Quiz 1: Lecture 1-8 + Labs Flashcards
(128 cards)
1
Q
What is cranial nerve I? How do you test it?
A
Olfactory n.
Function: Smell
2
Q
What is cranial nerve II? How do you test it?
A
Optic
Function: Vision
3
Q
What is cranial nerve III? How do you test it?
A
Oculomotor n.
Function: Eye movements
4
Q
What is cranial nerve IV? How do you test it?
A
Trochlear n.
Function: Eye movements
5
Q
What is cranial nerve V? How do you test it?
A
Trigeminal n.
Sensation of face, muscles of mastication
6
Q
What is cranial nerve VI? How do you test it?
A
Abducens n.
Function: Eye movements
7
Q
What is cranial nerve VII? How do you test it?
A
Facial n.
Function: Facial expressions, taste on anterior 2/3 of tongue
8
Q
What is cranial nerve VIII? How do you test it?
A
Vestibulocochlear n.
Function: Hearing and Balance
9
Q
What is cranial nerve IX? How do you test it?
A
Glossopharyngeal n.
Function: Sensation to posterior 1/3 of tongue
10
Q
What is cranial nerve X? How do you test it?
A
Vagus n.
Function: Phonation (speech), swallowing
11
Q
What is cranial nerve XI? How do you test it?
A
Spinal Accessory n.
Function: Motor innervation to trapezius and SCM
12
Q
What is cranial nerve XII? How do you test it?
A
Hypoglossal n.
Function: Tongue movement
13
Q
What are the elements of patient client management?
A
- Examination
- Eval
- Diagnosis
- Prognosis
- Intervention
- Outcomes
14
Q
4 avenues for PT decision making?
A
- Refer out
- Consult
- Co-manage
- Retain
15
Q
What is the time frame for short term goal? long term goal?
A
STG: <4 weeks
LTG: >4 weeks
16
Q
Differentiate between activity and participation in the ICF model
A
Activity: Activities of Daily Living… (ex: brushing teeth, combing hair, getting dressed, walking)
Participation: Extracurriculars… (ex: attending grandson’s football game, etc.)
17
Q
What does the EXAMINATION part of patient management consist of?
A
- Objective info + History
- Tests and Measures
- Systems review (cardiovascular, pulmonary, neuro, musculoskeletal)
18
Q
What does the EVALUATION part of patient management consist of?
A
- Measures the patient’s response to the test and measures
19
Q
SMART stands for…
A
Specific, Measurable, Accurate, Realistic, Timely
20
Q
What are the 5 subcategories of the ICF Model?
A
- Body function + structure
- Activity
- Participation
- Environmental factors
- Personal factors
21
Q
Describe the L2 Myotome
A
Hip Flexion
22
Q
Describe the L3 Myotome
A
Knee Extension
23
Q
Describe the L4 Myotome
A
Ankle Dorsiflexion
24
Q
Describe the L5 Myotome
A
Big toe extension
25
Describe the S1 Myotome
Ankle Plantarflexion
26
Describe the L2 Dermatome
Medial Thigh sensation
27
Describe the L3 Dermatome
Medial Knee sensation
28
Describe the L4 Dermatome
Medial/Anterior lower leg, medial foot, medial great toe sensation
29
Describe the L5 Dermatome
Lateral Calf, Webspace between toe 1 and 2
30
Describe the S1 Dermatome
Lateral Foot
31
The quad reflex (knee jerk) corresponds with which nerve root?
L3-4
32
The achilles reflex (ankle jerk) corresponds with which nerve root?
S1-2
33
Describe the C4 Myotome
Shoulder shrug/elevation (upper traps, levator scap)
34
Describe the C5 Myotome
Shoulder abduction @90 (deltoids)
35
Describe the C6 Myotome
Elbow flexion + Wrist extension (biceps brachii, brachioradialis, wrist extensor muscles)
36
Describe the C7 Myotome
Elbow extension + Wrist flexion (triceps and wrist flexors)
37
Describe the C8 Myotome
Finger flexion (FDS, FDP, FPL, Lumbricals)
38
Describe the T1 Myotome
Finger abduction (dorsal interossei muscles)
39
Describe the C4 Dermatome
Upper trap sensation
40
Describe the C5 Dermatome
Lateral upper arm sensation
41
Describe the C6 Dermatome
Lateral lower arm + lateral thumb sensation
42
Describe the C7 Dermatome
Middle finger (top and bottom) sensation
43
Describe the C8 Dermatome
Ring finger, medial lower arm (forearm) sensation
44
Describe the T1 Dermatome
Middle upper arm sensation
45
Describe the T2 Dermatome
Underneath armpit sensation
46
Which nerve root corresponds with the biceps tendon reflex?
C5-6
47
Which nerve root corresponds with the brachioradialis tendon reflex?
C6
48
Which nerve root corresponds with the triceps tendon?
C6-7
49
What are the categories of a PT diagnosis?
- Musculoskeletal
- Cardiopulmonary
- Neuromuscular
- Integumentary
50
What are some examples of a PT diagnosis?
- Gait abnormality
- Decreased aerobic capacity
- Abnormal posture
- Muscle weakness
- Neck pain with mobility defecits
51
Differentiate between a sign and symptom
Sign: Observable findings detected upon exam (objective)
(ex: vomiting or elevated BP)
Symptom: Reported perceptions of the client (subjective)
(ex: feeling nauseous)
52
What are constitutional symptoms?
Symptoms that tend to impact the entire body
ex: fever, diahhrea, fatigue, dizziness
53
What is a red flag? provide examples
"warning"
Features of a clinical exam that are associated with a high risk of serious disorders
(ex: infection, inflammation, cancer, fracture)
54
What is a yellow flag? provide examples
"caution"
signals the clinician to slow the process down
55
What is a CLINICAL YELLOW flag (different from normal yellow flags)?
Psychological distress
56
When should you screen for systemic disease (potential red flags)?
>40 years old, history of cancer, recent trauma or infection, prescence of bilateral symptoms
57
T or F? Having one red flag means you must stop treatment immediately
False, having one red flag is not the end of the world
58
List the sensitivity of tissue from most to least sensitive
- Periosteum
- Joint Capsule
- Subchondral bone
- Tendons and Ligaments
- Muscle
- Cortical bone
- Synovium
- Articular cartilage
59
What are the 3 categories of neurophysiological pain?
- Nociceptive
- Peripheral neuropathic
- Nociplastic
60
What is nociceptive pain?❗️❗️
Pain resulting from the activation of nociceptors in response to actual or potential tissue damage
(ex: cut, burn, etc.)
61
What is nociceptive pain?❗️❗️
Pain resulting from the activation of nociceptors in response to actual or potential tissue damage
(ex: cut, burn, etc.)
62
What is peripheral neuropathic pain?❗️❗️
Pain that is caused by damage or dysfunction in the PNS
(ex: diabetes, nerve injury, shingles)
63
What is nociplastic pain?❗️❗️
Pain that arises from altered nociceptive function without clear evidence of actual tissue damage... can sometimes lead to chronic pain
Also known as "central sensitization"
(ex: fibromyalgia, chronic fatigue syndrome)
64
What is peripheral neuropathic pain?
Pain that is caused by damage or dysfunction in the PNS
(ex: diabetes, nerve injury, shingles)
65
What is nociplastic pain?
Pain that arises from altered nociceptive function without clear evidence of actual tissue damage... can sometimes lead to chronic pain
(ex: fibromyalgia, chronic fatigue syndrome)
66
What are A delta fibers?
Responsible for fast, sharp, and localized pain transmission (Myelinated)
(ex: touching a hot stove)
67
What are C fibers?
Responsible for slow pain transmission (Unmyelinated)
(ex: the pain following the initial stimulus from touching a hot stove)
68
What is acute pain?
Short term pain that often comes as a response to injury or illness
69
What is chronic pain?
Long lasting pain that may impact day to day life
70
Differentiate between fear avoidance and pain persistence
Fear avoidance: When the fear of pain is holding the patient back rather than the pain itself
Pain persistence: When the patient powers through the pain
71
What is gate control theory?
Distracting pain signals going to the brain through other stimulus
(ex: rubbing your head after you hit it against something)
72
What are two pain assessment tools?
NPRS and VAS
73
List some forms of nonpharmacological methods to ease pain
- Thermotherapy
- Cryotherapy
- Aquatics
- Exercise
74
What is the SINSS Model?
A way of assessing the Severity, Irritability, Nature, Stage and Stability of pain
75
Ranges for "Severity" out of 10
Minimal severity: 0-3
Moderate severity: 4-7
Maximal severity: 8-10
76
What are the "Irritability" ratios (aggravating to easing factors)
Minimal irritability: 2:1
Moderate irritability: 1:1
Maximal irritability: 1:2
77
What does "Nature" mean in the SINSS Model?
The type of pain (specific condition, classification, pathology)
78
Describe the acute stage? subacute stage? chronic stage?
Acute: Symptom duration less than 3 weeks, recent onset
Subacute: Symptom duration more than 3 weeks, less than 6 weeks
Chronic: Symptom duration is greater than 6 weeks
79
Describe the romberg test
patient balances with feet directly next to each other, arms crossed
Normal: 30-60secs
Fall Risk: <20secs
80
Describe the sharpened romberg test
Patient is in a tandem stance, arms crossed
Normal: 30-60secs
81
Describe the single leg stance
Patient stands stationary on one leg
Normal: 30secs
Fall Risk: <5secs
82
Describe the TUG test
"Timed up and go" test
Patient stands up from chair, walks 3 meters, returns back to chair as quick as possible
Normal: <10secs
Fall Risk: >13.5secs
83
How long should a patient be able to sustain pertubations?
30 seconds
84
A plumb line should go through which structures?
Ear, in front of acromion, greater trochanter, in front of knee, in front of lateral malleolus
85
What is the ankle strategy for balance?
Activates muscles from distal to proximal to maintain balance
86
What is the hip strategy for balance?
Activates muscles from proximal to distal to maintain balance
87
Describe the sensory orientation of an unstable surface
10% somatosensory
60% vestibular
30% visual
88
Describe the sensory orientation of a firm surface
70% somatosensory
20% vestibular
10% visual
89
Describe the functional reach test
Is a DYNAMIC stability test
Fall Risk: <7inches
90
How to conduct a Modified Clinical Test of Sensory Interaction on Balance (Modified CTSIB)
4 ways
- Firm surface, eyes open
- Firm surface, eyes closed
- Complaint surface, eyes open
- Complaint surface, eyes closed
30secs x 3 trials, average out the results
91
What is dexterity?
Ability for skillful use of the fingers during motor tasks
92
What is agility?
The ability to rapidly and smoothly stop, initiate or change/stop a movement while maintaining postural control
93
What does fixation mean?
Holding a limb in the same position
94
List a few diagnoses a PT can and cannot make?
Cannot: Myocardial infarction, diabetic neuropathy
Can: Cardiac pump dysfunction, absent sensation, gastroc weakness
95
Differentiate between objective and subjective info
Objective: Something that is a fact
Subjective: Something that is based off an individual's perception
96
Differentiate between a sign and symptom
Sign: Objective findings that are based on facts from an exam/measure
Symptom: Subjective findings that are based on an individual's perception (their opinion)
97
What does a red flag mean? yellow?
Red: Warning (may warrant a referral)
Yellow: Caution
98
T or F? pH of surrounding tissue influences nociceptor sensitivity
True
99
What are three different balance strategies?
Ankle, Hip, Stepping strategies
100
What is the ankle strategy for balance?
Using ankle plantar flexors and dorsiflexors to maintain balance
101
What is the hip strategy for balance?
The use of hip flexion or extension to maintain balance
102
What is the stepping strategy for balance?
When displacement occurs beyond the limits of stability and patient must step to maintain balance
103
What information goes in the health
conditions category of the ICF model?
a) PT diagnosis
b) Impairments
c) Medical diagnosis
d) Tests and measures
Medical diagnosis
104
Which of the following would fit best into
the participation category of the ICF?
a) Cannot drive, cannot perform work tasks, cannot attend social
functions, can perform yard work
b) Cannot get dressed, cannot make dinner, can shower, can walk dog
c) Decreased range of motion, decreased strength
d) Has support from family members, not internally motivated
a) Cannot drive, cannot perform work tasks, cannot attend social
functions, can perform yard work
105
Which of the following is not a PT
diagnosis?
a) Impaired biceps strength
b) Decreased aerobic capacity
c) Torn ACL ligament
d) Cardiac pump dysfunction
e) Decreased Hip IR ROM
c) Torn ACL ligament
106
Which of the following is not a red flag?
a) Night pain
b) History of smoking
c) Bilateral symptoms
d) Changes in muscle tone or joint ROM in neurologic populations
b) history of smoking
107
What is the correct order of most sensitive
to least sensitive tissue?
a) Periosteum > cortical bone > joint capsule > synovium > articular cartilage
b) Articular cartilage > synovium > cortical bone > joint capsule > periosteum
c) Periosteum > synovium > joint capsule > cortical bone > articular cartilage
d) Periosteum > joint capsule > cortical bone > synovium > articular cartilage
d) Periosteum > joint capsule > cortical bone > synovium > articular cartilage
108
Pain that is diffuse across the body, not localized
to any one location, cannot be reproduced
biomechanically, and does not subside in the
absence of movement is most likely to be
classified as?
a) Peripheral neuropathic
b) Nociceptive
c) Nociplastic
d) Referred pain
c) Nociplastic
109
You burn your hand on a hot stove, how
would the pain sensation be relayed initially?
a) Dorsal column of the spinal cord
b) C fibers
c) Spinothalamic tract
d) A-delta fibers
d) A delta fibers
110
After the afferent fibers synapse on the dorsal
horn of the spinal cord what locations in the brain is pain information relayed to next?
a) Midbrain and cerebellum
b) Hypothalamus
c) Thalamus and brainstem
d) Cerebral cortex and medulla
c) Thalamus and brainstem
111
A patient comes to you with c/o knee pain that
has been consistent for 8 weeks. This would be
best categorized as?
a) Acute pain
b) Subacute pain
c) Chronic pain
d) Acute on chronic exacerbation
c) Chronic pain
112
The functional reach test would be a test
of which type of balance?
a) Stability
b) Dynamic
c) Static
d) Step strategy
b) Dynamic
113
What are the types of muscle tone?
- Normal
- Hypotonia
- Hypertonia
114
What is hypertonia rigidity?
Stiffness of muscles in both directions (during passive movement)
- Constant overactivity of a muscle
- Not velocity dependent, present at rest (similar to parkinson's disease)
115
What is hypertonia spasticity?
Stiffness of muscles in one direction
- Usually more apparent in one direction than another
- Velocity dependent (faster the movement, faster the muscle response)
- Clonus may sometimes happen
116
What is clonus?
When a muscle experiences a quick stretch, then is followed by involuntary rhythmic response
117
What is dystonia?
- A movement disorder characterized by involuntary muscle contractions (twisting movements)
- Common in individuals with cognitive disabilites
- Becomes worse when the individual moves
118
You are examining a patient who presents with
abnormal twisting movements of their UE as they
reach for a light dumbbell rested on the treatment
table. Which form of hypertonia would this be
categorized as?
a) Clonus
b) Spasticity
c) Rigidity
d) Dystonia
e) Atonia
d) Dystonia
119
What are the three main features associated
with spasticity?
a) Hyper-reflexive, non-velocity dependent, clonus
b) Hypo-reflexive, velocity dependent, unidirectional
c) Hyper-reflexive, velocity dependent, clonus
d) Hypo-reflexive, non-velocity dependent, abnormal posture at rest
c) Hyper-reflexive, velocity dependent, clonus
120
You are assessing a patients R UE for tone abnormalities, and
while moving the shoulder through flexion-extension range of
motion, you discover a large resistance to passive flexion. What
tone abnormality should this be categorized as?
a) Spasticity
b) Dystonia
c) Rigidity
c) Rigidity
121
T or F? A pendulum motion can be a great way to test passive motion
True
122
You are testing the ability of your patient to
pronate and supinate the wrist. They are able to
alternate between the two positions slowly with
both hands. How would you regress the test to
accurately measure their coordination?
a) Ask them to complete the motion with eyes closed
b) Have them speed up
c) Ask them to do asymmetric motions
d) Have them complete the test with one side at a time
d) Have them complete the test with one side at a time
123
What are the 3 types of hypertonia?
Spasticity, rigidity, dystonia
124
What are the 4 components/steps of muscle tone assessment?
Observation, palpating, active motion, passive motion
125
Which type of hypertonia may have clonus?
Spasticity
126
What is spasticity?
Increased muscle tone that is velocity dependent (resistance increases when speed increases)
127
What is rigidity?
A constant increase in muscle tone that does not depend on velocity of movement (resistance remains the same through the movement)
128
What is dystonia?
Involuntary muscle contractions that lead to abnormal twisting movements
