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PT Screening > MIDTERM - Physical Tests > Flashcards

MIDTERM - Physical Tests Flashcards

1
Q

List of UMN and LMN tests

A
  • UMN (Pronator Drift, Hoffmans, Clonus, Babinski, Tone Assessment)
  • LMN (DTRs)
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2
Q

Pronator Drift

A

Instructions: Patient stands with both arms flexed at 90 and forearms supinated, eyes closed
Duration: 20-30 seconds
Positive: One arm starts to drift downward - indicates UMN disorder

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3
Q

Examples of anticipatory, reactive and dynamic balance

A

Anticipatory
- Functional reach test
- Catching

Reactive
- Nudge/push test

Dynamic balance tests
- Berg Balance Scale
- Tinetti Balance Gait

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4
Q

What is the primary nerve root and contributing roots for DTR?

A
  • Biceps Brachialis: C5 (C6)
  • Brachioradialis: C6 (C5)
  • Triceps: C7 (C6)
  • Quads: L4 (L2, L3)
  • Achilles: S1 (S2)
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5
Q

How do you perform a tone assessment? - UE

A
  • Place patient in a supine position
  • Support upper arm with one hand and move the forearm
  • Slowly move patient through elbow ROM and increase speed with each cycle
  • **Spasticity will more often be felt moving out of flexion into extension
  • If resistance is greater as speed increases, spasticity is present**
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6
Q

Tone Assessment - LE

A
  • Place patient in a supine position
  • Grasp plantar aspect of patient’s foot and the hand just distal to popliteal fossa
  • Slowly move patient through knee and hip from extended to flexed
  • Perform ROM several times and increase speed with each cycle
  • **Spasticity will more often be felt moving out of extension into flexion
  • If resistance is greater as speed increases, spasticity is present**
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7
Q

Clonus

A
  • Instructions: Patient in supine position. Knee flexed and limb supported. Gently move the patient’s ankle from PF/DF several times and then rapidly DF the ankle and hold
  • Positive: Feel and observe oscillation equal or great than 3
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8
Q

Babinski

A
  • Instructions: Patient lies supine with skin below ankle exposed. Scrape bottom of foot from lateral calcaneous towards toes and then medially across metatarsals
  • Normal: No response or first toe flexion
  • Abnormal: 1st toe extension and splaying
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9
Q

Hoffman’s

A
  • Grasp distal phalanx of the middle finger between thumb and index finger. Apply pressure to distal fingernail to induce flexion and then quickly slip your thumb off the patient’s finger
  • Normal: No response
  • Abnormal: Thumb flexes, adducts and other fingers flex.
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10
Q

How would you distract someone during DTR?

A

UE: Fingers grasp one another with eyes closed and pull
LE: Cross ankles and with eyes closed try to pull apart

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11
Q

When do you ask AOx4? What does it stand for?

A
  • People with Balance, Coordination, Cognition
  • Name, Age, Date/Time, Event
  • IF only AOx2: Name and Date? (You can choose)
  • Alert and Oriented
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12
Q

What is important to do when having the patient change positions?

A

Inquire if they are feeling dizzy after sitting/standing
Worried about orthostatic hypotension

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13
Q

What should you aquire before coordination testing?

A

ROM Screen
Strength Screen

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14
Q

What are some UE Coordination Tests?

A
  • Rapid alternating Movements
  • Finger Opposition
  • Finger to Nose (Chin)
  • Finger to Clincian Finger
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15
Q

What are some LE Coordination Tests?

A
  • Toe Tapping
  • Heel to shin
  • Romberg (Feet together)
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16
Q

Rapid Alternating Movement (RAM)

A

Patient position: Arms ar sides, elbows flexed to 90 degrees
Test: patient moves both forearms repeated from supination to pronation
Duration: 10-15 seconds
Test Progression: Increase speed of movement
Abnormal test: Difficulty producing RAM (slow, irregular, clumsy

17
Q

Inability to produce ram is a condition called…

A

dysdiadochokinesia

18
Q

Finger Opposition

A

Patient Position: Arm at sides, elbows flexed to 90 degrees
Test: Thumb touches to the tip of each: ipsilateral finger in sequence
Duration: Several

19
Q

Finger to Nose (chin)

A

Patient Position: Arms abducted to 90 degrees
Test: Eyes open, patient brings tip of index finger to nose (chin)
Duration: Several sequences
Test progression: Finger to clinicial finger
Abnormal: Slow, irregular, clumsy

20
Q

Finger to Clinician Finger

A

Patient Position: Arms abducted to 90 degrees
Test: Sit in front of patient, ask patient to touch nose and then touch the tip of your finger
Duration: Several sequences
Test progression: move the target to several locations, increase speed of testing
Abnormal: Slow, Irregular, clumcy movement ot intention tremor

  • Dysmetria or Past pointing
21
Q

Dysmetria or Past pointing

A

Patient will overshoot your finger which may indicate cerebellar dysfunction

22
Q

Toe Tapping

A

Patient position: Sitting with feet on floor
Test: Tap the bal of the foot on the floor repeatedly, do not raise the heel
Duration: Several sequences
Progression: Both feet at same time
Abnormal: Slow, irregular, clumsy movement

  • If lacking DR ROM, can be performed in supine and patient taps clinicans hand
23
Q

Heel to Shin

A

Patient Position: Supine
Test: Ask patient to place heel of one foot on the opposite knee and then run heel down the shin and back to knee
Duration: Several Sequences
Progression: Weight bearing tests
Abnormal: Slow, irregular, clumsy movement

24
Q

Romberg (Feet Together)

A

Patient Position: Standing on the floor with feet touching and together
Test: Stand unsupported
Duration: 30 Seconds
Progression: Tandem Romberg (feet heel to toe), Eyes Closed, Balance Testing
Abnormal: Unable to maintain balance

ALWAYS NEED A GAIT BELT

25
Q

Potential UMN Findings

A
  • Dysdiadochokinesia
  • Hyperreflexia
  • Hyper/hypotonia
  • +Clonus/Babinski
  • Dysmetria
  • Weakness
  • Sensory & Balance Deficits
  • CN Involvement
26
Q

Potential LMN Findings

A
  • Hyporeflexia
  • Hypotonia
  • Weakness
  • Somatosensory Deficits
  • Pain, tingling and numbness along nerve
  • Negative UMN

PT Screening (21 decks)

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