Neuro 2

Question 1

Joints have _________

Answer 1

range of motion

It is not proper to say the that the patient is strong at the elbow or has good range of motion of the biceps.

Question 2

Muscles have ________

Answer 2

strength

It is not proper to say the that the patient is strong at the elbow or has good range of motion of the biceps.

Question 3

What is wrong with this statement?

the patient is strong at the elbow

Answer 3

Joints have range of motion

Muscles have strength

Question 4

What is wrong with this statement?

the patient has good range of motion of the biceps.

Answer 4

Joints have range of motion

Muscles have strength

Question 5

•muscular twitching involving the simultaneous contraction of contiguous groups of muscle fibers

Answer 5

fasciculation

Question 6

residual muscle tension present in the muscle at rest

Answer 6

TONE

Question 7

How do you test for muscle TONE?

Answer 7

1. Assessed by feeling for resistance to passive stretch
2. Move the joints through Passive Range of Motion & feel for resistance

Question 8

Assessing muscle tone

INCREASED; Variable, worse at extremes of PROM

Answer 8

Spacticity

Question 9

Assessing muscle tone

INCREASED; Continuous throughout PROM

Answer 9

Lead pipe rigidity

Question 10

Assessing muscle tone

INCREASED; Intermittent/rachet like

Answer 10

Cogwheeling

Question 11

Assessing muscle tone

DECREASED

Answer 11

• hypotonia
• flacidity

Question 12

Abnormal Involuntary Movements

•most common cause is Parkinson’s Disease. This tremor is often called a “pill rolling” tremor for its characteristic movement.

Answer 12

Resting Tremor-

Question 13

Abnormal Involuntary Movements

•a tremor of movement. Does not exist at rest. Usually is caused by brainstem or cerebellar disease.

Answer 13

Intention Tremor-

Question 14

Abnormal Involuntary Movements

Answer 14

tremors and dyskinesias

Question 15

Abnormal Involuntary Movements

Two types of tremors/Dyskinesia

Answer 15

• Tremor at rest (pill rolling)
• Intention tremor (best seen on finger-to-nose)

Question 16

Abnormal Involuntary Movements

What is the best way to spot an ​Intention tremor?

Answer 16

•(best seen on finger-to-nose)

Question 17

Abnormal Involuntary Movements

Identify:

• a tremor of sustained posture. Is usually normal variant.

Answer 17

• Postural Tremor
• May be familial, or be caused or enhanced by medications, anxiety, sleep deprivation, caffeine, or hyperthyroidism

Question 18

Abnormal Involuntary Movements

Identify the causes:

• Postural Tremor

Answer 18

• Postural Tremor
• May be familial, or be caused or enhanced by medications, anxiety, sleep deprivation, caffeine, or hyperthyroidism
• a tremor of sustained posture. Is usually normal variant.

Question 19

Abnormal Involuntary Movements

Tics worsen with ______ and disappear during _______.

Answer 19

• Tics
• Tics worsen with stress and disappear during sleep.
• Sudden, quick, coordinated movements that may be easily imitated.
• Occurs repeatedly and can be voluntarily suppressed for a short time.

Question 20

Abnormal Involuntary Movements

Identify:

• Sudden, quick, coordinated movements that may be easily imitated.
• Occurs repeatedly and can be voluntarily suppressed for a short time.

Answer 20

• Tics
• Tics worsen with stress and disappear during sleep.

Question 21

Abnormal Involuntary Movements

Identify:

• –Unpredictable, brief, rapid, jerky movements

Answer 21

• •Chorea
• –Seen in Huntington’s Disease

Question 22

Abnormal Involuntary Movements

Identify the cause:

• Chorea

Answer 22

• •Chorea
• –Seen in Huntington’s Disease
• –Unpredictable, brief, rapid, jerky movements

Question 23

Abnormal Involuntary Movements

Identify the cause:

• •Athetosis

Answer 23

• Athetosis
• –Seen in Cerebral Palsy
• –Slow, twisting writhing movement

Question 24

Abnormal Involuntary Movements

Identify:

• –Slow, twisting writhing movement

Answer 24

• Athetosis
• –Seen in Cerebral Palsy

Question 25

Strength examination is the act of....

Answer 25

Testing muscles against resistance

Question 26

**_Strength scale_** Identify: * No movement/flicker

Answer 26

Zero-0 \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ GRADED 0 – 5 scale: 0 = No movement / flicker 1 = Visible flicker of contraction 2 = Active movement with gravity eliminated 3 = Active movement against gravity (no resistance at all) 4 = Active movement against gravity with some resistance 5 = Active movement against gravity with full resistance

Question 27

**_Strength scale_** Identify: * Visible flicker of contraction

Answer 27

One-1 \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ GRADED 0 – 5 scale: 0 = No movement / flicker 1 = Visible flicker of contraction 2 = Active movement with gravity eliminated 3 = Active movement against gravity (no resistance at all) 4 = Active movement against gravity with some resistance 5 = Active movement against gravity with full resistance

Question 28

**_Strength scale_** Identify: * Active movement with gravity eliminated

Answer 28

Two-2 \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ GRADED 0 – 5 scale: 0 = No movement / flicker 1 = Visible flicker of contraction 2 = Active movement with gravity eliminated 3 = Active movement against gravity (no resistance at all) 4 = Active movement against gravity with some resistance 5 = Active movement against gravity with full resistance

Question 29

**_Strength scale_** Identify: * Active movement against gravity (no resistance at all)

Answer 29

Three-3 \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ GRADED 0 – 5 scale: 0 = No movement / flicker 1 = Visible flicker of contraction 2 = Active movement with gravity eliminated 3 = Active movement against gravity (no resistance at all) 4 = Active movement against gravity with some resistance 5 = Active movement against gravity with full resistance

Question 30

**_Strength scale_** Identify: * Active movement against gravity with some resistance

Answer 30

Four-4 \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ GRADED 0 – 5 scale: 0 = No movement / flicker 1 = Visible flicker of contraction 2 = Active movement with gravity eliminated 3 = Active movement against gravity (no resistance at all) 4 = Active movement against gravity with some resistance 5 = Active movement against gravity with full resistance

Question 31

**_Strength scale_** Identify: * Active movement against gravity with full resistance

Answer 31

Five-5 \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ GRADED 0 – 5 scale: 0 = No movement / flicker 1 = Visible flicker of contraction 2 = Active movement with gravity eliminated 3 = Active movement against gravity (no resistance at all) 4 = Active movement against gravity with some resistance 5 = Active movement against gravity with full resistance

Question 32

Two rules for accurate strength testing

Answer 32

1. Always test side to side! 2. Never test both sides at the same time!

Question 33

**_Strength Testing_** ## Footnote Need to immobilize the _____________ of the muscles you are testing

Answer 33

limb proximal to the joint

Question 34

**_Strength Testing_** Do the deltoids have a joint you need to immobilize?

Answer 34

No; therefore may test both at same time

Question 35

**_Strength Testing_** Which muscle? “Make chicken wings and hold them up”

Answer 35

Deltoids * Nothing to immobilize

Question 36

**_Strength Testing_** Which muscle? “Make a muscle and don’t let me move it”

Answer 36

Biceps or Elbow Flexion * Immobilize shoulder

Question 37

**_Strength Testing_** Which muscle? “Push me away”

Answer 37

Triceps or Elbow Extension * Immobilize shoulder

Question 38

**_Strength Testing_** Which muscle? “Curl your wrist down and don’t let me uncurl it”

Answer 38

Wrist Flexion * Immobilize arm so patient can't move at elbow

Question 39

**_Strength Testing_** Which muscle? “Stick ‘em up and don’t let me move your wrist”

Answer 39

Wrist Extension * Immobilize arm so patient can't move at elbow

Question 40

**_Strength Testing_** Which muscle? “Lift your leg straight up and don’t let me push it down ”

Answer 40

Hip Flexors

Question 41

**_Strength Testing_** Which muscle? “Kick out against my hand”

Answer 41

Knee extension * Support thigh just above the knee

Question 42

**_Strength Testing_** Which muscle? “Bend your knee and don’t let me straighten it”

Answer 42

Knee extension * Support thigh just above the knee

Question 43

**_Strength Testing_** Which muscle? “Toes to the nose and don’t let me move them”

Answer 43

Ankle dorsiflexion * Support heel

Question 44

**_Strength Testing_** Which muscle? “Step on the gas!”

Answer 44

Ankle plantarflexion * Support heel

Question 45

**_Strength Testing_** Which muscle? “Big toe up like a thumbs up and hold it”

Answer 45

Toe extensors

Question 46

**_Strength Testing_** Which muscle? “Curl your toes and don’t let me uncurl them”

Answer 46

Toe flexors