Physio Prac

Front 1

steps of rinnes test

Back 1

hit tuning fork, ask subject if he can hear it.

hit again, and place base of vibrating tuning fork at the mastoid process until the subject no longer hears it

put it in air next to the ear on the same side

repeat with other ear

Front 2

What does +ve rinne mean?

Back 2

patient can hear vibration in air after cnoduction is over.
it indicates normal conduction

Front 3

What does -ve rinne mean?

Back 3

subject does not hear vibration in air after bone conduction is over

Front 4

what does -ve rinne indicate?

Back 4

conductive deafness

Front 5

causes of conductive deafness?

Back 5

impaired sound transmission in external or middle ear

from:

a) obstruction of external auditory meatus eg wax

b) closure of eustachian tube --> -ve pressure in middle ear

c) damage to tympanic membrane eg perforation

d) destruction of the auditory ossicles

Front 6

What does reduced +ve rinne mean?

Back 6

subject hears a vibration after conduction is over but hearing is reduced in both

Front 7

what does reduced +ve rinne indicate?

Back 7

nerve deafness

Front 8

causes of nerve deafness?

Back 8

impaired sound transmission in the cochlea or damage to the auditory pathway
due to:

a) damage of fibers of the basilar membrane by high intensity sounds

b) degeneration of the hari cells in the organ of corti eg prolonged use of antibiotics such as KANAMYCIN, NEOMYCIN, GENTAMYCIN

c) damage to the cochlear nerve by tumour

d) damage of the hearing pathway beyond the cochlear nerve

e) damage of the auditory cortex on both sides

Front 9

what is rinnes test used for ?

Back 9

to compare between air and bone conduction

ie to compare between conduction and nerve deafness

Front 10

enumerate another test that could be used

Back 10

webers test

Front 11

steps of webers test

Back 11

place the base of a vibrating tuning fork against the subjects forehead

compare hearing in the two ears

???? occlude the ear tightly with a piece of cotton and repeat the test (?? no? )

Front 12

normal webers test result

Back 12

vibration heard equally on both sides

Front 13

webers test with conductive deafness

Back 13

vibration heard better on the diseased side because of the masking effect of environmental noise

Front 14

webers test with nerve deafness

Back 14

the sound is louder in the healthy ear

Front 15

use of webers test

Back 15

to compare between bone conduction of both ears

and

conductive and nerve deafness

Front 16

which tuning fork is used to perform hearing tests

Back 16

highest freq (shortest one)

Front 17

Identify cranial nerve lesion (ptosis)

Back 17

occulomotor

Front 18

cause of ptosis

Back 18

loss of nerve supply to levator palpabrae superioris

Front 19

other manifestations of oculomotor lesion

Back 19

a. eye deviated down and out
b. dilated pupil
c. loss of accomodation

Front 20

cause of dilated pupil

Back 20

loss of nerve supply to sphincter pupillae muscle

Front 21

cause of impaired downward movement

Back 21

trochlear nerve lesion

Front 22

function of trochlear nerve

Back 22

supplies the superior oblique which moves the eye ball down and out

Front 23

other tests

Back 23

ocular movement

conjugate eye movement

Front 24

cause of deviation of eye
(patient asked to look right)

Back 24

lesion in abducent nerve

Front 25

functions of abducent nerve

Back 25

supplies the lateral rectus which moves the eyeball outwards

Front 26

other manifestations of abducent nerve lesion

Back 26

diplopia on looking out

(with inability to move eye outwards)

Front 27

paralysis of conjugate movement

Back 27

lesion of the brain stem

which integrates the function of oculomotor, trochlear and abducent nerves

Front 28

functions of facial nerve

Back 28

motor to muscles of facial expression

secretory to the lacrimal and salivary glands

taste from the ant 2/3 of mouth

Front 29

mouth deviated to the right ..

Back 29

bells palsy

Front 30

other manifestations of bells palsy

Back 30

failure to close the eye ont he affected side

deviation of the mouth to the healthy side

loss of forehead corrigations

Front 31

other tests of facial nerve lesion

Back 31

1 motor function:
ask patient to
a. look up while fixing his head
b. frown
c. close eyes and assess strength by trying to open his eyes with your fingers
d. show his teeth
e. blow his cheeks
f. whistle

2. sensory function

patient asked to protrude his tongue and apply sweet, sour, or salty substances to the ant 2/3 of the tongue to test taste

Front 32

identify
pic of deviated uvula

Back 32

lesion in vagal nerve

Front 33

other manifestations

Back 33

1. uvula moves to one side with gag reflex [moves to healthy side]

2. difficulty in swallowing, aspiration

3. vocal cord weakness

Front 34

function of vagus

Back 34

1. motor to soft palate, larynx and pharynx

2. sensory to the pharynx, larynx, esophagus, external ear, aortic body, aortic arch, thoracic and abdominal viscera

3. parasympathetic to the thoracic and abdominal viscera

Front 35

other tests

Back 35

a. central uvula?
b. palatal reflex
c. gag reflex
d. ask patient to swallow
e. laryngoscopy

Front 36

identify
pic of shoulder drop

Back 36

accessory nerve lesion

Front 37

function of accessory nerve

Back 37

motor to the sternomastoid and trapezius

Front 38

tests

Back 38

a. patient asked to move his head to one side against resistance (sterno)

b. patient asked to elevate his shoulder (trapezius)

Front 39

manifestations

Back 39

weakness of rotation of the head towards the opposide side of the lesion

inability to elevate the shoulder

Front 40

identify
pic of deviated tongue

Back 40

hypoglossal nerve lesion

Front 41

functions of hypoglossal nerve

Back 41

motor to the intrinsic and extrinsic muscles of the tongue

Front 42

test for hypoglossal

Back 42

ask patient to
1. protrude the tongue (deviation?)
2. move his tongue from side to side
3. note if there is any wasting of tongue

Front 43

manifestations

Back 43

tongue deviates to the paralyzed side when protruded