tests and measures Flashcards
(115 cards)
1
Q
What are the levels of alert mental status?
A
Alert, Lethargic, Obtunded, Stupor, Comatose
2
Q
What does AO x4 indicate?
A
Normal orientation to person, place, time, and event
3
Q
What are the grades for deep tendon reflexes?
A
- 0: Absent
- +1: Hyporeflexia (LMN)
- +2: Normal
- +3: Hyperreflexia (UMN)
- +4: Abnormal
- +5: Abnormal
4
Q
What is the purpose of the Jendrassik Maneuver?
A
To help elicit a reflex response
5
Q
What are the primary reflexes tested in the upper extremities?
A
- Biceps
- Brachioradialis
- Triceps
6
Q
What are the primary reflexes tested in the lower extremities?
A
- Patellar
- Achilles
7
Q
What does a positive Hoffman’s test indicate?
A
Upper motor neuron (UMN) involvement
8
Q
What is the Modified Ashworth Scale (MAS) used for?
A
To assess muscle tone and spasticity
9
Q
What does a score of 3 on the MAS indicate?
A
Considerable increase in muscle tone; passive movement is difficult
10
Q
What is the difference between fractionated and unfractionated movement?
A
- Fractionated: Voluntarily move one segment independently
- Unfractionated: Simultaneous movement of multiple segments
11
Q
What is dysmetria?
A
Inability to judge distance and range of movement
12
Q
What is the significance of a score of >26 on the MOCA?
A
Normal cognitive function
13
Q
What does the term dysdiadochokinesia refer to?
A
Abnormal rapid alternating movements
14
Q
What does the term ‘cogwheel rigidity’ describe?
A
Tension in a muscle that gives way in little jerks when passively stretched
15
Q
What does a positive Babinski sign indicate?
A
Upper motor neuron (UMN) involvement
16
Q
What is the purpose of the pendulum test?
A
To determine resting tension of the muscle
17
Q
What are the cranial nerves tested in the assessment?
A
- I: Olfactory
- II: Visual Fields
- III: Pupillary Response
- IV: Extraocular Movements
- V: Sensation
- VII: Facial symmetry & expression
- VIII: Hearing assessment
18
Q
What does a negative Rinne test indicate?
A
Sensorineural hearing loss
19
Q
What does the term ‘bradykinesia’ refer to?
A
Slower movement often associated with basal ganglia damage
20
Q
Fill in the blank: The MAS score of 0 indicates _______.
A
No increase in tone
21
Q
What is the significance of a score of <10 on the MOCA?
A
Severe cognitive issues
22
Q
What is assessed during the smooth pursuit test?
A
Ability for eyes to perform smooth conjugate movement
23
Q
What does the term ‘hypertone’ refer to?
A
Increased muscle tone, often seen in upper motor neuron lesions
24
Q
What is assessed in the VOR cancellation test?
A
Central vestibular disorders
25
What does the term 'nystagmus' describe?
Involuntary eye movement
26
What does a positive pupillary response indicate?
Pupils are equal, round, and reactive
27
What does a positive visual field test indicate?
Monocular visual loss or visual field deficits
28
What is the significance of the extraocular movements test?
To assess for nerve palsy or dysconjugate gaze
29
What is assessed during the finger to nose test?
Dysmetria and coordination
30
What does the term 'lead pipe rigidity' refer to?
A smooth rigidity in flexion and extension that continues through the range of a stretched muscle
31
What is indicated by sound being louder in the unaffected ear?
Possible conductive hearing loss in the affected ear
## Footnote
This phenomenon can suggest that the sound is not being transmitted effectively through the affected ear.
32
What does it mean if sound heard through bone is equal to or longer than sound heard through air?
Possible conductive hearing loss
## Footnote
This indicates that the bone conduction is not impaired, suggesting issues with air conduction.
33
What does it indicate if sound heard through air is longer than sound heard through bone?
Possible sensorineural hearing loss
## Footnote
This suggests that the inner ear or auditory nerve may be compromised.
34
What is the procedure to assess hearing laterality using a tuning fork?
Strike tuning fork and place on top/middle of patient’s head, ask where they hear vibration
## Footnote
This helps determine if the sound lateralizes to one ear.
35
What cranial nerves control the palatal and pharynx muscles?
Cranial nerves IX and X
## Footnote
These nerves are responsible for motor control in these areas.
36
How is symmetrical elevation of the soft palate assessed?
Have patient say 'ahh' and observe for asymmetry
## Footnote
Asymmetry may indicate a lesion affecting one side.
37
What indicates a positive gag reflex?
Presence of gag reflex
## Footnote
This is assessed by touching the palate, pharynx, or tonsil.
38
What does weakness on the side of the lesion indicate in neck motor function testing?
Negative assessment
## Footnote
This suggests dysfunction in the associated cranial nerve or muscle.
39
What indicates a lower motor neuron lesion during tongue movement assessment?
Tongue deviation toward the weak side
## Footnote
This contrasts with upper motor neuron lesions, which deviate towards the strong side.
40
What is the first step in the ASIA examination?
Assess sensory level
## Footnote
This is determined by testing both pin prick and light touch.
41
What is the criteria for determining the motor level in the ASIA examination?
Strength must be at least 3/5 with all levels above being 5/5
## Footnote
This is scored for each side and overall.
42
What defines the Neurological Level of Injury (NLI)?
Lowest level at which both motor and sensory are intact on both sides of the body
## Footnote
This includes criteria for sensory and motor function.
43
What indicates whether an injury is complete or incomplete?
Presence of sacral sparing
## Footnote
This includes sensory function in S4/S5.
44
What is the scoring for sensory testing using light touch?
0: Absent, 1: Impaired, 2: Normal
## Footnote
Must test in a cephalo->caudal sequence.
45
What is the procedure for pinprick testing?
Use a sterilized safety pin and alternate between sharp and dull stimuli
## Footnote
Patient must verbalize the sensation.
46
What is an indicator of sensory function in the perianal area?
Sensation detected in S4/S5
## Footnote
This is critical for assessing sacral function.
47
What muscle groups are included for scoring in motor testing?
* C5: elbow flex
* C6: wrist extensors
* C7: elbow extensor
* C8: finger flexors
* T1: finger abductors
* L2: hip flex
* L3: knee ext
* L4: ankle DF
* L5: long toe ext
* S1: ankle PF
## Footnote
Scoring is based on the lowest level where strength is at least 3/5.
48
What does sacral sparing indicate in the context of spinal injuries?
Presence of any sensory function in S4/S5
## Footnote
This is crucial for classifying the injury as incomplete.
49
What are the categories of the Asia Impairment Scale?
* A: Complete
* B: Sensory incomplete
* C: Motor incomplete
* D: Motor incomplete with more than half scoring >3
* E: Normal
## Footnote
Each category defines the level of function preserved.
50
What is the testing location for sensory level C5?
Lateral side of the antecubital fossa just proximal to the elbow
## Footnote
Accurate testing is essential for determining sensory function.
51
What is the normative data for two-point discrimination at the fingertips?
2-5 mm
## Footnote
This varies by location on the body.
52
What is assessed during the vibration sense test?
Ability to detect vibratory sense
## Footnote
Testing is done at various points on the body.
53
What does the ability to identify an object placed in the patient's hand signify?
Stereognosis
## Footnote
This assesses cortical processing and sensory integration.
54
What is the scoring for proprioception testing?
0: Absent, 1: Impaired, 2: Normal
## Footnote
This tests the ability to perceive joint position.
55
What is the purpose of the kinesthesia test?
To detect the movement of a joint in space
## Footnote
This assesses the ability to recognize movement direction.
56
What is the significance of the temperature sensation test?
To perceive differences between hot and cold stimuli
## Footnote
This assesses the lateral spinothalamic tract.
57
What is the purpose of the C5 motor test?
Assess muscle strength in SCI, specifically for Biceps Brachii/Brachialis
## Footnote
This test evaluates the muscle strength of the elbow flexors.
58
What is the grading scale for muscle strength?
* 0: Total Paralysis
* 1: Palpable or visible contraction
* 2: Active movement, full range of motion (ROM) with gravity eliminated
* 3: Active movement, full ROM against gravity
* 4: Active movement, full ROM against gravity and moderate resistance
* 5: Normal active movement, full ROM against gravity and full resistance
* NT: Not testable
## Footnote
Grading is essential for assessing muscle strength in patients.
59
What is the setup for the C6 motor test?
Supine, shoulder in neutral, elbow extended, and forearm pronated
## Footnote
This position is critical for accurately testing wrist extension.
60
What is the purpose of the C7 motor test?
Test muscle strength of the Triceps muscles
## Footnote
This evaluates the ability to extend the elbow.
61
For the C8 motor test, which muscle is being assessed?
Flexor digitorum profundus
## Footnote
This muscle is essential for finger flexion.
62
What is the purpose of the T1 motor test?
Assess muscle strength of the Abductor digiti minimi
## Footnote
This test evaluates the movement of the little finger.
63
What are the primary muscles tested in the L2 motor test?
Hip flexors; iliopsoas muscle
## Footnote
This test assesses the strength of the hip flexors.
64
What is the purpose of the L3 motor test?
Test knee extensors (rectus femoris)
## Footnote
This assesses the strength of the quadriceps muscle.
65
What is the setup for the L4 motor test?
Supine, neutral hips, hip and knee slight flexion, ankle in full PF
## Footnote
This position allows testing of the anterior tibialis.
66
What is evaluated in the L5 motor test?
Extensor hallucis longus
## Footnote
This muscle is crucial for extending the big toe.
67
What is the purpose of the S1 motor test?
Assess muscle strength of the Gastrocnemius and Soleus
## Footnote
This test evaluates the ability to plantarflex the foot.
68
What is the grading system for sensory testing?
* 2: Intact (5/5 correct)
* 1: Impaired (4/5 minimally impaired, 2-3/5 moderately impaired)
* 0: Absent (inability to feel anything)
## Footnote
This grading is used to assess sensory function in patients.
69
How is light touch tested at C2?
Lightly touch at least 1 cm lateral to the occipital protuberance at the base of the skull
## Footnote
This is done with a piece of cotton.
70
What is the purpose of the pin prick test at C3?
Assess sharp vs dull sensation over the supraclavicular fossa
## Footnote
This helps evaluate sensory integrity in that region.
71
What is the sensory test setup for C5?
Lightly touch the lateral side of the antecubital fossa just proximal to the elbow
## Footnote
This area is tested to assess sensation in the upper limb.
72
What is the sensory test for C6?
Lightly touch the dorsal surface of the proximal phalanx of the thumb
## Footnote
This assesses sensory function in the thumb.
73
What is assessed at the C7 sensory level?
Dorsal surface of proximal phalanx of middle finger
## Footnote
This is to evaluate sensation in the middle finger.
74
What is the sensory location for C8?
Dorsal surface of the proximal phalanx of the little finger
## Footnote
This helps assess sensory function in the little finger.
75
What is the sensory test for T9?
Expose the area to be tested and lightly touch it with cotton
## Footnote
This assesses sensation in the lower thoracic region.
76
What is the purpose of exposing the area to be tested?
To assess sensory function by rolling up or removing clothing
77
How should the reference test be conducted?
Lightly touch an area with known, intact sensation and ask the patient to identify the touch
78
What is the procedure for testing T9 sensation?
Lightly touch the midclavicular line, three quarters down from the xiphisternum to the umbilicus, ask the patient to close their eyes and say 'yes' when touched
79
What is the procedure for testing T10 sensation?
Lightly touch at the midclavicular line at the level of the umbilicus, ask the patient to close their eyes and say 'yes' when touched
80
What is the procedure for testing T11 sensation?
Lightly touch the midclavicular line midway between the umbilicus and inguinal ligament, ask the patient to close their eyes and say 'yes' when touched
81
What is the procedure for testing T12 sensation?
Lightly touch at the midclavicular line over the midpoint of the inguinal ligament, ask the patient to close their eyes and say 'yes' when touched
82
What is the procedure for testing L1 sensation?
Lightly touch midway between the key sensory points for T12 and L2, ask the patient to close their eyes and say 'yes' when touched
83
What is the procedure for testing L2 sensation?
Lightly touch at the medial femoral condyle above the knee, ask the patient to close their eyes and say 'yes' when touched
84
What is the procedure for testing L3 sensation?
Lightly touch over the medial malleolus, ask the patient to close their eyes and say 'yes' when touched
85
What is the procedure for testing L4 sensation?
Lightly touch the dorsum of the foot at the third metatarsophalangeal joint, ask the patient to close their eyes and say 'yes' when touched
86
What is the procedure for testing L5 sensation?
Lightly touch the lateral aspect of the calcaneus, ask the patient to close their eyes and say 'yes' when touched
87
What is the procedure for testing S1 sensation?
Lightly touch the midpoint of the popliteal fossa, ask the patient to close their eyes and say 'yes' when touched
88
What is the procedure for testing S2 sensation?
Lightly touch over the ischial tuberosity or infragluteal fold, ask the patient to close their eyes and say 'yes' when touched
89
What is the procedure for testing S4/S5 sensation?
Lightly touch the perianal area, ask the patient to close their eyes and say 'yes' when touched
90
What are the grading criteria for functional sensation?
* Normal = intact 5/5
* Impaired = 1-4/5 correct or feels different from reference
* Absent = 0 probes correct
91
What is the purpose of using a 128 Hz tuning fork in vibration testing?
To provide clearer separation of normal from abnormal vibratory sensation
92
How is vibration tested in a practical setting?
Expose bony prominences, demonstrate in an area of intact sensation, instruct patient to identify when they feel the vibration
93
What is the purpose of stereognosis testing?
To assess the ability to perceive and integrate sensory modalities to identify small objects placed in the hand
94
What equipment is used for stereognosis testing?
* Safety pin
* Pen
* Nickel
* Penny
* Dime
* Quarter
* Paper clip
* Tooth brush
* Comb
95
What is the purpose of proprioception testing?
To assess static joint position sense
96
What is the purpose of kinesthesia testing?
To assess the ability to detect movement in space
97
What is the normative data for two-point discrimination on fingertips?
2-5 mm
98
How is two-point discrimination tested?
Use calipers to alternate 1- and 2-point stimuli, ask the patient to respond 'one' or 'two'
99
What is the purpose of graphesthesia testing?
To assess the ability to identify a number or letter drawn onto the hand while vision is occluded
100
What is the purpose of the sensory input assessment?
To assess the ability to use sensory input to identify a number or letter drawn onto the hand while vision is occluded
## Footnote
This assessment evaluates proprioceptive and tactile sensation.
101
What equipment is needed for the sensory input assessment?
Fine-tipped pencil or stick
## Footnote
These tools are used for drawing letters or numbers on the patient's hand.
102
What is the recommended patient position during the assessment?
Supine or sitting
## Footnote
The position should allow for comfortable access to the patient's hand.
103
What is the clinician's position during the sensory input assessment?
Standing or sitting beside the patient
## Footnote
This positioning facilitates better visualization and interaction.
104
What is the first step in the procedure for sensory input assessment?
Explain and demonstrate the procedure to the patient with their eyes open on their uninvolved hand
## Footnote
This ensures the patient understands what to expect.
105
What should the patient do after the clinician demonstrates the procedure?
Close their eyes
## Footnote
This is crucial for occluding vision during the assessment.
106
How is the stimulus drawn on the patient's hand?
The examiner slowly draws a number or letter using their finger or a blunt instrument
## Footnote
This method helps to assess tactile sensation without the patient seeing the drawing.
107
How many times should the drawing be repeated to determine sensation integrity?
3-5 times
## Footnote
Repetition helps to ensure accuracy in the assessment results.
108
What type of letters or numbers should be used during the assessment?
Letters or numbers that don’t involve lifting the stimulus from the patient’s hand
## Footnote
This ensures continuous contact and better sensory evaluation.
109
What is the purpose of the temperature assessment?
To assess the ability to perceive the difference between hot and cold stimuli
## Footnote
This evaluates thermal sensation.
110
What is the first step in the temperature assessment procedure?
Explain and demonstrate the procedure to the patient with their eyes open using a reference area
## Footnote
This helps the patient understand the test and ensures they know what to expect.
111
What should the patient do during the temperature assessment?
Close their eyes
## Footnote
This is important to prevent visual cues from influencing their responses.
112
What is the method for delivering temperature stimuli?
Place the hot or cold probe against the patient’s skin
## Footnote
This direct contact is necessary for accurate sensory assessment.
113
What should the patient identify during the temperature assessment?
Each stimulus as hot or cold
## Footnote
This identification is crucial for evaluating thermal sensation.
114
What can be used as probes for the temperature assessment?
Test tubes filled with hot/cold water, hot or cold (but not wet) surface of a metal spoon or fork
## Footnote
These items provide a practical way to test temperature perception.
115
Where is the temperature assessment typically performed?
On hands and feet
## Footnote
These areas are commonly used due to their sensitivity and accessibility.
