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150 Cards in this Set

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ideational apraxia

problems with conceptualizing, planning, executing motor actions with objects of everyday life




eg: striking a candle against a matchbox

ideomotor apraxia

difficulty with carrying out familiar actions ON COMMAND. can recognize gestures but can't imitate them




however, patient can do them automatically.




eg: patient walks up stairs to get to the clinic but won't climb them on request at therapy

agnosia

inability to process sensory information, when the sensory organ is undamaged.

pelvic floor innervation

pudendal nerve (S2-S3-S4)

pituitary

growth hormone (GH)


ACTH (corticosteroid release)


prolactin




antidiuretic hormone (ADH)


oxytocin (uterine contractions)



thyroid

thyroxine and T3: accelerates metabolism


calcitonine: lowers blood calcium (stimulates bone calcium resorption)

parathyroid

PTH (calcitonin antagonist)

pancreas

insulin (glycemia high)

glucagon (when glycemia is low)



postural drainage

upper lobes

apical: sitting, 30deg posterior lean, upper shoulder clap



posterior: sitting, 30deg anterior lean, upper back clap




anterior: supine, clavicle-nipple clap


postural drainage


right middle lobe


lingular segment

right mid: elevated 16in, left sidelying, right nipple clap




lingular : elevated 16in, right sidelying, left nipple clap



postural drainage


lower lobes

lateral basal: 20in elevated, prone, 1/4 turn to affected side, lower rib clap




posterior basal: 20in elevated, prone, lower rib clap




superior: bed flat, 2 pillows beneath waist, scapular clap

wheelchair measurements


seat width


seat depth


leg length


seat height


armrest


back height

width: widest part of hips + 2in (18in)


depth: butt - popliteal fossa - 2in (16in)


leg length: bottom of shoe to thigh (20in)


seat height: leg length+2in (footplate + floor)


armrest: 9in from seat


backheight: seat to lower-mid scapula (16in)

iontophoresis




acetic acid


dexamethasone


lidocaine


zinc oxide

acetic acid: calcific deposits (-)




dexamethasone: inflammation (-)




lidocaine: analgesia, inflammation (+)




zinc oxide: healing, ulcers, wounds (+)

iontophoresis




calcium chloride


copper sulfate


iodine


magnesium sulfate


salicylates

calcium chloride: keloids, muscle spasm (-)




copper sulfate: fungal infection (+)




iodine: scars, adhesive capsulitis (-)




magnesium sulfate: spasm, ischemia (+)




salicylates: muscle/joint pain, warts (-)



ramp grade

12 in horizontal for every 1in height




aka 8.3% grade




36in width

accesibility requirements




doorway width & depth


hallway clearance


wheelchair turning

doorway width: 32in

doorway depth: 24 in


hallway width: 36 in


wheelchair turning radius: 60in


moro reflex

occurs with neck extension




flexion and abduction of shoulders, then shoulder adduction

asymmetrical tonic neck refle

occurs with head rotation to one side




arm&leg on face side extend


arm&leg on scalp side flex

symmetrical tonic neck reflex

head in flexion = arms flexed, legs extended


head in extension = arms extended, legs flexed

tonic labyrinthine reflex

supine= body and limbs in extension


prone= body and limbs in flexion

1 month newborn

lifts head briefly in prone (head to side)


follows moving object to midline

newborn

2-3 months


head bobs in sitting

head lifts briefly in prone to 90


rolls prone to supine




4-5 months newborn

rolls supine to side


sits alone briefly


prone with extended arms

6-7 months newborn

rolls supine to prone


sits without assistance

8-9 months newborn

hands-knees prone


sitting to prone


pivots in sitting


pulls to stand at furniture


cruising (walks along furniture)



10-11 months baby

stands without support briefly


picks up object from floor standing


bear walk

12-15 months child

walks without support

iliopsoas sign

irritation in abdomen, retroperitoneal




psoas test: ptt sidelying, resisted hip flexion




pain (+): appendicitis, psoas abcess, hemorrhage



lymph node palpation


infected


malignant

infected: firm, tender, enlarged, warm




malignant: firm, non-tender, matted (stuck to each other), fixed (not mobile)

ankle brachial index

checks for peripheral vascular disease


systolic ankle/systolic brachial




normal: 1.0-1.4


>1.4: calcification, normal in elderly/diabetic


<0.9: pad diagnostic


<0.5: severe pad, risk for limb ischemia

hypothyroidism

metabolic processes slowed

weight gain, lethargy, dry skin, low BP




exercise intolerance, weakness, apathy, myalgia from exercise, reduced cardiac output



hyperthyroidism

nervousness, hyperreflexia


tremor, hunger, weight loss, fatigue, tachycardia


exercise intolerance (fatigue)

upper motor neuron syndrome

pyramidal weakness (UL extensors - LL flexors)




spasticity


babinski sign (dorsiflexion + abd of toes)


increased DTR

lower motor neuron syndrome

muscle paralysis, wasting, flaccidity


hypotonia


decreased DTR


absent babinski


only in innervated region



reflex grading scale

0= no response


1+=diminished


2+=normal


3+=exaggerated


4+=hyperactive, abnormal

amyotrophic lateral sclerosis

(charcot disease)



has UMN (spasticity, hyperreflexia) and LMN symptoms (muscle weakness progressive; atrophy, cramping)




progressive, 2-5y life expectacy




loss of anterior horn, motor cranial nerves, death


multiple sclerosis

patches of demyelination in brain/spinal cord


lesions scattered in place and time




common


vestibular involvement


diplopia


ataxic gait


fatigue

multiple sclerosis types




primary progressive


secondary progressive



primary progressive: continuous worsening without relapses or remissions


secondary progressive: initial relapse-remitting then progression at variable rate

multiple sclerosis types




relapsing/remitting


progressive-relapsing

relapsing-remitting: most common .acute exacerbation then remission, periods without symptoms




progressive-relapsing: progression since onset, with acute relapses, but progression continues between relapses

pressure ulcer stages

I) non-blanchable erythema




II) partial thickness skin loss: abrasion, blister




III) full thickness: damage subcutaneous, up to fascia




IV)full thickness: necrosis to muscle, bone

burns grade

epidermal (1st): pink/red, no blisters, minimal edema, tendernes




superficial/partial thickness (2nd): pink/red, blisters, mod edema, painful




deep partial thickness: (2nd) red/white, edema, no light touch




full thickness (3rd): white (ischemic), up to muscle, no pain




subdermal (4th): charred, no vascular

brown-sequard

most frequently mechanical




ipsilateral: hemiplegia (corticospinal), vibration/fine touch/conscious propioception loss (dorsal column-lemniscus pathway)




contralateral: pain/temperature (spinothalamic tract)

anterior cord syndrome

most frequently aortic insufficiency




complete paralysis (corticospinal)


loss of pain/temperature (spinothalamic)




intact fine touch/vibration/propioception

central cord syndrome

UL>LL (ventral horn loss)


loss of pain/T (spinothalamic bilateral)


intact dorsal columns

posterior cord syndrome

bilateral propioception, fine touch loss

stable angina

classic during exertional activity


passes with rest / nitroglycerin


occurs at predictable rate-pressure product

unstable angina

preinfarction (coronary insufficiency)


without precipitating factors


refractory to treatment



prinzmetal's

variant of angina




vasospasm of coonaries in absence of occlusive disease




responds well to nitroglycerin / calcium channel blockers

rate-pressure product

HR x BP




myocardial O2 consumption

cyclosporine


prednisone

cyclosporine - immunosuppresant




prednisone - corticosteroid: reduces inflammation, immunosuppresor



hypoglicemia signs

sweating, lightheadedness, weakness


difficulty speaking or concentrating


too much insulin

hyperglycemia

blurry vision, polyuria, headache


glycemia > 180


fruity breath


thirst, nausea, vomiting


dry, crusty membranes

sulfamylon


silver nitrate


nitrofurazone

sulfamylon - antibacterial, penetrates eschar




silver nitrate/nitrofurazone: superficial antimicrobial agents

festinating gait

short shuffling steps, slowness of movement, akinesia


typical in parkinsons

bacterial pneumonia

gradual onset, productive cough


high WBC

viral pneumonia

abrupt onset, dry cough


normal WBC

AIDS neurological symptoms

wide ranging: 1/3 patients exhibit




aids dementia complex: confusion, memory loss, disorientation




motor deficits: ataxia, weakness, tremor, fine motor loss




peripheral neuropathy: hypersensitivity, pain, sensory loss

electrode placement in wounds

cathode (-) bactericidal effect on wound


anode (+) promotes healing in uninfected wounds

relative risk


odds ratio

relative risk : risk of event in one group vs another




odds ratio> event in one group vs event in another group in retrospective studies




>1: increased because of exposure


1: exposure doesnt increase odds


<1: exposure decreases odds

scales of measurement (nominal, ordinal, ...)

nominal: qualitative values, can only belong to one category (blood type, arthritis type)




ordinal: ranking scale. intervals not known (MMT, levels of assistance, pain grades)




interval: intervals are known but no true zero point (temperature)




ratio: intervals are known, have true zero point (ROM, distance walked, time to complete)

levels of evidence



systematic review


RCT


cohort


case-control


case-series


opinion

validity




intrarater


interrater


test-retest

intrarater: same tester gets same results




interrater: different testers get same results




test-retest: same results when testing over time

type I error


type II error

type I: false positive (rejects null hypothesis incorrectly)




type II: false negative (wrongly keeps null hypothesis)

ANOVA

parametric




for 2-3 groups




tests equality between treatment groups




eg: walking time in test for a) elderly b) adult c) teens

t-test

parametric




compares 2 groups (randomized) for effect of treatment

chi-square test

non-parametric




compares nominal data by frequency counts




eg: subjects rate treatment preferences

kruskal wallis

non-parametric ANOVA




compares 3 samples from same population

mann-whitney

non parametric ttest




compares 2 independent samples with ordinal data

pearson product moment (r)




spearman's rank correlation (rss)

r: measures magnitude and direction of correlation (parametric)



rss: for ordinal




yield -1 (negative correlation) -> 0 (no correlation) -> 1 (positive correlation(


chorea


hemiballismus

chorea: non-rhythmic, rapid, jerking, affects different parts of body (huntingtons, wilsons)




hemiballismus:nonrhythmic , rapid, violent, unilateral

athetosis




myoclonus

athetosis: non-rhythmic, slow, writhing movements (cerebral palsy, huntingtons)




myoclonus: involuntary twtiching of specific muscles (UMN disorders)

wound dressings




silver


charcoal


alginate

silver: antimicrobial agent




charcoal: managing fetid odor in infection




alginate: highly absorbent

blood tests normal values




ph


bicarbonate


glucose


hematocrit


triglycerides

ph: 7.35-7.45


bicarbonate: 18-23


glucose: 70-110


hematocrit: 45-52(m) 37-48(f)


triglycerides: 40-200

blood tests normal values




platelet


white blood count


hemoglobin

platelet: 150000-300000




WBC: 4k-10k




hemoglobin: 13-17(m) 12-15(f)

graves disease

hyperthyroidism (most common)


irritability, weakness, tachycardia, weight loss

addison's disease

chronic adrenal insufficiency




adrenal gland dysfunction -> less steroid hormones




abdominal pain, weakness, weight loss, low BP, coma

cushing's disease

hyperactive adrenal gland, more ACTH and cortisol




cushing's syndrome: high BP, weak muscles and bones, irritability, poor short term memory, weight gain

pagets disease

osteitis deformans




enlarged, misshappen bones




excessive breakdown/formation + disorganized remodeling

myasthenia gravis

autoimmune, affects neuromuscular junction




progressive muscular weakness, increased fatigability on exertion

braden scale

for risk of developing pressure ulcer




15-18: at risk


13-14: moderate


10-12: high risk


<9: very high

ortolani and barlow tests

for hip dislocation




barlow: ptt supine, hips 90 flx, knees flx. test leg into add, apply pressure at greater trochanter. (+): clunk




ortolani: ptt supine, hips 90flx, knees flx. abduct hips, pressure at greater trochanter. (+): clunk





turner syndrome




klinefelter syndrome

turner: X female. webbed neck, short stature, underdeveloped breasts, infertility




klinefelter: XXY in males. infertility, tall, incoordination, sparse body hair



legg-calve-perthes

childhoos hip avascular necrosis




flattened femoral head in rx

arnorld chiari malformation

obstruction of cerebrospinal fluid: hydrocephalus




central symptoms: headaches, fatigue, weakness, dizziness




pushes down cerebellar tonsils

shunt malfunction

partial or complete blockage of shunt -> CSF accumulates




irritability, vomiting, lethargy

charcot-marie-tooth

peroneal muscular atrophy (inherited neuropathy), lower leg. eventually hands, forearm

arrythmias




bigeminy


couplet


ventricular tachycardia

bigeminy: PVC every other beat


couplet: 2 PVC in a row




ventricular tachycardia: 3 PVC in a row. extended in time can be life threatening

hallpike dix maneuver

diagnostic for benign paroxysmal positioning vertigo




ptt sitting, rotate head to side. move ptt to spine and head to extension. (+) if vertigo, nystagmus for side head is rotated to

postpolio syndrome

15-30y post recovery






acute muscle weaknes, myalgia, fatigue

lyme's disease

from deer tick




erythema migrans (bull's eye pattern)




headaches, facial palsy (meningitis like symptoms)



rancho los amigos scale




1-3

1) no response: no response to stimuli, asleep



2) generalized: response nonspecific, inconsistent, stereotypical




3) localized: simple commands for motor actn


rancho los amigos




4-6

4) confused agitated: incoherent, no short-term memory, short attention span




5) confused nonagitated: follows simple commands, memory/attention impaired




6) confused appropriate: context appropriate, dependant on external input



rancho los amigos




7-8

automatic appropriate: automatic daily routine, impaired judgment




purposeful appropriate: normal, but abstract reasoning below normal

heterotopic ossification

maintain rom (gentle stretching), maintain optimal wheelchair positioning

APGAR

0-10: normal 7+




Appearance (skin)


Pulse (HR)


Grimace (reflex irritability)


Activity (muscle tone)


Respiration (respiratory effort)

crohn's disease

chronic inflammatory disorder


inflammatory bowel disease

scleroderma

systemic sclerosis




hardening of skin


limited (cutaneous) or diffuse (skin, internal organs)

duchenne muscular dystrophy

proximal muscle weakness (legs, pelvis), atrophy




hypertrophy of calves (characteristic)

rule of nines

legs: 18% each


arms: 9% each


trunk: 18% anterior and posterior each


head: 9%

PNF - UL

D1F: FADDUL



D2F: FABDUL




D1E: EABDUM




D2E: EADDUM


PNF - LL

D1F: FADDUL




D2F: FABDUM




D1E: EABDUM




D2E: EADDUL

gillet's test


gaenslen test


longsitting (supine to sit)


goldthwait test

gillets: posterior movement of ilium vs sacrum. ptt standing, thumb in PSIS, ptt bring knee to chest.




gaenslen: SIJ dysfunction. ptt sidelying, holding bottom leg in flx. passively extend hip of upper leg.




s-to-s: leg length discrepancy SIJ dysfunction. ptt supine, palpate medial malleoli. ptt into long sitting, compare malleoli.




goldthwait: lumbar spine vs SIJ dysfunction. ptt supine, palpate spinous lumbar processes. passively perform straight leg raise.

patrick test


scouring test


trendelemburg sign

patrick (FABER): hip disfunction. ptt supine. passive flx, abd, ext rotate (foot on opposite leg). lower leg down.




scouring: DJD of hip. ptt hip flx 90. compressive load on knee towards hip.




trendelemburg: ptt stand on one leg. observe pelvis of stance leg.

thomas test


ober test


ely test

thomas: hip flx tightness. ptt supine, hip/knee flx. observe straight leg while other hip flexes.



ober: TFL/iliotibial band tightness. ptt sidelying, lower limb flx. passive ext/abd other hip, knee flx 90. lower the uppermost limb, should reach table.




ely: tightness of rectus femoris. ptt prone, knee flx, observe for hip flx.




90-90 test


piriformis test


leg length test

90-90 hamstring test: for hamstring tightness. ptt supine, hip and knee in 90 flx. passive ext knee (should reach 10deg from extension)




piriformis: piriformis syndrome. ptt supine, foot of test leg placed lateral to opposite knee. testing hip adducted. testing knee should be able to pass over resting knee.




leg length: identifies true leg length discrepancy. ptt supine, measure ASIS to malleolus

craig test

abnormal femoral antetorsion angle




ptt prone, knee flx 90. palpate great trochanter, rotate hip. normal 8-15 deg antetorsion (medial rotation)

lachman stress test


pivot shift


posterior sag

lachman: for ACL. ptt supine, knee flx 20-30. try to glide tibia anterior.




pivot shift: anterolateral rotary instability. ptt supine, knee ext, hip flx and abd. valgus force on knee + flex knee (positive if tibia clunk)




posterior sag: for PCL. ptt supine, hip flx 45, knee flx 90. observe for tibia sag posterior.

posterior drawer test


reverse lachman


mcmurray test

posterior drawer: PCL integrity. ptt supine, hip flx 45, knee flx 90. glide tibia posterior




reverse lachman: PCL integrity. ptt prone,knee flx 30. glide tibia posterior.




mcmurray: meniscal tear. ptt supine, maximal flexion. internally rotate + extend knee (lateral meniscus). ext rotate (medial meniscus)

apley test

hughston's test


patellar aprehension


apley: differentiate meniscal from ligamentous lesions. ptt prone, knee flx 90. distract knee, rotate tibia ext/int, compress and again rotate.




hughstons plica test: dysfunction of plica. ptt supine, tet knee flx and tibia int rotate. gilde patella medially, feel for popping as flx/ext knee.




patellar apprehension: ptt supine, patella glided laterally.

clarke's sign


ballotable patella


fluctuation test

clarkes sign: patellofemoral dysfunction. ptt supine, knee ext. push down on superior patella pole, ptt contracts quadriceps.




ballotable (patellar tap test): infrapatellar effusion. ptt supine, knee ext, tap over central patella, look for floating patella.




fluctuation: knee joint effusion. ptt supine, knee ext, hand on suprapatellar pouch, other on anterior aspect of knee joint, alternate pushing down. look for movement of fluid.

Q-angle measurement


noble compression test


tinel's sign

qangle: angle between quadriceps muscle and tendon. 13 for men, 18 for women.




noble: distal ITB friction syndrome. ptt supine, hip flx 45 knee flex 90. pressure on lateral femoral epicondyle, ext knee.




tinels: dysfunction of common fibular nerve. tap region posterior to fibular head, look for tingling or paresthesia.

anterior drawer test (ankle)


talar tilt


thompson's



anterior drawer: anterior talofibular ligament. ptt supine, plantar flx 20. pull talus anterior.




talar tilt: calcaneofibular ligament. ptt sidelying, move ffot into adduction for calcaneofibular, abduction for deltoid ligament.




thompson: achilles' tendon. ptt prone, squeeze calf.

tinel's ankle sign


morton's test

tinel's: dysfunction of posterior tibial nerve. ptt supine, tap over posterior tibial, posterior to medial malleolus. test deep fibular under dorsal retinaculum.




morton: stress fracture or neuroma in forefoot.


ptt supine, grasp metatarsal heads and squeeze.

yergason's test


speed's test


neer's impingement

yergason: transverse ligament integrity. ptt sitting, shoulder neutral, elbow 90 flx, forearm prone. resist supination of forearm, ext rotation of shoulder. watch for biceps tendon pop.




speed's: bicipital tendinosis. ptt sitting, UL in full extension and forearm prone. resist flexion.




neer's: impingement of biceps or supraspinatus. ptt sitting, shoulder internally rotated, then full abd.



empty can test


drop arm test


posterior internal impingement test

empty can: supraspinatus tear. ptt sitting, shoulder 90 flx, resist abd. then shoulder int rotate and horizontal add, resist abd. differentiate pain between positions.



drop arm: tear or rupture of rotator cuff. ptt sitting, shoulder passive abd to 120. ptt brings down arm to side slowly, check for inability to do so.




posterior internal blah: impingement between rotator cuff and greater tuberosity. ptt supine, shoulder into 90 abd, maximum ext rotate, 20 horizontal add, check for pain in posterior shoulder.




clunk test


anterior apprehension


posterior apprehension

clunk: glenoid labrum tear. ptt supine, shoulder full abd, push humeral head ant and ext rotate arm. check for clunk.




anterior apprehension: past history of dislocation. ptt supine, shoulder 90 abd, ext rotate shoulder




posterior app: history of dislocation. ptt supine, shoulder abd 90, place posterior force.

shear test


adson test



acromioclavicular shear test: dysfunction of AC. ptt sitting, arm resting at side. examiner clasps hands, heels on spine of scapula and clavicle, squeeze hands together.




adson's: pathology in thoracic inlet. ptt sitting, find radial pulse. rotate head to extremity, arm into ext and ext rotate.





costoclavicular (military brace)test


wright test


roos elevated arm test



THORACIC INLET SYNDROME ASJKDSAALSKD

tinel's sign (ulnar)


bunnel-littler


tight retinacular test

tinel: dysfunction of ulnar n. at olecranon. tap ulnar n at cubital tunnel.




bunnel-littler: tightness around MCP. MCP in slight ext, PIP flx. then MCP flx and PIP flx.




retinacular: tightness around PIP. PIP stabilized while DIP is flexed. thne PIP flexed and DIP flexed.

froment's sign


allen's test

froment: ulnar nerve dysfunction. ptt grasps paper between 1-2 digits. pull paper, look for IP flx of thumb (compensation for adductor pollicis)




allen: vascular compromise. occlude ulnar artery, observe palm, release compression. repeat for radial. look for abnormal filling (should white -> normal)

lasegue test


quadrant test

lasegue (straight leg): dysfunction of neuro structures in LL. ptt supine, flx hip with knee ext until pain. then try again with dorsiflx foot.




quadrant: compression of neural structures by foramen or facet dysfunction. foramen: ptt bends/rotates left, extends. facet: bend left, rotate right, extends.

stork test


bicycle (van gelderen's) test

stork: spondylolisthesis. ptt stand on one leg, trunk extension. positive with low back pain with that leg on ground.




bicycle: differentiate between intermittent claudication and spinal stenosis. ptt rides bike sitting erect vs ride slumped.

after anterior dislocation of shoulder

avoid anterior glide (hyperextension / external rotation)




positive apprehension sign (shoulder abduction + lateral rotation)

erb palsy

c5-c6 upper arm paralysis


unilateral


limb in pronation, medial rotation

klumpke's paralysis

c8-t1 lower arm paralysis


muscles of hand, flexors / extensors of wrist / fingers

down syndrome neuro symptoms

hypotonia


decreased force generation for muscles


visual / hearing loss


possible atlantoaxial dislocation due to laxity of transverse ligament -> LMN signs


cognitive deficit

COPD

chronic obstructive pulmonary disease




FEV1 drops as severity increases


increased FRC, RV (obstructive)




increased respiratory rate


increased diameter of chest wall


cyanosis


clubbing


hyperinflation, flattened diaphragm



bronchiectasis

abnormal dilation of bronchi, excessive sputum




hyperproductive cough


hemoptysis


cyanosis, clubbing




rx= bronchial markings, interstitial changes

restrictive diseases


spirometric findings

reduced vital capacity, functional residual capacity, total lung capacity

sarcoidosis

abnormal nodules develop in lungs



restrictive disease


emphysema

obstructive


damage to the bronchial walls


part of COPD

tunneling


undermining

tunneling: wound that extends in one direction




undermining: damaged area is greater than the superficial wound area, all directions

clubfoot

plantar flexion + forefoot adduction


charot foot disease

result of neuropathy, often in diabetes


weakening of the bones in the foot


can result in rocker-bottom appearance




warmth to the touch, redness, swelling

epibole

wound edges rolled in, wound bed open

keloid scarring

scar tissue grows outside original margins of wound

lichenification

hard and leathery skin

hypertrophic scarring

thick fibrous tissue, remains in wound border

dermatomes




l2


L3


L4


L5


S1

L2: anterior upper thigh, medial thigh


L3: medial knee


L4: lateral thigh, medial malleolus


L5: posterior/lateral thigh, dorsum of first toes


S1: plantar heel, foot

CN II, III, IV

II Optic: test visual fields (confrontation test), homonymous hemianopsia




III Oculomotor: pupillary reflex and levator of eyelid (motor), upward/downward/medial gaze.




IV Trochlear: downward / inward gaze.



CN V, VI, VII

V Trigeminal: skin of lower face, motor mastication.




VI: Abducens: lateral gaze




VII: Facial: anterior taste, facial motor

CN VIII, IX, X

VIII Vestibulococlear: hearing, balance.




IX: Glossopharyngeal: posterior tongue taste, gag/swallow,




X Vagus: gag/swallow, uvula deviation to opposite side if paralysis

CN XI, XII

XI Accesory: sternocleidomastoid, trapezius




XII: Hypoglossal: tongue deviation to ipsilateral side if paralysis,

homonymous hemianopsia

visual field loss of contralateral nerve damage (right damage = loss of left hemifield on one or both eyes)

metabolic acidosis



ph below 7.35


bicarbonate <24


diabetes, renal insufficiency, diarrhea




hyperventilation (compensatory), malaise, vomiting,

metabolic alkalosis

ph over 7.45


bicarbonate >24


excess vomiting, hypokalemia




hypoventilation (compensatory),

respiratory acidosis

PCO2 >40mmHg


caused by hypoventilation




lethargy, confusion, cyanosis




look for dyspnea, hyperventilation cyanosis

respiratory alkalosis

PCO2<40mmHg


caused by hyperventilation,




tachypnea, blurred vision

UL flexor / extensor synergy

flexor: shoulder abd/ext rot, elbow flx, forearm sup, wrist flx,




extensor: shoulder add/med rot, elbow ext, forearm pro, wrist ext

LL flexor / extensory synergy

flexor: hip abd/ext rot, knee flx, ankle dorsi




extensor: hip ext/med rot/ext, knee ext, ankle plantar/inversion