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CDM Final


cervical flexion ROM 45
cervical extension ROM 45
cervical lateral flexion ROM 45
cervical rotation ROM 70
shoulder flexion ROM 180
shoulder extension ROM 60
shoulder internal rotion ROM 70
elbow flexion ROM 150
elbow extension ROM 0
supination ROM 80
pronation ROM 80
wrist flexion ROM 80
wrist extension ROM 70
radial deviation ROM 20
ulnar deviation ROM 30
thumb flexion ROM 50
thumb extension ROM 0
finger flexion ROM 90
finger extension ROM 45
IP thumb flexion ROM 80
PIP finger flexion ROM 100
DIP finger flexion ROM 90
IP thumb extension ROM 20
PIP finger extension ROM 0
DIP finger extension ROM 0
lumbar flexion ROM 90
lumbar lateral flexion ROM 35
lumbar extension ROM 30
hip flexion ROM 120
hip extension ROM 30
hip abduction ROM 45
hip adduction ROM 30
hip external rotation (knee flexed) ROM 45
hip internal rotation (knee flexed) ROM 45
knee extension ROM 10
knee flexion ROM 135
plantar flexion ROM (point toes) 50
dorsiflexion ROM 20
inversion ROM 35
eversion ROM 15
big toe (MTP) flexion ROM 30
big toe (MTP) extension ROM 70
When testing coordination the therapist is observing all of the following for quality of the movement by the patient, except? Understanding of movement
patient is presenting with diplopia, head tilt to the right, weakness in depression of left adducted eye, which cranial nerve would most likely be involved? right trochlear
pathologic reflex? babinski's reflex
When measuring range of motion using a goniometer, the reliability of the observed score is a function of which of the two following components? True score and error component
Which area of the body would be most sensitive in distinguishing two points close together? finger tips
In order to test cranial nerve XII the therapist would ask the patient to _______________ stick out their tongue
Which of the following types of reliability is important for determining the consistency of the measurement tool? test-retest reliability
If you see the following documented in a chart, A and O X 2 (time), which of the following would be true? The patient is oriented to person and place
Before proceeding with a neurological examination, which of the following should the physical therapist measure first in order to determine whether the exam would be valid? orientation
Which of the following is involved in self-protective reaction as a response to potentially harmful stimuli and contains slow-conducting fibers of small diameter, some of which are unmyelinated? antereolateral spinothalmic pathway
This patient is presenting with upper motor neuron signs and symptoms. To test for clonus which of the following techniques would be used? Quick stretch stimulus then maintain stretch
This patient is presenting with obtunded arousal and consciousness. Which of the following would define the patient’s level of arousal and consciousness? Difficult to arouse, constant stimulation needed, confused
When the physical therapist is testing the abdominal reflex which type of reflex is being tested? superficial
Achilles reflex, the integrity of which of the following nerve roots is being tested? S1
A measurement of reflexes using a scale of present or absent, would be what level of measurement? nominal
Which of the following is impacted by amplitude and velocity of stretch? spasticity
If a patient’s arousal state is drowsy and he consistently falls asleep when no stimulation is occurring and has trouble focusing and maintaining attention to the therapist, which of the following would define the patient’s state? lethargic
Proprioceptors are responsible for deep sensation and receive stimuli from all of the following except? viscera
therapist will take a measurement, using a goniometer then will compare the score to a standard. This patient’s score is compared to which of the following standards? norm referenced standards
Which of the following would be the most disruptive to collecting sensory information from an older patient? short term memory deficits
Validity is the extent to which an instrument measures what it is intended to measure and is the degree of truthfulness of a test score. Validity is a measure of _______________________? Question 21 answers systematic error
When testing sensation, which of the following should the physical therapist test first? superficial
difficulty performing the following coordination tests: finger to nose, alternating nose to finger, pronation/supination. Movement is jerky, and becomes irregular with a rapid loss of range and rhythm as speed is increased. What is this? Dysdiadochokinesia
Which of the following scales can any mathematical procedures and statistics be used and is the highest level of measurement? ratio scale
Which of the following cranial nerves is considered to be mixed, having both sensory and motor functions? facial
Which of the following cranial nerves can cause syncope (drop attack)? vagus
The “0-10” scale to evaluate pain is an example of which type of scale? ordinal scale
Which of the following would be the best way to test dysmetria? pointing and past pointing
an outcome measurement tool could be modified to determining an older patient’s ability to perform activities of daily living. It was developed for the use with peds - what must she determine as far as the modifications to the tool? validity of a tool
What temperature range for cold and warm is suggested for use when testing sensation for temperature? Question 32 answers Cold 41º F to 50º F; warm 104º F to 113º F
Which of the following best defines the term rigidity? Resistance to passive movement involving both agonist and antagonist muscles
Which of the following most closely defines the meaning of deep sensation of proprioception? Joint position sense and awareness of joints at rest
When testing tone which of the following is speed dependent or will result in an increase in resistance with increased speed of movement of the limb by the tester? spasticity
Which of the following responds to change in posture, position, proprioception, muscle tone, speed, and direction of movement? deep sensory receptors
All of the following represent nonequilibrium coordination tests EXCEPT? single limb stance
When testing for dysdiadochokinesia, dyssynergia, and intention tremor, which of the following tests could the physical therapist use to test for all three at the same time? finger to nose
Which of the following statements is true when testing a patient’s reflexes? pt can be conscious or unconscious
All of the following should be screened prior to testing coordination, EXCEPT? equilibrium
When the patient sticks out her tongue, it deviates to the right. Which of the following cranial nerves is most likely involved? cranial nerve 12 palsy (right)
Which of the following statements is true in regards to reliability and validity of a measure? A valid test is always reliable
For standardized testing, it has been determined that a turning fork at which frequency is best to use in the clinical setting when testing vibration sense in patients? 128 Hz
In order to determine if the treatment done by the physical therapist truly caused the patient to get better it is important that the therapist know whether the measurement tool has which of the following characteristics? responsiveness
All of the following can significantly influence the results of tonal testing except? visual and acuity of hearing of pt
A lesion of the ______________ cranial nerve will result in difficulty speaking and swallowing, and hoarseness? vagus
The ______________ is testing C5 and C6 segmental level and nerve? biceps reflex
When testing cranial nerve IX the therapist is testing _________________. swallow and gag
When testing kinesthesia, all of the following statements is true, except? The patient should respond once the movement is stopped
When positioning a patient for testing deep tendon reflexes the physical therapist should always ___________ place the muscle at mid range position
coronal view / sagittal view side view / straight on
disablement various impacts of chronic and acute conditions on the functioning of specific body systems
impairement usually a consequence of a disease or pathology, some change that affects your anatomy, and keeps you from being able to participate in life at your normal ability -can be permanent, such as the effects of polio or temporary like a broken ankle.
functional limitations usually a result of an impairment, limitations limit your ability to perform tasks and activities efficiently - you can't get up your steps and into your house after breaking your foot.
system level of disablement model physiological and tissue level - identifies the disease
body level of disablement model loss or abnormality at tissue or organ level
task level of disablement model skills that a person must have appropriate ROM, strength, endurance, balance, etc (home vs hospital - the chairs)
context level of disablement model environment in which a skill is performed
social level of disablement model roles people play in their societal lives
reflex is a motor response to a sensory stimulus and is used to assess the integrity of the motor system in the conscious or unconscious patient
Types of Reflexes 1. Superficial (corneal, gag/swallow, Perianal, Babinski Sign) 2. Deep tendon (myotatic) reflexes 3. Visceral (organic) reflexes 4. Pathologic (abnormal) reflexes
muscle spindles provide info about length and rate of change in muscle
alpha motor neurons elicit muscle contraction
gamma motor neurons detect the gain on the muscle spindle
renshaw cells feedback loop to prevent overactivity
golgi tendon organs within muscle tendon - activated by stretching or contracting muscles
polysynaptic reflexes not limited to 1 muscle, usually many
activity performance of a task or action
context situations, in which activity can be assessed
disease a pathological condition or abnormal entitiy
function activities identified by an individual as essential to support physical, social and psychological well-being and to create personal sense of a meaningful life
quality of life what people feel about their health condition or it's consequences
signs objective evidence of physical abnormality
symptoms subjective evidence of physical abnormality
alert patient is awake, attentive
lethargic appears drowsy and may fall asleep if not stimulated
obtunded difficult to arouse, somnolent state
stupor responds only to strong noxious stimuli
coma can't be aroused by any stimulation
cognition awareness and judgment - fund of knowledge, calculation ability & proverb interpretation
rigidity passive movement, observed during functional activities
Cranial nerve 1 lesion cerebral cortex - inability to smell
cranial nerve 2 lesion thalamus - ipsilateral blindness, loss of reflex
CN 3 lesion midbrain - ptosis, ipsilateral, diplopia, loss of reflex, loss of constriction
CN 4 lesion midbrain - double vision
CN 5 lesion pons - blink reflex, jaw deviates to side
CN 6 lesion pons - can't abduct eye, double vision, eye looks inward
CN 7 lesion pons - paralysis of facial expression, one side face droop, bells palsy
CN 9 lesion medulla - gag reflux, salvation decreased
CN 10 lesion medulla - difficulty speaking, asymmetrical palate elevation, hoarseness
CN 8 lesion medulla - deafness
CN 11 lesion medulla - SCM, trap weakness (same side)
CN 12 lesion medulla - atrophy of tongue - deviate to same side
cerebellum funct: voluntary movement, control equillibrium, postural control, muscle tone Disorder: hypotonia, ataxia
basal ganglia fucnt: movement, posture control, gross movements, chose motor response while inhibiting others, automatic movements, postural adjustments, muscle tone Disorder: tremor, akinesia, chorea, athetosis, dystonia
dorsal columns (posterior) Funct: coordinated movements, posture, input from muscles and joint receptors Disorders: lack proprioceptive feedback, disturbances of gait, dysmetria
4 basic motor task requirements 1. mobility 2. stability 3. controlled mobility 4. skill
superficial tests of sensation pain, temp, light touch, pressure
deep sensation tests kinesthesia (movement), proprioception (at rest), vibration, recognition of weight (barognosis), traced figure (graphesthesia), recognition of texture
combined cortical sensation tests tactile object recognition (stereognosis), tactile location, 2 pt discrimination, double stimulation
isotonic constant external force - constant muscle tension **1 rep max, test with free weights
isokenetic pt provides resistance thru range of motion at constant velocity
isometric against an immovable resistance, so muscle length remains the same - MMT, HHD (hand held dynamometry
anterolateral spinothalmic pathway self protective, harmful stimuli, slow-conducting fibers, small in diameter, thermal and pain, touch (tickle, itch and sexual)
when to sensory test? edema, impaired: gait, mobility, motor function, muscle performance, reflexes, posture, respiration and pain
hypertonia muscles feel taut and harder then normal, caused by: clasp knife, clonus, babinksi sign - lesion: UMN or CNS
clasp knife high resistance, followed by sudden inhibition or letting go
clonus spasmodic alteration of muscle contraction
hypotonia (flaccidity) decreased or absence of muscle tone, soft and flabby - lesion: LMN
dystonia hyperkinetic movement disorder, twisting and writhing movements - lesion: CNS(basal ganglia)
decorticate rigidity LE in extension, UE flexed diencephalon
decerebrate rigidity All extremities extended brainstem
opisthotonus contraction of extensor muscles of neck tetanus
cogwheel rigidity rachetlike fell to passive movement
leadpipe rigidity constant rigidity, independent to velocity
Tone Scale 0: none (flaccid) 1+: decreased (hypotonia) 2+: normal 3+: exaggerated (hypertonia) 4+: sustained response (severe hypertonia)
osteokinematics gross angular motions of the shafts of the bone, the WHOLE bone (lever arm) - usually what you are measuring when you take a goni measurement - anatomical position = start ex: shoulder flex -> lever arm is the humerus
sagittal plane flexion and extension
frontal plane abduction and adduction
transverse plane medial and lateral rotation
arthrokinematics actual joint movements in relation to each other - (roll, glide, slide or spin) ex: shoulder flex -> humerus rolls and glides on glenoid fossa
3 components of an exam history, systems review & tests and measures (formal observation - analysis of posture)
posture relative positions of different joints at any given moment OR ideal skeletal alignment involves minimal stress and strain and maximum efficiency of body
factors influencing posture: heredity, environment, disease, habit, muscle length and dysfunction
outcomes assessment screen, assess, monitor, description, prediciton
3 level of ADLs 1. BADL: basic (eat, bathe, groom, dress etc) 2. IADL: instrumental activities (cook, shop, wash) 3. AADL: advanced (work, reaching, walking, lifting #, recreation - dance etc)
Created by: picnic321