Lab Exam

Question 1

Pain Sensation what tool do we use to assess pain, and what manner?

Answer 1

Sterilized safety pin.

Alternating randomly between the sharp and dull side of the safety pin.

Question 2

True or False. Patient sight does not have to be occluded during pain sensation testing?

Answer 2

False.

Question 3

What does a patient have to do to when is being tested for pain sensation?

Answer 3

Indicate if it is the sharp or dull following application

Question 4

Correct response to pain sensation means?

Answer 4

intact protective sensation

Question 5

Incorrect response to pain sensation means?

Answer 5

Absent of protective sensation

Question 6

How do we test for temperature awareness ?

Answer 6

Apply rest tubes filled with hot or cold fluid to areas of hand/UE.

Question 7

What does the patient have to do when is being tested from temperature awareness?

Answer 7

Indicate if tube is hot or cold

Question 8

Correct response to temperature awareness means?

Answer 8

Intact temperature awareness

Question 9

InCorrect response to temperature awareness means?

Answer 9

Absent of temperature awareness.

Question 10

What static two point discrimination test for?

Answer 10

Receptors density and mapping for improvement following nerve repair

Question 11

How do we begin the test for TPD?

Answer 11

Test the fingertips with light pressure, stop when skin begins to blanch.
Randomly test one or two points on the radial and ulnar aspects of each digits fro 10 applications.

Question 12

At what distance btween each pin do we begin with TPD?

Answer 12

Begins with distance of 5 mm between testing points

Question 13

What patient respond should be when testing TPD?

Answer 13

Responds with 1 or 2 or I don’t know

Question 14

True or False.7/10 correct responses at that number of millimeters of distance between 2 points can terminate the test as it normal senation?

Answer 14

True

Question 15

1-5 mm indicates?

Answer 15

Normal 2 point

Question 16

6-10 mm indicates?

Answer 16

fair static 2 point

Question 17

11-15 mm indicates?

Answer 17

poor static 2 point

Question 18

1 point perceived indicates what?

Answer 18

Protective sensation only

Question 19

No point perceived indicates what?

Answer 19

Anestheric area.

Question 20

What do we beging with Moving Two Point testing?

Answer 20

Begin with distance of 8 mm between points

Question 21

Moving Two Point how does testing look like?

Answer 21

randomly select 1 or 2 points and move proximal to distal on the distal phalanx parallel to the longitudinal axis of the finger (so adjacent nerves are not stimulated)

Question 22

Moving Two Point if patient responds correctly what do we do?

Answer 22

decrease the distance between points

Question 23

What responses should be in place during Moving Two Point

Answer 23

1, 2, or I dont know

Question 24

how many times does patient have to respond Moving Two Point to be terminated ?

Answer 24

7/10

Question 25

2-4 mm ages 4-60?

Answer 25

normal

Question 26

4-6mm ages 60+?

Answer 26

normal

Question 27

What does monofilament testing measures?

Answer 27

Light and deep touch

Question 28

Light touch is important for ?

Answer 28

fine discriminatory hand use

Question 29

Deep touch is important for?

Answer 29

Protective sensation

Question 30

With whom is monofilament testing good to use with ?

Answer 30

nerve entrampments

Question 31

True or False? Monofilaments come in a set of 20 or a screen kit of 5?

Answer 31

Ture

Question 32

Monofilaments are color coded why?

Answer 32

To correspond to threshold caregories

Question 33

What Monofilamet should we start with ?

Answer 33

1.65

Question 34

What is the procedure of Monofilament testing ?

Answer 34

Start with 1.65 apply for 1 - 1.5 sec (it should bend) Lift for 1 -1.5 sec Repeat 3 times in the same spot for filaments 1.65 to 4.8 Filaments higher then 4.08 are only applied once Randomly select areas in the hand to test

Question 35

What should the patient say during monofilament testing?

Answer 35

Pt says touch when they feel the monofilament

Question 36

What do you do if patient feels or does not feel the monofilament?

Answer 36

Record the number on the ahnd grid if the pt does NOT perceive filament proceed to the next thicker monofilament up to 6.65.

Question 37

Green Indicates?

Answer 37

Normal light touch 1.65-2.83

Question 38

Blue Indicates?

Answer 38

Diminished light touch 3.22-3.61

Question 39

Purple Indicates?

Answer 39

Dminished Protective senstation 3.84-4.31

Question 40

Red Indicates?

Answer 40

Loss of protective sensation 4.56-6.65 loss of protective sensation

Question 41

Untestable indicates?

Answer 41

inability to feel the largest monofilament.

Question 42

Grip Testing what is the process ?

Answer 42

Should be measured with a calibrated dynamometer | Second rung of the dynamometer is used for standard testing (if different used it should be documented)

Question 43

How many trials do we have to have when measuring grip testing?

Answer 43

average of 3 trials should be scored (unless painful).

Question 44

Grip Testing How is it calculated ?

Answer 44

``` Average of 3 trials Grip held for 3 seconds 15 seconds intervals between traisl Compare to uninvolved side Compare to established norms. ```

Question 45

What is the standard position during grip testing?

Answer 45

Patient seated with arm adducted at side Elbow flexed to 90, forearm in neutral, wrist at 15-30 of extension and 0-15 ulnar deviation Patient instructed to squeeze as hard as possible Therapist gently supports the base of the dynamometer

Question 46

Dynamometer 5 rungs measure?

Answer 46

1st measures intrinsics 2nd standard grip 3rd someone has a large hand 4th and 5th rung extrinsic strength.

Question 47

Pinch Testing what are they?

Answer 47

``` 2 point pinch (tip to tip) 3 point pinch (3 jaw chuck) Lateral pinch (key pinch) ```

Question 48

Pinch testing position

Answer 48

patient seated, elbow flexed 90 degrees arm abducted at side forearm neutral

Question 49

What observation of edema consist of ?

Answer 49

``` Visualization, color, location touch; temperature, rebounding/pitting Sings and symptoms of infection open areas scarring ```

Question 50

What volumetry of edema consist of ?

Answer 50

Volumeter, beaker and 500ml graduated cylinder

Question 51

Figure of eigth methods uses what?

Answer 51

tape measure

Question 52

Circumferential measurement uses what?

Answer 52

Use of tape measure of circumferential measurement device

Question 53

what is going on in the sage of Acute edema?

Answer 53

Transudate edema COnsist of excess H2O and electrolytes pits and rebounds

Question 54

what is going on in the sage of Sub-Acute edema?

Answer 54

Consits of large plasma proteins: is viscous | Slow to rebound after pitting

Question 55

what is going on in the sage of Chronic edema?

Answer 55

Indurated edema is hard and nonpitting | Fibrotic - consists of large plasma proteins that have been trapped over time.

Question 56

Figure of Eigth Method ?

Answer 56

Begin at the distal wrist crease of the palmar side of the wrist . Wrap tape measure In an ulnar direction Bring the tape diagonally across the dorsum of the hand to the 2nd MCP joint The tape was then wrapped across the ventral surface of the 5th MCP joint Continure over the palmar crease of the 5th digit brining the tape back across the dorsum surface to the starting point.

Question 57

What factors may influence results of volumetry ?

Answer 57

Time of day Exercise Forearm position Water temp

Question 58

Citcumferential measurement consist of?

Answer 58

Using flexible tape measure or finger circumference gauge Wrap tape measure around body part Use bony landmarks to and document accurately increase retest reliability Dont allow tape measure to dig into skin

Question 59

What are edema treatments?

Answer 59

``` Low stretch bandages Self-adherent wrap (coban) Kinesotaping Chip bag Exercise Edema gloves Manual edema mobilization ```

Question 60

Exercises for Edema?

Answer 60

Diaphragmatic breathing Should start at the trunk low level aerobic exercises followed by shoulder/elbow ROM, wrist/hand fisting overhead

Question 61

Treatement of Edema; Cold?

Answer 61

Initiates vasoconstricion causing decreased outflow. should not be <59 15C Percaustions are? nerve damage, impaired sensation, digit replantation

Question 62

Treatement of Edema; Elevation?

Answer 62

Decreased outflow via decreasing arterial hydrostatic pressure Stimulates lymph flow via increasing hydrostatic pressure Position of hand: Elbow above shoulder, wrist above elbow, hand above wrist, ELbow should not be in extreme flexion Precautions: digit replantation R side hemiparesis L stroke.

Question 63

What type of compression garment we have?

Answer 63

Elastic gloves, stockinette, and coban wrap

Question 64

Treatement of Edema; Compression

Answer 64

Light compression increases the absorption of small molecules in fluid Too tight will restrict fluid flow causing more edema.

Question 65

Treatement of Edema; Chip bag

Answer 65

For small localized edema | Compression depends on mix of foam.

Question 66

Treatement of Edema; Retrograde massage

Answer 66

Light stokes working distal to proximal

Question 67

Treatement of Edema; Manual Edema Mobilization

Answer 67

Used to reduce subacute edema. ONly regular edema in subacure or chronic stage Light massage is provided to prevent collapse of the lymph pathways

Question 68

What are contradications to Manual Edema Mobilization?

Answer 68

``` Infections areas of inflammation Hematoma or clot Active cancer CHF, severe cardiac or pulmonary problem Renal failure Primary lymphedema or lymphedema from mastectomy wounds ```

Question 69

Treatement of Edema; Kinesotape

Answer 69

Promotes absorption of large and samll molecules via increasing the available space between skin and connective tissue Creates a pull on the anchor filaments in the lymphatic system

Question 70

Treatement of Edema; Pump Point Stimulation (MEM)

Answer 70

Simultaneous, synchronous movement of therapist two hands in a U pattern over areas of lymph bundles Therapist does 20-30 U's in one area before proceeding to the next area of pump points. NEED TO BE TRAINED

Question 71

U hand movement pattern..

Answer 71

Pattern of hand on skin Very light pressure Pulls skin lightly distal then circles back up and around

Question 72

Clearing U's skin Tractioning Pattern

Answer 72

Start proximal and moves to the distal part of the limb | Minimum of 5 Us are done in 3 sections to create interstitial pressure changes

Question 73

Flowing U's Lymp Movement Pattern

Answer 73

Distal moves prximal Moving one U after another from distal to proximal is repeated 5 times The flowing U pattern is performed all the way to the contralaterl upper quadrant Followed by active muscle contracion in each segment.