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Fall 2023 > Assessment Exam 3 > Flashcards

Assessment Exam 3 Flashcards

1
Q

bending limb at joint

A

Flexion

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2
Q

straightening limb at joint

A

Extension:

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3
Q

moving limb away from midline of body

A

Abduction:

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4
Q

moving limb toward midline of body

A

Adduction:

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5
Q

turning forearm so that palm is down

A

Pronation:

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6
Q

turning forearm so that palm is up

A

Supination:

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7
Q

moving arm in circle around shoulder

A

Circumduction:

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8
Q

moving sole of foot inward at ankle

A

Inversion:

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9
Q

moving sole of foot outward at ankle

A

Eversion:

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10
Q

moving head around central axis

A

Rotation:

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11
Q

moving body part forward, parallel to ground

A

Protraction:

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12
Q

moving body part backward, parallel to ground

A

Retraction:

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13
Q

Nonsynovial Joints:

A

bones united by fibrous tissue or cartilage are: Immovable, sutures in skull

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14
Q

Synovial joints

A

Move freely because bones are separated and enclosed in joint cavity.

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15
Q

Temporomandibular joint (TMJ) what is it and what does it do?

A

Articulation of mandible and temporal bone

TMJ permits jaw function of speaking and chewing

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16
Q

Temporomandibular joint (TMJ) motions

A
  1. Hinge action to open and close jaws
  2. Gliding action for protrusion and retraction
  3. Gliding for side-to-side movement of lower jaw
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17
Q

OS

A

Left eye

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18
Q

OD

A

right eye

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19
Q

OU

A

both eyes

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20
Q

conjunctiva

A

epithelial layer on top of sclera: lubrication of the eye (mucus and tears)

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21
Q

connective tissue that surrounds the eye: maintains shape and protects

A

Sclera:

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22
Q

Myopia

A

nearsightedness

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23
Q

Halos effect cause

A

glaucoma (eye disease)

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24
Q

Floaters cause

A

myopia, retinal detachment

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25
Q

Clouding of eyes cause

A

cataracts

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26
Q

Snellen chart

A

eye exam

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27
Q

Ishihara

A

test for color blindness

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28
Q

Tumbling E and Picture charts

A

for younger children about ages 3 to 6.

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29
Q

Allen Chart

A

15 ft away 3 out of 7 pictures is normal

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30
Q

Cover test

A

tests for Strabismus

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31
Q

The six cardinal positions of gaze:

A

Tests for weak eye muscles, also look out for nystagmus

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32
Q

Fundoscopic exam what to look for

A

red reflex no black spots

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33
Q

Exotropia

A

eye misalignment where one moves outward

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34
Q

Esotropia

A

cross eyed

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35
Q

The normal color of the conjunctiva and sclera

A

Pink and white

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36
Q

eversion of the upper lid,

A

it can be useful if you have to inspect the conjunctiva of the upper lid.

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37
Q

Palpebral fissures

A

it refers to the opening between the eye lids. In adults, this measures about 10mm vertically and 30mm horizontally

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38
Q

PERRLA:

A

pupils, equal, round, reactive, accommodation

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39
Q

accommodation:

A

do pupils constrict and converge when you bring something close to their face

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40
Q

Ectropion

A

where the lower lid drops away (elderly)

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41
Q

Entropion

A

where the lower lid is turning in. (elderly)

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42
Q

Eyes @ Birth–2 wks:

A

blinks to bright light

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43
Q

Eyes @ 2-4 wks:

A

fixates on object.

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44
Q

Eyes @ 1m

A

tracks light or bright object

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45
Q

Eyes @ 3-4m:

A

fixates, tracks, reaches for object

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46
Q

Eyes @ 6-10m:

A

can track in all directions

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47
Q

Eyes for elderly

A
  • Ectropion
  • entropion
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48
Q

Strabismus

A

is when the eyes are not working as one unit, one eye is on the object and one is either pointed outward, inward, upward, or downward.

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49
Q

Diplopia

A

is double vision.

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50
Q

xerophthalmia

A

dry eyes PRONOUNCED zere – opthal - mia

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51
Q

Presbyopia

A

@ 40y: Loss of accommodation for near vision

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52
Q

Amblyopia:

A

lazy eye

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53
Q

Exophthalmos:

A

bulging/protruding eyes

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54
Q

Ptosis

A

upper eyelid drooping over the eye

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55
Q

Anisocoria:

A

when the pupils are not the same size.

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56
Q

Retinoblastoma:

A

If the red reflex is absent, it could indicate. eye cancer that begins in the retina.

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57
Q

Pingueculae:

A

yellowish elevated nodules on the sclera due to thickening of the conjuctiva from prolonged exposure to sun, wind, and dust.

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58
Q

Pterygium:

A

a fleshy mass of thickened conjunctiva that grows over part of the cornea and causes a disturbance of vision, The exact cause is unknown. It is more common in people who have a lot of exposure to sunlight.

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59
Q

Arcus Senilis:

A

cloudy cornea, sometimes in a ring around the eye, caused by the deposition of lipid material. It has no effect on vision.

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60
Q

Xanthelasma:

A

yellowish plaques that are slightly raised on the skin surface of eyelids. caused by tiny deposits of fat in the skin and is often associated with abnormal blood fat levels (hyperlipidemia)

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61
Q

Drusen:

A

yellow or white accumulations of extracellular material that build up on the retina of the eye, normal with age. No effect on vision

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62
Q

Periorbital edema:

A

swelling around the eyes. Think of crying

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63
Q

Blepharitis:

A

is inflammation of the eyelids.

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64
Q

Chalazion:

A

beady nodule protruding on the lid, it is an infection or cyst. It is a non-tender, firm swelling, and if it becomes inflamed, it points inside and not out like a hordeolum or stye.

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65
Q

stye/hordeolum:

A

localized staph infection of the hair follicles at the lid margin. It is painful, red, and swollen. It can spread if rubbed, so we encourage patients who have this not to rub them.

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66
Q

Dacryocystitis:

A

infection and blockage of the lacrimal sac and duct. It will hurt, be warm to the touch, red, and swollen toward the nose. Tearing is present, and pressure on the sac yields purulent discharge from the puncta.

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67
Q

Conjunctivitis

A

is an infection of the conjunctiva, also called pink eye

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68
Q

Subconjunctival hemorrhage

A

is a red patch on the sclera, looks alarming, but is usually not serious. It occurs from increased intraocular pressure.

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69
Q

syndactyly:

A

fused fingers

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70
Q

polydactyly

A

extra fingers

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71
Q

Joint disease:

A

major sign is limited ROM.

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72
Q

Joint disease major sign

A

major sign is limited ROM.

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73
Q

Crepitation:

A

Crackling or grating sound caused by bones rubbing against each other, also called creaky joints

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74
Q

Rheumatoid arthritis:

A

boutonniere deformity of thumb, swan neck fingers

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75
Q

Genu Varum what is it

A

(bowlegged)

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76
Q

Genu Varum when does it start

A

1y after start walking.

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77
Q

Genu Valgum when does it start

A

1 to @ 3 yr.

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78
Q

Genu Valgum what is it

A

(knock knees)

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79
Q

Kyphosis:

A

curve in upper spine (mostly elderly)

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80
Q

Lordosis:

A

Inward curve of lower spine (popping out booty) some arch is normal

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81
Q

Scoliosis:

A

sideways curve of spine

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82
Q

Up and go test:

A

time patient ambulating 3 meters.

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83
Q

Goniometer:

A

measures angles. Helps determine ROM.

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84
Q

Bulge test:

A

massage test for the knee. Checks for suprapatellar pouch, bulge sign confirms presence of fluid as you try to move fluid from one side of joint to other.

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85
Q

Ballottement of patella:

A

like the bulge test but if there’s a larger amount of fluid present use left hand to compress suprapatellar pouch.

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86
Q

McMurray’s Test:

A

(knee) Special test for meniscal tears

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87
Q

How to assess MSK in order

A

inspection, palpation, ROM, muscle testing; proximal to distal, head to toe

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88
Q

MSk changes during pregnancy

A

increased mobility in joints
Changes in maternal posture
lordosis (spine curve)
increased mobility in the pelvic girdle
Forward neck flexion
CTS Carpal tunnel

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89
Q

3 months MSk changes

A

has formed skeleton of cartilage.

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90
Q

Epiphysis what is it and when does it change

A

(growth plates) closes @ 20 yrs.

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91
Q

Osteoporosis

A

bone disease that causes less bone mass
mostly elderly

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92
Q

Diaphoresis:

A

sweating, wet

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93
Q

Wood’s light

A

ultraviolet light filtered through special glass

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94
Q

ABCDE of lesions:

A

A - asymmetry
B - border
C - color
D - diameter
E - elevation or Evolution

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95
Q

A nodule

A

is solid and elevated. larger than 1 cm that may extend deeper into the dermis than a papule, and an example is xanthoma – remember – we talked about this when we talked about eyes, and there is a picture there for you.

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96
Q

A tumor

A

is larger than a few centimeters, examples are lipoma or hemangioma

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97
Q

A wheal (lesion)

A

is a superficial, raised, transient, slightly irregular in shape – and an example is an allergic reaction.

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98
Q

Annular

A

– circular – like ring worm (I have a picture in the next slide)

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99
Q

Discrete (lesions)

A

distinct individual lesions that remain separate –skin tags are discrete, and sometimes acne is as well

100
Q

Grouped

A

clusters of lesions (contact dermatitis)

101
Q

Confluent (lesion)

A

lesions that run together (urticaria – or hives)

102
Q

Gyrate (lesion)

A

snake-like formation

103
Q

Target or iris

A

is like a bullseye

104
Q

Linear

A

form a streak, line or stripe

105
Q

Polycyclic lesion

A

annular lesions that grow together.

106
Q

Zosteriform

A

lesions take a linear arrangement along a nerve route (herpes zoster)

107
Q

Psoriasis:

A

scaly/red patch with silvery scales on top. Usually on the scalp, outside of elbows and knees, low back, and anogenital area.

108
Q

seborrheic dermatitis/cradle cap:

A

presents as flaky, dry skin that looks like dandruff, or thick, oily, yellowish or brown scaling or crusting patches, it is harmless and the cause is unknown.

109
Q

Hemangioma

A

are caused by a benign proliferation of blood vessels in the dermis. present at birth or develops in the first few months, and usually disappears by age 5 to 7. pressure from parents and peers may prompt treatment.

110
Q

Squamous Cell Carcinoma SCC:

A

red scaly patch with sharp margins, 1 cm or more. Develops central ulcer and surrounding erythema. Usually on hands or head, areas exposed to sun. Less common than BCC but grows rapidly.

111
Q

Basal Cell Carcinoma BCC:

A

usually starts as a skin-colored papule with translucent top. Then develops rounded pearly borders with central red ulcer or looks like large open pore with central yellowing. Most common form of skin cancer; slow growth.

112
Q

pediculosis capitis: .

A

Head lice– symptoms like itching of the scalp. The nits or eggs are easier to see, appearing as 2-3 mm oval translucent bodies, adherent to the hair shafts

113
Q

clubbing causes

A

fragmented platelets that get trapped in the finger tip vasculature, releasing platelet-derived growth factor and promoting growth of vessels which shows as clubbing.

114
Q

clubbing

A

Normal angle between the nail and the base is 160 degrees and a curved nail may have an angle that is less, but when it is straight it is considered clubbing.

115
Q

clubbing diseases associated

A

from COPD, congenital heart disease, cystic fibrosis.

116
Q

Beau’s lines:

A

transverse groove from trauma, acute illness, or toxic reaction. The dent appears first at the cuticle and moves forward as the nail grows.

117
Q

Leukonychia:

A

white spotting seen in nails, streaking, or discoloration of the fingernails, (congenital/hereditary) or due to a result from arsenic poisoning, injury, heart disease, renal failure, pneumonia, ill health, or hypoalbuminemia.

118
Q

Thyroid gland location and action

A

endocrine gland straddles trachea in middle of the neck
Synthesizes/secretes thyroxine (T4) and triiodothyronine (T3), which are hormones that stimulate
rate of cellular metabolism.

119
Q

isthmus

A

separates two lobes of the thyroid

120
Q

How to palpate lymph nodes

A

Using a gentle circular motion of fingerpads, palpate lymph nodes
Beginning with preauricular lymph nodes in front of ear, palpate the 10 lymph nodes in routine order
Many nodes are closely packed, so you must be systematic and thorough in your examination
Do not vary sequence or you may miss some small nodes

121
Q

Preauricular (lymph)

A

1– front of the ear

122
Q

Posterior auricular(lymph)

A

2– superficial to the mastoid

123
Q

Occipital(lymph)

A

3- at base of skull

124
Q

Submental

A

4- midline behind tip of mandible

125
Q

Submandibular

A

5– , halfway between angle and tip of mandible

126
Q

Jugulodigastric

A

6– , under angle of mandible

127
Q

Superficial cervical,
(lymph)

A

7– overlying sternomastoid muscle

128
Q

Deep cervical,

A

8– deep under sternomastoid muscle

129
Q

Posterior cervical,

A

9– in posterior triangle along edge of trapezius muscle

130
Q

Supraclavicular,

A

10– just above and behind clavicle, at sternomastoid muscle

131
Q

Chloasma:

A

a blotchy, hyperpigmented area over cheeks and forehead that fades after delivery (2nd trimester)

132
Q

lymphatics during pregnancy

A

chloasma and thyroid enlarges

133
Q

face/head of elderly

A

Facial bones and orbits appear more prominent, facial skin sags resulting from decreased elasticity, decreased subcutaneous fat, and decreased moisture in skin
Temporal arteries may look twisted and prominent
Lower face may look smaller if teeth have been lost
Senile tremors of head

134
Q

Normocephalic

A

term used for a round, symeteric skull that is appropriately related to body size – but there is a wide range of sizes that can be considered normal.

135
Q

Temporal arteritis

A

literally means “inflammation of the temporal arteries.“ Symptoms can range from relatively minor–jaw pain or headache–through major– including temporary or permanent blindness.

136
Q

Cranial Nerve 11

A

Spinal accessory nerve

137
Q

how to test CN 11

A

spinal accessory nerve: examining the sternomastoid and trapezius muscles for equal size and strength – ask the person to rotate the head forcibly against resistance applied to the side of the chin or face, then ask the person to shrug their shoulders against resistance. The movements should feel equally strong on both sides.

138
Q

Trachea: how should it look

A

Normally, trachea is midline; palpate for any tracheal shift
Space should be symmetric on both sides
Note any deviation from midline

139
Q

goiter

A

enlargement of thyroid

140
Q

how to assess for goiter

A

have the patient bend head slightly forward and to right: left hand displaces trachea; right hand palpates thyroid. Ask to swallow.

141
Q

bruits:

A

occur with turbulent blood flow; indicating hyperplasia of thyroid => hyperthyroidism.

142
Q

how to palpate thyroid

A

thyroid you can either stand behind the patient and have them turn their head slightly one way and then the other, or you can stand in front of them and do that. You can do both in lab and decide which you like better

143
Q

measuring infants skull

A

Measure infant’s head at each visit up to age 2 years; and yearly up to age 6 years

144
Q

AF where and when does it grow

A

by 9m-2yr
fontanelle plate in skull

145
Q

PF

A

plate in back of the skull
2 months

146
Q

Caput succedaneum:

A

edematous swelling and ecchymosis of presenting part of head caused by birth trauma; gradually resolves during first few days of life and needs no treatment

147
Q

Cephalhematoma:

A

subperiosteal hemorrhage, a result of birth trauma appears several hours after birth and gradually increases in size; will be reabsorbed during first few weeks of life without treatment

148
Q

Hydrocephalus

A

Obstruction of drainage of cerebrospinal fluid results in excessive accumulation, increasing intracranial pressure, and enlargement of the head
dilated scalp veins, frontal bossing, and downcast or “setting sun” eyes
usually infants

149
Q

Congenital hypothyroidism

A

is a thyroid deficiency at an early age which produces impaired growth and neurologic deficit. There are facial signs like low hairline, swollen eyelids, narrow palpebral fissures, widely spaced eyes, depressed nasal bridge, and more.

150
Q

Down syndrome

A

has head and face characteristics line upslanting eyes, flat nasal bridge, small, broad, flat nose, protruding thick tongue, and more.

151
Q

Allergic salute and crease

A

is a transverse line on the nose that occurs from a child chronically using their hand to push up the nose to relieve itching and to free swollen turbinates which allows air passage.

152
Q

Fetal alcohol syndrome

A

happens when a pregnant woman abuses alcohol and the facial malformations in this condition includes narrow palpebral fissures, a flat midface, a short nose, thin upper lip and more as shown in the picture.

153
Q

acromegaly

A

enlarged features

154
Q

tension

A

band-like, dull aching, non-throbbing, non-pulsating
stress, anxiety, depression, posture

155
Q

migraine

A

throbbing, pulsating, one sided can be both
Hormones, foods, hunger, stimuli

156
Q

cluster(headache)

A

always one sided, burning, piercing
alcohol, stress, daytime napping

157
Q

Gray matter

A

outer layer of the brain
composed mostly of neuron body cells

158
Q

white matter

A

fiber tracts inside gray matter

159
Q

cerebral cortex

A

is the cerebrum’s outer layer, and is the center for human’s highest functions, governing thought, memory, reasoning, sensation, and voluntary movement.

160
Q

White matter disease symptoms:

A

trouble learning or remembering new things, hard time problem solving, slowed thinking, problems walking, balance issues

161
Q

Gray matter disease symptoms:

A

fatigue and memory loss.

162
Q

frontal lobe

A

personality, emotion, intellectual functions

163
Q

precentral gyrus

A

primary motor function

164
Q

broca’s area

A

motor speech

165
Q

temporal lobe

A

hearing, taste, smell

166
Q

cerebellum

A

coordination, balance

167
Q

occipital lobe

A

vision

168
Q

Wernicke’s area

A

speech comprehension

169
Q

parietal lobe

A

sensation

170
Q

postcentral gyrus

A

primary sensory area

171
Q

thalamus

A

main relay station where the sensory pathways of the spinal cord, cerebellum, and brainstem form synapses on their way to the cerebral cortex.

172
Q

hypothalamus

A

major respiratory center with basic vital functions like temperature, appetite, sleep, sex drive, heart rate, and blood pressure control

173
Q

brain stem

A
  • is the central core of the brain consisting of mostly nerve fibers
  • 3 areas: midbrain, pons, and medulla.
  • The brainstem provides the main motor and sensory innervation to the face and neck via the cranial nerves
  • in charge of 10/12 CN
  • regulation of cardiac and respiratory function.
  • regulates the central nervous system
    -pivotal in maintaining consciousness and regulating the sleep cycle. The brainstem has many basic functions including heart rate, breathing, sleeping, and eating.
174
Q

spinal cord

A

-Main highway from the brain to the spinal nerves
-Mediates reflexes

175
Q

“mixed” nerves

A

they contain both sensory and motor fibers
example: spinal nerves

176
Q

dermatomes

A

area of skin supplied with nerve fibers by a single spinal root.

177
Q

Cranial nerves where are they supplied from?

A
  • Enter and exit brain rather than spinal cord
    -CN I and II extend from cerebrum; cranial nerves III to XII extend from the brain stem
    -12 pairs of cranial nerves supply primarily head and neck, except vagus nerve, which travels to heart, respiratory muscles, stomach, and gallbladder
178
Q

sympathetic

A

part of the nervous system is the part that allows our bodies to function under stress, or fight or flight. The

179
Q

parasympathetic

A

it is in opposition to the sympathetic part. It is all about rest, relax, eat, and sex.

180
Q

Reflexes:

A

basic defense mechanisms of nervous system

181
Q

Deep tendon reflexes (myotatic) example

A

knee jerk

182
Q

Superficial reflex example

A

abdominal reflex
corneal reflex

183
Q

Visceral reflex example

A

pupillary response to light

184
Q

Pathologic reflex example

A

(abnormal)
example Babinski’s reflex or extensor plantar reflex

185
Q

how a reflex works

A

the patellar tendon is stimulated with a reflex hammer and the sensory nerve takes this action potential toward the CNS or spinal cord (where the reflex is mediated), it synapses there and then the descending motor nerve is stimulated and a muscle reaction occurs.
hammer-> sensory nerve-> CN or spinal cord-> synapses-> motor nerve-> muscle reacts

186
Q

reflexes/neuro in infants

A
  • neurologic system isn’t completely developed by birth
    -Movement directed primarily by primitive reflexes
  • Persistence of primitive reflexes is an indication of CNS dysfunction
  • Sensory and motor development proceed with gradual acquisition of myelin needed to conduct most impulses
  • As myelinization develops, infant able to localize stimulus more precisely and make more accurate motor response
187
Q

reflexes/neuro in elderly

A
  • Atrophy w/steady loss of neuron structure in brain & spinal cord
  • decreased or absent Achilles reflex, pupillary miosis, irregular pupil shape, and decreased pupillary reflexes
  • Velocity of nerve conduction decreases making reaction time slower in some older persons
  • Increased delay at synapse results in diminished sensation of touch, pain, taste, and smell
  • Progressive decrease in cerebral blood flow and oxygen consumption may cause dizziness and loss of balance
188
Q

what to ask during a neuro exam

A

Drugs such as: mood-altering: marijuana, cocaine, barbiturates, tranquilizers
history of menangitis
history of stroke

189
Q

Reflexes in infants that you would check (there’s 4)

A

rooting, grasp, tonic neck, and Moro

190
Q

A screening examination

A
  • is performed on well persons who have no significant subjective findings revealed in their history.
    Integrate through rest of exam
    But record neuro findings under Neuro!
191
Q

A complete examination

A

is performed on persons who have neurologic concerns identified through the neurologic history (headache, weakness, loss of coordination). Cranial nerves!

192
Q

A neurologic recheck

A

is performed on persons who have had a complete neurologic examination and are being seen for follow-up care (hospitalized clients due to head trauma or systemic disease).
LOC, Level of consciousness
Motor Function
Pupils
VS, Vital Signs
Perrla

193
Q

order of checking neuro

A

Mental status
Cranial nerves
Motor system
Sensory system
Reflexes

194
Q

CN 1

A

olfactory
smell test

195
Q

CN 2

A

Optic
snellen and exam fundus
confrontation test

196
Q

confrontation test:

A

both cover opposite eye, use wiggling fingers from 6 directions to check peripheral vision

197
Q

CN 3, CN 4, CN 6

A

CN III Oculomotor, IV Trochlear, & VI Abducens
Equal palpebral fissures
PERRLA
EOM’s (extraocular muscle)

198
Q

CN 5

A

Trigeminal Nerve
Mastication/jaw palpation
cotton test (corneal test) not usually done

199
Q

CN 7

A

facial nerve
smile, frown, brows, puff cheek

200
Q

CN 8

A

acoustic
whisper test

201
Q

CN 9 and CN 10

A

CN IX Glossopharyngeal & X Vagus Nerves
gag reflex
inspect mouth/tongue

202
Q

CN 11

A

accessory nerve
shrug shoulders against resistance
cheek against resistence

203
Q

CN 12

A

“light, tight, dynamite”

204
Q

Paresis

A

is weakness or diminished strength

205
Q

Flaccidity

A

is decreased resistance

206
Q

spasticity and rigidity

A

are types of increased resistance

207
Q

tic

A

is a sudden, repetitive, nonrhythmic motor movement or vocalization involving discrete muscle groups

208
Q

tremor

A

is an involuntary, somewhat rhythmic, muscle contraction and relaxation involving to and from movements (oscillations or twitching) of one or more body parts

209
Q

Myoclonus

A

refers to sudden, involuntary jerking of a muscle or group of muscles

210
Q

fasciculation

A

term for muscle twitch
small, local, involuntary muscle contraction and relaxation which may be visible under the skin

211
Q

Chorea

A

is a condition that causes involuntary, unpredictable body movements that do not have a pattern

212
Q

Athetosis

A

is a symptom characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, arms, legs, neck and tongue.

213
Q

Cerebral palsy -

A

spasticity

214
Q

tandem walking

A

walking heel to toe

215
Q

romberg test

A

feet together close eyes and see if they move
20 seconds

216
Q

shallow knee bed or hop

A

in place on one leg then the other. You could have them rise from a chair without using armrests instead.
tests cerebellar function

217
Q

RAM (3 tests)

A

rapid altering movements
1. finger to finer
2. finger to nose
3. heel to shin

218
Q

sensory assessment

A

test temp only if pain is abnormal
Have the person close their eyes, avoid leading questions, like “can you feel this pinprick” . Just break a tongue blade to make a sharp point and use the other smooth end for dull sensations. Have the person say “sharp” or “dull” . Wait 2 seconds between each stimulus.

219
Q

Stereognosis –

A

ability to recognize object by feeling their forms, sizes and weights (ex. Key, coin) – the eyes should be closed

220
Q

Graphesthesia –

A

ability to read a number by having it traced on the skin.

221
Q

2-point discrimination –

A

ability to distinguish the separation of 2 simultaneous pin points on the skin (getting closer) – you can use two points of an opened paper clip for this

222
Q

reflex grading scale

A

0 no reaction
1+ diminished
2+ Normal
3+ Brisker
4+ Hyperreflexia (clonus)

223
Q

Hyperreflexia –

A

exaggerated reflex seen in those with stroke.

224
Q

Clonus –

A

set of short jerking contractions of the same muscle.

225
Q

what to do if no reflex is shown during assessment

A
  • Try encourage relaxation,
  • change pt. position,
    -increase blow strength.
    -OR ask person to do isometric exercise in a muscle group away from being tested.
226
Q

when using a reflex hammer use:

A

wrist action

227
Q

5 places to perform reflexes

A

bicep (front elbow crease)
brachioradialis (inner wrist by thumb)
tricep (back above the elbow)
quadriceps (good ol’ knee)
achilles (right above the heel)

228
Q

Abdominal reflex:

A

have the person lay down, knees slightly bent, stroke skin with an object toward the umbilicus, and there will be ipsilateral (same side) muscle contraction and movement of the umbilicus toward the stimulus

229
Q

ipsilateral

A

means same side

230
Q

Cremasteric reflex

A

– stroke inner thigh and the ipsilateral (same side) testicle will elevate.

231
Q

Contralateral.

A

opposite of ipsilateral
not the same side

232
Q

plantar reflex –

A

you put the thigh in slight external rotation, use the reflex hammer to draw a light stroke up the lateral side of the sole and inward across the ball of the foot, like an upside down. Normal response is plantar flexion of the toes. (curl toes)

233
Q

Babinski sign

A

toes flex outward during plantar reflex (abnormal/ not good)

234
Q

rooting reflex

A

can be checked by brushing the infants cheek near the mouth and the infant will turn their head toward that side and open the mouth.

235
Q

grasp reflex

A

is when you just offer your finger to the infant and the infant grasps your finger with all of their fingers.

236
Q

tonic neck reflex

A

is when the baby is laying down, turn their head to one side with their chin over one shoulder and the ipsilateral extension of the arm and leg and flexion of the opposite arm and leg happens

237
Q

mono reflex

A

baby reacts as if falling
spread out arms
(abnormal)

238
Q

Fasciculations:

A

rapid, continuous twitching of resting muscle or part of muscle, without movement of limb, that can be seen or palpated. 2 Types:
Fine – occurs with lower motor neuron disease.
Coarse – occurs with cold exposure or fatigue, not significant.

239
Q

Intention Tremor:

A

rate varies, worse with voluntary movement. Occurs with cerebellar disease and multiple sclerosis. Intention tremors occur when a person makes a purposeful movement, such as reaching for a glass. The tremor subsides when the movement ceases

240
Q

Senile tremors

A

are essential tremors that begin in old age.

241
Q

Parkinsonian

A

pill-rolling tremor with opposing fingers. AKA Rest tremors, which are characteristic of Parkinson’s disease, occur while the body is at rest, and disappear when the person moves.

242
Q

tests to rule out meningitis

A

kernig’s sign
brudzinski’s neck sign

243
Q

Kernig’s sign

A

in flat, lying position Raise leg straight at hip
Abnormal response: resistance to straightening & pain down posterior thigh

244
Q

Brudzinski’s neck sign

A

with one hand under head or neck, and one hand on the chest, Flex chin to chest, watch hips and knees
Abnormal response: resistance & pain in neck, with flexion of hips and knees

245
Q

Decorticate:

A

(abnormal) cerebral cortex lesion
Upper: flexion of arm, wrist, fingers; adduction of arm
Lower: extension, internal rotation, plantar flexion (sternal rub)
(T-rex)

246
Q

Decerebrate:

A

(abnormal) brain stem lesion
Upper: arms stiffly extended, adducted, internal rotation, palms pronated.
Lower: legs stiffly extended, plantar flexion (sternal rub)

Fall 2023 (6 decks)

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