midterm 1 Flashcards
(105 cards)
1
Q
open-ended q’s
A
invite pt to give narrative response; broad and general
2
Q
closed-ended q’s
A
definitive response from pt
3
Q
graded-response q’s
A
quantify pt’s experience
4
Q
multiple-option q’s
A
few options for pts to answer
5
Q
aching
A
muscular
6
Q
burning
A
neural, muscular
7
Q
shooting, lightning, electrical
A
nerve root irritation
8
Q
coldness
A
may be due to lack of blood flow
9
Q
hotness
A
localized inflammation or infection
10
Q
clicking, snapping, popping
A
ligament/tendon dysfunction
11
Q
joint locking
A
cartilage tear, loose body, joint malalignment
12
Q
global weakness/fatigue, no clear pattern
A
cardiovascular dysfunction
13
Q
whole body pain
A
central somatization, “chronic pain”
14
Q
joint pain/stiffness, worse in AM
A
inflammatory
15
Q
joint pain/stiffness, worse w/ activity
A
degenerative
16
Q
back pain worse in AM, better after a few hours, and worse in PM
A
disc pathology
17
Q
pain varies throughout day, activity, or position
A
muscular
18
Q
constant, intense pain, worse in PM + wakes pt from sleep w/o relief
A
malignancy (RED FLAG)
19
Q
red flags requiring IMMEDIATE attention
A
- anginal pain not relieved in 10-20 minutes
- anginal pain w/ nausea, vomiting, profuse sweating
- diabetic pt who is confused, lethargic, or changes in mental alertness + function
- onset of incontinence or saddle anesthesia
- anaphylactic shock symptoms (hives, asthma, tachycardia, hypotension, anxiety, N/V)
20
Q
ABCS of radiographic evaluation
A
a > alignment
b > bone density
c > cartilage spaces
s > soft tissues
21
Q
vital signs
A
HR, BP, O2 sat, RR, temperature, pain
22
Q
nominal measures
A
checklist of activities and pt responds w/ either “yes or no”, “independent or dependent”, “able or unable to do”
23
Q
ordinal measures
A
outcome is measured in rank order (not equal intervals)
24
Q
interval/ratio measures
A
equal intervals b/w responses
- interval: #’s start at 1 (ie. girth)
- ratio: #’s start at 0 (ie. joint degrees)
25
reliability
dependable, accurate, predictable, and w/o variation time after time
- test-retest = over time
- intra-rater = w/in same rater
- inter-rater = b/w raters
26
face validity
instrument measures what it claims to measure
27
content validity
subcomponents of instrument adequately cover entire construct
28
6 components of ADLs
bathing, dressing, toileting, transfers, walking, feeding
29
floor effect
too difficult, produces low scores
30
ceiling effect
too easy, produces high scores
31
gold standard measure of balance
BERG balance scale
32
MDC
minimal detectable change
- statistical #, no significant change in pt
33
MCID
minimal clinically important difference
- clinical #, meaningful change in pt
34
"ability" type scale
higher # w/ improving condition
- ie. LEFS, UEFS, UEFI
35
"disability" type scale
lower # w/ improving condition
- ie. ODI, NDI, qDASH
36
household ambulator
< 0.40 m/s
37
limited community ambulator
0.40 - 0.80 m/s
38
community ambulator
> 0.80 m/s
39
DCML
light touch ID + localization, fine touch, vibration, proprioception, kinesthesia
40
spinothalamic tract
crude touch, pain, temperature
41
discriminative sensation testing
stereognosis, graphesthesia, 2-point discrimination, point localization
42
hypotonic
- injury or compression along nerve pathway (LMNL)
- unilateral
43
hypertonic
- CNS pathology (UMNL)
- bilateral
44
DTR grading
0: no reflex
1+: minimal response
2+: normal
3+: overly brisk response
4+: extremely brisk response, clonus, cross-over
45
DTR's
C5 = biceps, elbow flexion
C6 = brachioradialis, elbow flexion
C7 = triceps, elbow extension
L4 = patellar, knee extension
S1 = achilles, ankle PF
46
pupillary light reflex
- CN II: contralateral pupil constriction (sympathetic)
- CN III: ipsilateral pupil constriction (parasympathetic)
47
oculomotor (CN III) innervation
medial + inferior + superior rectus, inferior oblique, levator palpebrae superioris
48
trochlear (CN IV) innervation
superior oblique
49
abducens (CN VI) innervation
lateral rectus
50
oculomotor palsy
dilated pupil, drooping eyelid (ptosis), eye drifting lateral + down
51
bell's palsy
- LMNL > CN VII impairment
- motor: paralysis of ipsilateral half of face
- sensory: loss of taste on anterior 2/3 tongue
- parasympathetic: loss of tear + saliva production
52
global signs of cerebellar dysfunction
ataxia, tremors, hypotonia, dysarthria, eye deviations
53
ataxia
lack of control of body movements; decreased movement coordination
54
dysmetria
error in trajectory due to abnormal range, rate, and/or force of motion
55
dysdiadochokinesia
impaired ability to perform rapid alternating movements
56
UMNL presentation
- hyperreflexia
- pathologic reflexes = clonus, babinski, hoffman's, pronator drift
- increased muscle tone/spasticity
- underlying weakness
57
LMNL presentation
- hyporeflexia
- muscle weakness + atrophy
- sensory changes along dermatome or peripheral nerve distribution
58
anesthesia
complete loss of sensation
59
hypoesthesia
abnormally decreased sensitivity to stimulation
60
hyperesthesia
abnormally increased sensitivity to stimulation
61
hypoalgesia
diminished sensitivity to pain
62
hyperalgesia
increased sensitivity to pain
63
astereognosis
inability to recognize familiar objects by sense of touch
64
atopognosis
inability to correctly locate sensation
65
abaragnosis
inability to distinguish b/w different weights
66
paresthesia
abnormal sensation such as numbness, prickling, burning, or tingling
67
dysesthesia
impairment of any sensation, especially touch
68
paralysis
loss or impairment of motor or sensory function in a body part due to lesion in neural or muscular symptoms
69
hemiparaplegia
paralysis of lower half of one side of body
70
hemiparesis
muscular weakness or partial paralysis affecting one side of body
71
hemiparesthesia
abnormal sensation to one side of body
72
hemiplegia
paralysis of one side of body
73
paraparesis
partial paralysis of LEs
74
paraplegia
paralysis of LEs + lower part of body
75
tetraplegia, quadriplegia
paralysis of all 4 extremities
76
triplegia
paralysis of 3 extremities
77
diplegia
paralysis in either both UEs or LEs
78
ROM testing
perform before MMT
79
AROM
- subject's willingness to move
- coordination, muscle strength, joint ROM
- contractile tissue integrity
80
PROM
- integrity of joint surfaces
- extensibility of capsule, ligaments, muscles, fascia, skin
- end feels
- should be slightly greater than AROM
81
hypomobility
decrease in PROM that is less than normal values
82
hypermobility
increase in PROM that exceeds normal values
83
end feel
feeling experienced by examiner that is a barrier to further motion at end of PROM
84
capsular pattern
pattern of restriction of PROM of joint in presence of pathological conditions
- ER > abduction > IR
- abnormal
85
hard end feel
bone approximating bone (bone-to-bone)
- ie. elbow extension
86
firm end feel
tissue stretch
- ie. wrist flexion
87
soft end feel
soft tissue approximation
- ie. elbow or knee flexion
88
empty end feel
no resistance
- presence of pain
- always abnormal
89
grade 5
full ROM against gravity, maximum resistance
90
grade 4
full ROM against gravity, moderate resistance
91
grade 3+
full ROM against gravity, minimal resistance
92
grade 3
full ROM against gravity, no resistance
93
grade 3-
> 50% ROM against gravity, but full ROM in gravity-reduced
94
grade 2+
< 50% ROM against gravity, but full ROM in gravity-reduced
95
grade 2
full ROM in gravity-reduced
96
grade 2-
partial ROM in gravity-reduced
97
grade 1
palpable contraction (trace ROM)
98
grade 0
nothing palpable (no ROM)
99
spine - grade 5
full ROM against gravity, maximum resistance
100
spine - grade 4
full ROM against gravity, moderate resistance
101
spine - grade 3
full ROM against gravity, arms by side
102
spine - grade 2
partial ROM against gravity
103
spine - grade 1
palpable contraction, no trunk motion
104
spine - grade 0
nothing palpable
105
MMT indications
- strong + painless = everything intact
- strong + painful = minor lesion
- weak + painful = major lesion
- weak + painless = complete lesion, neurologic deficit
