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1192 Cards in this Set

  • Front
  • Back

Iliopsoas
Which muscle test for the following movement|- hip flexion
Sartorius
Which muscle test for the following movement|- hip flexion, abduction, lateral rotation (sitting with legs crossed)
quads
Which muscle test for the following movement|- knee extension
pectineus, adductor longus/brevis, gracilis
Which muscle test for the following movement|- hip adduction
gluteus medius,minimus
Which muscle test for the following movement|- hip abduction,flexion, medial rotation
tensor fascia lata
Which muscle test for the following movement|- hip flexion, abduction, medial rotation
piriformis, obturator internus, gamelli, guadratus femoris
Which muscle(s) test for the following movement|- hip lateral rotation
gluteus maximus
Which muscle test for the following movement|- hip extension, lateral rotation
biceps femoris
Which muscle test for the following movement|- hip extension,knee flexion,leg lateral rotation
semitendinosus
Which muscle test for the following movement|- hip extension,knee flexion
semimembranosus, popliteus
Which muscle(s)test for the following movement|- leg medial rotation

tibialis anterior

Which muscle test for the following movement|- ankle dorsiflexion
Which muscle test for the following movement|- 2nd - 5th digit MTP extension
extensor digitorum longus
Which muscle test for the following movement|- great toe MTP extension
extensor hallucis longus
Which muscle test for the following movement|- foot eversion
peroneus longus/brevis
Which muscle test for the following movement|- foot inversion
tibialis posterior
Which muscle test for the following movement|- ankle plantarflexion
gastrocnemius, soleus

flexor digitorum longus

Which muscle test for the following movement|- 2nd-5th digit DIP flexion
Which muscle test for the following movement|- great toe IP flexion
flexor hallucis longus
Which muscle test for the following movement|- 2nd-5th digit PIP flexion
flexor digitorum brevis
Which muscle test for the following movement|- great toe MTP flexion
flexor hallucis brevis
Which muscle test for the following movement|- toe adduction/abduction
dorsal/plantar interossei
Which muscle test for the following movement|- pelvic floor control
perineals and sphincters
Which nerve innervates this muscle|- iliopsoas
femoral
Which nerve innervates this muscle|- sartorius
femoral

Femoral

Which nerve innervates this muscle|- quadriceps femoris
Which nerve innervates this muscle|- pectineus
obturator

obturator

Which nerve innervates this muscle|- adductor longus/brevis
Which nerve innervates this muscle|- gracilis
obturator
Which nerve innervates this muscle|- gluteus medius,minimus
superior gluteal
Which nerve innervates this muscle|- tensor facia lata
superior gluteal
Which nerve innervates this muscle|- piriformis
superior gluteal
Which nerve innervates this muscle|- gluteus maximus
inferior gluteal
Which nerve innervates this muscle|- obturator internus
sacral plexus
Which nerve innervates this muscle|- hamstrings (biceps femoris, semitendinosus, semimembrenosus)
tibial
Which nerve innervates this muscle|- tibialis anterior
deep peroneal

deep peroneal

Which nerve innervates this muscle|- extensor digitorum longus
Which nerve innervates this muscle|- extensor hallucis longus
deep peroneal

superficial peroneal

Which nerve innervates this muscle|- peroneus longus/brevis
Which nerve innervates this muscle|- popliteus
tibial

Tibial

Which nerve innervates this muscle|- tibialis posterior
Which nerve innervates this muscle|- gastrocnemius, soleus
tibial
Which nerve innervates this muscle|- flexor digitorum longus
tibial
Which nerve innervates this muscle|- flexor hallucis longus
tibial
Which nerve innervates this muscle|- flexor digitorum brevis
medial plantar
Which nerve innervates this muscle|- flexor hallucis brevis
medial plantar

lateral plantar

Which nerve innervates this muscle|- dorsal/plantar interossei
Which nerve innervates this muscle|- perineals and sphincters
prudendal
Gillet's test
asseses posterior movement of the ilium relative to the sacrum
Gillet's test
Patient is standing. Place your thumb of your hand under PSIS of limb to be tested and place your other thumb on center of sacrum at same level as thumb under PSIS.|Ask patient to FLEX hip and knee of limb being tested as if bringing their knee to chest.|Assess movement of PSIS via comparison of positions of your thumbs. Make sure your eyes are level with your thumbs. |PSIS should move in an INFERIOR direction|(+) TEST: no identified movement of PSIS as compared to sacrum
Ipsilateral anterior rotation test
assess anterior movement of ilium relative to sacrum
Ipsilateral anterior rotation test
Place thumb of your hand under PSIS of limb to be tested and place your other thumb on center of sacrum at same level as thumb under PSIS.|Ask patient to EXTEND hip of limb being tested.|Assess movement of PSIS via comparison of positions of your thumbs. Make sure your eyes are level with your thumbs. |PSIS should move in a SUPERIOR direction|(+) TEST: no identified movement of PSIS as compared to sacrum
Gaenslen's test
identifies sacroiliac joint dysfunction
Gaenslen's test
Patient sidelying at edge of table while holding bottom leg in maximal hip and knee flexion (knee to chest).|Stand behind the patient and passively extend hip of upper most limb. This places stress on SIJ associated with upper most limb.|(+) TEST: pain in SIJ
Long sitting or supine to sit test
identifies dysfunction of SIJ that may be cause of functional leg length discrepancy
Long sitting or supine to sit test
Patient supine with correct alignment of trunk, pelvis, and lower limbs. YOU stand at edge of table by patient's feet palpating the medial malleoli to assess symmetry (one longer than other).|Have patient come into long sitting position and once again assess their leg length making a comparison between supine and long sitting|(+) TEST: abnormal finding is reversal in limb length between supine as compared to long sit
Goldthwait's test
differentiates between dysfunction in lumbar spine vs SIJ
Goldthwait's test
Patient supine with your fingers in between spinous of lumbar spine. With your other hand, passively perform a straight leg raise (SLR)|(+) TEST: if pain presents prior to palpation of movement in lumbar segments, dysfunction is related to SIJ
TMJ compression
Evaluates for pain with compression of the retrodiscal tissues
TMJ compression
Patient sitting or supine. Support/stabilize patients head with one hand and with other hand push mandible superior causing a compressive load to the TMJ|(+) TEST: pain in TMJ
Anterior innominate
Apparent leg shortening occurs as the malleolus moves from a longer position to a shorter one
Posterior innominate
Apparent leg lengthening occurs as the malleolus moves from a shorter postion to a longer one
Lasegue's test or Straight leg raising test
identifies dysfunction of neurological structures that supply lower limb
Lasegue's test or Straight leg raising test
Patient supine with legs resting on table. Passively flex hip of one leg with knee extended until patient complains of shootingpain into lower limb.|Slowly lower limb until pain subsides then passively dorsiflex foot|(+) TEST: reproduction of pathological, neurological symptoms when foot is dorsiflexed
Femoral nerve traction test
identifies compression of femoralnerve anywhere along its course
Femoral nerve traction test
Patient lies on non-painful side with trunk in neutral, head flexed slightly, and lower limb's hip and knee flexed.|Passively extend hip while knee of painful limb is in extension. |if no reproduction of symptoms flex knee of painful leg|(+) neurological pain in anterior thigh
Valsalva's maneuver
identifies a space-occupying lesion.
Valsalva's maneuver
Patient sitting. Instruct patient to take a deep breath and hold while they "bare down" as if having a bowel movement.|(+) TEST: increasing low back pain or neurological symptoms into lower extremity
Babinski's test
identifies upper motor neuron lesion.
Babinski's test
Patient supine or sitting.|Glide bottom end of a standard reflex hammer along plantar surface of patient's foot.|(+) TEST: extension of big toe and splaying (abduction) of other toes
Quadrant test
identifies compression of neural structures at the intervertebral foramen and facet dysfunction.
Quadrant test
INTERVERTEBRAL FORAMEN: (L = left, R = right)|Patient is standing, cue patient into:|- side bending L, rotation L, and extension to maximally close intervertebral foramen on the L|-Repeat to other side|FACET DYSFUNCTION:|Patient is standing, cue patient into:|- side bending L, rotation R, and extension to maximally compress facet joint on L|- Repeat to other side|(+) TEST: pain and/or paresthesia in the dermatomal patern for the involved nerve root or localized pain if facet dysfunction
Stork standing test
identifies spondylolisthesis
Stork standing test
Patient standing on one leg. Cue patient into trunk extension.|Repeat with opposite leg on ground|(+) TEST: pain in low back with ipsilateral leg on ground
McKenzie's side glide test
Differentiate between scoliotic curvature vs. neurlogical dysfunction causing abnormal curvature (lateral shift) of trunk.
McKenzie's side glide test
Test is perfromed if "lateral shift" of trunk is noted.|Patient is standing. Stand on side of patient that upper trunk is shifted toward.|Place your shoulders into patient's upper trunk and wrap your arms around patient's pelvis. |Stabilize upper trunk and pull pelvis to bring pelvis and trunk into proper alignment|(+) TEST: reproduction of neurological symptoms as alignment of trunk is corrected
Bicycle (van Gelderen's) test
differentiates between intermittent claudication and spinal stenosis
Bicycle (van Gelderen's) test
Patient seated on stationary bicycle, and rides the bike while sitting erect and time how long patient can ride at a set pace/speed. After a sufficient rest period, have patient ride the bike at the same speed while in a slumped position.|Determination based on length of time patient can ride bike in sitting upright vs. sitting slumped|(+) TEST: Pain related to spinal stenosis, should be able to ride bike longer while slumped.
Rib springing
evaluates rib mobility
Rib springing
Patient prone. Begin at upper ribs applying a posterior to anterior force through each rib progressively working through entire rib cage.|Following prone test, Position patient in sidelying and repeat.|BE CAREFUL with springing the 11th and 12th ribs since they have no anterior attachment and therefore are less stable|(+) TEST: pain, excessive motion of rib or restriction of rib
Thoracic springing
evaluate intervertebral joint mobility in thoracic spine
Thoracic springing
Patient prone. Apply posterior to anterior glides/spring to transverse process of thoracic vertebra.|Remember that the spinous process and transverse process of the same vertebra may not be at the same level in the thoracic region.|(+) TEST: pain, excessive movement, and/or restricted movement
Slump test
identifies dysfunction of neurological structures supplying the lower limb
Slump test
Patient is sitting on edge of table with knee flexed.|Patient slumps sits while maintaining neutral postion of head and neck.|Follow this progression after:|1.- Passively flex patient's head and neck. If no reproduction of symptoms, move on to next step.|2.- Passively extend one of patient's knees. If no reproduction of symptoms, move on to the next step|3.- Passively dorsiflex ankle of limb with extended knee|4.- Repeat steps 1-3 with opposite leg|(+) TEST: reproduction of pathological neurological symptoms
Vertebral artery test
identifies the integrity of the vertebrobasilar vascular system
Vertebral artery test
Patient supine with head supported on table (follow the progression)|1.- Extend head and neck for 30 sec. if no change in symptoms, progress to next step|2.- Extend head and neck with rotation left, then right for 30 seconds, if no change in symptoms progress to next step|3.- With head being cradled off table, extend head and neck for 30 seconds. If no change in symptoms, progress to next step|4.- With head being cradled off table, extend head and neck with rotation left for 30 seconds, and then right|(+) TEST: dizziness, visual distribuances, disorientation, blurred speech, nausea/vomiting
Hautant's test
differentiates between vascular vs vestibular causes of dizziness/vertigo
Hautant's test
Part 1|Patient sitting with shoulder at 90° of flexion, and palms up.|Have patient close eyes and remain in this position for 30 seconds. |(+) TEST: If arm lose their position , there may be a vestibular condition, there may be a vestibular condition|Part 2|Patient sitting with shoulder at 90° of flexion and palms up.|Have patient close eyes and cue patient into head and neck extension with rotation right and left remaining in each position for 30 seconds|(+) TEST: If arm lose their position, the condition may be vascular in nature.
Vestibular condition
A PT performs a Hautant's on a patient. Patient is sitting with shoulder at 90° of flexion. PT ask patient to close his/her eyes and remain in this position for 30 seconds. PT observes that his arms lose their position. This is likely due to a:___________
Vascular condition
A PT performs a Hautant's on a patient. Patient is sitting with shoulder at 90° of flexion. PT ask patient to close his/her eyes and to extend his/her head and neck with rotation to the right and then left with 30 seconds holds each. PT observes that arms lose their position. This is likely due to a:_________
Transverse ligament stress test
tests integrity of transverse ligament
Transverse ligament stress test
Patient supine with head supported on table.|Glide C1 anterior. Should be firm end feel|(+) TEST: findings i.e.. soft end feel, dizziness, nystagmus, a lump sensation in throat, nausea
Anterior shear test
assesses integrity of upper cervical spine ligaments and capsules
Anterior shear test
Patient supine with head supported on table|Glide C2-C7 anterior. Should be firm end feel|(+) TEST: laxity of ligaments , also, dizziness, nystagmus, a lump sensation in the throat, nausea
Foraminal compression (Spurling's) test
identifies dysfunction (typically compression) of cervical nerve root
Foraminal Compression (Spurling's) test
Patient sitting with head side bent toward uninvolved side.|Apply pressure through head straight down.|Repeat with head side bent toward involved side|(+) TEST: Pain and/or paresthesia in dermatomal pattern for involved nerve root
Maximum cervical compression test
identifies compression of neural structures at intervertebral foramen and/or facet dysfunction
Maximum cervical compression test
Patient in sitting. Passively move head into side bending and rotation towards the non-painful side followed by extension.|Repeat this step towards the painful side.|(Be careful since this test is very similar to vertebral artery test)|(+) TEST: pain and/or paresthesia in dermatomal pattern for involved nerve root or localized pain in neck if facet dysfunction
Distraction test
indicates compression of neural structures at the intervertebral foramen or facet dysfunction
Distraction test
Patient sitting and head is passively distracted|(+) TEST: finding: |- A decrease in symptoms in neck (facet dysfunction)|- A decrease in upper limb pain (neurological condition)
Shoulder abduction test
indicates compression of neural structures within intervertebral foramen
Shoulder abduction test
Patient is sitting and asked to place one hand on top of their head. Repeat this step with the opposite hand.|(+) TEST: findings, A decrease in symptoms into upper limb
Lhermitte's sign
identifies dysfunction of spinal cord and/or an upper motor neuron lesion.
Lhermitte's sign
Patient is long sitting on table. |Passively flex patient's head and one hip while keeping knee in extension. Repeat this step with other hip|(+) TEST: pain down the spine and into the UE or LE
Romberg's test
identifies upper motor neuron lesion
Romberg's test
Patient is standing and closes eyes for 30 seconds.|(+) TEST: Excessive swaying during test indicates
Neutral subtalar positioning
examination to determine if abnormal rearfoot to forefoot positioning exists
Neutral subtalar positioning
Patient in prone with foot over edge of table. Palpate dorsal aspect of talus on both sides with one hand and grasp lateral forefoot with other hand.|Gently dorsiflex foot until resistance is felt then gently move foot through arc of supination and pronation|Neutral position is point at which you feel foot fall off easier to one side or other. At this point, compare : rearfoot to forefoot, and rearfoot to leg
Anterior drawer test
identifies ligamentous instability (particularly, anterior talofibular ligament).
Anterior drawer test
Patient supine with heel just off edge of table in 20° of plantarflexion.|Stabilize lower leg and grasp foot. Pull talus anterior.|(+) TEST: if talus has excessive anterior glide and/or pain is noted
Talar tilt
identifies ligamentous instability (particularly calcaneofibular ligament)
Talar tilt
Patient sidelying with knee slightly flexed and ankle in neutral.|Move foot into adduction testing for calcaneofibular ligament.|Move foot into abduction testing for deltoid ligament|(+) TEST: if excessive adduction or abduction occurs and/or pain is noted
Thompson's test
evaluates the integrity of the Achilles' tendon
Thompson's test
Patient prone with foot off edge of table. Squeeze calf muscles|(+) TEST: No movement of foot while squeezing calf.
Tinel's sign
identifies dysfunction of posterior tibial nerve, posterior to the medial malleolus or deep fibular anterior to talocrural joint
Tinel's sign
Patient supine with foot supported on the table.|Tap over region of posterior tibial nerve as it passes posterior to medial malleolus.|Tap over region of deep fibular nerve as it passess under dorsal retinaculum (anterior to ankle joint)|(+) TEST: Reproduces tingling and/or paresthesia into the respective nerve distribution
Morton's test
identifies stress fracture or neuroma in forefoot
Morton's test
Patient supine with foot supported on table|Grasp around metatarsal heads and squeeze|(+) TEST: if finding pain in forefoot
Collateral ligament instability test
Testing for medial and lateral knee ligaments, identifies laxity or restriction
Collateral ligament instability test
Patient is supine. Entire lower limb is supported and stabilized and knee placed in 20°-30° of flexion.|Valgus/Varus force are placed through the knee to tests for medial/lateral collateral ligaments|(+) TEST: finding laxity, but pain may be noted as well
Lachman's stress test
indicates integrity of ACL
Lachman's stress test
Patient is supine with testing knee flexed to 20°-30°.|Stablize femur and passively try to glide tibia anterior|(+) TEST: finding excessive anterior glide of tibia
Pivot shift
indicates integrity of ACL
Pivot shift
Patient is supine with testing knee in extension, hip flexed and abducted to 30° with slight internal rotation.|Hold knee with one hand and foot with other hand.|Place valgus force through knee and flex knee.|(+) TEST: finding ligament laxity as indicated by tibia relocating during the test. As knee is being flexed, the tibia clunks backward at approximately 30°-40°. The tibia at begining of test was subluxed and then was reduced by pull of ilitobial band as knee was being flexed.
Posterior sag test
indicates integrity of PCL
Posterior sag test
Patient supine and testing hip flexed to 45° and knee to 90° |Observe to see if tibia "sags" posteriorly while in this position|(+) TEST: finding is sag of tibia relative to femur
Posterior drawer test
indicates integrity of PCL
Posterior drawer test
Patient is supine ,+testing hip flexed to 45°,+ knee flexed to 90°.|Passively glide tibia posteriorly following the joint plane.|(+) TEST: finding is excessive posterior glide
Reverse Lachman
indicates integrity of PCL
Reverse Lachman
Patient is prone with knees flexed to 30°|stabilize femur and passively try to glide tibia posterior|(+) TEST: ligament laxity
McMurray's test
identifies meniscal tears
McMurray's test
patient supine with testing knee in maximal flexion.|Passively:|- internally rotate and extend the knee (for lateral meniscus)|- externally rotate and extend the knee (for medial meniscus)|(+) TEST: reproduction of click and/or pain in knee joint
Apley test
helps differentiate between meniscal tears and ligamentous lesions.
Apley test
patient prone with testing knee flexed to 90°.|stabilized patient's thigh to table with your knee.|Passively :|-distract the knee joint and rotate tibia internally/externally slowly. THEN|-apply a compressive load to knee joint and rotate int/ext to tibia slowly|(+) TEST:|- pain or decreased motion during compression = mensical dysfunction|- pain or decreased motion during distraction = ligamentous dysfunction
meniscal dysfunction
Patient is being evaluated by a PT for knee pain. the PT suspects the problems might either be mensical or ligamentous. the Apley test is performed and the patient reported pain or decreased motion with compression. this is most likely due to:______________________
ligamentous dysfunction
Patient is being evaluated by a PT for knee pain. the PT suspects the problems might either be mensical or ligamentous. the Apley test is performed and the patient reported pain or decreased motion with distraction. this is most likely due to:______________________
Hughston's plica test
identifies dysfunction of the plica
Hughston's plica test
Patient is supine, and testing knee is flexed with tibia in int. rot.|Passively glide the patella medially while palpating the medial femoral condyle. Feel for "popping" as you passively flex and extend the knee|(+) TEST: pain and/or popping noted during test
Patellar apprehension test
indicates history of patella dislocation
Patellar apprehension test
Patient is supine and patella is passively glide laterally.|Patient does not allow and/or does not like patella to move in lateral direction to simulate subluxation/dislocation
Clarke's sign
indicates patellofemoral dysfunction
Clarke's sign
Patient supine with knee in extension resting on the table|push posterior on superior pole of patella then ask the patient to perform an active contraction of the quads mucles.|(+) TEST: pain is produced in knee as a result of the test
Ballotable patella (Patellar tap test)
indicates infrapatellar effusion
Ballotable patella (Patellar tap test)
Patient supine with knee in extension resting on the table|apply a soft tap over the central patella|(+) TEST: perception of the patella floating ("dancing patella" sign)
Fluctuation test
indicates knee joint effusion
Fluctuation test
Patient supine with knee in extension resting on the table.|Place one hand over suprapatellar pouch and other over anterior aspcect of kne joint.|Alternate pushing down with one hand at a time|(+) TEST: finding is fluctuation (movement) of fluid noted during test.
Q angle measurements
measurement of angle between the quadriceps muscle and the patellar tendon|Normal for men = 13°; Normal for women = 18°|angles < or > of normal, may indicate knee dysfunction and/or biomechanical dysfunctions within the lower limb
Noble compression test
identifies if Distal iliotibial band (Distal IT band) friction syndrome is present
Noble compression test
patient supine with hip flexed to 45° and knee flexed to 90°|Apply pressure to lateral femoral epicondyle then extend knee|(+) TEST: Reproduces same pain over the lateral femoral condyle. Patient will complain of pain over lateral femoral epicondyle at ≈ 30° flexion
Tinel's sign
identifies dysfunction of common fibular nerve posterior to fibula head
Tinel's sign
Tap region where common fibular nerve passes through posterior to fibula head|(+) TEST: Reproduces tingling and/or paresthesia into leg following common fibular nerve distribution
Patrick's (FABER) test
Patient lies supine. Passively flex, abduct and externally rotate test leg so that foot is resting just above knee on opposite leg. Slowly lower testing leg down toward table surface|(+) TEST: when involved knee is unable to assume relaxed position and/or reproduction of painful symptoms
Patrick's (FABER) test
identifies dysfunction of hip such as mobility restriction
Grind (Scouring) test
Identifies DJD of hip joint
Grind (Scouring) test
Patient supine with hip in 90° flexion and knee maximally flexed.|Place compressive load into femur via knee joint therefore loading hip joint
Trendelenburg's sign
identifies weakness of gluteus medius or unstable hip
Trendelenburg's sign
Patient standing and asked to stand on one leg (flex opposite knee).|Observe pelvis of stance leg|(+) TEST: when ipsilateral pelvis drops when lower limb support is removed while standing.
negative test
Patient is being evaluated, PT asked the patient to balance on one leg. the examiner looks closely and observe that the pelvis on the nonstance leg rises. The trendelenburg's sign is considered a:___________
positive test
Patient is being evaluated, PT asked the patient to balance on one leg. the examiner looks closely and observe that the pelvis on the nonstance falls. The trendelenburg's sign is considered a:___________
Thomas' test
identifies tightness of hip flexors
Thomas' test
Patient supine and one hip and knee are maximally flexed to chest and held there. Opposite limb is kept straight on table.|(+) TEST: Hip flexion occurs or limb is unable to remain flat on the table on the straight leg as the opposite limb is flexed.
Ober's test
identifies tightness of tensor fascia latae and/or iliotibial band tightness
Ober's test
Patient lying on side with lower limb flexed at hip and knee.|Passively extend and abduct testing hip with knee flexed to 90°.|Slowly lower uppermost limb observe if it reaches table|(+) TEST: if uppermost limb is unable to come to rest on table
Ely's test
identifies tightness of rectus femoris
Ely's test
Patient prone and knee of testing limb is flexed|Observe hip of testing limb|(+) TEST: if hip of testing limb flexes
90-90 hamstring test
identifies tightness of hamstrings
90-90 hamstring test
patient supine and hip and knee of testing limb is supported in 90° flexion. |Passively extend knee of testing limb until a barrier is encountered|(+) TEST: if knee is unable to reach 10° from neutral position (lacking 10° of extension)
Piriformis test
identifies piriformis syndrome
Piriformis test
Patient supine and foot of test leg is passively placed lateral to opposite limb's knee.|Testing hip is adducted. Observe position of testing knee relative to opposite knee|(+) TEST: if testing knee is unable to pass over the resting knee and/or reproduction of pain in buttock and/or along sciatic nerve distribution
Leg length test
identifies true leg length discrepancy
Leg length test
patient is supine and pelvis is balanced/aligned with lower limbs and trunk.|Measure the distance from ASIS to lateral malleoulus on each limb several tiems for consistency and compaire results|A difference in lengths between two limbs is noted identifying a true leg length discrepancy
Craig's test
identifies abnormal femoral antetorsion angle
Craig's test
patient prone with knee flexed to 90° palpate greater trochanter and slowly move hip through internal/external rotation. |when greater trochanter feels most lateral stop, and measure the angle of leg relative to a line perpendicular with table surface|Normal angle = 8°-15° hip internal rotation|< 8° = retroverted hip; > 15° = anteverted hip
Finkelstein's test
Patient makes a fist with thumb within confines of fingers.|Passively move wrist into ulnar deviation|Reproduces pain in wrist. Often painful with no pathology, so compare to uninvolved side
Finkelstein's test
identifies deQuervain's tenosynovitis (parentendonitis of abductor pollicis longus and/or extensor pollicis brevis (AbPL + EPB)
Bunnel-Littler test
The MCP joint is stablized in slight extension while PIP joint is flexed. Differentiates between a tight capsule and tight intrinsic muscles. (all passive movements)| - IF MCP joint is slightly extended + PIP joint = no flexion = Tight intrinsic muscles|- IF MCP joint is slightly flexed + PIP joint = FULL flexion = Tight intrinsic muscles|- IF MCP joint is slightly flexed + PIP joint = LITTLE flexion = Capsular tightness
Intrinsic muscle tightness
A PT performs the Bunnel-Litter test on a patient with finger ROM restrictions. The PT holds MCP in slight extension and attempts to flex the PIP joint but it is unable to. The PT then holds the MCP in slight flexion and the PIP flexes fully. |This is due to:______________
Capsule tightness
An PT performs the Bunnel-Littler test on a patient with finger ROM restrictions. the PT holds the MCP joint in slight extension, and attempts to flex the PIP joint but is unable to, then, PT then holds the MCP joint in slight flexion, but the PIP joint either flexes minimally or no at all.| This is due to: _________
Tight retinacular test
This test differentiates between a tightness in the capsule and tight rectinacular ligaments.
Tight retinacular test
PIP is stabilized in neutral while DIP is flexed. Then PIP is flexed and DIP is flexed|IF DIP flexion is limited with PIP in held in neutral = capsule is tight|IF DIP flexion is greater with PIP held in flexion = retinacular ligaments tightness
Capsular tightness
A PT is performing the Tight retinacular test. He holds the PIP joint in neutral while DIP is passively flexed, but is unable to. then the he holds the PIP joint in slight flexion and DIP flexion is limited. this is due to: __________
Retinacular ligament tightness
A PT is performing the Tight retinacular test. He holds the PIP joint in neutral while DIP is flexed, but is unable to or flexion is minimal. then he holds the PIP joint in slight flexion, and the DIP flexion is greater. This is due to:___________
Ligamentous instability tests
Fingers are supported and stabilized.|Valgus and Varus forces are applied to PIP joints all digits, and the same is repeated at the DIP joints.|(+) TEST: finds laxity either medial or collateral ligaments or both
Froment's sign
Patient graps paper between 1st. and 2nd. digits of hand. Pull paper out and look for IP flexion of thumb, which is compensation due to weakness of adductor pollicis |Indication of ulnar nerve dysfunction: = Patient is unable to perform test without compensation. what's the name of this test?
Tinel's sign
Tap region where median nerve passes through carpal tunnel.|Reproduces tingling and/or paresthesia into hand following median nerve distribution. |Identifies carpal tunnel compression of median nerve
Phalen's test
Patient maximally flexes both wrist holding them against each other for 1 minute.|(+) TEST: Reproduces tingling and/or paresthesia into hand following median nerve distribution
Two point discrimination test
identifies the level of sensory innervation within hand which correlates with functional ability to perform certain tasks involving grasp.
Two point discrimination test
patient sitting with hand stabilized. Using a caliper, two point discriminator, or paper clip apply device to palmar aspect of fingers to assess patients ability to distinguish between two points of testing device.|Record smallest difference that patient can sense two separate points.|Normal amount that can be discriminated is generally < 6 mm
Allen's test
Identifies vascular compromise. identifies radial and ulnar arteries at wrist.
Allen's test
Have patient open/close fingers quickly several times, and then make a closed fist.|Using your thumb, occlude the ulnar artery and have patient open hand. Observe palm of hand and then release the compression on artery and observe for vascular filling. Perform same procedure with radial artery.|Under normal circumstances there is a change in color from white to normal appearance on palm of hand
Adductor pollicis
A patient graps paper between 1st. and 2nd. digits of hand. the PT pulls the paper out and patient compensates by flexing the IP joint of thumb. What muscle is weak on this test?
ulnar nerve
A patient graps paper between 1st. and 2nd. digits of hand. the PT pulls the paper out and observes IP flexion of thumb which is a compensatory technique. Since patient was not able to perform test without compensation. What nerve is affected?
Ligament instability test
Patient is sitting or supine. Entire UE is supported and stabilized and elbow placed in 20°-30° of flexion.|Valgus force placed through elbow tests UCL|Varus force placed through elbow tests RCL|(+) TEST: laxity, but pain may be noted as well
Lateral epicondylitis test
Patient is sitting, elbow flexed to 90° and supported/stabilized.|RESIST: wrist extension, radial deviation and forearm pronation with fingers fully flexed (fist) simultaneously.|(+) TEST: Pain in lateral epicondyle
Medial epicondylitis test
Patient is sitting, elbow flexed to 90° and supported/stabilized.|Passively supinate forearm, extend elbow, and extend wrist|(+) TEST: Reproduces pain at medial epicondyle
Tinel's sign
Tap region where the ulnar passes through cubital tunnel|Reproduces a tingling sensation in ulnar distribution
Pronator teres syndrome test
Patient is sitting, elbow flexed to 90° and supported/stabilized.|RESIST: forearm pronation and elbow extension simultaneously|(+) TEST: Reproduces a tingling sensation or paresthesia within median nerve distribution
Yergason's test
Patient is sitting with shoulder in neutral, stabilized against the trunk, elbow = 90°, and forearm pronated.|RESIST: supination of forearm and external rotation of shoulder|WILL NOTE: that tendon of biceps long head will "POP OUT" of groove. |May also reproduce pain in long head of biceps tendon
Speed's test
(Biceps straight arm).|(1) Patient is sitting or standing with upper limb in full extension, and forearm supinated.|RESIST: shoulder flexion|(2) May also place shoulder in 90° flexion, and PUSH upper limb into extension causing an eccentric contraction of biceps|WILL reproduce symptoms (pain) in long head of biceps tendon
Neer's impingement test
Patient sitting and shoulder is passively internally rotated then fully abducted|WILL reproduce symptoms of pain within shoulder region
Supraspinatus test (empty can)
Patient sitting with shoulder at 90° and no rotation|RESIST: shoulder abduction, THEN place shoulder in "empty can" position [internal rotation and 30° forward (horizontal adduction)]|RESIST: Abduction. |Differentiate if pain present between two positions|(+) TEST: Reproduces pain in supraspinatus tendon and/or weakness while in "empty can" position
Drop arm test
Patient sitting with shoulder passively abducted to 120°. |Patient is instructed to slowly to bring arm down to side.|Guard the patient's arm from falling in case it gives way.|(+) TEST: Patient is unable to lower arm back down to side
Posterior internal impingement test
Patient supine and move shoulder into 90° abduction, maximum external rotation and 15°-20° horizontal adduction|(+) TEST: Reproduction of pain in posterior shoulder during test
Clunk test
Patient supine with shoulder in full abduction.|PUSH humeral head anteriorly while rotating humerus externally|(+) TEST: Audible "clunk" is heard while performing the test
Anterior apprehension sign
Patient supine with shoulder in 90° abduction.|Slowly take shoulder into external rotation|(+) TEST: Patient does not allow and/or does not like shoulder to move in direction to simulate anterior dislocation
Posterior apprehension sign
Patient supine with shoulder in 90°abduction (in plane of scapula) with scapula stabilized by table.|Place a posterior force through shoulder via force on patient's elbow while simultaneously moving shoulder into medial rotation and horizontal adduction|(+) TEST: Patient does not allow and/or does not like shoulder to move in direction to stimulate posterior dislocation
Acromiocalvicular (AC) shear test
Patient sitting with arm resting at side, examiner clasps hands and places heel of one hand on spine of scapula and heel of other hand on clavicle. Squeeze hands together causing compression of AC joint.|(+) TEST: Reproduces pain in AC joint
Adson's test
Patient is sitting, find radial pulse of UE being tested. Rotate head towards the UE being tested, then extend + ext. rotate the shoulder while extending the head|(+) TEST: Disappearance of pulse will be reproduced in UE
Costoclavicular syndrome (military brace) test
Patient is sitting, find radial pulse of UE being tested.|Move involved shoulder down + back|(+) TEST: Disappearance of pulse will be reproduced in UE.
Wright (hyperabduction) test
Patient is sitting, find radial pulse of UE being tested.|Move involved shoulder into MAX abduction + Ext. Rot.|Take a deep breath, + rotate head opposite to side being tested|(+) TEST: Disappearance of pulse will be reproduced in UE.
Roos elevated arm test
Patient is standing with shoulders full ext. Rot, 90° abducted, and slightly horizontally abducted. Elbow flexed to 90°.|Patient opens/closes hands for 3 minutes SLOWLY|(+) TEST: Disappearance of pulse will be reproduced in UE
Yergason's test
shoulder special test
speed's test
shoulder special test
Neer's impingement test
shoulder special test
supraspinatus test
shoulder special test
drop arm test
shoulder special test
posterior impingement test
shoulder special test
clunk test
shoulder special test
anterior apprehension sign
shoulder special test
posterior apprehension sign
shoulder special test
acromioclavicular shear test
shoulder special test
Adson's test
shoulder special test, thoracic outlet syndrome
Costoclavicular syndrome (military brace) test
shoulder special test, thoracic outlet syndrome
Wright (hyperabduction) test
shoulder special test, thoracic outlet syndrome
Roos elevated arm test
shoulder special test, thoracic outlet syndrome
upper limb tension test
shoulder special test
lateral epicondylitis
elbow special test (tennis elbow)
medial epicondylitis
elbow special test (golfer's elbow)
pronator teres syndrome
elbow special test
Finkelstein's test
wrist special test
Bunnel-Litter test
wrist special test
tight retinacular test
wrist special test
froment's sign
wrist special test
phalen's test
wrist special test
allen's test
wrist special test (vascular)
Patrick's (FABER) test
hip special test
grind (scouring) test
hip special test (for DJD)
trendelenburg's sign
hip special test
thomas' test
hip special test
ober's test
hip special test
ely's test
hip special test
90-90 hamstring test
hip special test
piriformis test
hip special test
leg length test
hip special test
craig's test
hip special test
lachman's test
knee special test
pivot shift
knee special test
posterior sag test
knee special test
posterior drawer test
knee special test
reverse lachman
knee special test
mcmurray
knee special test
apley test
knee special test
hughston plica test
knee special test
patellar apprehension test
knee special test
Clarke's sign
knee special test
Ballotable patella (patellar tap test)
knee special test
fluctuation test
knee special test
noble compression test
knee special test
anterior drawer test
ankle/foot special test
talar tilt
ankle/foot special test
thompson's test
ankle/foot special test
morton's test
ankle/foot special test
vertebral artery test
cervical special test
hautant's test
cervical special test
transverse ligament stress test
cervical special test
anterior shear test
cervical special test
foraminal compression (spurling's) test
cervical special test
maximum cervical compression test
cervical special test
distraction test
cervical special test
shoulder abduction test
cervical special test
Lhermitte's sign
cervical special test
romberg's test
cervical special test
rib springing test
thoracic special test
thoracic springing test
thoracic special test
slump test
thoracic special test
Lasegue's test
lumbar special test
femoral nerve traction test
lumbar special test
valsalva's maneuver
lumbar special test
babinski's test
lumbar special test
quadrant test
lumbar special test
stork standing test
lumbar special test
mckenzie side glide test
lumbar special test
bicycle (van gelderen's) test
lumbar special test
Gillet's test
SIJ
ipsilateral anterior rotation test
SIJ

Gaenslen's test

Test for SIJ problems
long sitting (supine to sit) test
SIJ
Goldthwait's test
SIJ
Gillet's test
asseses posterior movement of the ilium relative to the sacrum
Ipsilateral anterior rotation test
assess anterior movement of the ilium relative to the sacrum
Gaenslen's test
identifies sacroiliac joint dysfunction
Long sitting or supine to sit test
identifies dysfunction of SI joint that may be cause of functional leg length discrepancy
Goldthwait's test
differentiates between dysfunction in lumbar spine vs SI joint
TMJ Special test
evaluates for pain with compression of the retrodiscal tissues
Lasegue's test or straight leg raising
identifies dysfunction of neurological structures that supply the lower limb
Femoral nerve traction test
identifies compression of femoral nerve anywhere along its course
Bicycle van Gelderen's test
differentiates between intermittent claudication and spinal stenosis
Quadrant test
Identifies compression of neural structures at the intervertebral foramen and facet dysfunction
Stork standing test
Identifies Spondylolisthesis
Spondylolisthesis
The actual anterior or posterior slippage of one vertebra on another following bilateral fracture of pars interarticularis
Spondylolysis
It is a fracture of the parts interarticularis with postive "scotty dog" sign on oblique radiographic view of spine
Rib spring test
evaluates ribs mobility
Thoracic springing
evaluates interverebral joint mobility in thoracic spine
Slump test
identifies dysfunction of neurological structures supplying the lower limb
Vertebral artery test
assesses the integrity of the vertebrobasilar vascular system
Hautant's test
differentiates vascular vs vestibular causes of dizziness/vertigo
Transverse ligament stress test
tests integrity of transverse ligament
Anterior shear test
assesses integrity of upper cervical spine ligaments and capsules
Foraminal compression (Spurling's) test
identifies dysfunction (typically compression of cervical nerve root)
Maximum cervical compression test
identifies compression of neural structues at intervertebral foramen and/or facet dysfunction.|Careful this test is similar to vertebral artery test
Distraction test
indicates compression of neural structures at the intervertebral foramen or facet joint dysfunction
Shoulder abduction test
indicates compression of neural structures within intervertebral foramen
Lhermitte's sign
identifies dysfunction of spinal cord and/or an upper motor neuron lesion
Romberg's test
identifies upper motor neuron lesion
Neutral subtalar positioning
examination to determine if abnormal rearfoot to forefoot positioning exists
Anterior drawer test
identifies ligamentous instability (particularly anterior talofibular ligament)
Talar tilt test
identifies ligamentous instability (particularly calcaneofibular ligament)
Thompson's test
evalutates the integrity of the achilles' tendon
Tinel's sign
identifies dysfunction of posterior tibial nerve, posterior nerve anterior to talocrural joint
Morton's test
identifies stress fracture or neuroma in forefoot
Collateral ligament instability tests
identifies laxity or restrictions (medial & lateral stability)
Lachman's stress test
indicates integrity of anterior cruciate ligament (ACL)
pivot shift test
identifies anterior cruciate ligmament instability|(anterolateral rotary instability)
Posterior sag test
indicates integrity of posterior cruciate ligament
Posterior drawer test
indicates integrity of posterior cruciate ligament
Reverse lachman
indicates integrity of posterior cruciate ligament
McMurray's test
identifies meniscal tears
Apley test
helps to differentiate between meniscal tears and ligamentous lesions
Hughston's plica test
identifies dysfunction of the plica
Patellar apprehension test
indicates past history of patela dislocation
Clarke's sign
indicates patellofemoral dysfunction
Ballotable patella (patellar tap test)
indicates infrapatella effusion
Fluctuation test
indicates knee joint effusion
Q-angle measurement
measurement of angle between the quadriceps mucle and the patellar tendon
Noble compression test
identifies if distal iliotibial (IT) band friction syndrome is present
Tinel's sign
identifies dysfunction of common fibular nerve posterior to fibula head
Patrick's (FABER) test
identifies dysfunction of hip such as mobility restriction
Grind (scouring) test
identifies degenerative joint disease (DJD) of hip joint
Trendelenburg's sign
identifies weakness of gluteus medius or unstable hip
Thomas' test
identifies tightness of hip flexors
Ober's test
identifies tightness of tensor fascia latae and/or iliotibial band
Ely's test
identifies tightness of rectus femoris
90 - 90 Hamstring test
identifies tightness of hamstrings
Piriformis test
Identifies piriformis syndrome
Leg length test
identifies true leg length discrepancy
Craig's test
identifies abnormal femoral antetorsion angle
Finkelstein's test
identifies deQuervain's tenosynovitis (paratendonitis of the abductor pollicis longus and/or extensor pollicis brevis (AbPL & EPB)
Bunnel-Littler test
identifies tightness in structures surrounding the MCP joints
Tight retinacular test
identifies tightness around proximal interphalangeal joint
Ligamentous instability tests
identifies ligament laxity or restrictions (medial & lateral stability)
Froment's sign
identifies ulnar nerve dysfunction
Tinel's sign
identifies carpal tunnel compression of median nerve
Phalen's test
identifies carpal tunnel compression of median nerve
Two point discrimination test
identifies level of sensory innervation
Allen's test
identifies vascular compromise. |identifies radial and ulnar arteries at wrist
Lateral epicondylitis test
identifies lateral epicondylitis aka tennis elbow
Medial epicondylitis test
identifies medial epicondylitis aka golfer's elbow
Tinel's sign
identifies dysfunction of ulnar nerve at olecranon
Pronator teres syndrome test
identifies a median nerve entrapment within pronator teres
Yergason's test
Tests for the integrity of transvere ligament and may also identify bicipital tendonitis
Speed's test
identifies bicipital tendonitis or tendonosis
Neer's impingement test
for impingement of soft tissue structures of shoulder complex (long head of biceps and supraspinatus)
Supraspinatus test
identifies tear and/or impingement of supraspinatus tendon or possible suprascapular nerve neuropathy
Drop arm test
identifies tear and/or full rupture of rotator cuff
Posterior internal impingement test
identifies an impingement between rotator cuff and greater tuberosity or posterior glenoid labrum
Clunk test
identifies a glenoid labrum tear
Anterior apprehension sign
identifies past history of anterior shoulder dislocation
Posterior apprehension sign
identifies past history of posterior shoulder dislocation
Acromioclavicular (AC) shear test
identifies dysfunction of AC joint such as : arthritis, separation
Adson's test
identifies pathology of structures that pass through thoracic inlet
Costoclavicular syndrome (military brace) test
identifies pathology of structures that pass through thoracic inlet
Wright (hyperabduction) test
identifies pathology of structures that pass through thoracic inlet
Upper limb tension test (ULTTs)
evaluation of peripheral nerve compression
ULTT1
nerve bias|- Median nerve|- Anterior interosseous nerve|- C5,6,7
ULTT2
nerve bias|- Median nerve|- Musculocutaneous nerve|- Axillary nerve
ULTT3
nerve bias|- Radial nerve
ULTT4
nerve bias|- Ulnar nerve|- C8 and T1 nerve roots
ULTT1
Shoulder = Depression and Abduction to 110°|Elbow = extension|Forearm = supination|Wrist = extension |Finger & Thumb = extension|Shoulder (n/a)|Cervical spine = Contralateral side flexion
ULTT2
Shoulder = Depression and Abduction to 10°|Elbow = extension|Forearm = supination|Wrist = extension |Finger & Thumb = extension|Shoulder = lateral rotation|Cervical spine = Contralateral side flexion
ULTT3
Shoulder = Depression and Abduction to 10°|Elbow = extension|Forearm = pronation|Wrist = flexion and ulnar deviation|Finger & Thumb = flexion|Shoulder = medial rotation|Cervical spine = Contralateral side flexion
ULTT4
Shoulder = Depression and Abduction to 10° - 90°|Elbow = flexion|Forearm = supination|Wrist = extension and radial deviation|Finger & Thumb = extension |Shoulder = lateral rotation|Cervical Spine = Contralateral side flexion
Evaluation of peripheral nerve compression
What's the purpose of Upper limb tension tests?
80-90
Normal cervical flexion ROM (degrees)
70
Normal cervical extension ROM (degrees)
20-45
Normal cervical side-bending ROM (degrees)
70-90
Normal Cervical Rotation ROM (degrees)
20-45
Normal thoracic flexion ROM (degrees)
20-45
Normal thoracic extension ROM (degrees)
20-40
Normal thoracic side-bending ROM (degrees)
35-50
Normal thoracic rotation ROM (degrees)
40-60
Normal lumbar flexion ROM (degrees)
20-35
Normal lumbar extension ROM (degrees)
15-20
Normal lumbar side-bending ROM (degrees)
3-18
Normal Lumbar rotation ROM (degrees)
35-50mm
Normal TMJ ROM, mouth opening in mm
3-6mm
Normal TMJ ROM protrusion in mm
3-4mm
Normal TMJ ROM retrusion in mm
10-15mm
Normal TMJ ROM on lateral deviation mm
spinal accessory
Which nerve innervates this muscle|- sternocleidomastoid, trapezius and other deep neck muscles
spinal accessory
Which nerve innervates this muscle|- upper trapezius
medial and lateral pectoral
Which nerve innervates this muscle|- pectoralis major/minor
medial pectoral
Which nerve innervates this muscle|- pectoralis minor
long thoracic nerve
Which nerve innervates this muscle|- serratus anterior
dorsal scapular
Which nerve innervates this muscle|- levator scapula
dorsal scapular
Which nerve innervates this muscle|- rhomboids
suprascapular
Which nerve innervates this muscle|- supraspinatus
suprascapular
Which nerve innervates this muscle|- infraspinatus
thoracodorsal
Which nerve innervates this muscle|- latissumus dorsi
subscapular
Which nerve innervates this muscle|- teres major
subscapular
Which nerve innervates this muscle|- subscapularis
axillary
Which nerve innervates this muscle|- deltoid
axillary
Which nerve innervates this muscle|-teres minor
musculocutaneous
Which nerve innervates this muscle|-biceps brachii
musculocutaneous
Which nerve innervates this muscle|-coracobrachialis
musculocutaneous
Which nerve innervates this muscle|-brachialis
ulnar
Which nerve innervates this muscle|-flexor digitorum profundus (ulnar part)
ulnar
Which nerve innervates this muscle|-flexor carpi ulnaris
ulnar
Which nerve innervates this muscle|-adductor pollicis
ulnar
Which nerve innervates this muscle|-abductor digiti quinti
ulnar
Which nerve innervates this muscle|-opponens digiti quinti
ulnar
Which nerve innervates this muscle|-flexor digitiquinti brevis
ulnar
Which nerve innervates this muscle|-interossei
median
Which nerve innervates this muscle|-pronator teres
median
Which nerve innervates this muscle|-pronator quadratus
median
Which nerve innervates this muscle|-flexor carpi radialis
median
Which nerve innervates this muscle|-palmaris longus
median
Which nerve innervates this muscle|-flexor digitorum superficialis
median
Which nerve innervates this muscle|-flexor pollicis longus
median
Which nerve innervates this muscle|-flexor digitorum profundus (radial part)
median
Which nerve innervates this muscle|-abductor pollicis brevis
median/ulnar
Which nerve innervates this muscle|-flexor pollicis brevis
median
Which nerve innervates this muscle|-opponens pollicis
median/ulnar
Which nerve innervates this muscle|-lumbricals
radial
Which nerve innervates this muscle|-brachioradialis
radial
Which nerve innervates this muscle|-triceps brachii
radial
Which nerve innervates this muscle|-anconeus
radial
Which nerve innervates this muscle|-extensor carpi radialis
radial
Which nerve innervates this muscle|-extensor digitorum communis
radial
Which nerve innervates this muscle|-extensor digit quinti proprius
radial
Which nerve innervates this muscle|-extensor carpi ulnaris
radial
Which nerve innervates this muscle|-supinator
radial
Which nerve innervates this muscle|-abductor pollicis longus
radial
Which nerve innervates this muscle|-extensor pollicis longus/brevis
radial
Which nerve innervates this muscle|-extensor indicis proprius
Sterncleidomastoid
Actions to be tested (Identify which muscle)|- Neck Flexion
Trapezius
Actions to be tested (Identify which muscle)|- Neck Extension
Upper trapezius
Actions to be tested (Identify which muscle)|- Shoulder shrug, scapular upward rotation
Pectoralis major/minor
Actions to be tested (Identify which muscle)|- Shoulder horizontal adduction
Serratus anterior
Actions to be tested (Identify which muscle)|- Shoulder protraction, scapular upward rotation
levator scapula
Actions to be tested (Identify which muscle)|- scapular elevation, downward rotation
rhomboids
Actions to be tested (Identify which muscle)|- scapular adduction, elevation and downward rotation
Supraspinatus
Actions to be tested (Identify which muscle)|- shoulder abduction
Infraspinatus
Actions to be tested (Identify which muscle)|- shoulder lateral rotation
Latissimus Dorsi,Teres major and subscapularis
Actions to be tested (Identify which muscle)|- Shoulder medial rotation and adduction
Anterior deltoid
Actions to be tested (Identify which muscle)|- Shoulder flexion
middle deltoid
Actions to be tested (Identify which muscle)|- Shoulder abduction
Posterior deltoid
Actions to be tested (Identify which muscle)|- shoulder extension
Teres minor
Actions to be tested (Identify which muscle)|- Shoulder lateral rotation
Biceps brachii
Actions to be tested (Identify which muscle)|- elbow flexion, forearm supination
coracobrachialis
Actions to be tested (Identify which muscle)|- shoulder flexion, adduction
brachialis
Actions to be tested (Identify which muscle)|- elbow flexion
Flexor digitorum profundus (ulnar part)
Actions to be tested (Identify which muscle)|- 4th and 5th digit DIP flexion
Flexor digitorum profundus (radial part)
Actions to be tested (Identify which muscle)|- 2nd and 3rd digit DIP flexion
flexor carpi ulnaris
Actions to be tested (Identify which muscle)|- wrist ulnar flexion
adductor pollicis
Actions to be tested (Identify which muscle)|- thumb adduction
abductor digiti quinti
Actions to be tested (Identify which muscle)|- 5th digit abduction
opponens digiti quinti
Actions to be tested (Identify which muscle)|- 5th digit opposition
flexor digiti quinti brevis
Actions to be tested (Identify which muscle)|- 5th digit MCP flexion
Interossei
Actions to be tested (Identify which muscle)|- 2nd - 5th digit MCP flexion, adduction, abduction
pronator teres, pronator quadratus
Actions to be tested (Identify which muscle)|- forearm pronation
flexor carpi radialis
Actions to be tested (Identify which muscle)|- wrist radial flexion
palmaris longus
Actions to be tested (Identify which muscle)|- wrist flexion
flexor digitorum superficialis
Actions to be tested (Identify which muscle)|- 2nd - 5th digit PIP flexion
Flexor pollicis longus
Actions to be tested (Identify which muscle)|- thumb IP flexion
abductor pollicis brevis
Actions to be tested (Identify which muscle)|- thumb abduction
abductor pollicis longus
Actions to be tested (Identify which muscle)|- thumb MCP abduction
extensor pollicis longus and brevis
Actions to be tested (Identify which muscle)|- thumb extension
flexor pollicis brevis
Actions to be tested (Identify which muscle)|- thumb MCP flexion
opponens pollicis
Actions to be tested (Identify which muscle)|- thumb opposition
lumbricals
Actions to be tested (Identify which muscle)|- 2nd - 5th digit MCP flexion,IP extension
brachioradialis
Actions to be tested (Identify which muscle)|- elbow flexion
triceps brachii, anconeus
Actions to be tested (Identify which muscle)|- elbow extension
extensor carpi radialis
Actions to be tested (Identify which muscle)|- wrist radial extension
extensor digitorum communis, extensor digiti quinti proprius
Actions to be tested (Identify which muscle)|- 2nd - 5th digit MCP, IP extension
extensor carpi ulnaris
Actions to be tested (Identify which muscle)|- wrist ulnar extension
supinator
Actions to be tested (Identify which muscle)|- forearm supination
extensor indicis proprius
Actions to be tested (Identify which muscle)|- 2nd digit extension
Glasgow coma scale
This scale relates to consciousness to three elements of response: eye, motor response and verbal response. This scale is called?
Mini-mental status examination (MMSE)
This test is a brief screening test for cognitive dysfunction
Balance and gait
What does the Performance Oriented Mobility Assessment (POMA, Tinetti) examines?
Functional Balance
What does the Berg Balance Scales examines?
Functional balance during rise from a chair
Timed up and Go test what does it examines?
Examines maximal distance a person can reach forward beyond's arm length
Functional reach test what does examines?
Examines maximal distance a person can reach in all directions
Multidirectional Reach test what does it examines?

measures repeated chair sit to stand rises

Short physical performance battery (SPPB) what does it measure?
A timed measures of walking using 5 environments challenges (floor, carpet, up and go, obstacles, stairs)
What does Modified Emory Functional Ambulation Profile Scale measures?
stroke patients
In which population is this test used|- Fugl-Meyer Assessment of Physical Performance
stroke patients
In which population is this test used|- Stroke impact scale
CVAs,TBIs, SCIs
In which population are these tests used|- Functional Independence Measure (FIM)|- Functional Assessment Measure (FAM)
Fugl-Meyer Assessment of Physical Performance (FMA)
Identify the test based on the content description|- Provides objective criteria for scoring of movements (0 = cannot perform, to 2 = fully performed) Includes subtests for UEs + LEs functions, balance, sensation, ROM and pain
TBI
Which patient population is more likely to use this standardized test?|- Glasgow Coma Scale
TBI
Which patient population is more likely to use this standardized test?|- Rancho Los Amigos Levels of Cognitive Functioning (LOCF)
TBI
Which patient population is more likely to use this standardized test?|- Rappaport's Disability Rating Scale (DRS)
Rappaport's Disability Rating Scale (DRS)
Identify the test based on following description?|- Classifies levels of disability using a wide range of functional behaviors
TBI
Which patient population is more likely to use this standardized test?|- Glasgow Outcome Scale
Glasgow Outcome Scale
Based on description identify the following scale|- Expands on the original Glasgow Coma Scale; includes major disability categories for outcome assessment
TBI
Which patient population is more likely to use this standardized test?|- High Level Mobility Assessment Tool (HI-MATP)
Multiple Sclerosis
Which population is likely to use the following standardized tests for examination?|- Expanded Disability Status Scale (EDSS)|- Minimum Record of Disability (MRD)|- Modified Fatigue Impact Scale
Parkinson's disease
Which population is likely to use the following standardized tests for examination?|- Unified Rating Scale for Parkinsonism documents (UPDRS)|- The Parkinson's Disease Questionnaire (PDQ-39)
CVAs
Which population is likely to use the following test for examination?|- Barthel Index
Barthel Index
Identify the following test based on the description|- An ordinal scale used to measure performance in activities of daily living (ADL). |- Each performance item is rated on this scale with a given number of points assigned to each level or ranking.|- It uses ten variables describing ADL and mobility. A higher number is = greater likelihood of being able to live at home with a degree of independence following discharge from hospital.|Items tested are:|- Bowel, bladder,grooming, toilet use, feeding|- Transfer, mobility, dressing,stairs, bathing
Iontophoresis
the process by which medications are induced through the skin into the body by means of continuous direct current
acidic reaction
sclerotic in nature and can cause hardening of the skin over time
alkaline reaction
sclerotic in nature and can soften the skin over time, exposing it to the risk of irritation and burn during further treatment
Buffering
a technique used to stabilize the pH of the skin during iontophoresis by placing buffering agents into the electrode pads that cover the designated drug reservoir area within the electrode
Positive
What is the polarity of the following ion?|lidocaine
positive
What is the polarity of the following ion?|lithium
Positive
What is the polarity of the following ion?|histamine
positive
What is the polarity of the following ion?|hydrocortisone
positive
What is the polarity of the following ion?|magnesium
positive
What is the polarity of the following ion?|zinc
negative
What is the polarity of the following ion?|acetate
negative
What is the polarity of the following ion?|dexamethasone
negative
What is the polarity of the following ion?|salicylate
negative
What is the polarity of the following ion?|chlorine
either positive or negative
What is the polarity of the following ion?|tap water
Positive
What is the polarity of the following ion?|hyaluronidase
lidocaine, xylocaine,salicylate
Three ions indicated for analgesia
acetate
indicated for calcium deposits
zinc
indicated for dermal ulcers
hyaluronidase
indicated for fungal infections
water
indicated for hyperdidrosis
calcium, magnesium
Two ions indicated for muscle spasms
dexamethasone
indicated for musculoskeletal
hydrocortisone
indicated for inflammatory conditions
Paget's Disease
what is a slowly-progressing disorder that involves accelerated and abnormal bone remodeling (osteoblast)
Paget's Disease
what affects approx 10% of people over 70 yrs old
Paget's Disease
what has bones become enlarged, but weakened and mainly affects the skull, spine & pelvis
Deep ache that is worse at night
what is the most common symptom of Paget's Disease
Headaches, tinnitus, vertigo or hearing loss
if the skull is involved with Paget's Disease what are symptoms
Fractures and osteogenic sarcoma
with Paget's Disease pt's have increased risk of what
Delerium
what disorder usually has an acute onset and is reversible
Delerium
what disorder is caused by toxic or metabolic abnormalties
Alcohol, Analgesics, OTC meds, HTN meds, Heart meds
what are things that cause delerium
Parkinson's meds, Seizure meds, Antidepr meds, Liver/kidney failure
what are things that cause delerium
Pulmonary failure, Hypoglycemia, Hyponatremia (sodium), Hypocalemia (calcium)
what are things that cause delerium
Hypothermia, Hypothyroidism
what are things that cause delerium
Dementia
what is a slow onset of increasing intellectual impairment
Alzheimer's and multi-farct dementia (left-side brain lesion)
what is the most common causes of Dementia
Alzheimer's
what disorder affects 10% of people > 65 yrs old and 50% of people > 85 yrs old
Alzheimer's
what disorder is the 4th leading cause of death related to environmental factors such as poor nutrition and exposure to toxins
No cure
what is the cure for Alzheimer's
Cell death and atrophy of the cerebral cortex which causes accumulation of "senile plaque" (amyloid)
what happens with Alzheimer's
Several yrs
pathological changes with Alzheimer's begins how long before symptoms appear
7-11 yrs
with Alzheimer's death usually occurs when after onset of symptoms and is often due to infection or dehydration
The inability to learn new information
what are the first signs and symptoms of Alzheimer's
Progressive dementia & Motor function affected
what are signs and symptoms of Alzheimer's
Personality changes & Visuospatial deficits (affect ability to navigate the environment and perform household duties)
what are signs and symptoms of Alzheimer's
Huntington's Disease
what disorder affects 6-7 per 1,000,000 people
Huntington's Disease
what disorder may have an onset that occurs during childhood but usually starts in middle age
Basal ganglia
with Huntington's Disease atrophy happens where
Rigidity and bradykinesia
with Huntington's Disease what type of movements happens
No cure
with Huntington's Disease what is the cure
15-20 yrs
with Huntington's Disease death usually occurs when after onset and often due to infection
Ataxic gait, Chorea, Personality disorder, Dementia Deterioration of writing and speech
what are signs and symptoms of Huntington's Disease
Dysphagia, Urinary incontinence, Sleep disorders, Abnormalities of eye movement (problems with fixation & saccadic movements), Depression (25%) with attempt suicide
what are signs and symptoms of Huntington's Disease
Parkinson's Disease
what disorder affects an estimated 1 in 3 people over age 85
50 and 80
with Parkinson's Disease majority of cases are diagnosed between what ages, but 10% of cases deveolp before age 40

Basal ganglia

with Parkinson's Disease part of the area affected and these cells are responsible for producing DOPAMINE, a neurotransmitter
Unknown and no cure
with Parkinson's Disease what is the cause and what is the cure
Resting tremors (starts in one limb and spreads to others), Pill roll tremors, Rigidity, Loss of facial expression
what are signs and symptoms of Parkinson's Disease
Dysarthria & Dysphagia, Micrographia (small writing), Dementia, Balance and gait changes
what are signs and symptoms of Parkinson's Disease
Impaired balance: decreased righting and equilibrium responses
with Parkinson's Disease what are balance and gait changes
Shuffling/festinating gait: shortened stride, decreased speed, increased cadence, decreased arm swing and trunk rotation
with Parkinson's Disease what are balance and gait changes
Stooped posture, Difficulty initiating and stopping movement
with Parkinson's Disease what are balance and gait changes
Difficulty changing direction, Bradykinesia
with Parkinson's Disease what are balance and gait changes
Levadopa which is precursor to dopamine
what is a drug used with Parkinson's Disease

When the patient confuses the order of letters

A therapist is testing for attention by asking a patient to spell short words such as bottle,garden, fork etc.. (this task can be made progressively more difficult by adding longer words; Individuals with high attention span will be able to perform this task). What attention deficits it will be apparent to the therapist?
Anterior (ventral) spinothalamic tract
Among the three major tracts of the spinothalamic system, which is the one concern with crude localized touch and pressure?
Lateral spinothalamic tract
Among the three major tracts of the spinothalamic system, which one carries pain and temperature sensations?
Spinoreticular tract
Among the three major tracts of the spinothalamic system, which is involved with diffuse pain sensations?
Tactile localization
Defined as the ability to localize touch sensation on the skin. It examines the ability to identify the specific point of application of a touch (e.g., tip of ring finger, lateral malleolus, etc..)
Two point discrimination
This test determines the ability to perceive two points applied to the skin simultaneously. It is a measure of the smallest distance between two stimuli (applied simultaneously and with equal pressure) that can still be perceived as two distinct stimuli. This is a practical test for cutaneous sensation
Barognosis
It is the recognition of weight. A set of small objects of the same size and shape but different weight. two objects of different or equal weights are given to the patient. the patient is asked to identify which is heavier or lighter
UMN
Identy if the following signs & symptoms are either Upper Motor Neuron syndrome (UMN) or Lower Motor Neuron syndrome (LMN)|- Hyperactive stretch reflexes|- Involuntary flexor or extensor spasms|- clonus|- Babinski's sign|- Exagerated cutaneous reflexes|- Loss of precise autonomic
LMN
Identy if the following signs & symptoms are either Upper Motor Neuron syndrome (UMN) or Lower Motor Neuron syndrome (LMN)|- Decreased or absent tone|- Decreased or absent reflexes|- Paresis|- Muscle fasciculations and fibrillations with denervation|- Neurogenic atrophy

Decorticate rigidity

Abnormal flexor response. It refers to sustained contraction and posturing of the upper limbs in flexion and the lower limbs in extension. The elbows, wrist and fingers are held in flexion with shoulder adducted tightly to the sides while the legs are held in extension, internal rotation and plantarflexion. This condition is called?
Decerebrate rigidity
Abnormal extensor response. Refers to sustained contraction and posturing of the trunk and limbs in a position of full extension. The elbows are extended with shoulders adducted, forearms pronated, and wrist and finger flexed. The legs are held in stiff extension with plantaflexion.
Grade 0
Modified Ashworth Scale for grading spascity|No increase in muscle tone
Grade 1
Modified Ashworth Scale for grading spascity|Slight increase in muscle tone, minimal resistance at the end of ROM
Grade 1+
Modified Ashworth Scale for grading spascity|Slight increase in muscle tone, miminal resistance through less than half of ROM
Grade 2
Modified Ashworth Scale for grading spascity|Marked increase in muscle tone through most of ROM, affected part moved easily
Grade 3
Modified Ashworth Scale for grading spascity|Considerable increase in muscle tone, passive movement difficult
Grade 4
Modified Ashworth Scale for grading spascity|Affected part rigid in flexion or extension
Grade 0
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Flaccidity, no response
Grade 1+
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Decreased response (hypotonia)
Grade 2+
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Normal response
Grade 3+
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Exaggerated response (mild to moderate hypertonia)
Grade 4+
Muscle tone is graded on a scale from 0 - 4+. What grade?|- Sustained response (severe hypertonia)
Grade 0
Reflexes are graded on a 0 - 4+. What grade?|- No response
Grade 1+
Reflexes are graded on a 0 - 4+. What grade?|- Present but depressed, low normal
Grade 2+
Reflexes are graded on a 0 - 4+. What grade?|- Average, normal
Grade 3+
Reflexes are graded on a 0 - 4+. What grade?|- Increased, brisker than average, possibley but not necessarily abnormal
Grade 4+
Reflexes are graded on a 0 - 4+. What grade?|- Very brisk, hyperactive, with clonus; abnormal
Flexor withdrawal
Identify the type of primitive/spinal reflex being tested?|- Noxious stimulus (pinprick) to sole of foot. (tested in supine or sitting position)|- Response: Toes extend, foot dorsiflexes, entire LE flexes uncontrollably.|Onset: 28 weeks of gestation|Integraded: 1-2 months
Crossed extension
Identify the type of primitive/spinal reflex being tested?|- Noxious stimulus to ball of foot of LE fixed in extension. Tested in supine position.|Response: Opposite LE flexes, then adducts and extends.|Onset: 28 weeks of gestation|Integraded: 1-2 months
Traction
Identify the type of primitive/spinal reflex being tested?|- Grasp forearm and pull up from supine position|- Response: Grasp and total flexion of the UE.|Onset: 28 weeks of gestation|Integraded: 2-5 months
Moro
Identify the type of primitive/spinal reflex being tested?|- Sudden change in position of head in relation to trunk; drop patient backward from sitting position|- Response: Extension, abduction of UEs, hand opening, and crying followed by flexion, adduction of arms across chest.|Onset: 28 weeks of gestation|Integraded: 5-6 months
Startle
Identify the type of primitive/spinal reflex being tested?|- Sudden loud or harsh noise|- Response: Sudden extension or abduction of UEs, crying|Onset: birth|Integraded: persists.
Grasp
Identify the type of primitive/spinal reflex being tested?|- Maintained pressure to palm of hand (palmar grasp) or to ball of foot under toes (plantar grasp)|- Response: Maintained flexion of fingers or toes|Onset: palmar, birth; plantar, 28 weeks gestation.|Integraded: palmar =, 4 - 6 months and plantar, 9 months
Asymmetrical tonic neck reflex (ATNR)
Identify the type of tonic/brainstem reflexes being tested?|- Rotation of the head to one side|- Response: flexion of skull limbs, extension of the jaw limbs; bow and arrow or fencing posture. When the face is turned to one side, the arm and leg on the side to which the face is turned extend and the arm and leg on the opposite side flex.
Symmetrical tonic reflex (STNR)
Identify the type of tonic/brainstem reflexes being tested?|- Flexion or extension of the head|- Response: with head FLEXION: flexion of UEs, extension of LEs. -- with head EXTENSION: extension of UEs, and flexion of LEs.|Onset: 4 -6 months|Integrade: 8-12 months.
Symmetrical tonic labyrinthine (STLR)
Identify the type of tonic/brainstem reflexes being tested?|- Prone or supine position|- Response: with PRONE position: Increased flexor tone/flexion of all limbs; -- with SUPINE: Increased extensor tone/extension of all limbs
Postive supporting
Identify the type of tonic/brainstem reflexes being tested?|- Contact to the ball of the foot in upright standing position.|- Response: Rigid extension (co-contraction) of the LEs|Onset: birth|Integraded: 6 months
Associated reactions
Identify the type of tonic/brainstem reflexes being tested?|- Resisted voluntary movement in any part of the body|- Response: Involuntary movement in a resting extremity|Onset: birth - 3 months|Integraded: 8 - 9 years
Diplopia
Double vision. It is often present following brain change. The patient sees two of the entire environment. This condition is usually a result of defective function of extraocular muscles in which both eyes used but not in focus. Treatment involves, exercise for eye muscles, and patching of the other eye until condition clears. This condition is called?
patch the other eye
Diplopia or double vision.It is often present following brain change. The patient sees two of the entire environment. treatment involves exercises for eye muscles and?
Homonymous hemianopsia
The most common visual field affecting patients with hemiplegia, and occurs most frequently following damage to the middle cerebral artery near the internal capsule. This visual field deficit is called?
Turn the head to the affected side
The presence of a visual field cut may inhibit performance in many ADLs. The patient is usually unaware of the condition does not automatically conpensate by turning the head. The patient should be then instructed specifically to:__________ to compensate for visual field deficits.
Immediate recall
A therapist gives a patient instructions of what do next in the therapy session. after a few seconds the patient does not remember what the instructions were. This is a clinical example of what kind of memory deficit?
Short term memory
In a clinical setting, a patient with memory deficits a therapist teaches him/her how to perform a new transfer technique. Next day, the therapists asks the patient to performed the new learned technique,but the patient does not remember the steps. This is an example of what kind of memory deficit?
Long term memory
A patient experience difficulty recalling events from many years ago such a child's birth, work experience. What kind of memory deficit?
Body image
Defined as a visual and mental image of one's body that includes feelings about one's body, especially in relation to health and disease.
Body scheme
Refers to a postural model of the body, including the relationship of body parts to each other and the relationship of the body to the environment. the acquisition of an internal awareness of the body and the relationship of body parts to one another.
Unilateral neglect
A patient with body scheme and body image disorders, appears to be totally indifferent to the left side of the body and environment. When he dresses, he ignores the left side when putting on pants, or shaves only the right side ignoring the left. This condition is called?
Behavioral Inattention Test (BIT)
Which test can be useful to examine for unilateral neglect?
Anosognosia
Defined as a severe condition including denial and lack of awareness of te presence or severity of one's paralysis. It is a lack of awareness or denial of a paretic extremity as belonging to the person, or a lack of insight concerning or denial of paralysis. The presence of this disability may compromise rehabilitation potential greatly, because it limits the patient's ability to recognize the need for, and thus to use, compensatory techniques.
Anosognosia
This is a clinical example of what condition?|- Typically the patient maintains that there is nothing wrong and may disown the paralyzed limbs and refuse to accept responsibility for them.|- The patient may say " the limb has a mind of its own or that it was left at home or in a closet"
Anosognosia
A therapist asks the patient the following questions|- What happened to the arm, leg etc..|- Do you think it is paralyzed, and how the limb feels, and why it cannot be moved.|The patient responds by denying paralysis, stated that is of no concern, and begins to fabricate reasons why the limb does not move the way it should.|This patient is presenting with what kind of body image/scheme impairment?

Somatoagnosia

Derive from the words somato- body; a = no; gnosia = knowldege. It is a lack of wareness of the body structure and the relationship of the body parts to onself or to others. The patient may have difficulties performing transfer activities because he/she does not perceive the meaning of the terms related to body parts.
Somatoagnosia
This is a clinical example of what condition|- A therapist asks a patient to "Pivot on your leg, and reach for the armrest with your hand". The patient presents with difficulty performing the task.|- Patients may have a hard time participating in exercises that require somebody part to be moved in relation to the other body parts. For example, "Bring your arm across your chest and touch your soulder"
Somatognosia
A therapist asks a patient the following questions|- Can you point to your shoulder, nose, Can you point to my(the therapist) shoulder, forehead|- From a picture, puzzle of a human figure, can you point to (any part named by therapist)|- Show me your chin, point to your back|(do not use the word Right or left , patient may have right-left discrimination deficits and may lead to inaccurate diagnosis)|This patient is presenting with what kind of body image/scheme impairment?
Somatognosia
A patient is asked to rub with a rough cloth to body parts named by the therapist. This is a tx suggestion for what condition?
Right-left discrimination disorder
Defined as the inability to identify the RIGHT - LEFT sides of one's own body or the examiners. This includes the inability to execute movements in response to verbal commands that include the terms "RIGHT" or "LEFT"
Right-left discrimination disorder
Which body image/scheme impairment is being tested?|- A therapist ask a patient to: Point to your RIGHT shoulder, LEFT hand, knee, RIGHT ear etc..|Six responses should be elicited on the patient's body, therapists and on a model or picture of human body to rule out somatoagnosia. The patient should be tested first without using the words "right" or "left"
Figure ground discrimination
Defined as the inability to visually distinguish a figure from the background in which it is embedded. Functionally, it interferes with the patient's ability to locate important objects that are not prominent in a visual array.
Figure ground discrimination
This is a clinical example of what kind of spatial relation disorders?|- The patient cannot locate items in a pocketbook or drawer, locate buttons on a shirt, or distinguish the armhole from the remainder of a solid-colored shirt|- The patient may not be able to tell when one step ends and another begins on a flight of stairs, especially when decending.

The Ayres Figure-Ground Test

Which test is appropriate for Figure-ground discrimination disorder?
Figure ground discrimination
For the following functional test, identify which condition is being assessed?|- A white towel can be placed on a white sheet, and the patient is asked to find the towel.
Figure ground discrimination
For the following functional test, identify which condition is being assessed?|- The patient can be asked to point out the sleeve, buttons, and collar of a white shirt, or to pick out a spoon from an unsorted array of eating utensils.|(it is necessary to rule out poor eyesight, hemianopsia,visual agnosia, and poor comprehension to improve the validity of these testing techniques)
Form discrimination disorder
Defined as the inability to perceive or attend to subtle differences in form and shape. The patient is likely to confuse objects of similar shape or not to recognize and object placed in an unusual position.
Form discrimination disorder
This is a clinical example of what kind of spatial relations disorders?|- Patient confuses a pen with a toothbrush|- Patient confuses a vase with a water pitcher|- Patient confuses a cane with a crutch
Form discrimination disorder
Which spatial relations disorders is being tested?|A therapist gather a number of items similar and different in shape and size. A set contains a pencil, pen, straw, toothbrush, watch, and the other set contains a key, paper clip,coins, and a ring. Each object is presented in different positions (e.g., up sidedown). Visual object agnosia MUST be ruled out as a cause for poor performance by first presenting objects separately and asking the patient to identify them or to demonstrate how they are used)
Spatial relations disorder
aka spatial disorientation, is the inability to perceive the relationship of one object in space to another, or to one self. This may lead to or compound, problems in constructional tasks. Crossing midline may be a problem with patients with this condition, it is require to manage most ADLs
Spatial relations disorder
This is a clinical example of what condition?|- Patient may find it difficult to place cutlery, plate, and spoon in the proper position when setting the table.
Spatial relations disorder
This is a clinical example of what condition?|- The patient may be unable to tell the time from a clock because of difficulty in perceiving the relative postions of the hands.
Spatial relations disorder
This is a clinical example of what condition?|- The patient may have difficulty learning to position his/her arms, legs and trunk in relation to the wheelchair to prepare for transferring.
Rivermead Perceptual Assessment Battery (RPAB), Arnadottir OT-ADL, and Neurobehavioral Evaluation ( A-ONE)
What tests are recommended for spatial relations disorder or spatial disorientation?
Position in space impairment
Defined as the inability to perceive and to interpret spatial concepts such as up, down, under, in, out, in front of, and behind.
Position in space impairment
This is a clinical example of what condition?|- If the patient is asked to raise the arm "above" the head during ROM activities or is asked to place the feet "on" the footrest, the patient may behave as if he/she does not know what to do.
Position in space impairment
What spatial relations disorders is being tested?|A therapist is testing function for this condition|- Two objects are used, such as a shoe and a shoebox; for example, in the box, on top of the box, or next to the box|Alternatively, the patient is presented with two objects and asked to describe their relationship; for example, a toothbrush can be placed in a cup, under a cup, etc.., and the patient is then asked to indicate the location of the toothbrush.
Position in space impairment
What spatial relations disorders is being tested?|- Have the patient copy therapist's minipulation with an identical set of objects. For example, the therapist hands the patient a comb and a brush. The therapist then takes an identical set and places the comb on top of the brush. The patient is requested to arrage his/her comb and brush in the same way.
Topographic disorientation
Defined as the difficulty in understanding and remebering the relationship of one location to another. As a result, the patient is unable to get from one place to another, with, or without a map
Topographic disorientation
This is a clinical example of what condition?|- The patient cannot find the way from his/her room to the physical therapy clinic despite of being shown repeatedly.|- The patient cannot describe the spatial characteristics of familiar surroundings such as the layout of his/her bedroom at home.
Topographic disorientation
What condition is being tested?|- The patient is asked to describe or to draw a familiar route, such as te block on which he/she lives, the layout of his/her house, or a major neighborhood intersection. An impaired patient will be unable to succeed in this task.
Depth and distance perception
This patient experience inaccurate judgement of direction, distance, and depth. Spatial disorientation may be a contributing factor in faulty distance perception
Depth and distance perception
This is a clinical example of what condition?|- The patient may have diffculty navigating stairs, may miss the chair when attempting to sit or may continue pouring juice once a glass is filled.
Depth and distance perception
What condition is being tested?|- for a functional test a patient is asked to take or grasp an object that has been placed on a table. The object may held in front of , in the air, and the patient will overshoot or undershoot (dysmetria)|- The patient can be asked to fill a glass of water. A patient with this condition may continue poruing once the glass is filled
Vertical disorientation
Refers to a distorted perception of what is vertical. Displacement of the vertical position can contribute to disturbance of motor performance, both in posture and gait
Visual Agnosia
This is a clinical example of what condition?|A patient cannot recognize an given object despite normal function of the yes and optic tracts. However, patient recognizes it when the object is handled (stereognosis). The patient may not recognize people, possessions, and common objects.
Auditory agnosia
Refers to the inability to recognize non-speech sounds or to discriminate betwen them.
Auditory agnosia
This is a clinical example of what condition?|- The patient cannot tell, for example, the difference beteen the ring of a doorbell and that of a telephone or between a dog barking or a thunder
Astereognosis
Defined as inability to detect objects by touch with vision occluded
Astereognosis
This is a clinical example of what condition?|- A patient is handed an object e.g., a key, with vision occluded and fails to recognize it.

Apraxia

Impairment of voluntary skilled learned movement. It is characterized by inability to perform purposeful movements which cannot be accounted for by inadequate strength, loss of coordination, impaired sensation, attentional difficulties, abnormal tone, movement disorders,intellectual deterioration, poor comprehension or uncooperativeness
Ideomotor apraxia
Refers to a breakdown between concept and performance. There is a disconnection between the idea of a movement and its motor execution. The patient is able to carry out habitual tasks automatically and describe how they are done but is unable to imitate gestures or perform on command. Patient with this condition often perseverate, that is they repeat an activity or a segment of a task over, and over , even if it is no longer necessary or appropriate.
Ideomotor apraxia
This is a clinical example of what condition?|- The patient is unable to "blow" on command;however, if presented with a bubble wand, the patient will spontaneously blow bubbles.
Ideomotor apraxia
This is a clinical example of what condition?|- The patient is asked to walk to the other end of the room, but the patient is unable to perform on command.;however, another therapist places a cup of coffee on the table tells patient "please have coffee", and the patient walks towards the other end to get it.
Ideomotor apraxia
This is a clinical example of what condition?|- A male patient is asked to comb his hair. The patient is able to identify the object, and describe what is it used for, but will not use it when it is handed to him. Despite this observation, his wife reports that he spontaneously comb his hair every morning.
Ideomotor apraxia
This is a clinical example of what condition?|- A female is handed a dynamometer and is asked to squeeze it. She knows what it is for, and the task has been demonstrated, but she is unable to squeeze the hand dynamometer on command.
Ideational apraxia
Defined as a failure in the conceptualization of a task. It is an inability to perform a purposeful motor act, either automatically or on command. The patient can perform isolated components of a task, but cannot combine them into a complete act. The patient cannot verbally describe the process of performing an activity, describe the function of objects, or use them appropriately
Ideational apraxia
This is a clinical example of what condition?|- The patient is presented a toothbrush and toothpaste and told to brush the teeth, the patient may put the tube of toothpaste in the mouth, or try to put toothpaste on the toothbrush without removing the cap. The patient is unable to describe verbally how a toothbrush is done. This will be evident in all aspect of ADLs (e.g., washing, meal preparation etc..)
Neurogenic injury
A patient who presents with persistent fasciculations (Involuntary contractions or twitchings of groups of muscle fibers), suggests what kind of injury?
Leadpipe
Rigidity that is seen in basal ganglia nigrostriatal disorders are increased resistance to PROM in agonist and antagonist muscle. Rigidity that is uniform throughout the range is called?
Cogwheel
Rigidity that is seen in basal ganglia nigrostriatal disorders are increased resistance to PROM in agonist and antagonist muscle. Rigidity that is interrupted by a series of jerks during PROM is called?
Anterior cerebral artery Syndrome
This artery supplies the anterior 2/3 (67%) of the medial cerebral cortex. Occulusions produces:|- Contralateral sensory loss and hemiparesis, with leg more involved than arm (Leg > Arm)
Circle of willis
Occlusions proximal to the anterior communicating artery produce minimal deficits owing to collateral circulation of?
A
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Complete, no motor or sensory function is preserved in the sacral segments S4-S5
B
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Incomplete: Sensory, but NO motor function is preserved below the neurological level and includes the sacral segments S4-S5
C
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Incomplete: Motor function is preserved below the neurological level, and most key muscles below the neurological level have a muscle grade < 3
D
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Incomplete: Motor function is preserved below the neurological level, and most key muscles below the neurological level have a muscle grade ≥ 3
E
According to American Spinal Cord Injury Association (ASIA), what level is being described?|Normal: Motor and sensory function is normal
Anterior Cord
Identify the following spinal cord syndrome|- Mechanism of injury: hyperflexion, acute large disc herniation or as a result of anterior spinal artery injury|- This lesion damages: Anterolateral spinothalamic tract, cortical spinal tract, anterior horn (gray matter). |- Typically presents BILATERAL loss of pain and temperature sensation and motor function with PRESERVATION of light touch, proprioception (position sense) and vibration sense.
Brown Sequard
Identify the following spinal cord syndrome|- Mechanism of injury: Penetrating spinal trauma (e.g., Stab wound) epidural hematoma, spinal arteriovenous malformation, cervical spondylosis, or unilateral articular process fracture or dislocation.|- Lesion of 1/2 of the spinal cord; typically presents with:|- IPSILATERAL loss of touch, proprioception, and vibration sense|- IPSILATERAL motor paresis (weakness) or paralysis|- CONTRALATERAL loss of pain, and temperature sensation a few segments below the level of lesion.
Central cord
Identify the following spinal cord syndrome|- Usually occurs at the cervical level.|- Mechanism of injury: hyperextension injuries where the spinal cord is squeezed or pinched between anterior cervical spondylotic bone spurs and the posterior intraspinal canal ligament, the ligamentum flavum. or as a result of tumor, rheumatoid arthritis or syringomyelia [(the development of a fluid-filled cyst (syrinx) within your spinal cord. Over time, the cyst may enlarge, damaging your spinal cord and causing pain, weakness and stiffness, among other symptoms)]|This lesion exerts pressure on anterior horn cells, and typically presents with:|- BILATERAL motor paralysis or UEs > LEs, variable sensory deficits, and possible bowel/bladder dysfunction
Cauda equina
Identify the following spinal cord syndrome|- Indicates damage to the lumbar (below L1) and/or sacral spinal roots (LMN), causing sensory impairment and flaccid paresis (weakness) or paralysis of lower limb muscles, bladder and bowels. Some capacity for regeneration; LMN, autonomous or non-reflex bladder. |- Muscle hypertonia and hyperreflexia do not occur because the upper motor neurons are intact.
Emergency medical referral
If a patient presents to the clinic with low back pain and/or sciatica COMBINED with bladder or bowel retention or incontinence, knowing that cauda equina syndrome may progress to paraplegia and/or to permanent problems with bladder and/or bowel control, the patient needs?
Posterior cord
Identify the following spinal cord syndrome|- Condition caused by lesion of the posterior portion of the spinal cord. It can be caused by an interruption to the posterior spinal artery. rare condition|- Presents with loss of proprioception, discriminative touch information, vibration sense
Sacral sparing
Identify the following spinal cord syndrome|- Sparing of tracts to sacral segments, with preservation of perianal sensation, rectal sphincter tone, or active toe flexion
C1 - C4 lesions
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patients requires an electric wheelchair with:|- tilt-in-space or reclining seat back|- micro switch or puff and sip controls|- portable respirator may be attached
C5
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patients with cervical lesions, shoulder function and elbow flexion|- can use manual wheelchair with propulsion aids (i.e., projections)|- independent for short distance on smooth , flat surfaces|- may choose and electric wheelchair for longer distances and energy conservation
C6
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patients with cervical lesions , radial wrist extensors
C6
Identify the spinal cord level for the following description for appropriate wheelchair prescription|May use a manual wheelchair with friction surface and hand rims; independent.
C6
Identify the spinal cord level for the following description for appropriate wheelchair prescription|The highest SCI level that has the ability to drive a car independently with adaptive equipment
C7
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patients with cervical lesions and triceps function (elbow extension)
C7
Identify the spinal cord level for the following description for appropriate wheelchair prescription|may use manual wheelchair with friction surface hand rims independently, but with increased propulsion
C8 - T1
Identify the spinal cord level for the following description for appropriate wheelchair prescription|Patient with hand function and below
C8 - T1
Identify the spinal cord level for the following description for appropriate wheelchair prescription|May use manual wheelchair with standard hand rims
Midthoracic lesions ( T6-9)
Appropriate orthotic prescription/ambulation training. What lesion level?|- Supervised ambulation for short distances (physiological, limited household ambulator); requires bilateral knee-ankle-foot orthoses (KAFOs) and crutches, swing-to gait pattern; requires assistance; may prefer standing devices/standing wheelchairs for physiological standing
Swing to gait pattern
For a patient with midthoracic lesions (T6-9), what appropriate gait pattern will be recomended?
High lumbar lesions (T12-L3)
Appropriate orthotic prescription/ambulation training. What lesion level?|- Can be independent in ambulation all surfaces and stairs; using a swing-through or four point gait pattern and bilateral KAFOs and crutches.|- Patients may also use reciprocating gait orthoses (RGO) with walker with or without FES system.|- Typically independent household ambulators; wheelchair use for community ambulation.
Low lumbar lesions (L4-5)
Appropriate orthotic prescription/ambulation training. What lesion level?|- Can be independent with bilateral AFOs and crutches or canes.|- Typically independent community; may still use wheelchair for activities with high-endurance requirements.
Absolute contraindication
Do no harm. Identify based on ACSM guidelines if the following condition is an absolute contraindication or not for exercise testing and training of individuals with SCI.|- Autonomic dysreflexia
Absolute contraindication
Do no harm. Identify based on ACSM guidelines if the following condition is an absolute contraindication or not for exercise testing and training of individuals with SCI.|- Severe or infected skin on weight bearing surfaces
Absolute contraindication
Do no harm. Identify based on ACSM guidelines if the following condition is an absolute contraindication or not for exercise testing and training of individuals with SCI.|- Symptomatic hypotension
Absolute contraindication
Do no harm. Identify based on ACSM guidelines if the following conditions are absolute contraindications or not for exercise testing and training of individuals with SCI.|- Urinary tract infection|- Uncontrolled spasticity or pain|- Uncontrolled hot and humid environments
Absolute contraindication
Do no harm. Identify based on ACSM guidelines if the following conditions are absolute contraindications or not for exercise testing and training of individuals with SCI.|- Unstable fracture|- Insufficient ROM to perform exercise task
Postural stress syndrome
Defined as postural malalignment that produces chronic muslce lengthening and/or shortening and stress to soft tissues.
Myofascial pain syndrome
Defined as persistent, deep aching pain in muscle, nonarticular in origin;characterized by well-defined, highly sensitive tender spots (trigger points)
Fibromyalgia
Defined as widespread pain accompanied by tenderness of muscles and adjacents soft tissues, a non-articular rheumatic disease of unknown origin.
Approximation
The proprioceptive element that applies compression force to the joints;stimulates afferent nerve endings,and facilitates EXTENSOR muscles, mobilizaing patterns is called?
Traction
The proprioceptive element that applies a distraction force to the joints;stimulates afferent nerve endings and facilitates FLEXOR
Rhythmic initiation
Voluntary relaxation follwed by passive movements through increasing ROM, followed by AAROM, progressing to RROM; the patient finishes with AROM. |Indications:|- Inability to iniate movement (apraxia)|- Uncoordinated motion (rigidty, ataxia)|- General tension or tonal impairment (hypertonic muscles)|- Motor learning deficits;communication deficits (aphasia)
Rhythmic rotation
Voluntary relaxation combined with slow, passive, rhythmic rotations of the body or body parts;focus is on gaining ROM. Active holding in the new range is then stressed|Indications:|- General tension or hypertonica with limitations in function or ROM (hypertonic muscles)
Stabilizing reversals (alternating isometrics)
Isometric holding is facilitated first on one side of the joint,followed by alternate holding of the antagonist muscle groups. May be applied in any direction (anterior-posterior, medial lateral, diagonal)|Indications:|- Decreases stability|- Poor antigravity control|- Weakness
Rhythmic stabilization (RS)
Simultaneous isometric contractions of both agonist and antagonist muscles (co-contraction) performed without relaxation using carful grading of resistance; RS emphasizes rotational stability control.|Indications:|- Decreased stability in weight bearing and holding|- Poor antigravity control|- Weakness|- Ataxia|- Limitations in ROM caused by muscle tightness, painful muscle splinting.
Dynamic reversals (Slow reversals)
Slow isotonic contractions of first agonist,then antagonist patterns using careful grading of resistance and optimal facilitation;reversal of antagonist without relaxation or pause.|An isometric hold can be added at the end of the ROM at a point of weakness (hold can be added in both directions or only in one direction|Indications:|- Decreased AROM|- Weakness of antagonistic muscle|- Decreased reciprocal control|- Hypertonic muscle groups
Combination of isotonics (agonist reversals)
Combines concentric, eccentric, and isometric contractions of one muscle group. e.g., agonists: a slow isotonic,shortening contraction through the range followed by an isometric hold, and then, an eccentric, lengthening contraction using the same muscle group.|Indications:|- Weak postural muscles|- Inability to eccentrically control body weight during movement transistions; e.g., sitting down|- Decreased AROM , control and weakness.
Replication (hold relax - Active motion
An isometric contraction performed in the MID to SHORTENED range follwed by voluntary relaxation and passive movement into te lengthened range, and resistance to an isotonic contraction through the range.|Indications:|- Inability to iniate movements|- Hypotonia|- Weakness
Contract-relax
A relaxation technique usually performed at a point of limited ROM in the agonist pattern: isotonic movement in rotation is performed follwed by an isometric hold of the range-limiting muscles in the antagonist pattern against slowly increasing resistance, then voluntary relaxation, and active contraction (CRAC) into the newly gained range of the agonist pattern.|Indication:|- Limitations in ROM caused by muscle tightness, spasticity
Hold-relax
A relaxation technique usually performed at the point of limited ROM in the agonist pattern; isometric contraction of te range-limiting antagonist pattern is performed against slowly increasing resistance, followed by voluntary relaxation , and passive movement into the newly gained range of the agonist pattern.|Active contraction (HRAC) into the newly gained range of the agonist pattern can also be performed and serves to maintain the inhibitory effects through reciprocal inhibition.|Indications:|- Limitations in ROM caused by muscle tightness, muscle spasms, and pain
Repeated stretch (repeated contractions)
Repeated stretch linked to voluntary effort to contract stretched muscles;may be repeated, without stopping, as soon as the contraction weaknes or stops.|Indications:|- Weakness|- Fatigue|- Decreased ability to perform the desired pattern
Parkinson's
Identify the disease based on description|- A progressive neurodegenerative disorder associated with a loss of pigmented dopaminergic nigostriatal neurons in the substantia nigra and the presence of lewy bodies. This disorder is produced by abnormalities of basal ganglia function.|- three cardinal signs of this disorder are resting tremor,rigidity, and bradykinesia
Multiple Sclerosis
Identify the disease based on description|- A chronic progressive demyelinating disease of the CNS affecting mostly young adults|- fatigue pattern: early afternoon fatigue and exhaustion common with high energy periods in early morning, and some recovery in early evening.
Guillain-Barre Syndrome
Identify the disease based on description|- A heterogeneous grouping of immune-mediated processes generally characterized by motor, sensory, and autonomic dysfunction. It is an acute inflammatory demyelinating polyneuropathy characterized by progressive symmetric ascending muscle weakness, paralysis and hyporeflexia with/without sensory or autonomic symptoms.
Amyotrophic Lateral Sclerosis
Identify the disease based on description|- aka Lou Gehrig's disease. it is characterized by slowly progressive degeneration of upper and lower motor neurons
Bell's palsy
Identify the condition based on description|- A facial paralysis a LMN lesion involving CN VII (facial nerve), resulting in unilateral facial paralysis
Frontal lobe
Precentral gyrus: |- Primary motor cortex for voluntary muscle activation|- Prefrontal cortex: Controls emotions and judgement|- Broca's area: Control motor aspect of speech
Parietal lobe
Post central gyrus:|- primary sensory cortex for integration of sensation|- Receives fibers conveying touch, proprioceptive, pain, and temperature sensations from opposite side of body
Temporal lobe
Primary auditory cortex: receives/processess auditory stimuli|Associative auditory cortex: process auditory stimuli|Wernicke's area: language comprehension

Occipital lobe

Primary visual cortex: receives/processes visual stimuli|Visual association cortex: process visual stimuli. Location?
Limbic system
Part of the brain concerned with:|- instincts and emotions contributing to preservation of the individual.|- basic functions inlcude: feeding, aggression, emotions, and endocrine aspects of sexual response
Cheyne-Stokes respiration
A period of apnea lasting for 10 - 60 seconds followed by gradually increasing depth and frequency of respirations.|Accompanies depression of FRONTAL LOBE and diencephalic dysfunction
Primary motor cortex
This area is part of the frontal lobe of the brain and is concerned with voluntary muscle activations
Prefrontal corex
This area is part of the frontal lobe of the brain for control of emotions and judgements
Broca's area
This area of the brain controls the motor aspect of speech
Primary sensory cortex
This area is part of the parietal lobe of the brain and is responsible for integration of sensation. it receives fibers conveying touch, proprioception, pain, and temperature sensation from opposite side of body
Primary auditory cortex
This area of the temporal lobe that receives/processes auditory stimuli
Wernicke's area
Area of the temporal lobe of the brain reponsible for language comprehension
Primary visual cortex
Located in the occipital lobe, it receives/process visual stimuli
Insula
Located deep within lateral sulcus, it is associated with visceral functions
White Matter
Myelinated nerve fibers located centrally. This is called?
Transverse commissural fibers
This fibers interconnect two hemispheres, including the corpus callosum (the largest), anterior commissure, and hipocampal comissure
Basal Ganglia
Which part of the brain is this?|Masses of gray matter deep within the cerebral hemispheres including:|- the corpus striatum (caudate nucleus and lenticular nuclei|- amygdalid nucleus, and claustrum|- lenticular nuclei are further divided into the putamen and globus pallidus|Forms an associated motor system (extrapyramidal system) with other nuclei in the subthalmus and midbrain
occulomotor circuit
Caudate loop: originate in frontal and supplementary motor eye fields, projects to caudate functions with saccadic eye movements
Skeletomotor circuit
Putamen loop: Originates in precentral motor and postcentral somatosensory areas;|- projects to putamen functions to scale amplitude and velocity of movements|- reinforces selected pattern, supresses conflicting patterns; preparatory for movement (i.e. motor set, anticipatory movement)
Limbic circuit
Originates in prefrontal and limbic areas of cortex to Basal Ganglia, to prefrontal cortex|functions to organize behaviors (executive functions, problem solving, motivation) and for procedural learning (repeating a complex activity over and over again until all of the relevant neural systems work together to automatically produce the activity).
Archicerebellum
(flocculonodular lob) connects with vestibular system and is concerned with equillibrium and regulation of muscle tone helps coordinate vestibulo-occular reflex
Spinocerebellum
Receives input from proprioceptive pathways and is concerned with modifying muscle tone and synergistic actions of muscles|It is important in maintenance of posture and voluntary movement control
Neocerebellum
Receives input from corticopontecerebellar tracts and olivocerebellar fibers|-It is concerned with the soomth coordination of voluntary movements, ensures accurate force, direction and extent of movement|- Important for motor learning sequencing of movements, and visually triggered movements|- May have a role in assisting cognitive function and mental imagery
Anterior horn cells
It contains cell bodies that give rise efferent (motor) neurons: Alpha motor neurons to effect muscles and gamma motor neurons to muscle spindles.

Posterior horn cells

It contains afferent (sensory) neurons with cell bodies located in the dorsal root ganglia.
Fasciculus cuneatus
Ascending fibers systems (sensory pathways)|Dorsal columns/medial lemniscal system (Upper extremity tracts, laterally located) convey sensations of proprioception, vibration and tactile discrimination
Fasciculus gracilis
Ascending fibers systems (sensory pathways)|Dorsal columns/medial lemniscal system (Lower extremity tracts, medially located) convey sensations of proprioception, vibration and tactile discrimination
Lateral spinothalamic tract
Ascending tract (sensory pathways) that convey sensations of pain and temperature
Anterior spinothalamic tract
Ascending tract (sensory pathways) that convey crude touch
Spinocerebellar tracts
Ascending tract (sensory pathways) that convey proprioception information from muscle spindles, golgi tendon organs, and touch and pressure receptors to cerebellum for control of voluntary movements
Spinoreticular tratcs
Ascending tract (sensory pathways) that convey deep ande chronic pain to reticular formation of brainstem via diffuse polysynaptic pathways
Corticospinal tracts
Descending fiber systems (motor pathways)|Arise from primary motor cortex, descend in brainstem, cross in medulla (pyramidal decussation)|- Important for voluntary motor control
Vestibulospinal tract
Descending fiber systems (motor pathways)|Important for control of muscle tone, antigravity muscles, and postural reflexes.
Rubrospinal tract
Descending fiber systems (motor pathways)|Assist in motor function
Reticulospinal system
Descending fiber systems (motor pathways)|Arises in the reticular formation of the brainstem and descends (crossed and uncrossed) in ventral and lateral columns, terminates both on dorsal gray (modifies transmission of sensation, especially pain) and on ventral gray (influences gamma motor neurons and spinal reflexes)
Tectospinal tract
Descending fiber systems (motor pathways)|Arises from superior colliculus (midbrain) and descends to ventral gray; Assists in head-turning responses to visual stimuli
Neuroglia
Supports cells that do not transmit signals; important for myelin and neuron production;maintenance of K+ levels and reuptake of neurotransmitters after neural transmission at synapses
-70mV
Resting membrane potential: positive on outside, and negative on the inside. What is the value of the resting membrane potential on the inside?

Saltatory conduction

Myelinated axons, are axons covered with myelin with small gaps called nodes of Ranvier where myelin is absent. Myelin functions to increase speed of conduction and conserve energy. The action potential jumps from one node to the next. This type of conductions where the action potential jump from one node to the next is called?
A fiber
There are several different nerve fiber types, A, B and C fibers. This type of nerve fiber is large, myelinated and fast conducting. Which nerve fiber type is?
B fiber
There are several different nerve fiber types, A, B and C fibers. This type of nerve fiber is small, myelinated and conduct less rapidly; preganglionic autonomic. Which nerve fiber type is?
C fiber
There are several different nerve fiber types, A, B and C fibers. This type of nerve fiber is the smallest, unmyelinated, slowest conducting fiber. Which nerve fiber type is?
Alpha
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for proprioception, somatic motor?
Beta
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for touch and pressure?
Gamma
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for motor to muscle spindles?
Delta
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for pain, temperature and touch?
Dorsal root
C fibers are the smallest, unmyelinated, slowest conducting fibers, Whic type of C fiber is responsible for pain and reflex responses?
Motor (efferent) fibers
These fibers originate from motor nuclei (cranial nerves) or anteior horn cells (spinal nerves). These are?

Sensory (afferent) fibers

These fibers originate in cells outside of the brainstem or spinal cord, with sensory ganglia (cranial nerves) or dorsal root ganglia (spinal nerves).
Alert
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient responds appropriately, can open eyes, look at the examiner, respond fully and appropriately to stimuli. Patient is completely awake, aware of all stimuli and able to interact meaningfully with clinician.|Based on the above description, Identify which level of consciouness it represents?
Lethargy
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient appears drowsy; can open eyes and look at exminer, respond to questions, but fall asleep easily. Arousal with stimuli, that is falls asleep when not stimulated. Decreased awareness, loss of train of thought.|Based on the above description, Identify which level of consciouness it represents?

Obtundation

As part of the mental status examination, assessment of level of consciousness is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient can open eyes, look at examiner, but responds slowly and is confused; demonstrates decreased alertness and interest in environment. Difficult to arouse, requires CONSTANT stimulation for all activities.|Based on the above description, Identify which level of consciouness it represents?
Stupor
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient can be aroused from sleep ONLY with PAINFUL or VIGOROUS stimuli; verbal responses are slow or absent; patient returns to unresponsiveness state when stimuli are removed. Demonstrates minimal awareness of self and environment. Unable to complete mental status examination because responses are usually incomprehensible words.|Based on the above description, Identify which level of consciouness it represents?
Coma
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. |- Patient cannot be aroused, eyes remain closed; no response to external stimuli or environment. Patient is unrousable and non-verbal.|Based on the above description, Identify which level of consciouness it represents?
daiylight, radio or television sound, or a cold cloth on the forehead
Changes in body position, especially the transition from a recumbent position to a sitting position often stimulate increased alertness. Other stimuli that can be used to stimulate alertness include:?
Glasgow coma scale
It is a widely accepted measure of level of consciouness and responsiveness. It relates consciousness to three elements or response. Eye opening (E) with a max possible score = 4, Motor response (M) with a max possible score = 6, and verbal response (V) with a max possible score = 5. |Score = (E+M+V)|Max score = 15 and lowest score = 3. |A score of ≤ 8 signifies coma or severe brain injury
Minor brain injury
Using the glasgow coma scale. A score between 13 - 15 signifies what?
Moderate brain injury
Using the glasgow coma scale. A score between 9 - 12 signifies what?
Severe brain injury or coma
Using the glasgow coma scale. A score ≤ 8 signifies what?
Attention
As part of neurological examination, testing of cognitive function is important to assess attention, orientation, memory, abstract thought, and the ability to perform calculations or construct figures. |Bases on definition and task,what cognitive function is being assess?|- It is defined as the ability to attend to a specific stimulus or task. The patient is asked to repeat a series of numbers or letters, spelling words forward and backward
Orientation
Bases on definition and task,what cognitive function is being assess?|- It is defined as the ability to orient to person, place and time|- Identify name, age, current date, and season, birth date, present location, town etc...
Immediate recall
Bases on definition and task,what type of memory (cognitive function) is being assess?|- Name three items previously presented after a brief interval (a few seconds to a few minutes)|for example, the patient repeats, a red car, black pants, green tomatoes.
Short-term memory
Bases on definition and task,what type of memory (cognitive function) is being assess?|- Recounts words (after a few minutes) or recall recent events (i.e., What did you have for breakfast?)
Long-term memory
Bases on definition and task,what type of memory (cognitive function) is being assess?|- Recount past events (i.e., Where were you born?; Where did you grow up?)
Calculation
Bases on definition and task,what type of cognitive function is being assess?|- Defined as the ability to perform verbal or written mathematical problems (add,substract,multiply or divide whole numbers). i.e., 8 ÷ 4 =?; 7+5 =? etc..
Construction
Bases on definition and task,what type of cognitive function is being assess?|- Defined as the ability to construct a 2D or 3D figure or shape. i.e., Draw a figure after a verbal command or reproduce a figure from a picture
Calculation
A physical therapist asks a patient to perform the following mathematical operations. 9+3 =?; 4+7=? 8 ÷ 4 =?; 7 - 4 =? etc... Also the therapist aske to count backward from 100 by 7s. What cognitive function is being tested?
Construction
A physical therapist ask a patient (verbal command) to draw house and tree next to it. Also the therapist shows a picture of a red barn with white fences around it, and ask can you draw this picture in the best possible way you could? What cognitive function is being tested?
Abstraction
Bases on definition and task,what type of cognitive function is being assess?|- Defined as the ability to reason in an abstract rather than a literal or concrete fashion. i.e., discuss how two objects are similar or different
Abstraction
A therapist shows a patient a two cans of sodas. A can of regular Coca-Cola and a can of regular Pepsi. The therapis asks the patient what are the differences and similarities between the two objects. What cognitive function is being tested?
Jugdement
Bases on definition and task,what type of cognitive function is being assess?|- Defined as the ability to reason (according to age and lifestyle). Demonstrate common sense and safety.
Attention
A therapist ask a patient to recall up to seven numbers in order presented. | Then asks, can you spell backwards bottle, then fork, garden (using small words, and then ask progressively longer words) What cognitive function is being tested?
Sustained attention
In testing cognitive function, attention can be subdivided into sustained attention, divided attention, and focused attention. |Defined as the ability to attend to a task without redirection. As therapists determine time on task, and frequency of redirection. Based on definition this is called?
Divided attention
In testing cognitive function, attention can be subdivided into sustained attention, divided attention, and focused attention. |- Defined as the ability to shift attention from one task to another. As therapists, assess ability of dual taks control. (i.e., can the patient perform two activities simultaneously?) Also assess for perseveration (mental inertia) getting stuck on a task.
Focused attention
In testing cognitive function, attention can be subdivided into sustained attention, divided attention, and focused attention. |- Defined as the ability to stay on a task in presence of detractors. As therapists assess impact of environmental vs. internal detractors. This cognitive function is called?
Mini-mental status examination
Produced by Folstein, Folstein, and McHugh, in 1975. aka as Folstein test. It is a brief 30-point questionnaire test that is used to screen for cognitive impairment. Includes screenings items for orientation, registration, attention, calculation, recall and language. The max possible score is 30 points, and a score ≤ 15 indicates severe impairment. This test is called
No cognitive impairment
Mini-mental status examination or MMSE. A score ≥ 25 indicates?
Mild cognitive impairment
Mini-mental status examination or MMSE. A score between 21 - 24 indicates?
Moderate cognitive impairment
Mini-mental status examination or MMSE. A score between 16 - 20 indicates?
Severe cognitive impairment
Mini-mental status examination or MMSE. A score ≤ 15 Indicates?
Levels I
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the no response level?
Levels II, III
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the decreased response levels?
Levels IV, V, VI
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the confused levels?
Level VII
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the automatic appropriate level?
Level VIII
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the purposeful appropriate level?
I. No Response
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). |- Patient appears to be in a deep sleep and is completely unresponsive to any stimuli.|Based on the above description, This patient is said to be at what level/category?
II. Generalized Response
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient reacts inconsistently and non-purposefully to stimuli in a nonspecific manner.|- Responses are limited and often the same regardless of stimulus. |- Responses may be physiological changes, gross body movements, and/or vocalization.|Based on the above description, This patient is said to be at what level/category?
III. Localized Response
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient reacts specifically but inconsistently to stimuli.|- Responses are directly related to the type of stimulus presented. |- May follow simple commands such as closing the eyes or squeezing the hand in an inconsistent, delayed manner.|Based on the above description, This patient is said to be at what level/category?
IV. Confused-Agitated
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient is in a heightened state of activity.|- Behavior is bizarre and non-purposeful relative to the immediate environment. |- Does not discriminate among persons or objects; is unable to cooperate directly with treatment efforts. |- Verbalizations frequently are incoherent and/or innappropriate to the environment; confabulation may be present. |- Gross attention to environment to very brief; selective attention is often nonexistent. Patient lacks short and long-term recall.|Based on the above description, This patient is said to be at what level/category?
V. Confused-Inappropriate
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient is able to respond to simple commands fairly consistently. However, with increased complexity of commands or lack of any external structure, responses are non-purposeful, random, or fragmented. |- Demonstrates gross attention to the environment but is highly distractible and lacks the ability to focus attention on a specific task. With structure, may be able to converse on a social automatic level for short periods of time. |- Verbalization is often inappropriate and confabulatory. |- Memory is severly impaired; often shows inappropriate use of objects; |- May perform previously learned tasks with structure, but is unable to learn new information.|Based on the above description, This patient is said to be at what level/category?
VI. Confused-Appropriate
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient shows goal-directed behavior, but is dependent on external input or direction. |- Follows simple directions consistently and shows carryover for relearned tasks such as self-care. |- Responses may be incorrect due to memory problems, but they are appropriate to the situation. |- Past memories show more depth and detail than recent memory.|Based on the above description, This patient is said to be at what level/category?
VII. Automatic-Appropriate
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient appears appropriate and oriented within the hospital and home settings; goes gthrough daily routine automatically, but frequently robot-like. |- Patient shows minimal to no confusion and has shallow recall of activities.|- Shows carryover for new learning, but at a decreased rate. With structure is able to initiate social or recreational activities; judgment remains impaired.|Based on the above description, This patient is said to be at what level/category?
VII. Purposeful-Appropriate
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI).|- Patient is able to recall and integrate past and recent events and is aware of and responsive to environment. |-Shows carryover for new learning and needs no supervision once activities are learned.|- May continue to show a decreased ability relative to premorbid abilities, abstract reasoning, tolerance for stress, and judgment in emergencies or unusual circumstances.|Based on the above description, This patient is said to be at what level/category?
Broca's motor aphasia
Part of the neurological examination, is the assessment of speech and language. Aphasias can be divided into fluent aphasias and non-fluent aphasias. It is a central language disorder in which speech is typically awkward, restricted, interrupted, and produced with effort. Typically the result of a lesion involving the 3rd. frontal convolution of the left hemisphere. |Example of a normal speech: It's been 5 years since I have the stroke. I feel fine now, I am able to drive my car to the store, and to my relatives' house.|Speech impairment: ah...man..strooke.. uh..I.. geez. ... Drive car... uhh........I.. five yearshh.....housess...|This type of speech impairment is called?
Apraxia
Comes from the greek word praxis = work, act, deed. A = no. It is characterized by loss of the ability to execute or carry out learned purposeful movements, despite having the desire and the physical ability to perform the movements. Another definition: It is a disorder of the brain and nervous system in which a person is unable to perform tasks or movements when asked, even though:|- The request or command is understood|- They are willing to perform the task|- The muscles needed to perform the task work properly|- The task may have already been learned
Verbal apraxia
Impairment of volitional articulatory control secondary to a cortical, dominant hemisphere lesion. A person has trouble saying what he or she wants to say correctly and consistently, and it is not related to facial muscle weakness.
Dysarthria
Dys = having problem with; Arthr = articulating|Impairment of speech production, in the CNS/PNS mechanisms that control respiration, articulation, phonation, and movements of jaw and tongue. It is a condition in which problems occur with the muscles that help you talk; this makes it very difficult to pronounce words. It is unrelated to any problem with understanding cognitive language.Patient may present with a "slur speech", or speak softly or barely able to whisper.|This condition is called?
Wernicke's aphasia
A type of aphasia considered to be a fluent aphasia, receptive aphasia. It is central language disorder in which spontaneous speech is preserved and flows smoothly, while auditory comprehension is impaired. It is the result of a lesion in the posterior first temporal gyrus of the left hemisphere.| Individuals with this type of aphasia have difficulty understanding spoken language but are able to produce sounds, phrases, and word sequences. While these utterances have the same rhythm as normal speech, they are not language because no information is conveyed.|This is called?
Global aphasia
A severe form of aphasia characterized by marked impairments in comprehension and production of language
Olfactory (CN I)
Which cranial nerve is responsible for sense of smell
Olfactory (CN I)
Which cranial nerve is being tested in the following example?|- Have the patient close one nostril, and ask him/her to sniff a mils smelling substance and identify it. (e.g., coffee, vanilla etc.)
Anosmia
This condition is characterized by inability to detect smells. It is seen with frontal lobe lesions of patients with dysfunction of impairment of the CN I (Olfactory)

Olfactory (CN I)

A patient at a rehab center was asked by a therapist to use deodorant before coming to therapy session. The patient replied to the therapist " I am sorry, I did not know I had a strong smell, I could not smell anything". Which cranial nerve is being affected?
Anosmia
A patient at a rehab center was told at a request of a therapist to use deodorant before the coming to therapy session. The patient replied to the therapist " I am sorry, I did not I had a strong smell, I could not smell at all anything". This condition of inability to detect smells is called?
Optic (CN II)
Which cranial nerve for central and peripheral vision?
Optic (CN II)
Which cranial nerve is being tested?|- Acuity: Have patient cover one eye, and ask patient to read a visual chart (snellen eye chart)|- Fields: Have patient cover one eye, and hold an object (e.g., pen cap) at arm's length from the patient in his or her peripheral field. Hold the patient's head steady. Slowly move the object centrally, and ask the patient to state when he or she first sees the object. Repeat the process in all quadrants
Blindness, myopia, presbyopia, homonymous hemianopsia
Possible dysfunction or impairments of cranial nerve II (optic nerve) include?
Myopia
Defined as impaired far vision
Presbyopia
Defined as impaired near vision
Homonymouse hemianopsia
Defined as the loss of half of the field of view on the same side in both eyes. i.e., the patient cannot see from the left half of the left and right eye.
Occulomotor (CN III)
Which cranial nerve is responsible for eyelid elevation, pupil constriction (pupillary reflexes), visual focusing, upward, downward inward and infero-medial eye movement?
Occulomotor (CN III)
Which cranial nerve is being tested?|- Pupil reaction to light: Shine a flashlight into one eye and observe bilateral pupil reaction. Normal is bilateral pupil constriction occurs with flashing into one eye. Also hold an object about 10 cm from the patient's eye and ask him/her to look at the near object and to look off into the distance. Watch for pupil constriction with near object and pupil dilation with distance objects.
Occulomotor (CN III)
Which cranial nerve is being tested?|- Gaze: Hold objects (e.g., pen) at arm's length from the patient, and hold the patient's head steady. Ask the patient to follow the object with a full horizontal, vertical and diagonal gaze.
Occulomotor (CN III)
If a patient is exhibiting absence of pupillary constriction, Ptosis (drooping of eyelid), unequal pupils; Horner's syndrome this condition is likely to be an impairment of which cranial nerve?
Horner's syndrome
This condition is not a disease itself, but rather, it's a sign of another medical problem — such as a stroke, tumor or spinal cord injury. Typically involves, miosis (constriction of pupil), Ptosis (drooping of eyelid), and decreased sweating of the face on the same side.
Anisocoria
Condition defined as unequal pupils
Trochlear (CN IV)
Which cranial nerve is responsible for infero-lateral (downward and lateral) eye movement?
Trochlear (CN IV)
Which cranial nerve is being tested?|- Patient follows with eyes,(head steady) downward, lateral gaze
Strabismus
Condition where eyes deviate from normal conjugate position i.e., eyes are not properly aligned with each other. one eye might be aligned while the other is either up (hypertropia), down (hypotropia), inward (esotropia), and outward (exotropia). This is called?
Trigeminal (CN V)
Which cranial nerve is responsible for sensation of face, cornea and for mastication (motor: temporal and masseter muscles)?
Wisp of cotton on the patient's cornea
How would you test for cornea reflex?
Trigeminal (CN V)
If a patient lost his/her corneal reflex ipsilaterally (involuntary blinking in response to corneal touch), which cranial nerve is involved?
Trigeminal (CN V)
If a patient lost his/her facial sensation, or has numbness, which cranial nerve is involved?
Trigeminal (CN V)
A patient demosntrates weakness of muscles of mastication (temporal and masseter muscles). When asked to open his mouth, the jaw not the tongue deviates ipsilaterally. Which cranial nerve is involved?
Abducens (CN VI)
Which cranial nerve is responsible for lateral eye movement and proprioception?
Abducens (CN VI)
Inability to turn eye out is an impairment of which cranial nerve?
Facial (VII)
Which cranial nerve is responsible for Facial expressions, autonomic innervation of lacrimal and salivary glands, and sense of taste of anterior 2/3 of the tongue?
Facial (VII)
A therapist asks a patient to: smile, show your teeth,frown,raise eyebrows, wrinkle brows, purse lips, puff out both cheeks and close eyes tightly. Which cranial nerve is being tested?
Facial (VII)
A therapist asks a patient to smile, show your teeth,frown,raise eyebrows, wrinkle brows, purse lips, puff out both cheeks and close eyes tightly; however, he is unable to control the facial muscles which produce the above movements on the right side, but no problem with his left side. Which cranial nerve is impaired?
Bell's palsy
A therapist asks a patient to smile, show your teeth,frown,raise eyebrows, wrinkle brows, purse lips, puff out both cheeks and close eyes tightly; however, he is unable to control the facial muscles which produce the above movements on the right side, but no problem with his left side. As a result of this paralysis, the patient's face looks and feels stiff or pulled to one side. He also presents with drooling and drooping of the face, such as the eyelid or corner of the mouth. has trouble closing one eye. In addition other symptoms that this patient presents are: Dry eye or mouth, headache,loss of sense of taste(anterior 2/3 of tongue),sound that is louder in one ear (hyperacusis),twitching in face. The patient's wife added that he has difficulty eating and drinking, and that food falls out of one side of the mouth. Based on the above description, the patient's condition is called?
Facial (VII)
Bell's palsy is a condition where facial muscles are paralyzed on the affected side. This is due to a dysfunction of which cranial nerve?
Facial (VII)
A patient presents with ipsilateral paralysis of upper and lower facial muscles, loss of lacrimation, dry mouth, loss of taste of anterior 2/3 of the tongue on the ipsilateral side. Which cranial nerve is affected?
Vestibulocochlear (CN VIII)
Which cranial nerve is responsible for sense of equilibrium (vestibular branch) and a sense of hearing (cochlear branch)?
Vestibulocochlear (CN VIII)
Which cranial nerve is reponsible for gaze stability with head rotations?
Vestibulocochlear (CN VIII)
Testing of the vestibular branch involves the occulocephalic reflex aka Doll's eyes, or vestibular-occular reflex. It is a reflex that is tested by turning the patient's head from side to side, adn watch for eye movement. The eyes movement should be opposite to the direction of the head. Which cranial nerve is being tested?
Vestibulocochlear (CN VIII)
Vertigo, dysequilibrium,nystagmus, neural deafness, impaired hearing, tinnitus, unilateral conductive loss: sound lateralized to impaired ear, conductive loss: sound heard through bone = or longer than air, sensorineural loss: Sound heard in good ear, sound heard longer through air. All of above conditions are the result of which cranial nerve impairment?
Vestibulocochlear (CN VIII)
A therapist is testing for lateralization (weber's test). a vibrating tunning fork is placed on top of the head, mid position. The sound of the tunning fork is checked to see if it is heard in one ear or equally in both. This is testing for which cranial nerve impairment?
Weber's test
A therapist places a vibrating tunning fork on top of the head, mid forehead, and ask the patient if sound is heard equally (normal) or if it is heard louder in one ear (lateralized;the defective ear). This test is called?
Rinne's test
This test compares air and bone conduction. Place a vibrating tunning fork on the mastoid process, then close to ear canal; sound heard longer through air than bone. (+) test = sound heard on bone longer than air. This test is called?
Glossopharyngeal (IX)
Which cranial nerve is responsible for gag reflex, motor and proprioception of superior pharyngeal muscle, Autonomic innervation of salivary gland, Taste (posterior 1/3 of tongue?
Glossopharyngeal (IX)
Which cranial nerve is being tested?|- Induce gag with tongue depressor (one side at a time)|- Patient phonates a prolonged vowel sound or talks for an extended period oftime.|- Listen for voice quality and pitch
Glossopharyngeal (IX)
Loss of gag reflex, dysphagia (difficult swallowing), dysphonia: hoarseness denotes vocal cord paralysis, nasal quality denotes palatal weakness,dry mouth, loss of taste ipsilateral 1/3 of tongue are signs/symptoms of impairment of which cranial nerve?
Vagus (X)
Which cranial nerve is responsible for swallowing, proprioception of pharynx and larynx, parasympathetic innervation of heart, lungs, and abdominal viscera?
Vagus (X)
Examine for difficulty swallowing. Have the patient say "ah"; observe motion of soft palate (eleveates) and position of uvula (remains midline). Stimulate back of throat lightly on each side (gag reflex). Which cranial nerve is being tested?
Vagus (X)
Dysphagia, soft palate paralysis, contralateral deviation of uvula, ipsilateral anesthesia of pharynx and larynx, hoarseness:denotes vocal cord paralysis, nasal quality denotes palatal weakness. All these are signs & symptoms of which cranial nerve impairment?
Spinal accessory (CN XI)
Which cranial nerve is responsible for motor control and proprioception of head rotation, and shoulder elevation (sternocleidomastoid, trapezius)?
Spinal accessory (CN XI)
Which cranial nerve is being tested?|- Ask a patient to rotate the head or shrug the shoulders (with/without gentle resistance)
Spinal accessory (CN XI)
Weakness/ inability with head turning to the opposite side and ipsilateral shoulder shrug, shoulder droops are signs & symptoms of which cranial nerve impairment?
Hypoglossal (CN XII)
Which cranial nerve is responsible for motor control of pharynx and larynx, and movement and proprioception of tongue for chewing and speech?
Hypoglossal (CN XII)
Which cranial nerve is being tested?|- Listen to patient's articulation problems|- Examine the resting position of the tongue|- Ask patient to stick out his/her tongue and observe for midline. (deviation of tongue to weak side on protrusion)|- Ask patient to move tongue side to side
Hypoglossal (CN XII)
A therapist ask a patient to stick out the tongue. During protrusion, instead of tongue remaining in midline, the tongue deviates ipsilaterally. Which cranial nerve is impaired?
Deviation of the tongue towards the right side
A patient with RIGHT hypoglossal nerve (CN XII) involvement presents to the clinic. The therapist ask the patient to protrude his/her tongue. During protrusion, the tongue will deviate towards which side?

Cheyne-stokes respiration

A period of apnea lasting 10 - 60 seconds followed by gradually increasing depth and frequency of respiration; accompanies depression of frontal lobe and diencephalic dysfunction. This is called
Hyperventilation.
Increased rate and depth of respirations; accompanies dysfunction of lower midbrain and pons. This is called?
Apneustic breathing
Abnormal respiration marked by prolonged inspiration; acoompanies damage to upper pons. This is called?
Neck mobility
This is a test for CNS infection or meningeal Irritation. |- Patient in supine, flex neck to chest. (+) sign = pain in the neck with limitation and guarding of head flexion resulting from spasm of posterior neck muscles; can result from meningeal inflammation,arthritis, or neck injury. This is called?
Kernig's sign
This is a test for CNS infection or meningeal irritation.|- Patient in supine, flex hip and knee fully to chest and then extend knee. (+) causes pain and increased resistance to extending the knee owing to spasm of hamstrings; when bilateral suggest meningeal irritation. This called?
Bruzdzinski's sign
This is a test for CNS infection or meningeal irritation.|- Patient in supine flex neck to chest|(+) causes flexion of hips and knees (drawing up) suggests meningela irritation. This is called?
Lateral corticospinal tract
Motor pathway for contralateral VOLUNTARY fine muscle movement. This is the function of which tract?
Anterior corticospinal tract
Motor pathway for ipsilateral VOLUNTARY movement. This is the function of which tract?
Confusion, restlessness, lethargy
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Level of consciousness, an early sign of increased ICP is?
Coma
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Level of consciousness, a late sign of increased ICP is?

Ipsilateral pupil sluggish to light, ovoid in shape, with gradual dilatation

Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Pupil apprearance an early sign of increased ICP is?
Papilledema, ipsilateral pupil dilated and fixed or bilateral pupil dilated and fixed (if brain herniation has occurred)
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Pupil apprearance a late sign of increased ICP is?
Blurred vision, diplopia, and decreased visual acuity
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of vision an early sign of increased ICP is?
The sames as the early signs, but more exaggerated blurred vision, diplopia, and decreased visual acuity
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of vision a late sign of increased ICP is?
Contralateral paresis
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Motor performance an early sign of increased ICP is?
Abnormal posturing, bilateral flaccidity if herniation has occurred
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of Motor performance a late sign of increased ICP is?
Stable blood pressure, and heart rate
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of vital signs early sign of increased ICP is/are?
Hypertension and bradycardia (Cushing's response), altered respiratory pattern, increased temperature
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. During observation of vital signs late signs of increased ICP is/are?
Headache,seizure, cranial nerve palsy
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. Additional findings during early signs of ICP is/are?
Headache, vomiting, altered brain stem reflexes (pupillary, pharyngeal, and cough reflexes, and the control of respiration)
Maintenance of Intracranial pressure (ICP) or prompt recognition of elevated ICP is one of the primary goals for anyone caring for a postcraniosurgical patient, or cerebral traum, neoplasm or infection. ICP = the pressure CSF exerts within the ventricles. Additional findings during late signs of ICP is/are?
Brain stem reflexes
These reflexes are those regulated at the level of the brain stem, such as pupillary, pharyngeal, and cough reflexes, and the control of respiration; their absence is one criterion of brain death.|These are called?
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Activated in stressful situations producing an arousal reaction (flight or fight response)
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Results in conservation oand restoration of body energy and moeostatsis (system balance)
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- The effects are widespread instead of localized
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- The effects are localized and short acting
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Dilates pupils
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Constrict pupils
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases heart rate and force of contraction
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Decreases force of contraction
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Breaks down glycogen into glucose|- Increases blood sugar levels|- Increases blood flow in skeletal muscles|- Constricts blood flow to skin and abdomen
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases blood pressure and peripheral vascular resistance
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Decreases blood pressure
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Dilates bronchi for maximum respiratory flow
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Constricts bronchi
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Constricts bronchial arteries
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Dilates bronchial arteries
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Stimulates cortex and medulla, produces hyperalertness
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Dilates bronchial arteries
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Decreases peristalsis, intestinal motility
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases peristalsis, intestinal motility
Sympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases sweating|- Reduces glandular secretions
Parasympathetic nervous system
Identify which autonomic nervous system is being described.(Sympathetic or Parasympathetic)|- Increases glandular secretions
Joint position sense
Identify the following proprioceptive sensations test|- Test the ability to perceive joint position at rest in response to YOUR POSITIONING te patient's limb (up,down, in, out)
Kinesthesia
Identify the following proprioceptive sensations test|- Movement sense: Test the ability to perceive movement in response to YOUR MOVING the patient's limb; Patient can duplicate movement with opposite limb or give a verbal report
Pallesthesia
Identify the following proprioceptive sensations test|- Vibration sense: Test proprioceptive pathways by applying vibrating tunning fork or pressure only (sham vibration) on bony areas
Stereognosis
Identify the following cortical sensations test|- Test the ability to identify familiar objects placed in the hand by manipulation and touch. Can you identify this object? (a key, spoon, pencil etc..)
Barognosis
Identify the following cortical sensations test|- Test the ability to identify similar size/shaped objects placed in the hand with different gradations of weight (eyes closed)
Graphesthesia
Identify the following cortical sensations test|- Test ability to identify numbers, letters, or symbols traced on skin, typically the hand. Can you tell me what you feel I wrote on you hand? ( letter B, number 8 etc..)
Flexion
Spine biomechanics|The upper facets glide anteroproximallly and tilt forwad
Extension
Spine biomechanics|The upper facets move downward, and slightly posterior and tilt backward
facets moves down and slightly anterior
Spine biomechanics|When sidebending to the right which way the RIGHT upper facets move?
facets moves upward and slightly posterior
Spine biomechanics|When sidebending to the right which way the LEFT upper facets move?

facets on right glide down and back causing approximation of facet joint on the right

Spine biomechanics|Which way moves the facets in cervical RIGHT rotation?
Muscle strain
Identify the following condition|May be related to sudden trauma, chronic or sustained overlad or abnormal muscle biomechanics secondary to faulty function (abnormal joint or muscle biomechanics)|Commonly will resolve without internvention, but if trauma is too great or if related to chronic etiology, will benefit from intervention
Spondylolysis
A fracture of the pars interarticularis with (+) "Scotty Dog Sign" on OBLIQUE radiographic view of the spine
Spondylolisthesis
The actual anterior or posterior slippage of one vertebra on another following bilateral fracture of pars interarticularis. It can be graded I = 25% slippage to 4 = 100% slippage. Plain film is diagnostic test used. Oblique view = to see fracture, Lateral view = to see slippage
Stork test
What special test can be helpful to identify spondylolisthesis?
Extension, ipsilateral sidebending and contralateral rotation
An intervention for spondylolisthesis, the actual separation anteriorly or posteriorly of one vertebra over another, should focus on dynamic stabilization of trunk with particular emphasis on abdominals and trunk extension with multifidus muscle working from a fully flexed position of trunk up to neutral, but not into trunk extension. in addition what other positions that add stress to the defect should be avoided?
Spinal stenosis
Identify the following condition|Etiology: Congenital narrowing spinal canal or intervertebral foramen coupled with hypertrophy of the spinal lamina and ligamentum flavum or factes as the result of age-related degenerative processes or disease. Results in vascular and/or neural compromise|Signs/Symptomps include:|- Bilateral pain and paresthesia in back, buttocks, thighs, calves, and feet|- Pain is decreased in spinal felxion, and increased in extension
Plain films, MRI and/or CT scan
What diagnostic test(s) will be utilized for spinal stenosis?
Bicycle van gelderen's test
What test is helpful to differentiate spinal stenosis from intermitten claudication?
Extension, ipsilateral sidebending, and ipsilateral rotation
Spinal stenosis is a congenital condition where there is narrowing of the spinal canal or intervertebral foramen coupled with hypertropy of the spinal lamina and ligamentum flavum or facets as the result of age-related degenerative disease processes or disease. As part of PT intervention, performing flexion biased exercises and exercises that promote dynamic stability throughout the trunk and pelvis are recommended. In addition other position should be avoided in this condition?
15° of flexion
Manual and/or Mechanical traction are one of the recommended interventions for spinal stenosis, specifically the cervical spine. What cervical position provides the optimum intervertebral foraminal opening for traction as a treatment modality?
Internal disc disruption
Internal structure of disc annulus is disrupted;however, external structures remain normal. Most common in lumbar region|Symptoms include:|- Constant deep achy pain, increased pain with movement, no objective neurological findings, although patient may have referred pain into LL.|Diagnosed with CT discogram or MRI|Spinal manipulation is CONTRAINDICATED for this condition
Posterolateral bulge/herniation
Most commonly observed disc disorder of lumbar spine due to three structural deficiencies:|- Posterior disc is narrower in height than anterior disc|- Posterior longitudinal ligament is not as strong and only centrally located in lumbar spine|- Posterior lamelle of annulus are thinner|Etiology: Overstretching and/or tearing of annulus rings, verterbral endplate and/or ligamentous structures from high compressive forces or repetitive microtrauma.|Results in loss of strength, radicular pain, paresthesia and inability to perform ADLs|Spinal manipulation is CONTRAINDICATED for this condition
MRI
What diagnostic test is utilized in posterolateral bulge/herniation?
Posterolateral bulge/herniation
This intervention is helpful for which condition?|Positional gaping for 10 min to increase space within region of space-occupying lesion. e.g. If LEFT posterolateral lumbar herniation is present:|- Have patient sidelying on RIGHT side with pillow under RIGHT trunk (accentuating trunk sidebending RIGHT)|- Flex both hips and knees|- Rotate trunk to left (or pelvis to Right)|- Patient can be taught to perform this at home
Central posterior bulge/herniation
More commonly observed in the cervical spine but can be seen in the lumbar sine.|Etiology: overstretching and/or tearing of annulus rings, vertebral endplate, and/or ligamentous structures (posterior longitudinal ligament) from high compressive forces and/or long-term postural malalignment|Results in loss of strength, radicular pain, paresthesia and possible compression of the spinal cord with central nervous system symptoms (e.g., hyperreflexia, (+) babinski reflex|Diagnostic test utilized : MRI
Avascular Necrosis
Identify the following condition|Osteonecrosis of the hip. Multiple etiologies resulting in an impaired blood supply to the femoral head.|Hip ROM is decreased in flexion, internal rotation and abduction (capsular pattern)|Symptoms include: Pain in the groin and/or thigh and tenderness with palpation at the hip joint.|- Coxalgic gait
Plain film, Bone scans, CT and/or MRI
What diagnosistic tests are utilized in avascular necrosis of the hip?
Legg-Calve-perthe's disease
Identify the following condition:|Osteochondrosis|Age onset between 2 - 13 years with average age of onset at 6 years. Males x 4> incidence than females|Characteristic: Psoatic limp (hip in lateral rotation, flexion and adduction) due to weakness of psoas major|Gradual onset of "aching" pain at the hip, thigh and knee|AROM limited in abduction and extension|MRI is technique of choice. (+) bony crescent sign (collapse of subchondral bone at femoral neck/head)
MRI
What diagnosistic tests are utilized in Legg-Calve-Perthe's disease?
Slipped Capital Femoral Epihysis
Identify the following condition:|A medical term referring to a fracture through the physis (the growth plate), which results in slippage of the overlying epiphysis. It is a common cause of hip and knee pain in children ages 7 and 11 caused usually during a growth spurt. Most common hip disorder observed in adolescents and is of unkown etiology. |The average onset for males 10 - 17 years of age with average onset 13 years|The average onset for females 8 - 15 years of age with average onset 11 years. Males twice greater incidence than females|AROM restricted in abduction, flexion, and internal rotation)|Pain described as vague at knee, thigh and hip|with chronic condition may demo trendelenburg gait
Plain film
What diagnostic test is utilized in Slipped Capital Femoral Epiphysis?
Craig's test
What special tests helps to measure femoral anteversion/retroversion?
Plain film
What diagnosistic test is utilized in femoral anteversion/retroversion?
Coxa valga
The hip angle of inclination of the femur (neck - shaft )in adults is normally 120° - 135°|If the angle of inclination is > 135°, this is called?
Coxa vara
The hip angle of inclination of the femur (neck - shaft) in adults is normally 120° - 136°|If the angle of inclination is < 120°, this is called?
Plain films
What diagnosistic test is utilized in coxa valga and coxa vara?
Trochanteric bursitis
Identify the following condition|An inflammation of deep trochanteric bursa from a direct blow, irritation by iliotibial band (ITB), and biomechanical /gait abnormalities causing repetitive microtrauma. This condition is common in patients with rheumatoid arthritis. There is a marked tenderness to deep palpation of the greater trochanter
Iliotibial band tightness
Identify the following condition|Etiology: tight iliotibial band, abnormal gait pattern. |Results in inflammation of trochanteric bursa. Noble compression test is (+) when friction is introduced over the lateral femoral condyle during knee extension. Ober's test will also demonstrate tightness in ITB
Trochanteric bursitis
Identify the following condition|Pain is experienced over the lateral hip and possibly down the lateral thigh to the knee when the iliotibial band rubs over the trochanter. Discomfort may be experienced after standing asymmetrically for long periods with the affected hip elevated and adducted and the pelvis dropped on the opposite side. Ambulation and climbing stairs aggravate the condition. Muscle flexibility and strength imbalances and the resulting faulty posture of the pelvis may be the predisposing factors leading to bursal irritation
Piriformis syndrome
Identify the following condition|This muscle is an external rotator of the hip and can become overworked with excessive pronation of foot, which causes abnormal femoral internal rotation. It is considered a tonic muscle which is active with motion of sacroiliac joint, particularly the scarum. Tightness of spasm of piriformis muscle can result in compression of sciatic nerve and/or sacroiliac joint dysfunction.|Signs and symptoms include:|- Restriction in internal rotation|- Pain with palpation of piriformis muscle|- Referral of pain to posterior thigh|- Weakness in external rotation, (+) piriformis test|- Unable sacral base
Electrodiagnostic test
What possible diagnostic test will be utilized in piriformis syndrome?
lumbar spine and sacroiliac joint
While performing a lower extremity biomechanical examination to determine if abnormal biomechanics are the cause of possible piriformis syndrome, what other two joints involvement must be ruled out?
Unhappy triad
Identify the following condition|This is an injury to medial collateral ligament (MCL), anterior cruciate ligament (ACL), and Medial meniscus resulting from combination of valgum,flexion and external rotation forces applied to knee when the foot is planted
Mc Murray's test and Apley's test
What two special tests serve to test for meniscal injuries?
MRI
What diagnostic test is utilized for meniscal injuries?
Patella alta
Identify the following condition|Malalignment in which patella tracks superiorly in femoral intercondylar notch. May result in chronic patellar subluxation (+) camel back sign (two bumps over anterior knee region instead of typical one) Two bumps since patella is riding high within femoral condyles so there is a superior bump and then tibial tuberosity forms the second bump inferiorly
Patella baja
Identify the following condition|Malalignment in which patella tracks inferiorly in femoral intercondylar notch. Results in restricted knee extension with abnormal cartilagenous wearing resulting in DJD
lateral patellar tracking
Identify the following condition|This condition could result if there is an increas in "Q angle" with tendency for lateral subluxation or dislocation
MRI
What diagnostic test is utilized for patellofemoral pain syndrome?
Pes anserine bursitis
Identify the following condition|The inflammation of the pes anserine bursa located at the medial aspect of the knee. The pes anserine bursa is a fluid filled sac which acts as a cushion for the tendons of the Sartorius, Gracilis, and Semitendinosus muscles at the distal point of insertion on the shin bone (tibia). typically caused by overuse or a contusion
Osgood-schlatter disease
Identify the following condition|Aka jumper'sknee It's an irritation of the patellar ligament at the tibial tuberosity. Can cause a painful lump below the kneecap in children and adolescents experiencing growth spurts during puberty. It occurs most often in children who participate in sports that involve running, jumping and swift changes of direction — such as soccer, basketball, figure skating and ballet
Plain film
What diagnostic test is utilized in osgood-schlatter disease?
Anterior Compartment syndrome
Identify the following condition|It is an increased pressure within a muscular compartment that compromises the circulation to the muscles resulting in local ischemic condition. It can affect any and all four muscles of that compartment: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius. Multiple etiologies; direct trauma,fracture, overuse and /or muscle hypertrophy. Acute state of this condition is a medical emergency and requires immediate surgical intervention with fasciotomy

Shin splints

aka anterior tibial periostitis. Musculotendinous overuse condition. three common eitologies include: Abnormal biomechanical alignment, poor conditioning, improper training methods. Muscles involved: Tibialis anterior,extensor hallucis longus. Pain elicited with palpation of lateral tibia and anterior compartment
Medial tibial stress syndrome
Identify the condition|Overuse injury of the posterior tibialis and/or the medial soleus resulting in periosteal inflammation at the muscular attachments. Etiology; excessive pronation |Pain elicited with palpation of the distal posteromedial border of the tibia
Grade I
Which grade of liagment sprains?|Ligament sprains, 95% involve lateral ligaments|No loss of function with minimal tearing of the anterior talofibular ligament
Grade II
Which grade of liagment sprains?|Ligament sprains, 95% involve lateral ligaments|Some loss of function with partial disruption of the anterior talofibular and calcaneofibular ligaments
Grade III
Which grade of liagment sprains?|Ligament sprains, 95% involve lateral ligaments|Complete loss of function with complete tearing of the anterior talofibular and calcaneofibular ligaments with partial tear of the posterior talofibular ligament.
Tarsal tunnel syndrome
Identify the following condition|Entrapment of the posterior tibial nerve or one of its brachnes within the tarsal tunnel.|Over/excessive pronation, overuse problems resuling in tendonitis of the long flexor and posterior tibialis tendon, and trauma may compromise space in the tarsal tunnel|symptoms include: pain, numbness and paresthesias along the medial ankle to the plantar surface of the foot
Electrodiagnostic test
What diagnostic test will be utilized for tarsal tunnel syndrome?
Charcot-Marie-Tooth disease
Identify the following condition|Peroneal muscular atrophy that affects motor and sensory nerves. May begin in childhood or adulthood. Initially affects muscles in lowerleg and foot, but eventually progresses to muscles of hands and forearms|slowly progressive disorder that has varying degrees of involvement depending on degree of genetic dominance
Electrodiagnostic test
What diagnostic test will be utilized for Charcot-Marie-Tooth disease?
Rigid metatarsus adductus
Identify the following condition|Etiology: congenital, muscle imbalance, or neurmuscular diseases such as polio. There are two types.|Deformity observed: Medial subluxation of tarsometatarsal joints. Hindfoot is slightly in valgus with navicular lateral to head of talus
Flexible metatarsus adductus
Identify the following condition|Etiology: congenital, muscle imbalance, or neurmuscular diseases such as polio. There are two types.|Deformity observed: Adduction of all five metatarsals at the tarsometatarsal joints
Plantar fasciitis
Identify the following condition|Etiology: Usually mechanical. Chronic irritation of plantar fascia from excessive pronation. Limited ROM of 1st. MTP and talocrural joint|Tight tricep surae (Gastroc+ soleus)|acute injury from excessive loading of foot. Rigid cavus foot. Results in microtears at the attachment of plantar fascia
Negative tinel's sign
How plantar fasciitis can be differentiated from tarsal tunnel syndrome. what special test?
Rearfoot varus
Identify the following condition|Subtalar varus, calcaneal varus|Etiology: Abnormal mechanical alignment of tibia, shortened rearfoot soft tissues, or malunion of calcaneus.|Deformity observed: Rigid inversion of calcaneus when subtalar joint is in neutral position.
Rearfoot valgus
Identify the following condition|Etiology: Abnormal mechanical alignment of the knee (genu valgum) or tibial valgus.|Deformity observed: Eversion of calcaneus with neutral subtalar joint. Owing to increased mobility of hindfoot, fewer musculoskeletal problems develop from this deformity than occurs with rearfoot varus
Forefoot varus
Identify the following condition|Etiology: Congenital abnormal deviation of head and neck of talus|Deformity observed: Inversion of forefoot when subtalar joint is in neutral
Forefoot valgus
Identify the following condition|Etiology: Congenital abnormal development of head and neck of talus|Deformity observed: eversion of forefoot when subtalar joint is in neutral
Vascular
Pain that is described as throbbing
Vascular
Pain that is described as pounding
Vascular
Pain that is described as pulsing
Vascular
Pain that is described as beating
Neurogenic
Pain that is described as sharp
Neurogenic
Pain that is described as crushing
Neurogenic
Pain that is described as pinching
Neurogenic
Pain that is described as burning
Neurogenic
Pain that is described as hot
Neurogenic
Pain that is described as searing
Neurogenic
Pain that is described as itchy
Neurogenic
Pain that is described as stinging
Neurogenic
Pain that is described as pulling
Neurogenic
Pain that is described as jumping
Neurogenic
Pain that is described as shooting
Neurogenic
Pain that is described as Pricking
Neurogenic
Pain that is described as gnawing
Neurogenic
Pain that is described as electrical
Musculoskeletal
Pain that is described as aching
Musculoskeletal
Pain that is described as sore
Musculoskeletal
Pain that is described as heavy
Musculoskeletal
Pain that is described as hurting
Musculoskeletal
Pain that is described as dull
Musculoskeletal
Pain that is described as cramping
Musculoskeletal
Pain that is described as deep
Emotional
Pain that is described as tiring
Emotional
Pain that is described as miserable
Emotional
Pain that is described as vicious
Emotional
Pain that is described as agonizing
Emotional
Pain that is described as nauseating
Emotional
Pain that is described as frightful
Emotional
Pain that is described as piercing
Emotional
Pain that is described as dreadful
Emotional
Pain that is described as punishing
Emotional
Pain that is described as torturing
Emotional
Pain that is described as killing
Emotional
Pain that is described as unbearable
Emotional
Pain that is described as annoying
Emotional
Pain that is described as cruel
Emotional
Pain that is described as sickening
Emotional
Pain that is described as exhausting
Upper Lobes Apical Segments
Which lung segment is likely to be drained when the PT asks the patient "lean back on a pillow at 30°angle"?
Upper Lobes Apical Segments
If the therapist performing postural drainage claps with markedly cupped hand over area between clavicle and top of scapula on each side, which lung segment is likely to be drained?
Between clavicle and top of scapula
If the Upper Lobes Apical Segments needs to be drained, which area needs to be percussed?
Upper Lobes Posterior Segments
Which lung segment is likely to be drained when the PT asks the patient "lean forward a folded pillow at 30° angle"?
Upper Lobes Posterior Segments
If the therapist performing postural drainage claps with markedly cupped hand over upper back while the patient is leaning forward at 30°, which lung segment is likely to be drained?
Upper Lobes Posterior Segments
If the therapist performing postural drainage claps with markedly cupped hand over upper back, which lung segment is likely to be drained?
Upper Lobes Anterior Segments
Which lung segment is likely to be drained when the PT asks the patient "Lie on your back with a pillow under your knees, so you hips are at 45° angle approximately"?
Upper Lobes Anterior Segments
If the therapist performing postural drainage claps between the clavicle and nipple area, which lung segments is likely to be drained?
Upper Back
If the Upper Lobes Posterior Segments needs to be drained, which area needs to be percussed?
Between the clavicle & Nipple area
If the Upper Lobes Anterior Segments needs to be drained, which area needs to be percussed?
Right Middle Lobe
The PT prepares the Table for postural drainage. |- Foot of table is elevated 16", patient lies head down and LEFT SIDE and rotates 1/4 turn backward|- A pillow is placed behind from shoulder to hip, knee should be flexed|- Therapist claps over RIGHT nipple area. With females with breast development or tenderness, use cupped hand with heel of hand under armpit and fingers extending forward beneath the breast.|Based on the above description which lung segment is likely to be drained?
Over Right nipple area
If the Right Middle Lobes need to be drained, which area needs to be percussed?
Left Upper Lobe Lingular Segments
The PT prepares the Table for postural drainage. |- Foot of table is elevated 16", patient lies head down and RIGHT SIDE and rotates 1/4 turn backward|- A pillow is placed behind from shoulder to hip, knee should be flexed|- Therapist claps moderately cupped hand over LEFT nipple area. With females with breast development or tenderness, use cupped hand with heel of hand under armpit and fingers extending forward beneath the breast.|Based on the above description which lung segment is likely to be drained?
Over Left nipple area
If the Left Upper Lobe Lingular Segments need to be drained, which area needs to be percussed?
Trendelenburg, and lie head down on Left side and rotate 1/4 turn backward
What position should the patient assume if the Right Middle Lobe needs to be percussed?
Trendelenburg, and lie head down on Right side and rotate 1/4 turn backward.
What position should the patient assume if the Left Upper Lobe needs to be percussed?
Lower lobe Anterior Basal Segments
Which lung segment is likely to be drained when the PT asks the patient "lie on your side, head down and let me put a pillow under your knees" (table is elevated to 20"), and tells the patient "I am going to clap with slightly cupped hand over the lower ribs"
lower ribs
Which area needs to be percussed if the Lower Lobe Anterior Basal Segments are going to be treated?
Lower Lobes Lateral Basal Segments
Which lung segment is likely to be treated when the PT asks the patient to "lie on your abdomen, head down, then rotate 1/4 turn upward. Flex the upper leg over a pillow, and keep lower leg straight". " I am going to clap over the uppermost portion of lower ribs". Table is elevated 20"
uppermost portion of lower ribs
f the lateral basal segments need to be treated, which area should be percussed by the therapist?
Lower Lobes Posterior Basal Segments
Which lung segment is likely to be treated when the PT asks the patient to "lie on you abdomen, head down with a pillow under your hips, and I am going to clap over the lower ribs close to the spine on each side". Table is elevated 20"
over the lower ribs close to the spine
if the Lower Lobes Posterior Basal Segments need to be treated which are should be percussed by the therapist?
Lower Lobes Superior Segments
Which lung segment is likely to be treated when the PT asks the patient to" lie on your abdomen with two pillows under your hips (hips at 45° with respect to the trunk) and I am going to clap over middle of back at tip of scapula" (table is flat)?
middle of back at the tip of scapula
If the superior segments need to be treated, which area should be percussed by the therapist?
Rotator Cuff Lesion
During a PT examination, the Patient's age is between 30 - 50 yrs old, and there is pain and weakness with eccentric load. On observation, there is normal bone and soft tissue outlines, and there is a protective shoulder hike. AROM reveals weakness of abduction or rotation or both. crepitus may be present. PROM may reveal pain if impingement occurs. Resisted Isometric movement reveals Pain and weakness on abduction and lateral rotation.|Sensory function and reflexes are not affected. there is tenderness to palpation over the shoulder area. Special tests: Drop arm test is (+) and Empty can test is (+). What kind of lesion is therapist suspecting?
Drop arm test and empty can test
During a PT examination, the Patient's age is between 30 - 50 yrs old, and there is pain and weakness with eccentric load. On observation, there is normal bone and soft tissue outlines, and there is a protective shoulder hike. AROM reveals weakness of abduction or rotation or both. crepitus may be present. PROM may reveal pain if impingement occurs. Resisted Isometric movement reveals Pain and weakness on abduction and lateral rotation.|Sensory function and reflexes are not affected, and there is tenderness over the rotator cuff. If the therapist suspects a rotator cuff lesion, what two special tests should be performed /be positive to confirm supraspinatus tear?
MRI
What diagnostic imaging technique will be utilized to in the diagnosis of a rotator cuff lesion?
upward displacement of humeral head, acromial spurring.
What would be observed on a plain film (x-ray) for a patient with rotator cuff lesion if there is impingement involved?
Adhesive capsulitis
During a PT examination, the patient's age is ≥ 45 yrs old, and presents with insidious onset or after trauma or surgery symptoms. Functional restriction of lateral rotation abduction and medial rotation (capsular pattern). On observation, there is normal bone and soft tissue outlines. AROM is restricted, there is shoulder hiking. PROM is limited in a capsular pattern (LR > ABD> IR). Resisted Isometric movement is normal when arm by side. no special tests were necessary, sensory function and reflexes were not affected. Palpation was not painful unless the capsule was stretched. Based on the above information, what kind of lesion may be suspected?
Arthrography
If plain films are negative, what imaging technique will be utilized that may show decreased capsular size in patient with adhesive capsulitis (frozen shoulder)
Atraumatic instability
This type of condition is typically seen in patients whose age is betwen 10 - 35 yrs old. There is pain and instability with activity with no history of trauma. On observation, there is normal bone and soft tissue outlines. AROM and PROM will be either full or excessive. Resistive isometric movement will be normal. Special tests performed/ or that were (+) to confirm diagnosis were, Load and Shift test, Apprehension test, Relocation test, Augmentation test. Sensory function and reflexes were affected either anterior or posterior pain. Palpation was negative. Based on the above description what kind of a lesion may be suspected given the series of (+) special tests performed?
Cervical spondylosis
This type of condition is typically since in patient whose age is 50 yrs old or more, and may be either acute or chronic. On observation, there is minimal or no cervical spine movement. Torticollis may be present. AROM is limited with pain, and PROM is limited (symptoms may be exacerbated). Resisted isometric movement is normal, except if there is nerve root compression. Myotome may be affected. Special tests perfromed that were positive to confirm diagnosis were, Spurling's test, Distraction test, ULTTs and shoulder abduction test. Sensory function and reflexes: dermatomes affected and reflexes are affected. There is tenderness on palpation over appropriate vertebra or facet, and radiography revals narrowing osteophytes. Based on the above description, what kind of lesion may be suspected given the series of (+) special tests performed?
narrowing osteophytes
What does radiography shows in patients diagnosed with cervical spondylosis?
Osteoporosis
What condition does the following description presents?|- It is a metabolic disease which depletes bone mineral density/mass, predisposing individual to fracture.|- Affects women 10x more than men. Common sites of fractures include: Thoracic and lumbar spine, femoral neck, proximal humerus, proximal tibia, pelvis, and distal radius
CT Scan
What diagnostic test (imaging technique) is usually utilized for diagnosing osteoporosis?
Osteomalacia
What condition does the following description presents?|Its name implies softening of bones. It is characterized by decalcification of bones as result of a vitamin D deficiency|Symptoms includes: Severe pain, fractures, weakness, and deformities.
Plain films, Lab tests, Bone scan and potentially bone biopsy
What diagnostic tests (imaging technique,etc..) is usually utilized for diagnosing osteomalacia?
Osteomyelitis
What condition does the following description presents?|- An inflammatory response within bone caused by an infection. Usually caused by Staphylococcus aureus, but could be another organism.|- More common in children and immunosuppressed adults than healthy adults and more common in males than females
Lab tests for infection and possibly bone biopsy
What diagnostic tests is usually utilized for diagnosing osteomyelitis?
Arthrogryposis multiplex congenita
What condition does the following description presents?|- It is a congenital deformity of skeleton and soft tissues which is characterized by limitation in joint motion and a "sausage-like" appearance of limbs|- Intelligence develops normally|- Ongoping communication with family and school is important in therapeutic management
Plain films
What diagnostic technique (imaging technique) is usually utilized for diagnosing arthrogryposis multiplex congenita?
Osteogenesis imperfecta
What condition does the following description presents?|- It is an inherited disorder transmitted by an autosomal dominant gene. It is characterized by abnormal collagen synthesis which leads to an imbalance between bone deposition and reabsorption.|- Cortical and cancellous bones become very thin leading to fractures and deformity of weight bearing bones.
Bone scan, plain films, serological testing
What diagnostic technique is usually utilized for the diagnosis of osteogenesis imperfecta that would also demonstrate old fractures and deformities?
Osteochondritis dissecans
What condition does the following description presents?|It is a separation of articular cartilage from underlying bone (osteochondral fracture) usually involving medial femoral condyle near intercondylar nothch and observed less frequently at femoral head and talar dome
Plain films or CT scan
What diagnositic test is usually utilized to diagnose osteochondritis dissecans?
Myofascial pain syndrome
What condition does the following description presents?|- Characterized by clinical entity known as a "trigger point" which is focal point of irritability found within a muscle. Trigger point can be identified as a taut palpable band within the muscle. Trigger points may be active that is tender to palpation and have a characteristic referral pattern of pain when provoked or latent which are palpable taut bands that are not tender to palpation but can be converted into active trigger point. It is hypothesized to sudden overload, overstretching and/or repetitive/sustained muscle activities.
Tendonitis
What condition does the following description presents?|- An inflammation of tendon as result of microtrauma from overuse, direct blows, and/or excessive tensile forces
MRI
What diagnostic test is usually utilized for the diagnosis of tendonitis?
Tendonosis
What condition does the following description presents?|- Common chronic tendon dysfunction whose cause and pathogeneisis are poorly understood. Often referred to as chronic tendonitis; However there is NO inflammatory response noted.|- Common in many tendons throughout body (supraspinatus, common extensor tendond of elbow, patella, Achilles')
MRI
What diagnositic test is usually utilized for the diagnosis of tendonosis?
Bursitis
What condition does the following description presents?|- An inflammation of bursa secondary to oversue, trauma, gout or infection. Sign & Symptoms include: Pain with rest, PROM and AROM are limited due to pain but not in a capsular pattern

Muscle strains

What condition does the following description presents?|- Characterized by an inflammatory response within a muscle following a traumatic event that caused micro-tearing of the musculotendinous fibers.|- Pain and tenderness within the muscle
MRI
Which diagnostic test is usually utilized, if necessary, for the diagnosis of muscle strains?
Myositis ossificans
What condition does the following description presents?|- Painful condition of abnormal calcification within a muscle belly. Usually precipitated by direct trauma which results in hematoma and calcification of the muscle. It can also be induced by early mobilization and stretching with AGRESSIVE physical therapy following trauma to muscle.|- Most frequent locations are quadriceps, brachialis, biceps brachii muscles
Myositis ossificans
What condition can be induced by early mobilization and stretching with aggressive physical therapy following trauma to muscle?
Myositis ossificans
It is defined as a painful condition of abnormal calcification within muscle belly. It is recommended to the therapist to:|- AVOID being OVERLY AGRESSIVE with muscle flexibility exercises, which may worsen condition.|- AVOID AGRESSIVE soft tissue/massage techniques which may worse conditions|Which condition the above description represents?
Complex regional pain syndrome
What condition does the following description presents?|- Formerly referred as to reflex sympathetic dystrophy (RSD).|- Etiology largely unkown but thought to be related to trauma. Can affect the UEs, LEs, trunk, head and neck.|- Results in dysfunction of sympathetic nervous system to include pain, circulation and vasomotor disturbances
Complex regional pain syndrome I
There are two types of this condition. This type is frequently triggered by tissue injury; term describes all patients with these symptoms (pain, circulation, vasomotor disturbances), but no underlying nerve injury.
Complex regional pain symdrome II
There are two types of this condition. This type, the patient experience same symptoms (pain, circulation, vasomotor disturbances), but their cases are clearly associated with a nerve injury.
Muscle wasting, trophic skin changes, decreased bone density, loss of muscle strength from disuse and joint contractures.
Long term changes that occur in patients with complex regional pain symdrome include:
Paget's disease ( osteitis deformans)
What condition does the following description presents?|- Etilogy is largely unkown, but thought to be linked to a type of viral infection along with environmental factors. |- Considered to be a metabolic bone disease involving abnormal osteoclastic and osteoblastic activity.|- Results in spinal stenosis, facet arthropathy, and possible spinal fracture
Plain films = identifies bony changes, lab tests look for increased levels of serum alkaline phosphatase and urinary hydroxyproline
What diagnositic tests are usually utilized for the diagnosis of Paget's disease (osteitis deformans)?
Structural scoliosis
What condition does the following description presents?|- A irreversible lateral curvature of spine with a rotational component. Think of (S) shape from posterior view of patients spine.
Non-structural scoliosis
What condition does the following description presents?|- A reversible lateral curvature of spine without a rotational component, and straightening as individual flexes the spine. Think of (S) shape from posterior view of patients spine.
Conservative physical therapy
Intervention for structural scoliosis includes bracing and possible surgery with placement of Harrington rod instrumentation. if the curvature is < 25°, then the most likely Intervention will be:
Use spinal orthoses
Intervention for structural scoliosis includes bracing and possible surgery with placement of Harrington rod instrumentation. if the curvature is between 25° - 45°, then the most likely Intervention will be:
Surgery
Intervention for structural scoliosis includes bracing and possible surgery with placement of Harrington rod instrumentation. if the curvature is between > 45°, then the most likely Intervention will be:
Torticollis
What condition does the following description presents?|- Spasm and/or tightness of sternocleidomastoid (SCM) muscle with varied etiology.|- Dysfunction observed is side-bending towards and rotation away from the affected SCM
HLA-B27
Which Diagnostic test is helpful, in diagnosing anklyosing spondylitis
x-rays
It is used to demonstrate bony tissues. Beams pass through the tissues resulting in varying shades of gray on film depending on density of tissue it passed through. |- The more DENSE the structure (bone), the more WHITE the structure will appear on the film.|It does not demonstrate soft tissues well or at all
Computed tomography (CT scan)
It uses plain film x-ray slices that are enhanced by a computer to improve resolution. It is multiplanar so can image in any plane; therefore tissue can be viewed from multiple directions.|Typically used to assess complex fractures as well as facet dysfunction, disc disease, or stenosis of the spinal canal or intervertebral foramen. It demonstrate better quality and better visualization of bony structures than plain films. It is also able to demonstrate soft tissue structures, although not as well as MRI
Computed tomography (CT scan)
This imaging technique is typically used to assess COMPLEX FRACTURES as well as FACET DYSFUNCTION, DISC DISEASE or STENOSIS of the spinal canal or intervertebral foramen. It demonstrates better quality and better visualization of bony structures than plain films. It is also able to demonstrate soft tissue structures, although not as well as MRI
Discography
A radiopaque dye is injected into the disc to identify abnormalities within the disc (annulus or nucleus). The needle is inserted into the disc with the assistance fo radiography (fluoroscopy).|This is not commonly used. It requires a high level of skill and proper equipment to perform. Fairly specific technique to identify internal disc disruptions of the nucleus and/or annulus. Expensive, may be painful, since it is invasive, there is a risk of infection
MRI
Uses magnetic fields rather than radiation. It offers excellent visualization of tissue anatomy. Utilizes two types of images known as T1 and T2. |T1 demonstrates fat within the tissues, and is typically used to assess bony anatomy.|T2 suppresses fat and demonstrates tissues with higher water content, and is used to assess soft tissue structures|Fairly expensive, and patient with clastrophobia DO NOT tolerate this test well. There is an open imaging technique but quality is inferior to closed. May not be able to use with patients who have metallic implants
Whiter
In plain film radiograph (x-rays) the DENSER the structure (bone) is, the __________ the structure (bone) will appear on the film
Arthrography
Invasive technique injects water-soluble dye into area and is observed with a radiograph.|Dye is observed as it surrounds tissues, demonstrating the anatomy by where fluid moves within the joint|Typically used to identify abnormalities within joints such as tendon ruptures. Expensive procedure and carries risks since it is invasive.
Open MRI
Type of MRI that is used for patients with claustrophobia who DO NOT tolerate this test well because it is closed technique. The image is inferior when compared to closed.
Arthrography
It is an expensive invasive technique that is typically used to identify abnormalities within joints such as tendon ruptures.
Bone scans
aka osteoscintigraphy. Chemicals laced with radioactive tracers are injected, and isotopes settles in areas where there is a high metabolic activity of bone.|Radiograph is taken which demonstrates any "HOT SPOTS" of increased metabolic activity.|Patients with dysfunctions, such as rheumatoid arthritis, possible stress fractures, bone cancer, infection within bone are given this imaging technique because these dysfunctions are known to have an increase in metabolic activity of bone in affected region.
Bone scans
What imaging tecnique is given to patients with dysfunctions such as rheumatoid arthritis, possible stress fractures, bone cancer, and infection within bone? These dysfunctions are known to have an increase in metabolic activity of bone in affected region
Diagnostic ultrasound
This imaging technique utilizes transmission of high-frequency sound waves, similar to therapeutic ultrasound. |It is limited by contrast resolution, small viewing field, how deep it penetrates, and poor penetration of bone. |Interpretation of data is subjective, so results are dependent on skill of operator.|Provides real-time dynamic images and able to assess soft tissue dysfunction. no known harmful effects known
Myelography
It is an invasive technique using water soluble dye. Dye is visualized as it passess through vertebral canal to observe anatomy within the region.|It is seldom used because of many side effects vs. MRI or CT scan, which provide as good, if not better information. |VERY expensive since it is often involves a hospital stay overnight. |Traditionally had been used for diagnostic assessment of the discs and stenosis. May still be beneficial to identify stenosis.
MMSE
This is a brief screening test for cognitive dysfunction|It includes screening items for orientation, registration, attention and calculation, recall and language. The maximum score = 30 (min or no impairment)
30
What is the maximum score for the Mini-Mental Status Examination (MMSE)?
Mild cognitive impairment
If during a Mini-Mental Status Examination (MMSE) a patient scores between 21 - 24, what does this score indicates in terms of cognitive impairments?
Moderate cognitive impairment
If during a Mini-Mental Status Examination (MMSE) a patient scores between 16 - 20 , what does this score indicates in terms of cognitive impairments?
Severe cognitive impairment
If during a Mini-Mental Status Examination (MMSE) a patient scores ≤ 15, what does this score indicates in terms of cognitive impairments?
Olfactory
Name of Cranial Nerve I?
Olfactory
Which cranial nerve is being tested?|- Test sense of smell on each side (Close off other nostril)|Use common, non-irritating odors
Anosmia
Defined inability to detect smells. This is seen with frontal lobe lesions
Anosmia
Name a possible abnormal finding with CN I (olfactory) dysfunction?
olfactory
If a patient is diagnosed with anosmia (inability to detect smells) which cranial nerve is likely to be involved?
Optic
Name of cranial nerve II?
Optic
Which cranial nerve is being tested?|- Test visual acuity|Central: Snellen eye chart; Test each eye separately (covering one eye), test at distance of 20 ft.
Optic
Which cranial nerve is being tested?|Test peripheral vision (visual fields by confrontation.
Blindness, myopida, presbyopia
Name possible abnormal findings with cranial nerve II (optic)?
Homonymous hemianopsia
Possible abnormal finds with field defects with CN II (optic) when testing peripheral vision?
Myopia
Defined as: impaired far vision
Presbyopia
Defined as: impaired near vision

optic, occulomotor

Which cranial nerves function is pupillary reflexes?
optic, occulomotor
Which cranial nerves are being tested?|- Test pupillary reactions (constriction) by shining a light in the eye; if abnormal, test near reaction|- Examine pupillary size/shape
Absence of pupillary constriction
when testing for pupillary reactions (cranial nerves (optic II, occulomotor III) a possible abnormal finding will be?
optic, occulomotor
In the absence of pupillary constriction when testing cranial nerve (s), which cranial nerve(s) is/are likely to be involved?
optic
If a patient is diagnosed with homonymous hemianopsia, which cranial nerve is likely to be involved?
optic
If a patient is diagnosed with either blindness, myopia (impaired far vision), presbyopia (impaired near vision) which cranial nerve is likely to be involved?
Anisocoria
What is the term for unequal pupils?
Anisocoria,Horner's syndrome, Occulomotor paralysis
Name three possible abnormal findings with CN II (optic), and CN III (occulomotor)?
Occulomotor, Trochlear, abducens
What cranial nerves are being tested?|- Test saccadic ( patient is asked to look in each direction)|- Persuit eye movements (patient follows moving finger)
Strabismus, impaired eye movements, double vision
What are some of possible abnormal findings when testing CN III, IV, VI?
Turns eye up, down, in, and elevates the eyelid
What is/are the function(s) of the CN III (occulomotor)?
Occulomotor
Possible abnormal fingings may be, ptosis, pupillary dilation Which cranial nerve is involved?
Occulomotor
Name of cranial nerve III?
Trochlear
Name of cranial nerve IV?
Abducens
Name of cranial nerve VI?
Turns eye down, and laterally
What is/are the function(s) of the CN IV(trochlear)?
Eye cannot look down when eye is adducted
Possible abnormal findings with CN IV (trochlear)?
Turns eye laterally
What is the function of cranial nerve VI (Abducens)?
Eye cannot look out, esotropia
Possible abnormal finding with cranial nerve VI (abducens)?
Esotropia
Conditions defined as "eye pulled inward"
Trigeminal
Name of cranial nerve V?
Sensory face, sensory cornea, motor muscles of mastication
What is the function of cranial nerve V (trigeminal)?
Trigeminal
What cranial nerve is being tested?|- test pain, light touch sensations: Forehead, cheeks, jaws (eyes closed)|- Testing cornea reflex: touch lightly with wisp of cotton
Loss of facial sensation, numbness, trigeminal neuralgia, loss of cornea reflex ipsilaterally
Possible abnormal (sensory) findings with CN V involvement?
weakness of muscles, when open, jaw deviates to ipsilateral side
Possible abnormal (Motor) findings with CN V involvement?
Trigeminal
What cranial nerve is being tested?|- Palpate temporal and masseter muscles|- observe spontaneous movments|- Ask patient to clench teeth, hold against resistance (push down chin to separate jaw)
Facial
Name of cranial nerve VII?
Facial expressions, taste to anterior tongue
What is the function of cranial nerve VII?
Facial
What cranial nerve is being tested?|- Test motor function: Raise eyebrows, frown, smile, show your teeth, close eye tightly, puff out both cheeks
Facial
What cranial nerve is being tested?|- Apply a saline solution and sugar solutiong using a cotton swab to tongue

Incorrectly identifies solution (saline,sugar)

Possible sensory abnormal findings with CN VII (facial)?
Inability to close eye, drooping corner of mouth, difficulty with speech articulation, Bell's palsy, guillain-barre, stroke
Possible motor abnormal findings with CN VII (facial)?
Vestibulocochlear
Name of cranial nerve VIII?
Vestibular function, cochlear function
What is/are the function of cranial nerve VIII (vestibulocochlear)?
Vestibulocochlear
What cranial nerve is being tested?|- Test balance: vestibulospinal function (VSR)|- Test eye - head coordination: Vestibular ocular reflex (VOR)
Vestibulocochlear
What cranial nerve is being tested?|Test auditory acuity|Test for lateralization (weber test): Place a vibrating tuning fork on top of head, mind position; check if sound heard in one ear or equally in both|Compare air and bone conduction (Rinne test): Place vibrating tuning fork on mastoid bone, then close to ear canal; sound heard longer through air than bone
Vestibulocochlear
What cranial nerve is affected if possible abnormal finding include:|- Vertigo, dysequilibrium|- Gaze instability with head rotations, nystagmus (constant, involuntary cyclical movements of the eyeball)|- Deafness, impaired hearing, tinnitus (ringing in the ear)|- Unilateral conductive loss: Sound lateralized to impaired ear|- Sensorineural loss: Sound heard in good ear|- Conductive loss: sound heard through bone = or > than air|- Sensorineural loss: sound heard longer through air
Glossopharyngeal
Name of cranial nerve IX?
Glossopharyngeal
Which cranial nerve is involved in sensory to posterior 1/3 of the tongue, pharynx, middle ear, taste to posterior tongue?
Glossopharyngeal
Which cranial nerve is being tested?|- Apply saline solutiong and sugar solution, though not typically tested. (abnormal finding: incorrectly identifies solution)
Glossopharyngeal, vagus
Which cranial nerve(s) is/are involved in the function of:|- Phonation, swallowing|- Palatal, pharynx control|- Gag reflex
Glossopharyngeal, vagus
Which cranial nerve(s) is/are being tested?|- Listen to voice quality|- Examine for difficulty in swallowing a glass of water|- Stimulate back of throat lightly on each side (Gag reflex)
Vagus
Name of cranial nerve X?
Vagus
Which cranial nerve is being tested?|- Have patient say "ahhh, ahhh"; Observe motion of soft palate (elevates), and position of uvula (remains midline)
Dysphonia
Defined as hoarseness denotes vocal coard weakness. Nasal quality denotes palatal weakness
Dysphagia
Defined as difficulty swallowing
Vagus
If during testing, the patient is found to have palatal paralysis (the palate fails to elevate); which cranial nerve is likely to be involved?
Glossopharyngeal, vagus
If during testing, the patient shows poor palatal, pharynx control (asymmetrical elevation with unilateral paralysis) which cranial nerve(s) is/are likely to be involved?
Glossopharyngeal, vagus
During testing, it is shown that the Gag reflex is absent, which cranial nerve(s) is/are likely to be involved?
Spinal accessory
Name of cranial nerve XI?
Spinal accessory
Which cranial nerve innervates the trapezius and sternocleidomastoid muscles?
Spinal accessory
Which cranial nerve is being tested?|- Examine bulk, strength, Ask patient to:|- shrug both shoulders upward against resistance|- Turn head to each side against resistance
Spinal accessory
If a patient shows:|- LMN: atrophy, fasciculations, ipsilateral weakness, inability to shrug ipsilateral shoulder; shoulder droops|- Inability to turn head to opposite side|- UMN: weakness of ipsilateral sternocleidomastoid and contralateral trapezius
Hypoglossal
Name of cranial nerve XII?
Hypoglossal
Which cranial nerve is reponsible for tongue movements?
Hypoglossal
What cranial nerve is being tested?|- Listen to patient's articulation|- Examine resting position of tongue|- Examine tongue movements: ask the patient to protrude tongue, move it side to side
weak side
Possible abnormal findings with hypoglossal (CN XII) are impaired tongue movements and deviation of the tongue to which side?
away from side of cortical lesion
Possible abnormal findings with hypoglossal (CN XII) in UMN lesion that the tongue deviates_________________?
Sesorineural loss
When testing the vestibulocochlear nerve (cranial nerve VIII) if sound is heard in the good ear, this is called?
Conductive loss
When testing the vestibulocochlear nerve (cranial nerve VIII) if sound heard through bone = to or longer than air. this is called?