BIRD SHIT Flashcards
(183 cards)
1
Q
What is examination?
A
Patient history and tests and measures.
2
Q
What is evaluation?
A
Synthesizing of data; diagnosis and prognosis.
3
Q
What is the difference between open ended and closed ended questions?
A
Open ended questions will have open and broad responses; closed ended questions will have short responses (‘yes’ or ‘no’).
4
Q
What does aching indicate?
A
Muscular pain.
5
Q
What does burning indicate?
A
Neural or muscular pain.
6
Q
What do shooting, lightning, or electrical pain indicate?
A
Nerve root irritation.
7
Q
What does coldness in pain suggest?
A
Pain may be due to lack of blood flow.
8
Q
What does hotness in pain suggest?
A
Localized inflammation or infection pain.
9
Q
What do clicking, snapping, or popping sounds indicate?
A
Ligament/tendon dysfunction.
10
Q
What does joint locking indicate?
A
Cartilage tear, loose body, joint malalignment.
11
Q
What does global weakness/fatigue/no clear pattern suggest?
A
Cardiovascular dysfunction.
12
Q
What does whole body pain indicate?
A
Central somatization, chronic pain.
13
Q
What does joint pain/stiffness worse in the morning indicate?
A
Inflammatory pain.
14
Q
What does joint pain less in the morning and worse with activity indicate?
A
Degenerative pain.
15
Q
What does back pain worse in the morning, better after a few hours, and worse again in the evening suggest?
A
Disc pathology.
16
Q
What does constant, intense pain, worse in the evening, waking the patient from sleep without relief indicate?
A
RED FLAG MALIGNANCY.
17
Q
What are red flags requiring immediate attention?
A
Anginal pain not relieved in 10-20 minutes; client with angina who has nausea, vomiting, or profuse sweating; confused and lethargic diabetic with changes in mental alertness and function; onset of incontinence or saddle anesthesia; anaphylactic shock symptoms (hives, asthma, tachycardia, hypotension, anxiety, nausea, vomiting).
18
Q
What are ordinal measures?
A
Outcome measured in ranked order; points are based on self-reported performance; points summarized for a total score; number refers to something (fair, poor, good).
19
Q
What is an interval measure?
A
Numbers quantify what the patient describes, but do not include 0 (e.g., girth measurements).
20
Q
What is ratio data?
A
Numbers quantify what the patient is describing, includes 0 (e.g., ‘how often do you go to the gym’).
21
Q
What is a floor effect?
A
Data skewed because activities are too hard.
22
Q
What is a ceiling effect?
A
Results from the Berg balance scale would lead to this effect.
23
Q
What is the gold standard of balance?
A
Berg balance scale.
24
Q
When would you NOT use the Berg balance test?
A
It does not evaluate walking; does not need to be used for patients after stroke.
25
What does a higher score on the QuickDASH indicate?
Greater disability.
26
What does a higher score on the LEFS indicate?
Less disability.
27
What does a low score on the UEFS indicate?
Good outcome.
28
What is the gold standard for low back pain?
Oswestry Disability Index (ODI); score 0-50: low = no disability, high = completely disabled.
29
What do you want when using the NDI?
Less points.
30
What is anesthesia?
Complete loss of sensation.
31
What is hypothesia?
Abnormally decreased sensitivity to stimulation.
32
What is hyperesthesia?
Abnormally increased sensitivity to stimulation.
33
What is hypalgesia?
Diminished sensitivity to pain.
34
What is hyperalgesia?
Increased sensitivity to pain.
35
What is asterognosis?
Inability to recognize familiar objects by sense of touch.
36
What is atopognosis?
Inability to correctly locate sensation.
37
What is baragnosis?
Inability to distinguish between different weights.
38
What is paresthesia?
Abnormal tactile sensation often described as creeping, burning, tingling, or numbness.
39
What is dyesthesia?
Impaired sensation, especially touch.
40
What is paralysis?
Loss of impairment in body part due to lesion in neural or muscular systems; may also include impairment of sensory.
41
What is hemiparaplegia?
Paralysis of the lower half of one side of the body.
42
What is hemiparesis?
Muscular weakness or partial paralysis restricted to one side of the body.
43
What is hemiparesthesia?
Numbness of one side of the body.
44
What is hemiplegia?
Paralysis of one side of the body.
45
What is paraperesis?
Partial paralysis affecting lower limbs.
46
What is paraplegia?
Paralysis from the waist down.
47
What is tetraplegia (quadriplegia)?
Paralysis of all four limbs.
48
What is triplegia?
Paralysis of three extremities.
49
What is diplegia?
Paralysis in either both upper extremities or lower extremities.
50
What is coordination testing done to test?
Cerebellar dysfunction.
51
What are global signs of cerebellar dysfunction?
Ataxia, tremors, hypotonia, dysarthria, eye deviations.
52
What is ataxia?
Lack of control of body movements, decreased movement coordination.
53
What is dysmetria?
Error in trajectory due to abnormal range, rate, and/or force of motion; inability to touch target with hand or foot.
54
What does dysdiadochokinesia test for?
Impaired ability to perform rapid alternating movements.
55
What are upper extremity coordination tests?
Rapid alternating movement, finger opposition, finger to nose (eyes closed variation and open variation).
56
What does finger to nose with eyes open and closed test?
Dysmetria and intention tremors.
57
What are lower extremity coordination tests?
Rapid alternating movements, heel to shin, toe tapping.
58
What should you see when testing cranial nerves II and III?
Bilateral constriction followed by dilation of the eye not receiving the light.
59
What does the trochlear nerve innervate?
Superior oblique (moves eyeball down and in).
60
What does the abducens innervate?
Lateral rectus.
61
What are signs of oculomotor palsy?
Dilated pupil, drooping eyelid, eye drifting lateral and down.
62
Will oculomotor palsy present as ipsilateral or contralateral?
Ipsilateral.
63
How do you test the motor function of cranial nerve V?
Palpate masseter and temporalis as patient clenches jaw.
64
How do you test the sensory function of cranial nerve V?
Light touch assessment.
65
How do you test the reflex of cranial nerve V?
Reflex hammer to jaw (light tap on finger), should expect light jaw protrusion.
66
How do you test the sensory function of cranial nerve VII?
Test sweet, sour, or salt on patient's tongue.
67
How do you test the motor function of cranial nerve VII?
Have patient raise eyebrows, close eyes, smile/frown, puff out cheeks.
68
What is Bell's palsy?
Peripheral face nerve impairment; motor: ipsilateral paralysis of half of face; loss of taste on anterior 2/3 of tongue on affected side; loss of tear production and reduction of saliva.
69
How will the uvula deviate in a cranial nerve X issue?
Contralateral.
70
How will the tongue deviate if there is a lesion to cranial nerve XII?
Ipsilateral.
71
What are the symptoms of foraminal stenosis?
Patient presents with relieved pain with foraminal opening, pain increased with foraminal closing, and has unilateral radiating symptoms.
72
What questions should you ask someone if you suspect foraminal stenosis?
'Does the pain go down to the arm?' Ask about arm weakness.
73
What should be tested when examining someone with foraminal stenosis?
NDI, grip strength dynamometer, and cervical flexor endurance test.
74
What tests and measures are looked at to examine foraminal stenosis?
Reflex testing, cervical AROM, cervical MMT.
75
What needs to be included in the subjective interview when doing an exam on someone for central stenosis?
Cervical AROM, myotome screen, reflexes, UE sensation testing, cervical MMT.
76
What should be included in the subjective interview for lumbar degenerative disc disease (DDD)?
'What activities are difficult? What cannot be performed?' 24-hour behavior, AM? Previous lumbar surgeries, 'Any leg symptoms?'
77
What should be performed when examining lumbar DDD?
ODI, modified plank, 5 STS, and functional lifting index (FLI).
78
What tests and measures should be performed when examining lumbar DDD?
Posture, gait, thoracolumbar AROM, trunk and hip MMT, and LE neurosensory screen.
79
What does lumbar spine disc pathology present with?
Unilateral motor and sensory pending severity in addition to positive reproduction with Valsalva/WB.
80
What needs to be discussed in the subjective interview when examining for lumbar disc pathology?
'Do you have any areas in the leg with less sensation?' 'Any loss of strength in lower leg?'
81
What functional outcomes should be performed to test for lumbar pathology?
ODI, 5 STS, lumbar performance index, heel/toe walking.
82
What is the difference between spondylolysis and spondylolisthesis?
Spondylolysis: stress fracture of the pars interarticularis (scotty dog); Spondylolisthesis: vertebral sliding (step-off).
83
What is lumbar spinal stenosis?
Hypertrophy of ligamentum flavum.
84
What subjective information is needed for lumbar spinal stenosis?
Walking tolerance, standing tolerance, medications, relief with position.
85
What tests are used for lumbar spinal stenosis?
6-minute walk test, timed treadmill test, treadmill incline test.
86
What is hypermobility?
Patient presents with pain directly at SIJ, can radiate down posterior limb to posterior knee.
87
What is the arc format?
Combining extension and flexion measurements; extension - 0° - flexion.
88
What is the end feel of elbow extension?
Hard, bone to bone.
89
What is the end feel of wrist flexion?
Firm, tissue stretch.
90
What is the end feel of elbow or knee flexion?
Soft.
91
What is the end feel if there is pain present?
Empty (abnormal).
92
What is a grade 5 muscle strength?
Complete full ROM against gravity with max resistance.
93
What is a grade 4 muscle strength?
Complete full ROM against gravity, moderate resistance.
94
What is a grade 3+ muscle strength?
Complete full ROM against gravity, minimum resistance.
95
What is a grade 3 muscle strength?
Complete ROM against gravity, no resistance.
96
What is a grade 3- muscle strength?
>50% ROM against gravity but full in gravity reduced.
97
What is a grade 2+ muscle strength?
<50% ROM against gravity, but full in gravity reduced.
98
What is a grade 2 muscle strength?
Full ROM with gravity eliminated or 'minimized.'
99
What is a grade 2- muscle strength?
Completes partial ROM with gravity eliminated.
100
What is a grade 1 muscle strength?
Palpable contraction.
101
If a patient can move its full range against gravity, what do they already get?
A grade of 3.
102
If a patient cannot get full ROM against gravity, what is the highest they can get?
A grade of 3-.
103
What does AROM give an idea of?
Contractile tissue integrity; may give idea if inert tissues are stretched or pinched.
104
What does PROM indicate?
Integrity of joint surfaces; extensibility of capsule, ligaments, muscles, fascia, and skin; end feels of joint.
105
What is normal cervical flexion?
40°.
106
Where do inclinometers need to be placed for cervical flexion and extension?
Top of skull and T1.
107
What is normal cervical extension?
50-70°.
108
What is normal cervical side bending?
22°.
109
What is normal cervical rotation?
50°: 70-90°.
110
What is normal thoracolumbar flexion?
60°.
111
What is normal thoracolumbar extension?
25°.
112
What are the landmarks for thoracolumbar flexion/extension?
T1 and S2.
113
What is normal thoracolumbar side bending?
35°.
114
What is normal thoracolumbar rotation?
45°.
115
What is a grade 5 trunk flexion?
Trunk flexion with arms behind head.
116
What is a grade 4 trunk flexion?
Trunk flexion with arms crossed.
117
What is a grade 3+ trunk flexion?
Trunk flexion with arms at side.
118
What is a grade 3 trunk flexion?
Trunk flexion with arms by side with scapula on plinth.
119
What is a grade 2 trunk flexion?
Head on plinth, arms at side.
120
What is a grade 5 angle between lower extremities and table?
0-30°.
121
What is a grade 4 angle between lower extremities and table?
30-60°.
122
What is a grade 3 angle between lower extremities and table?
60-75°.
123
What is a grade 2 angle between lower extremities and table?
>75°.
124
What does a grade 1 indicate?
Patient cannot assume or maintain position but muscle contraction is palpable.
125
What muscles do you need to palpate before doing MMT of cervical flexion?
Scalenes and longus colli.
126
What muscle needs to be palpated for cervical lateral flexion?
SCM.
127
What needs to be palpated for trunk leg lowering?
Lumbar lordosis for flatness.
128
What needs to be palpated for trunk rotation?
EO.
129
What needs to be palpated for pelvic elevation?
QL.
130
What are the signs of a Labral Tear (Bankart Lesion) or SLAP lesion?
Patient reports FOOSH and heard pop, click, or clunk sound; arm feels heavy and like it is about to dislocate; pain with overhead reach, especially ABD/ER.
131
What can cause frozen shoulder (adhesive capsulitis)?
Middle-aged women, diabetes type 2, hypothyroidism.
132
What are the stages of frozen shoulder?
Freezing: losing ROM in shoulder, painful; Frozen: minimal ROM and less painful; Thawing: regaining ROM, pain varies.
133
What outcome measures should be performed when examining for adhesive capsulitis?
qDASH, UEFI, hand grip, wall overhead reach.
134
What tests and measures should be done to examine for adhesive capsulitis?
Clear spine, PROM and AROM of ER, ABD, IR, Flex, Apley scratch test, MMT, scap position and mobility.
135
What is normal shoulder flexion?
180°.
136
What is normal shoulder extension?
60°.
137
What is normal GH flexion?
120°.
138
What is normal GH extension?
20°.
139
What is normal shoulder abduction?
180°.
140
What is normal GH abduction?
100-130°.
141
What is normal shoulder internal rotation?
70°.
142
What is normal shoulder external rotation?
90°.
143
What is normal GH internal rotation?
50-60°.
144
What is normal GH external rotation?
90°.
145
What positon do you measure shoulder and GH internal rotation, external rotation, flexion, and abduction?
In supine.
146
When do you measure GH and shoulder extension?
In prone.
147
Where do you stabilize for shoulder measurements?
Trunk.
148
Where do you stabilize for GH measurements?
Trunk and scapula.
149
Where does the stationary arm of the goniometer need to be in shoulder and GH flexion and extension?
Parallel to midaxillary line of thorax.
150
Where does the stationary arm need to be in shoulder and GH abduction?
Parallel to midline of sternum.
151
Where is the axis of the goniometer in shoulder and GH flexion and extension?
Lateral aspect of greater tubercle.
152
Where is the axis of the goniometer in shoulder and GH abduction?
Anterior acromion.
153
Where is the axis of the goniometer in shoulder and GH internal/external rotation?
Olecranon process.
154
Where does the moving arm of the goniometer need to be in shoulder and GH flexion and extension?
Anterior midline of humerus.
155
Does the stationary arm need to be in shoulder and GH abduction?
Yes.
156
Where does the moving arm of the goniometer need to be in shoulder and GH flexion and extension?
Lateral epicondyle.
157
Where does the moving arm of the goniometer need to be in shoulder and GH abduction?
Anterior midline of humerus.
158
Where does the moving arm of the goniometer need to be in shoulder and GH internal/external rotation?
Midline of ulna.
159
What nerves go to the hand?
Ulnar nerve, radial nerve, median nerve.
160
What nerve is associated with wrist drop and ulnar deviation?
Radial nerve.
## Footnote
Measure atrophy muscles bilaterally.
161
What position will the hand be in if the radial nerve is affected?
Wrist drop.
162
What nerve is associated with ape hand?
Median nerve.
## Footnote
Thenar and hypothenar eminences.
163
What hand position will be shown if the median nerve is affected?
Ape hand.
164
What muscles will atrophy if the median nerve is affected?
Thenar and hypothenar muscles.
165
What nerve is associated with bishop's hand/claw hand?
Ulnar nerve.
## Footnote
Lumbricals and interossei.
166
What hand positions may you see if the ulnar nerve is affected?
Bishop's hand/claw hand.
167
What muscles are atrophied if the ulnar nerve is affected?
Lumbricals and interossei.
168
What nerve is being tested?
Median nerve.
169
What is done to test for median nerve injury?
Tinel's test, Phalen's test, Reverse Phalen's test.
170
What is done to test the radial nerve?
Resisted supination.
171
What nerve can be entrapped at the nerve roots?
Ulnar nerve.
172
What nerve can be entrapped at the first rib?
Ulnar nerve.
173
What nerve can be entrapped at the cubital tunnel?
Ulnar nerve.
174
What nerve can be entrapped at the triangular space?
Radial nerve.
175
What nerve can be entrapped at the carpal tunnel?
Median nerve.
176
What is the diagnosis if a patient presents with pain with gripping or initiating wrist flexion and hears/feels crepitus during wrist flex/ext after repetitive wrist extension with radial deviation?
Tennis elbow.
177
What is the diagnosis if a patient has pain with gripping and initiating gripping or eccentric wrist extension, and hears or feels crepitus when flexing wrist or gripping with twist?
Golfer's elbow.
178
What condition is associated with ulnar nerve entrapment and sustained positions?
Cubital tunnel syndrome (telephone elbow).
179
What condition is associated with repetitive, forceful valgus motion and possible catching and locking in joint?
Osteochondritis dissecans.
180
What condition is associated with sustained repeated wrist flexion or extension?
Carpal tunnel syndrome.
181
What needs to be asked in the subjective interview for carpal tunnel syndrome?
History of neck issues.
182
What is DeQuervain's?
Tenosynovitis of the abductor pollicus longus (APL) and the extensor pollicis brevis (EPB).
183
What does the DeQuervain's test assess?
Repetitive radial deviation.
