Week 5

Question 1

What are the goals of an objective exam?

Answer 1

Collect/test/measure objective data

Analyze data/establish working diagnosis

Determine prognosis

Formulate a plan of treatment

Question 2

Systems review

Answer 2

Brief limited tests or measures of 5 major body systems to assess their impact on movement and function

Question 3

What are the types of systems review?

Answer 3

ROM measures

Joint testing

Muscle tests

Special test

Palpations

Manual muscle test (strength)

Question 4

When is the system review performed?

Answer 4

At the beginning of the objective exam

Question 5

What are the 5 body systems routinely screened?

Answer 5

Cardiovascular/pulmonary

Integumentary

Musculoskeletal

Neuromuscular

Mental functions

Question 6

What is assessed in the cardiovascular/pulmonary system?

Answer 6

HR

Respiratory rate

BP

Edema

Oxygen levels

Gait speed

Question 7

What is assessed in the integumentary system?

Answer 7

Skin color

Scars

Pliability

Skin integrity (wounds)

Question 8

What is assessed in the musculoskeletal system?

Answer 8

Gross ROM

Gross strength

Muscle girth

Height/weight

Question 9

What is assessed in the neuromuscular system?

Answer 9

Gross UE and LE sensations

Deep tendon reflexes

Balance

Transfers

Gait

Transitions

Question 10

What is assessed in mental functions?

Answer 10

Consciousness

Orientation (person, place, time)

Expected response to requests

Learning preferences

Question 11

When should vital signs be taken?

Answer 11

Prior to treatment

During treatment

After treatment

Question 12

Pulse rate

Answer 12

Rate, rhythm, and volume of the pulse (do not use your thumb)

Question 13

How should pulse rate be taken?

Answer 13

30 seconds multiplied by 2

1 minute if their pulse is abnormal

Question 14

What is the scale for pulse rate?

Answer 14

0- No palpable pulse
1+ Faint, but detectable pulse
2+ normal
3+ increased or full
4+ bounding pulse

Question 15

Pulse oximetry

Answer 15

Measures blood O2 levels, monitor pulse rate, and calculates HR

Question 16

What is a normal blood O2 saturation?

Answer 16

95-100%

Question 17

What is often used to detect pulse oximetry?

Answer 17

Finger pulse oximeter

Question 18

What is considered a normal BP?

Answer 18

<120 and <80

Question 19

What is considered an elevated BP?

Answer 19

120-129 and <80

Question 20

What is considered hypertension stage 1?

Answer 20

130-139 OR 80-89

Question 21

What is considered hypertension stage 2?

Answer 21

> 140 OR >90

Question 22

What is considered hypertensive crisis?

Answer 22

> 180 OR >120

Question 23

What is the most common BP reading mistakes?

Answer 23

Using wrong sized cuff

Incorrect patient positioning

Normal reading prejudice

Not factoring in electronic units correctly

Question 24

What are reasons BP would be higher than normal?

Answer 24

Full bladder

Unsupported back

Unsupported feet

Crossed legs

Cuff over clothing

Unsupported arms

Patient talking

Question 25

Where are the 9 sites to take pulse rate?

Answer 25

Brachial (most common) Apical Temporal Carotid Radial Femoral Popliteal Posterior tibial Dorsal pedis

Question 26

Orthostatic hypotension

Answer 26

SBP drops by at least 20 mmHg when standing up from a supine position Or DBP drop by 10 mmHg within 3 minutes of standing up

Question 27

What is proper positioning of patient when taking BP?

Answer 27

Supported back Supported feet Supported arm and height of heart

Question 28

What are factors that can affect body temperature?

Answer 28

Time of day Age Environmental temperature Infection Physical activity Emotion status Site of measurement Menstrual cycle Oral cavity temperature

Question 29

How do you assess respiration rate?

Answer 29

Count amount of breaths but do not tell the patient (typically done during pulse measurement)

Question 30

What are normal amounts of respiration at rest?

Answer 30

12-18 per minute for adults 30-50 per minute for infants

Question 31

Gross sensory light touch screening

Answer 31

Have patient close eyes and lightly touch 5 different areas (score 1-5 based on how many patients tells you correctly)

Question 32

Where is the center of gravity of a standing person?

Answer 32

Second sacral segment

Question 33

What does L4 indicate in deep tendon reflex?

Answer 33

Quadriceps (tap patellar tendon)

Question 34

What does S1 indicate in the deep tendon reflex?

Answer 34

Achilles

Question 35

Scoring for deep tendon reflex

Answer 35

4+ very brisk response, associated with clonus 3+ Brisk response, possibly hyperreflexive 2+ normal, average response 1+ low normal response 0 no response 1+(R) absent response which appears with reinforcement 0(R) no response even with reinforcement

Question 36

Jendrassik maneuver

Answer 36

Reinforcement technique during deep tendon reflex (lock fingers and pull against eachother)

Question 37

Balance

Answer 37

Ability to keep the center of mass within the base of support

Question 38

Static balance

Answer 38

Control of COM when the BOS is static (sitting, standing)

Question 39

Dynamic balance

Answer 39

Maintaining COM over the BOS during voluntary movement (reaching for faucet)

Question 40

Reactive balance

Answer 40

Maintaining control of COM over BOS against external forces trying to move the COM outside the BOS