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NPTE Exam > Neuromuscular: Study Set 1 > Flashcards

Neuromuscular: Study Set 1 Flashcards

1
Q

Which cervical levels are most likely to be affected if a SCI occurs while in a flexed position

A

C5 -C6

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2
Q

Which cervical levels are most likely to be affected if a SCI occurs while in an extended position

A

C4 - C5

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3
Q

Which of the following incomplete SCI lesions are a result of compression and/or MOI of cervical flexion. This lesion results in a loss of motor function, pain and temperature sensation below the lesion due to damage of the corticospinal and spinothalamic tracts

Anterior Cord Syndrome
Brown-Sequard’s Syndrome
Cauda Equina Injury
Central Cord Syndrome
Posterior Cord Syndrome

A

Anterior Cord

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4
Q

If a patient presents with anterior cord syndrome, what are the typical signs and symptoms you would find

A

Compression to the anterior spinal cord with a MOI of cervical flexion

Loss of motor function, pain, and temperature sensation below the level bilaterally

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5
Q

Which of the following incomplete SCI lesions are a result of hemisection of the spinal cord typically due to a stab wound. This will result in a loss of vibratory and position sense ipsilateral to the lesion, and a loss of pain and temperature sense on the contralateral side of the lesion

Anterior Cord Syndrome
Brown-Sequard’s Syndrome
Cauda Equina Injury
Central Cord Syndrome
Posterior Cord Syndrome

A

Brown-Sequard’s Sydrome

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6
Q

If a patient presents with Brown-Sequard’s Syndrome, what are the typical signs and symptoms you would find

A

Hemisection of the spinal cord most likely due to a stab wound.

Loss of vibratory and position sense on the same side as the lesion, but a loss of pain and temperature sense are found on the opposite side of the lesion

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7
Q

Which of the following incomplete SCI lesions occur below the L1 spinal level and are not expected to make a full recovery. A patient with this injury will experience flaccidity, areflexia, and impairment of the bowel and bladder.

Anterior Cord Syndrome
Brown-Sequard’s Syndrome
Cauda Equina Injury
Central Cord Syndrome
Posterior Cord Syndrome

A

Cauda Equina Syndrome

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8
Q

Is Cauda Equina considered a CNS or PNS injury

A

PNS

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9
Q

If a patient presents with a cauda equina injury, what signs and symptoms will they demonstrate

A

Flaccidity, areflexia, and impaired bowel and bladder function

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10
Q

Which of the following incomplete SCI lesions results from compression and/or hyperextension that will cause the UE to have greater impairments than the LE, and motor deficits will be greater than sensory deficits

Anterior Cord Syndrome
Brown-Sequard’s Syndrome
Cauda Equina Injury
Central Cord Syndrome
Posterior Cord Syndrome

A

Central cord syndrome

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11
Q

If a patient presents with central cord syndrome, what signs and symptoms might they demonstrate

A

Compression and damage to the central spinal cord with a MOI of hyperextension

More UE involvement with greater motor deficits than sensory deficits

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12
Q

Which of the following SCI lesions results from compression of the spinal cord and is characterized by loss of proprioception, two point discrimination, and stereognosis; but motor function is preserved

Anterior Cord Syndrome
Brown-Sequard’s Syndrome
Cauda Equina Injury
Central Cord Syndrome
Posterior Cord Syndrome

A

Posterior cord syndrome

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13
Q

What is stereognosis

A

The ability to recognize an object with tactile senses without vision.

Ex: Being able to tell I’m holding an apple vs a banana

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14
Q

List the levels of the ASIA impairment scale and their definitions

A

Level A: Complete - no motor or sensory function is preserved
Level B: Sensory incomplete - Sensory is preserved, but no motor function is preserved more than three levels below the lesion
Level C: Motor incomplete - Sensory is preserved, but no motor function is preserved less than three levels below the lesion and less than half of the motor function that is preserved scores 3 or greater for MMT
Level D: Motor incomplete - Sensory is preserved, but no motor function is preserved less than three levels below the lesion, but more than half of the motor function that is preserved scores 3 or greater for MMT
Level E: Normal

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15
Q

State the muscle group to be tested in relation to the following myotomes in a patient with a SCI

C5
C6
C7
C8
T1
L2
L3
L4
L5
S1

A

C5 - elbow flexors
C6 - wrist extensors
C7 - elbow extensors
C8 - finger flexors
T1 - small finger abductors
L2 - hip flexors
L3 - Knee extensors
L4 - ankle DFs
L5 - great toe extensors
S1 - ankle PFs

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16
Q

State the specific muscle to be tested in relation to the following myotomes in a patient with a SCI

C5
C6
C7
C8
T1
L2
L3
L4
L5
S1

A

C5 - biceps, brachialis
C6 - extensor carpi radialis longus and brevis
C7 - triceps
C8 - flexor digitorum profundus
T1 - abductor digiti minimi
L2 - iliopsoas
L3 - quadriceps
L4 - tibialis anterior
L5 - extensor hallucis longus
S1 - gastrocnemius, soleus

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17
Q

State the site for sensory testing in relation to the dermatomes C2-C8

A

C2 - Just lateral to the occipital protuberance
C3 - Supraclavicular fossa
C4 - Top of AC joint
C5 - lateral antecubital fossa
C6 - Dorsal thumb, proximal phalanx
C7 - Dorsal middle finger, proximal phalanx
C8 - Dorsal little finger, proximal phalanx

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18
Q

State the site for sensory testing in relation to the dermatomes T1-T12

A

T1 - medial antecubital fossa
T2 - apex of axilla
T3 - Third intercostal space
T4 - fourth intercostal space
T5 - fifth intercostal space
T6 - xiphoid process
T7 - T7
T8 - T8
T9 - T9
T10 - level of umbilicus
T11 - T11
T12 - midpoint of inguinal ligament

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19
Q

State the site for sensory testing in relation to the dermatomes L1-S4/5

A

L1 - L1
L2 - anteromedial thigh
L3 - medial femoral condyle
L4 - medial malleolus
L5 - dorsal surface of third toe; (great toe per SBU)
S1 - lateral heel; (lateral side of pinky toe per SBU)
S2 - popliteal surface; (soleus per soleus)
S3 - ischial tuberosity
S4/5 - perianal area

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20
Q

True or False:

Balance relies on a combination of somatosensory input, visual input, and vestibular input.

A

True

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21
Q

When working with a balance patient, what are some general ways to challenge somatosensory input

A

Changing the surface they are standing on; foam; slopes; uneven surfaces

Anything that will challenge joint position and proprioception

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22
Q

When working with a balance patient, what are some general way to challenge visual input

A

eyes open; eyes close;

test for visual pursuits, saccades, and gaze control

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23
Q

When working with a balance patient, what are some ways to challenge vestibular input

A

Moving the head left/right or up/down. Walking faster/slower

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24
Q

Which of the following input systems have receptors located in the joints, muscles, and ligaments to provide proprioceptive information.

Somatosensory input
Visual input
Vestibular input

A

somatosensory input

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25
Q

Which of the following input systems have receptors that allow for perceptual acuity regarding verticality motion of objects and self, environmental orientation, postural sway, and movements of the head/neck.

Somatosensory input
Visual input
Vestibular input system

A

visual input

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26
Q

Which of the following input systems provides the NCS with feedback regarding the position and movement of the head with relation to gravity

Somatosensory input
Visual input
Vestibular input

A

vestibular input

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27
Q

Which of the following allows for head/eye movement coordination and gaze stabilization through eye movement that counters head movement?

VOR - vestibuloocular reflex
VSR - Vestibulospinal reflex

A

VOR

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28
Q

Which of the following allows for head and neck movement in relation to the body for postural control and stability during upright postures

VOR - vestibuloocular reflex
VSR - Vestibulospinal reflex

A

VSR

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29
Q

Which of the automatic postural strategies is the first strategy to be elicited by a small range and slow velocity perturbation if the feet are on the ground?

Ankle strategy
Hip strategy
Suspensory strategy
Stepping strategy

A

Ankle strategy

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30
Q

During an ankle strategy, do muscles contract from distal to proximal or proximal to distal?

A

distal to proximal

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31
Q

Which of the automatic postural strategies is elicited by a greater force in which the hips will move in an opposite direction than the head moves in order to maintain balance?

Ankle strategy
Hip strategy
Suspensory strategy
Stepping strategy

A

hip strategy

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32
Q

During a hip strategy, do muscles contract from distal to proximal or proximal to distal

A

proximal to distal

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33
Q

Which of the automatic postural strategies is used to lower the center of gravity during standing or ambulation to better control the center of gravity?
Hint: This strategy is often used when both mobility and stability are required of a task?

Ankle strategy
Hip strategy
Suspensory strategy
Stepping strategy

A

suspensory strategy

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34
Q

What would be a good example of using a suspensory strategy

A

surfing or skateboarding

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35
Q

Which of the following automatic postural strategies is elicited through unexpected perturbations during static standing or when a perturbation occurs beyond the base of support?

Ankle strategy
Hip strategy
Suspensory strategy
Stepping strategy

A

Stepping strategy

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36
Q

True or False:

If a patient reaches out with his/her upper extremities in attempt to regain balance, they are using an automatic stepping postural strategy

A

True, the use of UE reaching out or the use of LE stepping out to regain balance are both examples of stepping strategy

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37
Q

Vertigo can either have a PNS or CNS etiology. If the origin of vertigo is the PNS, what are the characteristics that a patient might experience?

A

Episodic, short duration
Precipitating factors
Pallor, sweating
Nausea, vomiting
Fullness or tinnitus

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38
Q

Vertigo can either have a PNS or CNS etiology. If the origin of vertigo is the CNS, what are the characteristics that a patient might experience?

A

Loss of consciousness
Neurological symptoms such as
-diplopia
-hemianopsia
-weakness
-numbness
-ataxia
-dysarthria
(red flags)
-

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39
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

BPPV

A

PNS

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40
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Meniere’s disease

A

PNS

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41
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Meningitis

A

CNS

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42
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Infection

A

PNS

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43
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Migraine headache

A

CNS

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44
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Complications of neurologic origin post ear infection

A

CNS

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45
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Trauma/tumor

A

CNS or PNS

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46
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Metabolic disorders such as diabetes mellitus

A

PNS

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47
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Cerebellar degeneration disorders such as alcoholism

A

CNS

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48
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Acute alcohol intoxication

A

PNS

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49
Q

State whether the following etiology of vertigo is caused from the PNS or CNS

Multiple sclerosis

A

CNS

50
Q

What is Meniere’s disease?

A

A build up of fluid in the inner ear causing vertigo.
A PNS issue.

51
Q

What is meningitis?

A

Inflammation and infection of the fluid/membrane surrounding the brain and spinal cord that could cause vertigo like symptoms.
A CNS issue.

52
Q

What is multiple sclerosis?

A

A disease in which the immune system attacks the myelin sheath in the CNS that disrupts the connection between the brain and body which cause vertigo like symptoms.
A CNS issue.

53
Q

Which canal does BPPV most commonly affect?

A

posterior semicircular canal

54
Q

Which of the following balance tests and measures is used to assess fall risk and is scored out of 56

Berg Balance Scale
Fregley-Graybiel Ataxia Test
Fugyl-Meyer Test
Function Reach Test
Romberg Test
Timed up and Go
Tinetti Balance Test

A

Berg balance scale

55
Q

True or False:

A patient who scores a 48 on the berg balance scale is at an increased risk of falling

A

False; Lower than 45 is an increased risk

56
Q

Which of the following balance tests and measures is used to assess balance in patients with a higher level of motor skills

Berg Balance Scale
Fregley-Graybiel Ataxia Test
Fugyl-Meyer Test
Function Reach Test
Romberg Test
Timed up and Go
Tinetti Balance Test

A

Fregley-Graybiel Ataxia Test

57
Q

Which of the following balance tests and measures is used to assess balance in patients with hemiplegia

Berg Balance Scale
Fregley-Graybiel Ataxia Test
Fugyl-Meyer Test
Function Reach Test
Romberg Test
Timed up and Go
Tinetti Balance Test

A

Fugly-Meyer

58
Q

Which of the following balance tests and measures is used to assess standing balance and risk of falling

Berg Balance Scale
Fregley-Graybiel Ataxia Test
Fugyl-Meyer Test
Function Reach Test
Romberg Test
Timed up and Go
Tinetti Balance Test

A

Functional reach test

59
Q

Which of the following balance tests and measures is used to assess balance and ataxia

Berg Balance Scale
Fregley-Graybiel Ataxia Test
Fugyl-Meyer Test
Function Reach Test
Romberg Test
Timed up and Go
Tinetti Balance Test

A

Romberg test

60
Q

Which of the following balance tests and measures is used to assess a patient’s level of mobility and balance

Berg Balance Scale
Fregley-Graybiel Ataxia Test
Fugyl-Meyer Test
Function Reach Test
Romberg Test
Timed up and Go
Tinetti Balance Test

A

Timed up and go

61
Q

Which of the following balance tests and measures is used to assess fall risk and is out of 28

Berg Balance Scale
Fregley-Graybiel Ataxia Test
Fugyl-Meyer Test
Function Reach Test
Romberg Test
Timed up and Go
Tinetti Balance Test

A

Tinetti Balance test

62
Q

True or False:

A patient who scores 18 on the Tinetti balance test is at an increased risk of falling

A

True, anything less than 19/28 is at an increased risk of falling

63
Q

Briefly describe the Fregley-Graybiel Ataxia Test

A

This test is used to assess balance in patients with high level of motor skills.
There’s 8 tests with 5 trials of each
The trials include standing/walking on a balance beam, standing SLS and in romberg, and walking with eyes closed

64
Q

Briefly describe the fugly meyer

A

This test is used for patients with hemiplegia.
7 items total with a total score of 14, 14 being the best/least deficits

65
Q

Briefly describe the functional reach test

A

Testing standing balance and risk of falling by a patient standing and reaching as far as they can next to a yard stick.
Average of three trials

66
Q

Briefly describe the romberg test

A

This test assess sensory ataxia and balance. Patient stands in romberg with eyes open then closed.
30 sec is normal.
A positive romberg is positive for sensory ataxia, not cerebral ataxia.
The sharpened romberg test is standing in tandem with eyes open and closed.

67
Q

Briefly describe the timed up and go test

A

This tests the level of mobility and and balance a patient has.
A patient starts in an armless chair, stands up and walks 10 feet, turns around and sits back down.
Out of 5 points, a score of 5 is severe risk.
A time 10 sec in normal
20 sec is an increased risk for falls
30 sec is a high risk for falls

68
Q

Briefly describe the tinetti balance test

A

used to assess risk of falling
Out of 28, a score of less than 19 is an increased risk of falling

69
Q

Briefly describe the balance berg scale

A

Used to assess risk of falling
Out of 56, a score of less than 45 is an increased fall risk

70
Q

Which region of the brain plays an important role in maintaining motor control and balance

A

cerebellum

71
Q

What is cranial nerve I
Is this an efferent or afferent nerve?

A

olfactory; sensory

72
Q

What is cranial nerve II
Is this an efferent or afferent nerve?

A

optic; sensory

73
Q

What is cranial nerve III
Is this an efferent or afferent nerve?

A

oculomotor; motor

74
Q

What is cranial nerve IV
Is this an efferent or afferent nerve?

A

Trochlear; motor

75
Q

What is cranial nerve V
Is this an efferent or afferent nerve?

A

trigeminal; both sensory and motor

76
Q

What is cranial nerve VI
Is this an efferent or afferent nerve?

A

abducens; motor

77
Q

What is cranial nerve VII
Is this an efferent or afferent nerve?

A

facial; both

78
Q

What is cranial nerve VIII
Is this an efferent or afferent nerve?

A

vestibulocochlear; sensory

79
Q

What is cranial nerve IX
Is this an efferent or afferent nerve?

A

glossopharyngeal; both sensory and motor

80
Q

What is cranial nerve X
Is this an efferent or afferent nerve?

A

vagus; both sensory and motor

81
Q

What is cranial nerve XI
Is this an efferent or afferent nerve?

A

accessory; motor

82
Q

What is cranial nerve XII
Is this an efferent or afferent nerve?

A

hypoglossal; motor

83
Q

How is cranial nerve I tested

A

identify familiar orders

84
Q

How is cranial nerve II tested

A

test visual fields and acuity
Ex: identify objects/letters from a chart

85
Q

How is cranial nerve III tested

A

The H test
Ex: having a pt follow an object with their eyes without moving their head in the shape of an H

86
Q

How is cranial nerve IV tested

A

moving eyes downward and inward without moving head

87
Q

How is cranial nerve V tested

A

Trigeminal Nerve
S: sharp or dull sensation
M: Clenching teeth; mastication
protruding, retracting, and lateral deviation of the mandible

88
Q

How is cranial nerve VI tested

A

Lateral glaze of the eyes without moving the head

89
Q

How is cranial nerve VII tested

A

S: Tasting on the anterior portion of the tongue
M: Mimicking facial expressions

90
Q

How is cranial nerve VIII tested

A

Identifying nose
Ex: rubbing fingers together next to ear; Weber and Rinne test

91
Q

How is cranial nerve IX tested

A

S: Depressing the tongue to stimulate a gag reflex
M: Tasting on the posterior portion of the tongue

92
Q

How is cranial nerve X tested

A

S: Depressing the tongue for a gag reflex; saying “ahh”
M: The ability to swallow

93
Q

How is cranial nerve XI tested

A

Accessory nerve; motor
Resisted shoulder shrug

94
Q

How is cranial nerve XII tested

A

Sticking out tongue

95
Q

Which muscle is innervated by the oculomotor nerve

Superior oblique
Upper trapezius
Lateral rectus
Medial rectus

A

Medial rectus

96
Q

Which muscle is innervated by the abducens nerve

Superior oblique
Upper trapezius
Lateral rectus
Medial rectus

A

lateral rectus

97
Q

What muscle is innervated by the trochlear nerve

Superior oblique
Upper trapezius
Lateral rectus
Medial rectus

A

superior oblique

98
Q

What muscle is innervated by the accessory nerve

Superior oblique
Upper trapezius
Lateral rectus
Medial rectus

A

upper trapezius

99
Q

True or False:

Bell’s palsy is a result of damage to cranial nerve VII

A

True; the facial nerve

100
Q

True or False:

Taste on the anterior tongue is the sensory component of the glossopharyngeal nerve

A

False; facial nerve

101
Q

True or False:

Autonomic innervation of the abdominal viscera is innervated by the vagus nerve

A

True

102
Q

True or False:

The superior oblique muscle of the eyeball is innervated by the trochlear nerve

A

true

103
Q

True or False:

An inability to protrude the mandible may be indicative of hypoglossal nerve damage

A

False; trigeminal

104
Q

True or False:

Anosmia may result due to damage to the olfactory nerve

A

True; anosmia is the inability to smell

105
Q

True or False:

Diplopia may result due to damage of the facial nerve

A

False; trochlear

106
Q

True or False:

The inability to clench the teeth may be indicative of damage to the trigeminal nerve

A

true

107
Q

Which two cranial nerves are not responsible for movement of the eyes

abducens
optic
oculomotor
trigeminal
trochlear

A

optic and trigeminal

108
Q

Which two cranial nerve pathways are associated with the corneal reflex

afferent trigeminal
efferent optic
afferent oculomotor
efferent facial

A

afferent trigeminal and efferent facial

109
Q

Which two cranial nerves originate from the midbrain

A

oculomotor and trochlear

110
Q

Autonomic innervation to the lacrimal gland is via the ______ nerve

A

smallest branch of the trigeminal nerve, the lacrimal nerve

111
Q

Testing pupillary reaction to light would assess the function of the ________ nerve

A

Oculomotor

112
Q

What is aphasia

A

impairment of processing expressive or receptive language

113
Q

what are the two categories of aphasia

A

fluent or non-fluent

114
Q

what is the definition of prosody

A

the use of rhythm and sounds when talking

115
Q

what is paraphasia

A

sentences are jumbled and don’t make sense

116
Q

what are the two types of fluent aphasia

A

Wernicke’s aphasia and conduction aphasia

117
Q

what are the characteristics of Wernicke’s aphasia

A

known as receptive aphasia
comprehension is impaired
poor writing and naming skills
no motor impairments typically

118
Q

what are the characteristics of conduction aphasia

A

good comprehension
impairment with repetition
hard to find words mid speech
reading is intact but writing is impaired

119
Q

what are the two types of non-influent aphasia

A

broca’s aphasia and global aphasia

120
Q

what are the characteristics of broca’s aphasia

A

expressive aphasia, most common form of aphasia
good comprehensive but impaired motor impairment

121
Q

what are the characteristics of global aphasia

A

comprehension impaired
impaired writing and naming
uses non verbal skills to communicate

NPTE Exam (54 decks)

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