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Assessment Exam 1 for PTA Students
83 cards
82
Medical
Professional
09/13/2012

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Term
End feels:
Definition
All of the end feels below are firm unless otherwise noted.
Term
Shoulder Flexion
Definition
Sag. (0-180) A-lateral aspect of the greater tubercle, S- parallel to the mid-axillary line of the thorax, M- lateral midline of the humerus Supine
Term
Shoulder Extension
Definition
Sag. (0-45) A- lateral aspect of the greater tubercle S- parallel to the midaxillary line of the thorax M- lateral midline of the humerus PRONE
Term
Shoulder Abduction
Definition
Frontal (0-180) A-anterior aspect of the acromial process S- parallel to the midline of the anterior aspect of the sternum M- anterior midline of the humerus Supine
Term
Shoulder IR
Definition
Transverse (0-70) A- olecranon process S- perpendicular to the floor M- ulnar styloid process SUPINE
Term
Shoulder ER
Definition
Transverse (0-90) A- olecranon process S- perpendicular to the floor M- ulnar styloid process SUPINE
Term
Elbow Flexion
Definition
Sag. (0-145) SOFT END FEEL A- Lateral epicondyle S- lateral midline of the humerus, acromion for reference M- lateral midline of the radius SUPINE
Term
Elbow Extention
Definition
Sag. (0) Hard or Firm SUPINE
Term
Forearm Pronation
Definition
Transverse(0 to 80-90) Hard or Firm A- laterally and proximally to the ulnar styloid process S- parallel to the anterior midline of the humerus M- dorsal aspect of the forearm, just proximal to the styloid process of the radius and ulna SITTING, lower arm 90 deg. Thumb pointed at ceiling
Term
Forearm Supination
Definition
Transverse(0 to 80-90) medially and just proximally to the ulnar styloid process S- parallel to the anterior midline of the humerus M- across the ventral aspect of the forearm, just proximal to the styloid process SITTING, lower arm 90 deg. Thumb pointed at ceiling
Term
Wrist Flexion
Definition
Sag. (0-80) A- lateral aspect of the wrist over the triquetrium S- lateral midline of the ulan, olecranon and ulnar styloid process for reference M- lateral midline of the 5th metacarpal Position the subject sitting next to a supporting surface with the shoulder abducted to 90 degrees, the elbow
flexed to 90 degrees, and the palm of the hand facing
the ground
Term
Wrist Extension
Definition
Sag.(0-70) A-lateral aspect of the wrist over the triquetrium S- lateral midline of the ulna, olecranon and ulnar stylid process for reference M- lateral midline of the 5th metacarpal Position the subject sitting next to a supporting surface with the shoulder abducted to 90 degrees, the elbow
flexed to 90 degrees, and the palm of the hand facing
the ground
Term
Radial Deviation
Definition
Frontal (0-20) Hard/Firm A- dorsal aspect of the wrist over the capitates S- dorsal midline of the forearm M- dorsal midline of the 3rd metacarpal Position the subject sitting next to a supporting surface with the shoulder abducted to 90 degrees, the elbow flexed to 90 degrees, and the palm of the hand facing the ground, palm on flat surface
Term
Ulnar Deviation
Definition
Frontal (0-30) A- dorsal aspect of the wrist over the capitates S- dorsal midline of the forearm M- dorsal midline of the 3rd metacarpal Position the subject sitting next to a supporting surface with the shoulder abducted to 90 degrees, the elbow flexed to 90 degrees, and the palm of the hand facing the ground, palm on flat surface
Term
MCP’s 2-5 Flexion
Definition
Sag.(0-90) Hard or Firm A- dorsal aspect of the MCP joint S- dorsal midline of the metacarpal M- dorsal midline of the proximal phalanx Position the subject sitting next to a supporting surface
with the upper extremity resting on the surface.
Place the elbow, MCP, PIP, and DIP joints in extension
(Fig. 6.20). Pronate the forearm and place the wrist in
neutral.
Term
MCP’s 2-5 Extension
Definition
Sag.(0-45) A- dorsal aspect of the MCP joint S- dorsal midline of the metacarpal M-dorsal midline of the proximal phalanx Position the subject sitting next to a supporting surface
with the upper extremity resting on the surface.
Place the elbow, MCP, PIP, and DIP joints in extension
(Fig. 6.20). Pronate the forearm and place the wrist in
neutral.
Term
PIP’s 2-5 Flexion
Definition
Sag.(0-100) A- dorsal aspect of the PIP joint S- dorsal midline of the proximal phalanx M- dorsal midline of the middle phalanx Hold the MCP, PIP, and DIP joints in full flexion while
flexing the wrist (Figs. 6.26 and 6.27). The end of the
testing motion occurs when resistance is felt and additional
wrist flexion causes the fingers to extend or the
elbow to flex.
Term
DIP’s 2-5 Flexion
Definition
Sag.(0-90) A- dorsal aspect of the DIP joint S- dorsal midline of the middle phalanx M- dorsal midline of the distal phalanx
Term
DIP’s 2-5 Extension
Definition
Sag.(0-10) A- dorsal aspect of the DIP joint S- dorsal midline of the middle phalanx M- dorsal midline of the distal phalanx Position the subject sitting next to a supporting surface with the upper extremity resting on the surface. Place the elbow, MCP, PIP, and DIP joints in extension
(Fig. 6.20). Pronate the forearm and place the wrist in
neutral.
Term
Hip Flexion
Definition
Sag.(0-125) Soft or Firm A- lateral aspect of the hip joint, greater trochanter of the femur S- lateral midline of the pelvis M- lateral midline of the femur, lateral epicondyle for reference
Term
Hip Extension
Definition
Sag.(0-10) A- lateral aspect of the hip joint, greater trochanter of the femur S- lateral midline of the pelvis M- lateral midline of the femur. Lateral epicondyle for reference
Term
Hip Abduction
Definition
Frontal (0-45) A- anterior superior iliac spine (ASIS) S- imaginary horizontal line extending from one ASIS to the other M- anterior midline of the femur, midline of patella for reference
Term
Hip Adduction
Definition
Frontal (0 to 20-30) A- ASIS S- imaginary horizontal line extending from one ASIS to the other M- anterior midline of the femur, midline of patella for reference
Term
Hip IR
Definition
Transverse(0-45) A- anterior aspect of the patella S- perpendicular to the floor M- anterior midline of the lower leg, crest of tibia
Term
Hip ER
Definition
Transverse (0-45) A- anterior aspect of the patella S- perpendicular to the floor M- anterior midline of the lower leg, crest of tibia
Term
Knee Flexion
Definition
Sag.(0-140) SOFT A- lateral epicondyle of the femur S- lateral midline of the femur, greater trochanter M- lateral midline of the fibula, lateral malleolus
Term
Ankle Dorsiflexion
Definition
Sag.(0-20) A- lateral aspect of the lateral malleolus S- lateral midline of the fibula M- lateral aspect of the 5th metatarsal Seated, leg at 90 degrees
Term
Ankle Plantarflexion
Definition
Sag.(0-45) A- lateral aspect of the lateral malleolus S- lateral midline of the fibula M- lateral aspect of the 5th metatarsal Seated, leg at 90 degrees
Term
Subtalar Inversion
Definition
Combo(0-35) A- anterior aspect of the ankle midway between the malleoli S- anterior midline of the lower leg, tibial tuberosity M- anterior midline of the 2nd metatarsal
Term
Subtalar Eversion
Definition
Combo(0-20) Hard or Firm A- anterior aspect of the ankle midway between the malleoli S- anterior midline of the lower leg, tibial tuberosity M- anterior midline of the 2nd metatarsal
Term
MTP Flexion
Definition
Sag.(0-45) A-dorsal aspect of the MTP joint S- dorsal midline of the metatarsal M- dorsal midline of the proximal phalanx
Term
MTP Extension
Definition
Sag.(0-70) A- dorsal aspect of the MTP joint S- dorsal midline of the metatarsal M- dorsal midline of the proximal phalanx
Term
TMJ depression (Open Mouth)
Definition
(35-50 MM)
Term
Rotation and forearm pronation/supination occurr in:
Definition
The transverse plane around a vertical Axis
Term
Cranial Nerve V
Definition
Trigeminal - Sensory Nerve of the face, motor n. to mm of mastication
Term
Cranial Nerve VII
Definition
Facial - muscles of face and taste
Term
Crainial Nerve VIII
Definition
Auditory (vestibulocochlear) - Hearing, Balance
Term
Cranial Nerve X
Definition
Vagus - Regulates the heartbeat, helps you speak and swallow
Term
Cranial Nerve XI
Definition
Spinal Accessory - Upper trap. And SCM (Sternocleidomastoid)
Term
Light Touch
Definition
Transmitted by two tracts: 1. Anterior-spionthalamic tract - Non discriminative touch 2. Dorsal Column/ medial leminiscus pathway - Discriminative touch: Provides more
Term
How is light touch checked? -
Definition
With a wisp of cotton. Don't CUE the patient. Ask them to say YES when they feel a touch, and vary the timing of your touches VS. asking them "Am I touching you now? Am I touching now? Touch the cotton to the skin. Do not Rub it. Wiping it tests a DIFFERENT tract to the brain - tickling. Really our goal is to touch the hair on their body, not to push on the skin.
Term
Temperature and Pain Sensation
Definition
Carried by Lateral Spinothalamic Tract along with pain. Ascends 2 to 4 segments before crossing to the opposite side. Use Sharp/dull descrimination test for pain.
Term
How to test sensation:
Definition
Begin testing sensation in abnormal areas and then working out toward the areas of intact sensation
Term
Usually if you lose pain sensation, you also lose _________ but occassionally you can lose __________ sensation before pain sensation? Pg. 497
Definition
temperature sensations, thermal
Term
Proprioception -
Definition
Delivered by Dorsal Column/medial lemniscus pathway (Same one that is Discriminatory light touch)
Term
Proprioceptors are found primarily in the ___________ and are a function of the ____________?
Definition
Joints, Dorsal Column/ medial lemniscus pathway
Term
When sensory testing reveals an abnormal response and pattern is determined, what should be the next step? -
Definition
The pattern must be interpreted based on the examiners working knowledge of the nervous system. The examiner should compare the patient's pattern of sensory loss (the problem) with the established Dermatome or Peripheral Nerve Charts to determine if the lesion lies in a peripheral nerve or a nerve root. #4 (Pg. 506)
Term
Long term and short term Memory
Definition
Short term memory allows one to recall information that was acquired seconds to minutes before, whereas long term memory permits recall of events experienced days, months, or even years earlier. Short term memory test: Words heard should be repeated 5 minutes later. Long term memory test, Questions about events, history, etc.
Term
Orientation -
Definition
Orientation refers to the patients knowledge of the present circumstances: who he or she is, where he or she is, and the time in which he or she exists. Referred to as orientation of Person, Place, and Time.
Term
Cerebellum: Responsible for? Sign of problems?
Definition
Balance and Coordination. One sign is Asynergia, the inability to adjust the impulses innervating the various muscles participating in a movement so that the range, direction, and force of movement are altered.
Term
The Glasgow Coma Scale -
Definition
Assesses level of conciousness with scores for motor (gait not included), verbal, and eye opening responses.
Term
Intrarater tests vs. Interrater tests
Definition
Intrarater tests (performed by the same person) are more reliable than Interrater tests (performed by a diff. person every time.
Term
When assesing for Edema, which method is more accurate? Water displacement, or measuring girth (volumetric measurement)
Definition
The water displacement method is more accurate
Term
The FIM (Functional Independence Measure) looks at what?
Definition
Accessment of ADL's Self-care, sphincter control, transfers, locomotion, communciation and social cognition. Locomotion may mean walking or it may mean propelling oneself in a wheel chair.
Term
The Barthel and Katz index assesses what?
Definition
ADL's - A measure of the minimal requirements for independence.
Term
Romberg Test - (pg. 504)
Definition
The Romberg test is a test of the body's sense of positioning (proprioception) which requires healthy functioning of the dorsal columns of the spinal cord. This test is used to determine sobriety or the lack there of in drunk drivers. When one's eyes are closed we should be able to determine where our limb is. If not, we demonstrate a positive Romberg sign. Can be done standing or supine.
Term
Finger-Nose
Definition
(limb coordination test) Position: Seated with arms at sides. Procedure: The examiner holds an index finger vertically at arms length away from the patient at shoulder level. The patient is asked to touch, with his or her own index finger, first his or her nose and then the examiners index finger. The patient is asked to repeat this movement several times as rapidly as possible. The time taken to complete five repetitions of the movement should be timed with the stopwatch. One repetition is the movement from the patient's nose to the examiners finger and back to the patients notes.
Normal response: Arm movement should be smooth and precise. The patient should be able to alternately touch his or her nose and the examiners finger with ease and accuracy.
Term
Heel-Shin
Definition
Patient position seated or supine on an examining table with the shoes removed in the eyes open.
Procedure examiner asks the patient to slide the heel of 1 foot from the knee down toward the great toe of the opposite leg. The test is repeated for the other side.
Normal response the patient's slides that heel smoothly along the shin of the opposite leg, maintaining contact between the heel and leg.
Lesions: Contact between the heel and Shin cannot be maintained, and the movement is jerky and unsteady.
Term
Diadochokinesia
Definition
(If impaired its called Dysdiadochokinesia) This test involves placing the palm faceup on one Knee while sitting, and making rapid hand movement up-and-down. The same thing is done with the palm facing down on the knee. The last two portions of the test involve pinching the fingers together and moving them rapidly, also rapid toe tapping. With a normal response movements should be rapid and rhythmic bilaterally.
If a patient has diadochokinesia, they will perform alternating movements without rhythm or with decreased speed.
Term
Rebound
Definition
Patient position -seated or standing in a comfortable position with the arms held straight out in front
Procedure- the examiner asks the patient to try as hard as possible to keep the arms level. The examiner then pushes downward on each of the patients arms with the firm, quick motion to try to displace the arms toward the floor. Normal response- the patient's arm will move downward toward the floor slightly and then back to a level position without going past the horizontal
Lesions - patients with cerebellar pathology will demonstrate rebounding, which involves the inability to stop motion quickly. Thus, when the examiner pushes downward on the patient's arm, the arm will move down toward the floor and then back up past the horizontal and downward once again before stopping in the original position. This may occur more than once.
Term
Tandem Romberg
Definition
Similar to Romberg test only one foot is placed in front of the other.
Term
Tandem Gait
Definition
patient position - standing with the arms at the sides and the feet positioned so that the heel of 1 foot is directly in front of the toes of the other foot.
Procedure- the examiner asks the patient to walk across the room in tandem fashion, stepping each time so the feel of the foot is brought down just in front of the toes of the opposite foot.
Normal response individuals up to age 60 should be able to walk 20 steps without losing balance
Lesions - Patients with cerebellar disorders will demonstrate loss of balance or excessive arm and trunk movements while attempting tandem gait
Term
What does CROM Stand for and what does it measure?
Definition
Cervical Range Of Motion - device uses a pendulum needle that reacts to gravity to measure motions in the frontal and sagittal planes (cervical flex/ext.), and use a compass needle that reacts to the earth’s magnetic field to measure motions in the horizontal plane (lat.rot. (L) and (R)).
Term
McGill Pain Questionanaire
Definition
Questionnaire tells where the pain is and how intense the pain is. Pain rating index may give clues to what type of problem may be ailing the pt. Sometimes this test is used to determine whether physical therapy interventions are appropriate for a particular problem. For instance, psychological problems cannot be addressed by physical therapy interventions.
Term
DTR - (pg. 507)
Definition
Deep tendon Reflex - Monosynaptic unconcious protective reflex. Example: Tap Tendon with reflex hammer which pulls on the muscle, so the body to protect itself shortens the Antagonist muscle. In more detail: Impulses are transmitted along the sensory fibers to the dorsal horn to the anterior horn to the motor fibers.
Term
Grading DTR's
Definition
A 2+ is normal but a 1+ and 3+ are also found in normals as long as the grade is symmetrical bilaterally. Grades of 0 and 4+ are abnormal.
Term
Function of the Muscle Spindle?
Definition
Muscle Spindles play a critical role in proprioception telling the brain a muscle's state of contraction, length, and joint angle.
They also help protect the muscle from being stretched too far, too quickly by signaling the muscle to contract before it is stretched too far.
Term
What is the stretch Reflex?
Definition
The protective muscular response to muscle stretching.
(Golgi Tendon not involved) Inhibitory Stimulus is sent to the Antagonist. The AgonistContracts, Antagonist Relaxes in a Monosynaptic Stretch Reflex.
Term
Double Inclinometer method can be used to assess what?
Definition
Cervical, Lumbar, or combined thoracis and lumbar ROM (so can a tape measure or goniometer)
Term
Brain stem damage/lesions typically results in sensory loss on what side of the body?
Definition
contralateral
Term
Cranial Nerve deficits or problems cause sensory loss on the _____________ side of the body?
Definition
ipsilateral (affected or same side)
Term
In Spinal Cord injuries, Pain and temperature sensation are lost where?
Definition
On the contralateral side of the body beginning about 2 segments below the lesion, unless the damage is complete, in which you will lose sensation on both sides.Complete fractures result in Bi-lateral loss of sensation.
Term
Nerve Root Sensory loss is typically _________________? (Location) -
Definition
Unilaterally (problem is only on one side)
Term
Signs of Peripheral Nerve damage -
Definition
Loss of ALL types of sensation occurs in the distribution of the affected nerve.
Term
Hyperesthesia - (pg. 496)
Definition
Hyper-More of than normal. Rather than loss of sensation, someone has irritated nerves or receptors. They feel more sensation than is comfortable.
Term
monofilaments use -
Definition
Touch the person just enough for the filament to bend and the PT
tells you when they can feel the sensation.
Term
If an Muscle GROUP like the Quads is impaired, you would know that what type of Nerve
is damaged?
Definition
Peripheral Nerve
Term
If a Dermatome is impaired then it is likely that only one ______________ is injured?
Definition
Spinal Nerve
Term
Peripheral Nerve -
Definition
Made up of more than one spinal nerve root. They are the nerves outside the brain and spinal cord. (See Chart of Peripheral Sensory Nerves on Pg. 489 in "Muscle and Sensory Testing Book")
Term
Dermatome -
Definition
Area of skin innervated by a single spinal nerve root (chart of Dermatomes in "Muscle and Sensory Testing Book", Page 488)
Term
End Feel -
Definition
A feeling experienced by an examiner as a barrier to further motion at the end of PROM.
Term
Capsular vs Non-capsular patterns
Definition
Capsular vs Non-capsular patterns - pathological conditions involving the entire joint capsule that cause a particular pattern of restriction involving all or most of the passive motions of the joint are referred to as Capsular Patterns. Non-capsular patterns of limitation of passive motion are not proportioned similarly to capsular patterns, and are usually caused by a condition involving structures other than the entire joint capsule. Non-capsular patterns usually involve only one or two motions of a joint, in contrast to capsular patterns, which involve all or most motions of a joint. Causes of non-capsular patterns include internal joint derangement, adhesion of a part of a joint capsule, ligament shortening, muscle strains, and muscle contractures.
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