Physical Dx Exam 3

Front 1

# of PNs

Back 1

31

Front 2

anterior (ventral) PN responsible for?

Back 2

motor

Front 3

posterior (dorsal) PN responsible for?

Back 3

sensory

Front 4

segmental level of DTR:
ankle

Back 4

S1

Front 5

segmental level of DTR:
knee

Back 5

L2-4

Front 6

segmental level of DTR:
supinator

Back 6

C5-6

Front 7

segmental level of DTR:
biceps

Back 7

C5-6

Front 8

segmental level of DTR:
triceps

Back 8

C6-7

Front 9

diplopia, dysarthria, and ataxia

Back 9

postior circulation stroke

Front 10

bilateral proximal weakness

Back 10

myopathy

Front 11

bilateral distal weakness

Back 11

polyneuropathy

Front 12

awareness of personal identity, place, and time

Back 12

orientation

Front 13

sensory awareness of objects in env. and their interrelationship

Back 13

perceptions

Front 14

awareness that sx or behaviors are NL or abNL

Back 14

insight

Front 15

comparing and evaluating alternatives when deciding on a course of action

Back 15

judgement

Front 16

5 things to test for aphasia

Back 16

word comprehension
repetition
naming
reading comprehension
writing

* if can write correct sentence then NOT aphasia

Front 17

speech characterized by delay in reaching pt. b/c of unnecessary detail

Back 17

circumstantiality

Front 18

person shifts from one subject to another that are unrelated

Back 18

derailment

Front 19

continuous flow of speech where person changes abruptly from one topic to the next

Back 19

flight of ideas

Front 20

invented or distorted words

Back 20

neologisms

Front 21

speech that is incomprehensible

Back 21

incoherence

Front 22

sudden interuption of speech in midsentence

Back 22

blocking

Front 23

fabrication of ffacts in response to questions

Back 23

confabulation (seen in amnesia)

Front 24

persistent repitition of words/ideas

Back 24

perseveration

Front 25

repitition of words/phrases of others

Back 25

echolalia

Front 26

person chooses a word based on sound rather than meaning

Back 26

clanging

Front 27

repetitive behaviors that a person feels driven to perform to produce or prevent future state of affairs

Back 27

compulsion

Front 28

recurrent uncontrollable thoughts, images, impulses that another considers unacceptable

Back 28

obsessions

Front 29

misinterpretations of real external stimuli

Back 29

illusions

Front 30

subjective sensory perceptions in absence of relevant external stimuli

Back 30

hallucinations

Front 31

What do these measure?
digit span
serial 7s
spelling backwards

Back 31

attention

Front 32

What does this measure?
proverbs
similarities

Back 32

abstract thinking

Front 33

CN I

Back 33

olfactory

Front 34

CN II

Back 34

optic

Front 35

CN III

Back 35

Oculomotor

Front 36

poor sense of smell

Back 36

olfactory (CN I)

Front 37

abNL
visual acuity
optic fundi
visual fields

Back 37

Optic (CN II)

Front 38

abNL size and shape of pupils and papillary rxns to light

Back 38

Optic and Oculomotor (CN II and CN III)

Front 39

CN IV

Back 39

Trochlear

Front 40

CN VI

Back 40

abducens

Front 41

abNL
extraocular movements
convergence of eyes
nystagmus
ptosis

Back 41

oculomotor, trochlear, abducens (III, IV, VI)

Front 42

abNL
masseter muscle
pain sensation of forehead, cheeks, and jaw
corneal reflex

Back 42

trigeminal (V)

Front 43

CN V

Back 43

trigeminal

Front 44

AbNL
raise eyebrows
frown
close eyes
show teeth
smile
puff out cheeks

Back 44

facial (VII)

Front 45

CN VII

Back 45

facial

Front 46

CN VIII

Back 46

acoustic

Front 47

hearing loss

Back 47

CN VIII (acoustic)

Front 48

CN IX

Back 48

Glossopharyngeal

Front 49

CN X

Back 49

vagus

Front 50

abNL
hoarseness of voice
swallowing
movement of soft palate and pharynx
gag reflex

Back 50

CN IX and X (glossopharyngeal and vagus)

Front 51

tongue abNL

Back 51

hypoglossal

Front 52

CN XII

Back 52

hypoglossal

Front 53

repetitive and consistent deviation to 1 side

Back 53

past pointing (w/ cerebellar disease)

Front 54

inability to heel walk

Back 54

corticospinal tract weakness

Front 55

stand w/ feet together and eyes open and then closed, w/o support- note ability to maintain upright posture

Back 55

Romberg Test

Front 56

pt stands w/ both arms straight forward, palms up, eyes closed - note ability to hold position

Back 56

test for pronator drift

Front 57

1st sensation lost in peripheral neuropathy

Back 57

vibration
(caused by DM, alcoholism, posterior column disease, tertiary syphilis, or Vit B12 deficiency)

Front 58

inability to ID an object by feeling it

Back 58

asterognosis

Front 59

stimulus on side opposite damaged cortex is extinguished

Back 59

sensory cortex lesion

Front 60

rating of DTR: very brisk, hyperactive w/ clonus

Back 60

4+

Front 61

NL DTR

Back 61

2+

Front 62

absent DTR

Back 62

0

Front 63

slow relaxation phase of ankle reflex

Back 63

hypothyroidism

Front 64

sudden, brief, nonrhythmic flexion of hands and fingers

Back 64

asterixis (helps to ID metabolic encephalopathy)

Front 65

what muscle weakness causes winging of the scapula

Back 65

serratus anterior

Front 66

flex neck, watch hips and knees for rxn

Back 66

Brudzinki's sx

Front 67

flex pt legs at both hip and knee, then straighten knee and determine presence of pain

Back 67

Kernig's sx

Front 68

to determine whether brainstem is intact check these reflexes

Back 68

oculocephalic reflex (Doll's eyes)
oculovestibular reflex w/ caloric stimulation (if intact, eyes drift toward irrigated ear)

Front 69

dpressed mood and sx for most of day, for more days than not, over at least 2 yrs (no more than 2mo of relief from symtoms)

Back 69

dysthymic disorder

Front 70

numerous periods of hypomanic and depressive sxs that last for at least 2 yrs

Back 70

cyclothymic disorder

Front 71

inflection and articulation good, but sentences lack meaning; word comprehension, repetition, naming, reading and writing are all impaired; lesion in temporal lobe

Back 71

Wernicke's Aphasia

Front 72

inflections and articulation are impaired but words are meaningful; word and reading comprehension are fair; repetition, naming and writing are impaired; lesion in frontal lobe

Back 72

Broca's Aphasia

Front 73

Delusions, hallucinations, disorganized speech, catatonic bx, and negative sx present for > 6mo

Back 73

Schizophrenia
(if < 6mo- schizophreniform disorder)

Front 74

nonbizarre delusions that involve real-life situations that last for a mo

Back 74

delusional disorder

Front 75

may be associated w/ uremia or acute hepatic failure

Back 75

delerium

Front 76

may be associated w/ thyroid disorders, alzheimers or vascular cause

Back 76

demetia

Front 77

paralysis of entire side of face including forehead, eye doesn't close

Back 77

CN 7 lesion

Front 78

paralysis of opposite lower side of face, can close eyes and wrinkle forehead

Back 78

UMN lesion

Front 79

spasticity

Back 79

caused by UMN lesion

Front 80

flaccidity

Back 80

cuased by lesion of LMN

Front 81

associated w/ corticospinal tract lesion; one arm held close to side, extended leg, dragging foot

Back 81

spastic hemiparesis

Front 82

associated w/ bilateral spastic paresis of legs

Back 82

scissor gait

Front 83

associated w/ foot drop due to LMN disease

Back 83

steppage gait

Front 84

upper arms tight to chest; legs extended and internally rotated

Back 84

decorticate rigidity
(lesion of corticospinal tract)

Front 85

jaw clenched, adducted arms, wrist flexed

Back 85

decerebrate rigidity