 of tongue?
|
|
Glossopharyngeal (IX)
|
Which cranial nerve is being tested?|- Induce gag with tongue depressor (one side at a time)|- Patient phonates a prolonged vowel sound or talks for an extended period oftime.|- Listen for voice quality and pitch
|
|
Glossopharyngeal (IX)
|
Loss of gag reflex, dysphagia (difficult swallowing), dysphonia: hoarseness denotes vocal cord paralysis, nasal quality denotes palatal weakness,dry mouth, loss of taste ipsilateral 1/3 of tongue are signs/symptoms of impairment of which cranial nerve?
|
|
Vagus (X)
|
Which cranial nerve is responsible for swallowing, proprioception of pharynx and larynx, parasympathetic innervation of heart, lungs, and abdominal viscera?
|
|
Vagus (X)
|
Examine for difficulty swallowing. Have the patient say "ah"; observe motion of soft palate (eleveates) and position of uvula (remains midline). Stimulate back of throat lightly on each side (gag reflex). Which cranial nerve is being tested?
|
|
Vagus (X)
|
Dysphagia, soft palate paralysis, contralateral deviation of uvula, ipsilateral anesthesia of pharynx and larynx, hoarseness:denotes vocal cord paralysis, nasal quality denotes palatal weakness. All these are signs & symptoms of which cranial nerve impairment?
|
|
Spinal accessory (CN XI)
|
Which cranial nerve is responsible for motor control and proprioception of head rotation, and shoulder elevation (sternocleidomastoid, trapezius)?
|
|
Spinal accessory (CN XI)
|
Which cranial nerve is being tested?|- Ask a patient to rotate the head or shrug the shoulders (with/without gentle resistance)
|
|
Spinal accessory (CN XI)
|
Weakness/ inability with head turning to the opposite side and ipsilateral shoulder shrug, shoulder droops are signs & symptoms of which cranial nerve impairment?
|
|
Hypoglossal (CN XII)
|
Which cranial nerve is responsible for motor control of pharynx and larynx, and movement and proprioception of tongue for chewing and speech?
|
|
Hypoglossal (CN XII)
|
Which cranial nerve is being tested?|- Listen to patient's articulation problems|- Examine the resting position of the tongue|- Ask patient to stick out his/her tongue and observe for midline. (deviation of tongue to weak side on protrusion)|- Ask patient to move tongue side to side
|
|
Hypoglossal (CN XII)
|
A therapist ask a patient to stick out the tongue. During protrusion, instead of tongue remaining in midline, the tongue deviates ipsilaterally. Which cranial nerve is impaired?
|
|
Deviation of the tongue towards the right side
|
A patient with RIGHT hypoglossal nerve (CN XII) involvement presents to the clinic. The therapist ask the patient to protrude his/her tongue. During protrusion, the tongue will deviate towards which side?
|
|
Cheyne-stokes respiration
|
A period of apnea lasting 10 - 60 secons followed by gradually increasing depth and frequency of respiration; accompanies depression of frontal lobe and diencephalic dysfunction. This is called
|
|
Hyperventilation.
|
Increased rate and depth of respirations; accompanies dysfunction of lower midbrain and pons. This is called?
|
|
Apneustic breathing
|
Abnormal respiration marked by prolonged inspiration; acoompanies damage to upper pons. This is called?
|
|
Neck mobility
|
This is a test for CNS infection or meningeal Irritation. |- Patient in supine, flex neck to chest. (+) sign = pain in the neck with limitation and guarding of head flexion resulting from spasm of posterior neck muscles; can result from meningeal inflammation,arthritis, or neck injury. This is called?
|
|
Kernig's sign
|
This is a test for CNS infection or meningeal irritation.|- Patient in supine, flex hip and knee fully to chest and then extend knee. (+) causes pain and increased resistance to extending the knee owing to spasm of hamstrings; when bilateral suggest meningeal irritation. This called?
|
|
Bruzdzinski's sign
|
This is a test for CNS infection or meningeal irritation.|- Patient in supine flex neck to chest|(+) causes flexion of hips and knees (drawing up) suggests meningela irritation. This is called?
|
|
Lateral corticospinal tract
|
Motor pathway for contralateral VOLUNTARY fine muscle movement. This is the function of which tract?
|
|
Anterior corticospinal tract
|
Motor pathway for ipsilateral VOLUNTARY movement. This is the function of which tract?
|
|
Confusion, restlessness, lethargy
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Level of consciousness, an early sign of increased ICP is?
|
|
Coma
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Level of consciousness, a late sign of increased ICP is?
|
|
Ipsilateral pupil sluggish to light, ovod in shape, with gradual dilatation
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Pupil apprearance an early sign of increased ICP is?
|
|
Papilledema, ipsilateral pupil dilated and fixed or bilateral pupil dilated and fixed (if brain herniation has occurred)
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Pupil apprearance a late sign of increased ICP is?
|
|
Blurred vision, diplopia, and decreased visual acuity
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of vision an early sign of increased ICP is?
|
|
The sames as the early signs, but more exaggerated blurred vision, diplopia, and decreased visual acuity
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of vision a late sign of increased ICP is?
|
|
Contralateral paresis
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Motor performance an early sign of increased ICP is?
|
|
Abnormal posturing, bilateral flaccidity if herniation has occurred
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Motor performance a late sign of increased ICP is?
|
|
Stable blood pressure, and heart rate
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of vital signs early sign of increased ICP is/are?
|
|
Hypertension and bradycardia (Cushing's response), altered respiratory pattern, increased temperature
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of vital signs late signs of increased ICP is/are?
|
|
Headache,seizure, cranial nerve palsy
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. Additional findings during early signs of ICP is/are?
|
|
Headache, vomiting, altered brain stem reflexes (pupillary, pharyngeal, and cough reflexes, and the control of respiration)
|
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. Additional findings during late signs of ICP is/are?
|
|
Brain stem reflexes
|
These reflexes are those regulated at the level of the brain stem, such as pupillary, pharyngeal, and cough reflexes, and the control of respiration; their absence is one criterion of brain death.|These are called?
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Activated in stressful situations producing an arousal reaction (flight or fight response)
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Results in conservation oand restoration of body energy and moeostatsis (system balance)
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- The effects are widespread instead of localized
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- The effects are localized and short acting
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Dilates pupils
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Constrict pupils
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases heart rate and force of contraction
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Decreases force of contraction
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Breaks down glycogen into glucose|- Increases blood sugar levels|- Increases blood flow in skeletal muscles|- Constricts blood flow to skin and abdomen
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases blood pressure and peripheral vascular resistance
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Decreases blood pressure
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Dilates bronchi for maximum respiratory flow
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Constricts bronchi
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Constricts bronchial arteries
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Dilates bronchial arteries
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Stimulates cortex and medulla, produces hyperalertness
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Dilates bronchial arteries
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Decreases peristalsis, intestinal motility
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases peristalsis, intestinal motility
|
|
Sympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases sweating|- Reduces glandular secretions
|
|
Parasympathetic nervous system
|
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases glandular secretions
|
|
Joint position sense
|
Identify the following proprioceptive sensations test|- Test the ability to perceive joint position at rest in response to YOUR POSITIONING te patient's limb (up,down, in, out)
|
|
Kinesthesia
|
Identify the following proprioceptive sensations test|- Movement sense: Test the ability to perceive movement in response to YOUR MOVING the patient's limb; Patient can duplicate movement with opposite limb or give a verbal report
|
|
Pallesthesia
|
Identify the following proprioceptive sensations test|- Vibration sense: Test proprioceptive pathways by applying vibrating tunning fork or pressure only (sham vibration) on bony areas
|
|
Stereognosis
|
Identify the following cortical sensations test|- Test the ability to identify familiar objects placed in the hand by manipulation and touch. Can you identify this object? (a key, spoon, pencil etc..)
|
|
Barognosis
|
Identify the following cortical sensations test|- Test the ability to identify similar size/shaped objects placed in the hand with different gradations of weight (eyes closed)
|
|
Graphesthesia
|
Identify the following cortical sensations test|- Test ability to identify numbers, letters, or symbols traced on skin, typically the hand. Can you tell me what you feel I wrote on you hand? ( letter B, number 8 etc..)
|
|
Flexion
|
Spine biomechanics|The upper facets glide anteroproximallly and tilt forwad
|
|
Extension
|
Spine biomechanics|The upper facets move downward, and slightly posterior and tilt backward
|
|
facets moves down and slightly anterior
|
Spine biomechanics|When sidebending to the right which way the RIGHT upper facets move?
|
|
facets moves upward and slightly posterior
|
Spine biomechanics|When sidebending to the right which way the LEFT upper facets move?
|
|
facets on right glide down and back causing approximation of facet joint on the right
|
Spine biomechanics|Which way moves the faces in cervical RIGHT rotation?
|
|
Muscle strain
|
Identify the following condition|May be related to sudden trauma, chronic or sustained overlad or abnormal muscle biomechanics secondary to faulty function (abnormal joint or muscle biomechanics)|Commonly will resolve without internvention, but if trauma is too great or if related to chronic etiology, will benefit from intervention
|
|
Spondylolysis
|
A fracture of the pars interarticularis with (+) "Scotty Dog Sign" on OBLIQUE radiographic view of the spine
|
|
Spondylolisthesis
|
The actual anterior or posterior slippage of one vertebra on another following bilateral fracture of pars interarticularis. It can be graded I = 25% slippage to 4 = 100% slippage. Plain film is diagnostic test used. Oblique view = to see fracture, Lateral view = to see slippage
|
|
Stork test
|
What special test can be helpful to identify spondylolisthesis?
|
|
Extension, ipsilateral sidebending and contralateral rotation
|
An intervention for spondylolisthesis, the actual separation anteriorly or posteriorly of one vertebra over another, should focus on dynamic stabilization of trunk with particular emphasis on abdominals and trunk extension with multifidus muscle working from a fully flexed position of trunk up to neutral, but not into trunk extension. in addition what other positions that add stress to the defect should be avoided?
|
|
Spinal stenosis
|
Identify the following condition|Etiology: Congenital narrowing spinal canal or intervertebral foramen coupled with hypertrophy of the spinal lamina and ligamentum flavum or factes as the result of age-related degenerative processes or disease. Results in vascular and/or neural compromise|Signs/Symptomps include:|- Bilateral pain and paresthesia in back, buttocks, thighs, calves, and feet|- Pain is decreased in spinal felxion, and increased in extension
|
|
Plain films, MRI and/or CT scan
|
What diagnostic test(s) will be utilized for spinal stenosis?
|
|
Bicycle van gelderen's test
|
What test is helpful to differentiate spinal stenosis from intermitten claudication?
|
|
Extension, ipsilateral sidebending, and ipsilateral rotation
|
Spinal stenosis is a congenital condition where there is narrowing of the spinal canal or intervertebral foramen coupled with hypertropy of the spinal lamina and ligamentum flavum or facets as the result of age-related degenerative disease processes or disease. As part of PT intervention, performing flexion biased exercises and exercises that promote dynamic stability throughout the trunk and pelvis are recommended. In addition other position should be avoided in this condition?
|
|
15° of flexion
|
Manual and/or Mechanical traction are one of the recommended interventions for spinal stenosis, specifically the cervical spine. What cervical position provides the optimum intervertebral foraminal opening for traction as a treatment modality?
|
|
Internal disc disruption
|
Internal structure of disc annulus is disrupted;however, external structures remain normal. Most common in lumbar region|Symptoms include:|- Constant deep achy pain, increased pain with movement, no objective neurological findings, although patient may have referred pain into LL.|Diagnosed with CT discogram or MRI|Spinal manipulation is CONTRAINDICATED for this condition
|
|
Posterolateral bulge/herniation
|
Most commonly observed disc disorder of lumbar spine due to three structural deficiencies:|- Posterior disc is narrower in height than anterior disc|- Posterior longitudinal ligament is not as strong and only centrally located in lumbar spine|- Posterior lamelle of annulus are thinner|Etiology: Overstretching and/or tearing of annulus rings, verterbral endplate and/or ligamentous structures from high compressive forces or repetitive microtrauma.|Results in loss of strength, radicular pain, paresthesia and inability to perform ADLs|Spinal manipulation is CONTRAINDICATED for this condition
|
|
MRI
|
What diagnostic test is utilized in posterolateral bulge/herniation?
|
|
Posterolateral bulge/herniation
|
This intervention is helpful for which condition?|Positional gaping for 10 min to increase space within region of space-occupying lesion. e.g. If LEFT posterolateral lumbar herniation is present:|- Have patient sidelying on RIGHT side with pillow under RIGHT trunk (accentuating trunk sidebending RIGHT)|- Flex both hips and knees|- Rotate trunk to left (or pelvis to Right)|- Patient can be taught to perform this at home
|
|
Central posterior bulge/herniation
|
More commonly observed in the cervical spine but can be seen in the lumbar sine.|Etiology: overstretching and/or tearing of annulus rings, vertebral endplate, and/or ligamentous structures (posterior longitudinal ligament) from high compressive forces and/or long-term postural malalignment|Results in loss of strength, radicular pain, paresthesia and possible compression of the spinal cord with central nervous system symptoms (e.g., hyperreflexia, (+) babinski reflex|Diagnostic test utilized : MRI
|
|
Avascular Necrosis
|
Identify the following condition|Osteonecrosis of the hip. Multiple etiologies resulting in an impaired blood supply to the femoral head.|Hip ROM is decreased in flexion, internal rotation and abduction (capsular pattern)|Symptoms include: Pain in the groin and/or thigh and tenderness with palpation at the hip joint.|- Coxalgic gait
|
|
Plain film, Bone scans, CT and/or MRI
|
What diagnosistic tests are utilized in avascular necrosis of the hip?
|
|
Legg-Calve-perthe's disease
|
Identify the following condition:|Osteochondrosis|Age onset between 2 - 13 years with average age of onset at 6 years. Males x 4> incidence than females|Characteristic: Psoatic limp (hip in lateral rotation, flexion and adduction) due to weakness of psoas major|Gradual onset of "aching" pain at the hip, thigh and knee|AROM limited in abduction and extension|MRI is technique of choice. (+) bony crescent sign (collapse of subchondral bone at femoral neck/head)
|
|
MRI
|
What diagnosistic tests are utilized in Legg-Calve-Perthe's disease?
|
|
Slipped Capital Femoral Epihysis
|
Identify the following condition:|A medical term referring to a fracture through the physis (the growth plate), which results in slippage of the overlying epiphysis. It is a common cause of hip and knee pain in children ages 7 and 11 caused usually during a growth spurt. Most common hip disorder observed in adolescents and is of unkown etiology. |The average onset for males 10 - 17 years of age with average onset 13 years|The average onset for females 8 - 15 years of age with average onset 11 years. Males twice greater incidence than females|AROM restricted in abduction, flexion, and internal rotation)|Pain described as vague at knee, thigh and hip|with chronic condition may demo trendelenburg gait
|
|
Plain film
|
What diagnostic test is utilized in Slipped Capital Femoral Epiphysis?
|
|
Craig's test
|
What special tests helps to measure femoral anteversion/retroversion?
|
|
Plain film
|
What diagnosistic test is utilized in femoral anteversion/retroversion?
|
|
Coxa valga
|
The hip angle of inclination of the femur (neck - shaft )in adults is normally 120° - 135°|If the angle of inclination is > 135°, this is called?
|
|
Coxa vara
|
The hip angle of inclination of the femur (neck - shaft) in adults is normally 120° - 136°|If the angle of inclination is < 120°, this is called?
|
|
Plain films
|
What diagnosistic test is utilized in coxa valga and coxa vara?
|
|
Trochanteric bursitis
|
Identify the following condition|An inflammation of deep trochanteric bursa from a direct blow, irritation by iliotibial band (ITB), and biomechanical /gait abnormalities causing repetitive microtrauma. This condition is common in patients with rheumatoid arthritis. There is a marked tenderness to deep palpation of the greater trochanter
|
|
Iliotibial band tightness
|
Identify the following condition|Etiology: tight iliotibial band, abnormal gait pattern. |Results in inflammation of trochanteric bursa. Noble compression test is (+) when friction is introduced over the lateral femoral condyle during knee extension. Ober's test will also demonstrate tightness in ITB
|
|
Trochanteric bursitis
|
Identify the following condition|Pain is experienced over the lateral hip and possibly down the lateral thigh to the knee when the iliotibial band rubs over the trochanter. Discomfort may be experienced after standing asymmetrically for long periods with the affected hip elevated and adducted and the pelvis dropped on the opposite side. Ambulation and climbing stairs aggravate the condition. Muscle flexibility and strength imbalances and the resulting faulty posture of the pelvis may be the predisposing factors leading to bursal irritation
|
|
Piriformis syndrome
|
Identify the following condition|This muscle is an external rotator of the hip and can become overworked with excessive pronation of foot, which causes abnormal femoral internal rotation. It is considered a tonic muscle which is active with motion of sacroiliac joint, particularly the scarum. Tightness of spasm of piriformis muscle can result in compression of sciatic nerve and/or sacroiliac joint dysfunction.|Signs and symptoms include:|- Restriction in internal rotation|- Pain with palpation of piriformis muscle|- Referral of pain to posterior thigh|- Weakness in external rotation, (+) piriformis test|- Unable sacral base
|
|
Electrodiagnostic test
|
What possible diagnostic test will be utilized in piriformis syndrome?
|
|
lumbar spine and sacroiliac joint
|
While performing a lower extremity biomechanical examination to determine if abnormal biomechanics are the cause of possible piriformis syndrome, what other two joints involvement must be ruled out?
|
|
Unhappy triad
|
Identify the following condition|This is an injury to medial collateral ligament (MCL), anterior cruciate ligament (ACL), and Medial meniscus resulting from combination of valgum,flexion and external rotation forces applied to knee when the foot is planted
|
|
Mc Murray's test and Apley's test
|
What two special tests serve to test for meniscal injuries?
|
|
MRI
|
What diagnostic test is utilized for meniscal injuries?
|
|
Patella alta
|
Identify the following condition|Malalignment in which patella tracks superiorly in femoral intercondylar notch. May result in chronic patellar subluxation (+) camel back sign (two bumps over anterior knee region instead of typical one) Two bumps since patella is riding high within femoral condyles so there is a superior bump and then tibial tuberosity forms the second bump inferiorly
|
|
Patella baja
|
Identify the following condition|Malalignment in which patella tracks inferiorly in femoral intercondylar notch. Results in restricted knee extension with abnormal cartilagenous wearing resulting in DJD
|
|
lateral patellar tracking
|
Identify the following condition|This condition could result if there is an increas in "Q angle" with tendency for lateral subluxation or dislocation
|
|
MRI
|
What diagnostic test is utilized for patellofemoral pain syndrome?
|
|
Pes anserine bursitis
|
Identify the following condition|The inflammation of the pes anserine bursa located at the medial aspect of the knee. The pes anserine bursa is a fluid filled sac which acts as a cushion for the tendons of the Sartorius, Gracilis, and Semitendinosus muscles at the distal point of insertion on the shin bone (tibia). typically caused by overuse or a contusion
|
|
Osgood-schlatter disease
|
Identify the following condition|Aka jumper'sknee It's an irritation of the patellar ligament at the tibial tuberosity. Can cause a painful lump below the kneecap in children and adolescents experiencing growth spurts during puberty. It occurs most often in children who participate in sports that involve running, jumping and swift changes of direction — such as soccer, basketball, figure skating and ballet
|
|
Plain film
|
What diagnostic test is utilized in osgood-schlatter disease?
|
|
Anterior Compartment syndrome
|
Identify the following condition|It is an increased pressure within a muscular compartment that compromises the circulation to the muscles resulting in local ischemic condition. It can affect any and all four muscles of that compartment: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius. Multiple etiologies; direct trauma,fracture, overuse and /or muscle hypertrophy. Acute state of this condition is a medical emergency and requires immediate surgical intervention with fasciotomy
|
|
Shin splints
|
aka anterior tibial periostitis. Musculotendinous overuse condition. three common eitologies include: Abnormal biocmechanical alignment, poor conditioning, improper training methods. Muscles involved: Tibialis anterior,extensor hallucis longus. Pain elicited with palpation of lateral tibia and anterior compartment
|
|
Medial tibial stress syndrome
|
Identify the condition|Overuse injury of the posterior tibialis and/or the medial soleus resulting in periosteal inflammation at the muscular attachments. Etiology; excessive pronation |Pain elicited with palpation of the distal posteromedial border of the tibia
|
|
Grade I
|
Which grade of liagment sprains?|Ligament sprains, 95% involve lateral ligaments|No loss of function with minimal tearing of the anterior talofibular ligament
|
|
Grade II
|
Which grade of liagment sprains?|Ligament sprains, 95% involve lateral ligaments|Some loss of function with partial disruption of the anterior talofibular and calcaneofibular ligaments
|
|
Grade III
|
Which grade of liagment sprains?|Ligament sprains, 95% involve lateral ligaments|Complete loss of function with complete tearing of the anterior talofibular and calcaneofibular ligaments with partial tear of the posterior talofibular ligament.
|
|
Tarsal tunnel syndrome
|
Identify the following condition|Entrapment of the posterior tibial nerve or one of its brachnes within the tarsal tunnel.|Over/excessive pronation, overuse problems resuling in tendonitis of the long flexor and posterior tibialis tendon, and trauma may compromise space in the tarsal tunnel|symptoms include: pain, numbness and paresthesias along the medial ankle to the plantar surface of the foot
|
|
Electrodiagnostic test
|
What diagnostic test will be utilized for tarsal tunnel syndrome?
|
|
Charcot-Marie-Tooth disease
|
Identify the following condition|Peroneal muscular atrophy that affects motor and sensory nerves. May begin in childhood or adulthood. Initially affects muscles in lowerleg and foot, but eventually progresses to muscles of hands and forearms|slowly progressive disorder that has varying degrees of involvement depending on degree of genetic dominance
|
|
Electrodiagnostic test
|
What diagnostic test will be utilized for Charcot-Marie-Tooth disease?
|
|
Rigid metatarsus adductus
|
Identify the following condition|Etiology: congenital, muscle imbalance, or neurmuscular diseases such as polio. There are two types.|Deformity observed: Medial subluxation of tarsometatarsal joints. Hindfoot is slightly in valgus with navicular lateral to head of talus
|
|
Flexible metatarsus adductus
|
Identify the following condition|Etiology: congenital, muscle imbalance, or neurmuscular diseases such as polio. There are two types.|Deformity observed: Adduction of all five metatarsals at the tarsometatarsal joints
|
|
Plantar fasciitis
|
Identify the following condition|Etiology: Usually mechanical. Chronic irritation of plantar fascia from excessive pronation. Limited ROM of 1st. MTP and talocrural joint|Tight tricep surae (Gastroc+ soleus)|acute injury from excessive loading of foot. Rigid cavus foot. Results in microtears at the attachment of plantar fascia
|
|
Negative tinel's sign
|
How plantar fasciitis can be differentiated from tarsal tunnel syndrome. what special test?
|
|
Rearfoot varus
|
Identify the following condition|Subtalar varus, calcaneal varus|Etiology: Abnormal mechanical alignment of tibia, shortened rearfoot soft tissues, or malunion of calcaneus.|Deformity observed: Rigid inversion of calcaneus when subtalar joint is in neutral position.
|
|
Rearfoot valgus
|
Identify the following condition|Etiology: Abnormal mechanical alignment of the knee (genu valgum) or tibial valgus.|Deformity observed: Eversion of calcaneus with neutral subtalar joint. Owing to increased mobility of hindfoot, fewer musculoskeletal problems develop from this deformity than occurs with rearfoot varus
|
|
Forefoot varus
|
Identify the following condition|Etiology: Congenital abnormal deviation of head and neck of talus|Deformity observed: Inversion of forefoot when subtalar joint is in neutral
|
|
Forefoot valgus
|
Identify the following condition|Etiology: Congenital abnormal development of head and neck of talus|Deformity observed: eversion of forefoot when subtalar joint is in neutral
|
|
Vascular
|
Pain that is described as throbbing
|
|
Vascular
|
Pain that is described as pounding
|
|
Vascular
|
Pain that is described as pulsing
|
|
Vascular
|
Pain that is described as beating
|
|
Neurogenic
|
Pain that is described as sharp
|
|
Neurogenic
|
Pain that is described as crushing
|
|
Neurogenic
|
Pain that is described as pinching
|
|
Neurogenic
|
Pain that is described as burning
|
|
Neurogenic
|
Pain that is described as hot
|
|
Neurogenic
|
Pain that is described as searing
|
|
Neurogenic
|
Pain that is described as itchy
|
|
Neurogenic
|
Pain that is described as stinging
|
|
Neurogenic
|
Pain that is described as pulling
|
|
Neurogenic
|
Pain that is described as jumping
|
|
Neurogenic
|
Pain that is described as shooting
|
|
Neurogenic
|
Pain that is described as Pricking
|
|
Neurogenic
|
Pain that is described as gnawing
|
|
Neurogenic
|
Pain that is described as electrical
|
|
Musculoskeletal
|
Pain that is described as aching
|
|
Musculoskeletal
|
Pain that is described as sore
|
|
Musculoskeletal
|
Pain that is described as heavy
|
|
Musculoskeletal
|
Pain that is described as hurting
|
|
Musculoskeletal
|
Pain that is described as dull
|
|
Musculoskeletal
|
Pain that is described as cramping
|
|
Musculoskeletal
|
Pain that is described as deep
|
|
Emotional
|
Pain that is described as tiring
|
|
Emotional
|
Pain that is described as miserable
|
|
Emotional
|
Pain that is described as vicious
|
|
Emotional
|
Pain that is described as agonizing
|
|
Emotional
|
Pain that is described as nauseating
|
|
Emotional
|
Pain that is described as frightful
|
|
Emotional
|
Pain that is described as piercing
|
|
Emotional
|
Pain that is described as dreadful
|
|
Emotional
|
Pain that is described as punishing
|
|
Emotional
|
Pain that is described as torturing
|
|
Emotional
|
Pain that is described as killing
|
|
Emotional
|
Pain that is described as unbearable
|
|
Emotional
|
Pain that is described as annoying
|
|
Emotional
|
Pain that is described as cruel
|
|
Emotional
|
Pain that is described as sickening
|
|
Emotional
|
Pain that is described as exhausting
|
|
Upper Lobes Apical Segments
|
Which lung segment is likely to be drained when the PT asks the patient "lean back on a pillow at 30°angle"?
|
|
Upper Lobes Apical Segments
|
If the therapist performing postural drainage claps with markedly cupped hand over area between clavicle and top of scapula on each side, which lung segment is likely to be drained?
|
|
Between clavicle and top of scapula
|
If the Upper Lobes Apical Segments needs to be drained, which area needs to be percussed?
|
|
Upper Lobes Posterior Segments
|
Which lung segment is likely to be drained when the PT asks the patient "lean forward a folded pillow at 30° angle"?
|
|
Upper Lobes Posterior Segments
|
If the therapist performing postural drainage claps with markedly cupped hand over upper back while the patient is leaning forward at 30°, which lung segment is likely to be drained?
|
|
Upper Lobes Posterior Segments
|
If the therapist performing postural drainage claps with markedly cupped hand over upper back, which lung segment is likely to be drained?
|
|
Upper Lobes Anterior Segments
|
Which lung segment is likely to be drained when the PT asks the patient "Lie on your back with a pillow under your knees, so you hips are at 45° angle approximately"?
|
|
Upper Lobes Anterior Segments
|
If the therapist performing postural drainage claps between the clavicle and nipple area, which lung segments is likely to be drained?
|
|
Upper Back
|
If the Upper Lobes Posterior Segments needs to be drained, which area needs to be percussed?
|
|
Between the clavicle & Nipple area
|
If the Upper Lobes Anterior Segments needs to be drained, which area needs to be percussed?
|
|
Right Middle Lobe
|
The PT prepares the Table for postural drainage. |- Foot of table is elevated 16", patient lies head down and LEFT SIDE and rotates 1/4 turn backward|- A pillow is placed behind from shoulder to hip, knee should be flexed|- Therapist claps over RIGHT nipple area. With females with breast development or tenderness, use cupped hand with heel of hand under armpit and fingers extending forward beneath the breast.|Based on the above description which lung segment is likely to be drained?
|
|
Over Right nipple area
|
If the Right Middle Lobes need to be drained, which area needs to be percussed?
|
|
Left Upper Lobe Lingular Segments
|
The PT prepares the Table for postural drainage. |- Foot of table is elevated 16", patient lies head down and RIGHT SIDE and rotates 1/4 turn backward|- A pillow is placed behind from shoulder to hip, knee should be flexed|- Therapist claps moderately cupped hand over LEFT nipple area. With females with breast development or tenderness, use cupped hand with heel of hand under armpit and fingers extending forward beneath the breast.|Based on the above description which lung segment is likely to be drained?
|
|
Over Left nipple area
|
If the Left Upper Lobe Lingular Segments need to be drained, which area needs to be percussed?
|
|
Trendelenburg, and lie head down on Left side and rotate 1/4 turn backward
|
What position should the patient assume if the Right Middle Lobe needs to be percussed?
|
|
Trendelenburg, and lie head down on Right side and rotate 1/4 turn backward.
|
What position should the patient assume if the Left Upper Lobe needs to be percussed?
|
|
Lower lobe Anterior Basal Segments
|
Which lung segment is likely to be drained when the PT asks the patient "lie on your side, head down and let me put a pillow under your knees" (table is elevated to 20"), and tells the patient "I am going to clap with slightly cupped hand over the lower ribs"
|
|
lower ribs
|
Which area needs to be percussed if the Lower Lobe Anterior Basal Segments are going to be treated?
|
|
Lower Lobes Lateral Basal Segments
|
Which lung segment is likely to be treated when the PT asks the patient to "lie on your abdomen, head down, then rotate 1/4 turn upward. Flex the upper leg over a pillow, and keep lower leg straight". " I am going to clap over the uppermost portion of lower ribs". Table is elevated 20"
|
|
uppermost portion of lower ribs
|
f the lateral basal segments need to be treated, which area should be percussed by the therapist?
|
|
Lower Lobes Posterior Basal Segments
|
Which lung segment is likely to be treated when the PT asks the patient to "lie on you abdomen, head down with a pillow under your hips, and I am going to clap over the lower ribs close to the spine on each side". Table is elevated 20"
|
|
over the lower ribs close to the spine
|
if the Lower Lobes Posterior Basal Segments need to be treated which are should be percussed by the therapist?
|
|
Lower Lobes Superior Segments
|
Which lung segment is likely to be treated when the PT asks the patient to" lie on your abdomen with two pillows under your hips (hips at 45° with respect to the trunk) and I am going to clap over middle of back at tip of scapula" (table is flat)?
|
|
middle of back at the tip of scapula
|
If the superior segments need to be treated, which area should be percussed by the therapist?
|
|
Rotator Cuff Lesion
|
During a PT examination, the Patient's age is between 30 - 50 yrs old, and there is pain and weakness with eccentric load. On observation, there is normal bone and soft tissue outlines, and there is a protective shoulder hike. AROM reveals weakness of abduction or rotation or both. crepitus may be present. PROM may reveal pain if impingement occurs. Resisted Isometric movement reveals Pain and weakness on abduction and lateral rotation.|Sensory function and reflexes are not affected. there is tenderness to palpation over the shoulder area. Special tests: Drop arm test is (+) and Empty can test is (+). What kind of lesion is therapist suspecting?
|
|
Drop arm test and empty can test
|
During a PT examination, the Patient's age is between 30 - 50 yrs old, and there is pain and weakness with eccentric load. On observation, there is normal bone and soft tissue outlines, and there is a protective shoulder hike. AROM reveals weakness of abduction or rotation or both. crepitus may be present. PROM may reveal pain if impingement occurs. Resisted Isometric movement reveals Pain and weakness on abduction and lateral rotation.|Sensory function and reflexes are not affected, and there is tenderness over the rotator cuff. If the therapist suspects a rotator cuff lesion, what two special tests should be performed /be positive to confirm supraspinatus tear?
|
|
MRI
|
What diagnostic imaging technique will be utilized to in the diagnosis of a rotator cuff lesion?
|
|
upward displacement of humeral head, acromial spurring.
|
What would be observed on a plain film (x-ray) for a patient with rotator cuff lesion if there is impingement involved?
|
|
Adhesive capsulitis
|
During a PT examination, the patient's age is ≥ 45 yrs old, and presents with insidious onset or after trauma or surgery symptoms. Functional restriction of lateral rotation abduction and medial rotation (capsular pattern). On observation, there is normal bone and soft tissue outlines. AROM is restricted, there is shoulder hiking. PROM is limited in a capsular pattern (LR > ABD> IR). Resisted Isometric movement is normal when arm by side. no special tests were necessary, sensory function and reflexes were not affected. Palpation was not painful unless the capsule was stretched. Based on the above information, what kind of lesion may be suspected?
|
|
Arthrography
|
If plain films are negative, what imaging technique will be utilized that may show decreased capsular size in patient with adhesive capsulitis (frozen shoulder)
|
|
Atraumatic instability
|
This type of condition is typically seen in patients whose age is betwen 10 - 35 yrs old. There is pain and instability with activity with no history of trauma. On observation, there is normal bone and soft tissue outlines. AROM and PROM will be either full or excessive. Resistive isometric movement will be normal. Special tests performed/ or that were (+) to confirm diagnosis were, Load and Shift test, Apprehension test, Relocation test, Augmentation test. Sensory function and reflexes were affected either anterior or posterior pain. Palpation was negative. Based on the above description what kind of a lesion may be suspected given the series of (+) special tests performed?
|
|
Cervical spondylosis
|
This type of condition is typically since in patient whose age is 50 yrs old or more, and may be either acute or chronic. On observation, there is minimal or no cervical spine movement. Torticollis may be present. AROM is limited with pain, and PROM is limited (symptoms may be exacerbated). Resisted isometric movement is normal, except if there is nerve root compression. Myotome may be affected. Special tests perfromed that were positive to confirm diagnosis were, Spurling's test, Distraction test, ULTTs and shoulder abduction test. Sensory function and reflexes: dermatomes affected and reflexes are affected. There is tenderness on palpation over appropriate vertebra or facet, and radiography revals narrowing osteophytes. Based on the above description, what kind of lesion may be suspected given the series of (+) special tests performed?
|
|
narrowing osteophytes
|
What does radiography shows in patients diagnosed with cervical spondylosis?
|
|
Osteoporosis
|
What condition does the following description presents?|- It is a metabolic disease which depletes bone mineral density/mass, predisposing individual to fracture.|- Affects women 10x more than men. Common sites of fractures include: Thoracic and lumbar spine, femoral neck, proximal humerus, proximal tibia, pelvis, and distal radius
|
|
CT Scan
|
What diagnostic test (imaging technique) is usually utilized for diagnosing osteoporosis?
|
|
Osteomalacia
|
What condition does the following description presents?|Its name implies softening of bones. It is characterized by decalcification of bones as result of a vitamin D deficiency|Symptoms includes: Severe pain, fractures, weakness, and deformities.
|
|
Plain films, Lab tests, Bone scan and potentially bone biopsy
|
What diagnostic tests (imaging technique,etc..) is usually utilized for diagnosing osteomalacia?
|
|
Osteomyelitis
|
What condition does the following description presents?|- An inflammatory response within bone caused by an infection. Usually caused by Staphylococcus aureus, but could be another organism.|- More common in children and immunosuppressed adults than healthy adults and more common in males than females
|
|
Lab tests for infection and possibly bone biopsy
|
What diagnostic tests is usually utilized for diagnosing osteomyelitis?
|
|
Arthrogryposis multiplex congenita
|
What condition does the following description presents?|- It is a congenital deformity of skeleton and soft tissues which is characterized by limitation in joint motion and a "sausage-like" appearance of limbs|- Intelligence develops normally|- Ongoping communication with family and school is important in therapeutic management
|
|
Plain films
|
What diagnostic technique (imaging technique) is usually utilized for diagnosing arthrogryposis multiplex congenita?
|
|
Osteogenesis imperfecta
|
What condition does the following description presents?|- It is an inherited disorder transmitted by an autosomal dominant gene. It is characterized by abnormal collagen synthesis which leads to an imbalance between bone deposition and reabsorption.|- Cortical and cancellous bones become very thin leading to fractures and deformity of weight bearing bones.
|
|
Bone scan, plain films, serological testing
|
What diagnostic technique is usually utilized for the diagnosis of osteogenesis imperfecta that would also demonstrate old fractures and deformities?
|
|
Osteochondritis dissecans
|
What condition does the following description presents?|It is a separation of articular cartilage from underlying bone (osteochondral fracture) usually involving medial femoral condyle near intercondylar nothch and observed less frequently at femoral head and talar dome
|
|
Plain films or CT scan
|
What diagnositic test is usually utilized to diagnose osteochondritis dissecans?
|
|
Myofascial pain syndrome
|
What condition does the following description presents?|- Characterized by clinical entity known as a "trigger point" which is focal point of irritability found within a muscle. Trigger point can be identified as a taut palpable band within the muscle. Trigger points may be active that is tender to palpation and have a characteristic referral pattern of pain when provoked or latent which are palpable taut bands that are not tender to palpation but can be converted into active trigger point. It is hypothesized to sudden overload, overstretching and/or repetitive/sustained muscle activities.
|
|
Tendonitis
|
What condition does the following description presents?|- An inflammation of tendon as result of microtrauma from overuse, direct blows, and/or excessive tensile forces
|
|
MRI
|
What diagnostic test is usually utilized for the diagnosis of tendonitis?
|
|
Tendonosis
|
What condition does the following description presents?|- Common chronic tendon dysfunction whose cause and pathogeneisis are poorly understood. Often referred to as chronic tendonitis; However there is NO inflammatory response noted.|- Common in many tendons throughout body (supraspinatus, common extensor tendond of elbow, patella, Achilles')
|
|
MRI
|
What diagnositic test is usually utilized for the diagnosis of tendonosis?
|
|
Bursitis
|
What condition does the following description presents?|- An inflammation of bursa secondary to oversue, trauma, gout or infection. Sign & Symptoms include: Pain with rest, PROM and AROM are limited due to pain but not in a capsular pattern
|
|
Muscle strains
|
What condition does the following description presents?|- Characterized by an inflammatory response within a muscle following a traumatic event that cuased micro-tearing of the musculotendinous fibers.|- Pain and tenderness within tht muscle, seen within muscles throughout the body
|
|
MRI
|
Which diagnostic test is usually utilized, if necessary, for the diagnosis of muscle strains?
|
|
Myositis ossificans
|
What condition does the following description presents?|- Painful condition of abnormal calcification within a muscle belly. Usually precipitated by direct trauma which results in hematoma and calcification of the muscle. It can also be induced by early mobilization and stretching with AGRESSIVE physical therapy following trauma to muscle.|- Most frequent locations are quadriceps, brachialis, biceps brachii muscles
|
|
Myositis ossificans
|
What condition can be induced by early mobilization and stretching with aggressive physical therapy following trauma to muscle?
|
|
Myositis ossificans
|
It is defined as a painful condition of abnormal calcification within muscle belly. It is recommended to the therapist to:|- AVOID being OVERLY AGRESSIVE with muscle flexibility exercises, which may worsen condition.|- AVOID AGRESSIVE soft tissue/massage techniques which may worse conditions|Which condition the above description represents?
|
|
Complex regional pain syndrome
|
What condition does the following description presents?|- Formerly referred as to reflex sympathetic dystrophy (RSD).|- Etiology largely unkown but thought to be related to trauma. Can affect the UEs, LEs, trunk, head and neck.|- Results in dysfunction of sympathetic nervous system to include pain, circulation and vasomotor disturbances
|
|
Complex regional pain syndrome I
|
There are two types of this condition. This type is frequently triggered by tissue injury; term describes all patients with these symptoms (pain, circulation, vasomotor disturbances), but no underlying nerve injury.
|
|
Complex regional pain symdrome II
|
There are two types of this condition. This type, the patient experience same symptoms (pain, circulation, vasomotor disturbances), but their cases are clearly associated with a nerve injury.
|
|
Muscle wasting, trophic skin changes, decreased bone density, loss of muscle strength from disuse and joint contractures.
|
Long term changes that occur in patients with complex regional pain symdrome include:
|
|
Paget's disease ( osteitis deformans)
|
What condition does the following description presents?|- Etilogy is largely unkown, but thought to be linked to a type of viral infection along with environmental factors. |- Considered to be a metabolic bone disease involving abnormal osteoclastic and osteoblastic activity.|- Results in spinal stenosis, facet arthropathy, and possible spinal fracture
|
|
Plain films = identifies bony changes, lab tests look for increased levels of serum alkaline phosphatase and urinary hydroxyproline
|
What diagnositic tests are usually utilized for the diagnosis of Paget's disease (osteitis deformans)?
|
|
Structural scoliosis
|
What condition does the following description presents?|- A irreversible lateral curvature of spine with a rotational component. Think of (S) shape from posterior view of patients spine.
|
|
Non-structural scoliosis
|
What condition does the following description presents?|- A reversible lateral curvature of spine without a rotational component, and straightening as individual flexes the spine. Think of (S) shape from posterior view of patients spine.
|
|
Conservative physical therapy
|
Intervention for structural scoliosis includes bracing and possible surgery with placement of Harrington rod instrumentation. if the curvature is < 25°, then the most likely Intervention will be:
|
|
Use spinal orthoses
|
Intervention for structural scoliosis includes bracing and possible surgery with placement of Harrington rod instrumentation. if the curvature is between 25° - 45°, then the most likely Intervention will be:
|
|
Surgery
|
Intervention for structural scoliosis includes bracing and possible surgery with placement of Harrington rod instrumentation. if the curvature is between > 45°, then the most likely Intervention will be:
|
|
Torticollis
|
What condition does the following description presents?|- Spasm and/or tightness of sternocleidomastoid (SCM) muscle with varied etiology.|- Dysfunction observed is side-bending towards and rotation away from the affected SCM
|
|
HLA-B27
|
Which Diagnostic test is helpful, in diagnosing anklyosing spondylitis
|
|
x-rays
|
It is used to demonstrate bony tissues. Beams pass through the tissues resulting in varying shades of gray on film depending on density of tissue it passed through. |- The more DENSE the structure (bone), the more WHITE the structure will appear on the film.|It does not demonstrate soft tissues well or at all
|
|
Computed tomography (CT scan)
|
It uses plain film x-ray slices that are enhanced by a computer to improve resolution. It is multiplanar so can image in any plane; therefore tissue can be viewed from multiple directions.|Typically used to assess complex fractures as well as facet dysfunction, disc disease, or stenosis of the spinal canal or intervertebral foramen. It demonstrate better quality and better visualization of bony structures than plain films. It is also able to demonstrate soft tissue structures, although not as well as MRI
|
|
Computed tomography (CT scan)
|
This imaging technique is typically used to assess COMPLEX FRACTURES as well as FACET DYSFUNCTION, DISC DISEASE or STENOSIS of the spinal canal or intervertebral foramen. It demonstrates better quality and better visualization of bony structures than plain films. It is also able to demonstrate soft tissue structures, although not as well as MRI
|
|
Discography
|
A radiopaque dye is injected into the disc to identify abnormalities within the disc (annulus or nucleus). The needle is inserted into the disc with the assistance fo radiography (fluoroscopy).|This is not commonly used. It requires a high level of skill and proper equipment to perform. Fairly specific technique to identify internal disc disruptions of the nucleus and/or annulus. Expensive, may be painful, since it is invasive, there is a risk of infection
|
|
MRI
|
Uses magnetic fields rather than radiation. It offers excellent visualization of tissue anatomy. Utilizes two types of images known as T1 and T2. |T1 demonstrates fat within the tissues, and is typically used to assess bony anatomy.|T2 suppresses fat and demonstrates tissues with higher water content, and is used to assess soft tissue structures|Fairly expensive, and patient with clastrophobia DO NOT tolerate this test well. There is an open imaging technique but quality is inferior to closed. May not be able to use with patients who have metallic implants
|
|
Whiter
|
In plain film radiograph (x-rays) the DENSER the structure (bone) is, the __________ the structure (bone) will appear on the film
|
|
Arthrography
|
Invasive technique injects water-soluble dye into area and is observed with a radiograph.|Dye is observed as it surrounds tissues, demonstrating the anatomy by where fluid moves within the joint|Typically used to identify abnormalities within joints such as tendon ruptures. Expensive procedure and carries risks since it is invasive.
|
|
Open MRI
|
Type of MRI that is used for patients with claustrophobia who DO NOT tolerate this test well because it is closed technique. The image is inferior when compared to closed.
|
|
Arthrography
|
It is an expensive invasive technique that is typically used to identify abnormalities within joints such as tendon ruptures.
|
|
Bone scans
|
aka osteoscintigraphy. Chemicals laced with radioactive tracers are injected, and isotopes settles in areas where there is a high metabolic activity of bone.|Radiograph is taken which demonstrates any "HOT SPOTS" of increased metabolic activity.|Patients with dysfunctions, such as rheumatoid arthritis, possible stress fractures, bone cancer, infection within bone are given this imaging technique because these dysfunctions are known to have an increase in metabolic activity of bone in affected region.
|
|
Bone scans
|
What imaging tecnique is given to patients with dysfunctions such as rheumatoid arthritis, possible stress fractures, bone cancer, and infection within bone? These dysfunctions are known to have an increase in metabolic activity of bone in affected region
|
|
Diagnostic ultrasound
|
This imaging technique utilizes transmission of high-frequency sound waves, similar to therapeutic ultrasound. |It is limited by contrast resolution, small viewing field, how deep it penetrates, and poor penetration of bone. |Interpretation of data is subjective, so results are dependent on skill of operator.|Provides real-time dynamic images and able to assess soft tissue dysfunction. no known harmful effects known
|
|
Myelography
|
It is an invasive technique using water soluble dye. Dye is visualized as it passess through vertebral canal to observe anatomy within the region.|It is seldom used because of many side effects vs. MRI or CT scan, which provide as good, if not better information. |VERY expensive since it is often involves a hospital stay overnight. |Traditionally had been used for diagnostic assessment of the discs and stenosis. May still be beneficial to identify stenosis.
|
|
MMSE
|
This is a brief screening test for cognitive dysfunction|It includes screening items for orientation, registration, attention and calculation, recall and language. The maximum score = 30 (min or no impairment)
|
|
30
|
What is the maximum score for the Mini-Mental Status Examination (MMSE)?
|
|
Mild cognitive impairment
|
If during a Mini-Mental Status Examination (MMSE) a patient scores between 21 - 24, what does this score indicates in terms of cognitive impairments?
|
|
Moderate cognitive impairment
|
If during a Mini-Mental Status Examination (MMSE) a patient scores between 16 - 20 , what does this score indicates in terms of cognitive impairments?
|
|
Severe cognitive impairment
|
If during a Mini-Mental Status Examination (MMSE) a patient scores ≤ 15, what does this score indicates in terms of cognitive impairments?
|
|
Olfactory
|
Name of Cranial Nerve I?
|
|
Olfactory
|
Which cranial nerve is being tested?|- Test sense of smell on each side (Close off other nostril)|Use common, non-irritating odors
|
|
Anosmia
|
Defined inability to detect smells. This is seen with frontal lobe lesions
|
|
Anosmia
|
Name a possible abnormal finding with CN I (olfactory) dysfunction?
|
|
olfactory
|
If a patient is diagnosed with anosmia (inability to detect smells) which cranial nerve is likely to be involved?
|
|
Optic
|
Name of cranial nerve II?
|
|
Optic
|
Which cranial nerve is being tested?|- Test visual acuity|Central: Snellen eye chart; Test each eye separately (covering one eye), test at distance of 20 ft.
|
|
Optic
|
Which cranial nerve is being tested?|Test peripheral vision (visual fields by confrontation.
|
|
Blindness, myopida, presbyopia
|
Name possible abnormal findings with cranial nerve II (optic)?
|
|
Homonymous hemianopsia
|
Possible abnormal finds with field defects with CN II (optic) when testing peripheral vision?
|
|
Myopia
|
Defined as: impaired far vision
|
|
Presbyopia
|
Defined as: impaired near vision
|
|
optic, occulomotor
|
Which cranial nerves its function is pupillary refexes?
|
|
optic, occulomotor
|
Which cranial nerves are being tested?|- Test pupillary reactions (constriction) by shining a light in the eye; if abnormal, test near reaction|- Examine pupillary size/shape
|
|
Absence of pupillary constriction
|
when testing for pupillary reactions (cranial nerves (optic II, occulomotor III) a possible abnormal finding will be?
|
|
optic, occulomotor
|
In the absence of pupillary constriction when testing cranial nerve (s), which cranial nerve(s) is/are likely to be involved?
|
|
optic
|
If a patient is diagnosed with homonymous hemianopsia, which cranial nerve is likely to be involved?
|
|
optic
|
If a patient is diagnosed with either blindness, myopia (impaired far vision), presbyopia (impaired near vision) which cranial nerve is likely to be involved?
|
|
Anisocoria
|
What is the term for unequal pupils?
|
|
Anisocoria,Horner's syndrome, Occulomotor paralysis
|
Name three possible abnormal findings with CN II (optic), and CN III (occulomotor)?
|
|
Occulomotor, Trochlear, abducens
|
What cranial nerves are being tested?|- Test saccadic ( patient is asked to look in each direction)|- Persuit eye movements (patient follows moving finger)
|
|
Strabismus, impaired eye movements, double vision
|
What are some of possible abnormal findings when testing CN III, IV, VI?
|
|
Turns eye up, down, in, and elevates the eyelid
|
What is/are the function(s) of the CN III (occulomotor)?
|
|
Occulomotor
|
Possible abnormal fingings may be, ptosis, pupillary dilation Which cranial nerve is involved?
|
|
Occulomotor
|
Name of cranial nerve III?
|
|
Trochlear
|
Name of cranial nerve IV?
|
|
Abducens
|
Name of cranial nerve VI?
|
|
Turns eye down, and laterally
|
What is/are the function(s) of the CN IV(trochlear)?
|
|
Eye cannot look down when eye is adducted
|
Possible abnormal findings with CN IV (trochlear)?
|
|
Turns eye laterally
|
What is the function of cranial nerve VI (Abducens)?
|
|
Eye cannot look out, esotropia
|
Possible abnormal finding with cranial nerve VI (abducens)?
|
|
Esotropia
|
Conditions defined as "eye pulled inward"
|
|
Trigeminal
|
Name of cranial nerve V?
|
|
Sensory face, sensory cornea, motor muscles of mastication
|
What is the function of cranial nerve V (trigeminal)?
|
|
Trigeminal
|
What cranial nerve is being tested?|- test pain, light touch sensations: Forehead, cheeks, jaws (eyes closed)|- Testing cornea reflex: touch lightly with wisp of cotton
|
|
Loss of facial sensation, numbness, trigeminal neuralgia, loss of cornea reflex ipsilaterally
|
Possible abnormal (sensory) findings with CN V involvement?
|
|
weakness of muscles, when open, jaw deviates to ipsilateral side
|
Possible abnormal (Motor) findings with CN V involvement?
|
|
Trigeminal
|
What cranial nerve is being tested?|- Palpate temporal and masseter muscles|- observe spontaneous movments|- Ask patient to clench teeth, hold against resistance (push down chin to separate jaw)
|
|
Facial
|
Name of cranial nerve VII?
|
|
Facial expressions, taste to anterior tongue
|
What is the function of cranial nerve VII?
|
|
Facial
|
What cranial nerve is being tested?|- Test motor function: Raise eyebrows, frown, smile, show your teeth, close eye tightly, puff out both cheeks
|
|
Facial
|
What cranial nerve is being tested?|- Apply a saline solution and sugar solutiong using a cotton swab to tongue
|
|
Incorrectly identifies solution (saline,sugar)
|
Possible sensory abnormal findings with CV VII (facial)?
|
|
Inability to close eye, drooping corner of mouth, difficulty with speech articulation, Bell's palsy, guillain-barre, stroke
|
Possible motor abnormal findings with CN VII (facial)?
|
|
Vestibulocochlear
|
Name of cranial nerve VIII?
|
|
Vestibular function, cochlear function
|
What is/are the function of cranial nerve VIII (vestibulocochlear)?
|
|
Vestibulocochlear
|
What cranial nerve is being tested?|- Test balance: vestibulospinal function (VSR)|- Test eye - head coordination: Vestibular ocular reflex (VOR)
|
|
Vestibulocochlear
|
What cranial nerve is being tested?|Test auditory acuity|Test for lateralization (weber test): Place a vibrating tuning fork on top of head, mind position; check if sound heard in one ear or equally in both|Compare air and bone conduction (Rinne test): Place vibrating tuning fork on mastoid bone, then close to ear canal; sound heard longer through air than bone
|
|
Vestibulocochlear
|
What cranial nerve is affected if possible abnormal finding include:|- Vertigo, dysequilibrium|- Gaze instability with head rotations, nystagmus (constant, involuntary cyclical movements of the eyeball)|- Deafness, impaired hearing, tinnitus (ringing in the ear)|- Unilateral conductive loss: Sound lateralized to impaired ear|- Sensorineural loss: Sound heard in good ear|- Conductive loss: sound heard through bone = or > than air|- Sensorineural loss: sound heard longer through air
|
|
Glossopharyngeal
|
Name of cranial nerve IX?
|
|
Glossopharyngeal
|
Which cranial nerve is involved in sensory to posterior 1/3 of the tongue, pharynx, middle ear, taste to posterior tongue?
|
|
Glossopharyngeal
|
Which cranial nerve is being tested?|- Apply saline solutiong and sugar solution, though not typically tested. (abnormal finding: incorrectly identifies solution)
|
|
Glossopharyngeal, vagus
|
Which cranial nerve(s) is/are involved in the function of:|- Phonation, swallowing|- Palatal, pharynx control|- Gag reflex
|
|
Glossopharyngeal, vagus
|
Which cranial nerve(s) is/are being tested?|- Listen to voice quality|- Examine for difficulty in swallowing a glass of water|- Stimulate back of throat lightly on each side (Gag reflex)
|
|
Vagus
|
Name of cranial nerve X?
|
|
Vagus
|
Which cranial nerve is being tested?|- Have patient say "ahhh, ahhh"; Observe motion of soft palate (elevates), and position of uvula (remains midline)
|
|
Dysphonia
|
Defined as hoarseness denotes vocal coard weakness. Nasal quality denotes palatal weakness
|
|
Dysphagia
|
Defined as difficulty swallowing
|
|
Vagus
|
If during testing, the patient is found to have palatal paralysis (the palate fails to elevate); which cranial nerve is likely to be involved?
|
|
Glossopharyngeal, vagus
|
If during testing, the patient shows poor palatal, pharynx control (asymmetrical elevation with unilateral paralysis) which cranial nerve(s) is/are likely to be involved?
|
|
Glossopharyngeal, vagus
|
During testing, it is shown that the Gag reflex is absent, which cranial nerve(s) is/are likely to be involved?
|
|
Spinal accessory
|
Name of cranial nerve XI?
|
|
Spinal accessory
|
Which cranial nerve innervates the trapezius and sternocleidomastoid muscles?
|
|
Spinal accessory
|
Which cranial nerve is being tested?|- Examine bulk, strength, Ask patient to:|- shrug both shoulders upward against resistance|- Turn head to each side against resistance
|
|
Spinal accessory
|
If a patient shows:|- LMN: atrophy, fasciculations, ipsilateral weakness, inability to shrug ipsilateral shoulder; shoulder droops|- Inability to turn head to opposite side|- UMN: weakness of ipsilateral sternocleidomastoid and contralateral trapezius
|
|
Hypoglossal
|
Name of cranial nerve XII?
|
|
Hypoglossal
|
Which cranial nerve is reponsible for tongue movements?
|
|
Hypoglossal
|
What cranial nerve is being tested?|- Listen to patient's articulation|- Examine resting position of tongue|- Examine tongue movements: ask the patient to protrude tongue, move it side to side
|
|
weak side
|
Possible abnormal findings with hypoglossal (CN XII) are impaired tongue movements and deviation of the tongue to which side?
|
|
away from side of cortical lesion
|
Possible abnormal findings with hypoglossal (CN XII) in UMN lesion that the tongue deviates_________________?
|
|
Sesorineural loss
|
When testing the vestibulocochlear nerve (cranial nerve VIII) if sound is heard in the good ear, this is called?
|
|
Conductive loss
|
When testing the vestibulocochlear nerve (cranial nerve VIII) if sound heard through bone = to or longer than air. this is called?
|