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final

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
cervical flexion ROM   45  
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cervical extension ROM   45  
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cervical lateral flexion ROM   45  
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cervical rotation ROM   70  
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shoulder flexion ROM   180  
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shoulder extension ROM   60  
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shoulder internal rotion ROM   70  
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elbow flexion ROM   150  
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elbow extension ROM   0  
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supination ROM   80  
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pronation ROM   80  
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wrist flexion ROM   80  
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wrist extension ROM   70  
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radial deviation ROM   20  
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ulnar deviation ROM   30  
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thumb flexion ROM   50  
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thumb extension ROM   0  
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finger flexion ROM   90  
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finger extension ROM   45  
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IP thumb flexion ROM   80  
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PIP finger flexion ROM   100  
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DIP finger flexion ROM   90  
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IP thumb extension ROM   20  
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PIP finger extension ROM   0  
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DIP finger extension ROM   0  
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lumbar flexion ROM   90  
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lumbar lateral flexion ROM   35  
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lumbar extension ROM   30  
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hip flexion ROM   120  
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hip extension ROM   30  
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hip abduction ROM   45  
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hip adduction ROM   30  
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hip external rotation (knee flexed) ROM   45  
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hip internal rotation (knee flexed) ROM   45  
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knee extension ROM   10  
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knee flexion ROM   135  
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plantar flexion ROM (point toes)   50  
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dorsiflexion ROM   20  
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inversion ROM   35  
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eversion ROM   15  
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big toe (MTP) flexion ROM   30  
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big toe (MTP) extension ROM   70  
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When testing coordination the therapist is observing all of the following for quality of the movement by the patient, except?   Understanding of movement  
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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  
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pathologic reflex?   babinski's reflex  
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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  
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Which area of the body would be most sensitive in distinguishing two points close together?   finger tips  
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In order to test cranial nerve XII the therapist would ask the patient to _______________   stick out their tongue  
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Which of the following types of reliability is important for determining the consistency of the measurement tool?   test-retest reliability  
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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  
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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  
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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  
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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  
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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  
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When the physical therapist is testing the abdominal reflex which type of reflex is being tested?   superficial  
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Achilles reflex, the integrity of which of the following nerve roots is being tested?   S1  
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A measurement of reflexes using a scale of present or absent, would be what level of measurement?   nominal  
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Which of the following is impacted by amplitude and velocity of stretch?   spasticity  
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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  
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Proprioceptors are responsible for deep sensation and receive stimuli from all of the following except?   viscera  
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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  
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Which of the following would be the most disruptive to collecting sensory information from an older patient?   short term memory deficits  
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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  
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When testing sensation, which of the following should the physical therapist test first?   superficial  
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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  
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Which of the following scales can any mathematical procedures and statistics be used and is the highest level of measurement?   ratio scale  
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Which of the following cranial nerves is considered to be mixed, having both sensory and motor functions?   facial  
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Which of the following cranial nerves can cause syncope (drop attack)?   vagus  
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The “0-10” scale to evaluate pain is an example of which type of scale?   ordinal scale  
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Which of the following would be the best way to test dysmetria?   pointing and past pointing  
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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  
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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  
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Which of the following best defines the term rigidity?   Resistance to passive movement involving both agonist and antagonist muscles  
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Which of the following most closely defines the meaning of deep sensation of proprioception?   Joint position sense and awareness of joints at rest  
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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  
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Which of the following responds to change in posture, position, proprioception, muscle tone, speed, and direction of movement?   deep sensory receptors  
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All of the following represent nonequilibrium coordination tests EXCEPT?   single limb stance  
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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  
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Which of the following statements is true when testing a patient’s reflexes?   pt can be conscious or unconscious  
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All of the following should be screened prior to testing coordination, EXCEPT?   equilibrium  
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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)  
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Which of the following statements is true in regards to reliability and validity of a measure?   A valid test is always reliable  
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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  
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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  
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All of the following can significantly influence the results of tonal testing except?   visual and acuity of hearing of pt  
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A lesion of the ______________ cranial nerve will result in difficulty speaking and swallowing, and hoarseness?   vagus  
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The ______________ is testing C5 and C6 segmental level and nerve?   biceps reflex  
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When testing cranial nerve IX the therapist is testing _________________.   swallow and gag  
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When testing kinesthesia, all of the following statements is true, except?   The patient should respond once the movement is stopped  
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When positioning a patient for testing deep tendon reflexes the physical therapist should always ___________   place the muscle at mid range position  
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coronal view / sagittal view   side view / straight on  
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disablement   various impacts of chronic and acute conditions on the functioning of specific body systems  
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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.  
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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.  
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system level of disablement model   physiological and tissue level - identifies the disease  
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body level of disablement model   loss or abnormality at tissue or organ level  
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task level of disablement model   skills that a person must have appropriate ROM, strength, endurance, balance, etc (home vs hospital - the chairs)  
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context level of disablement model   environment in which a skill is performed  
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social level of disablement model   roles people play in their societal lives  
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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  
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Types of Reflexes   1. Superficial (corneal, gag/swallow, Perianal, Babinski Sign) 2. Deep tendon (myotatic) reflexes 3. Visceral (organic) reflexes 4. Pathologic (abnormal) reflexes  
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muscle spindles   provide info about length and rate of change in muscle  
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alpha motor neurons   elicit muscle contraction  
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gamma motor neurons   detect the gain on the muscle spindle  
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renshaw cells   feedback loop to prevent overactivity  
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golgi tendon organs   within muscle tendon - activated by stretching or contracting muscles  
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polysynaptic reflexes   not limited to 1 muscle, usually many  
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activity   performance of a task or action  
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context   situations, in which activity can be assessed  
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disease   a pathological condition or abnormal entitiy  
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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  
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quality of life   what people feel about their health condition or it's consequences  
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signs   objective evidence of physical abnormality  
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symptoms   subjective evidence of physical abnormality  
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alert   patient is awake, attentive  
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lethargic   appears drowsy and may fall asleep if not stimulated  
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obtunded   difficult to arouse, somnolent state  
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stupor   responds only to strong noxious stimuli  
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coma   can't be aroused by any stimulation  
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cognition   awareness and judgment - fund of knowledge, calculation ability & proverb interpretation  
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rigidity   passive movement, observed during functional activities  
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Cranial nerve 1 lesion   cerebral cortex - inability to smell  
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cranial nerve 2 lesion   thalamus - ipsilateral blindness, loss of reflex  
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CN 3 lesion   midbrain - ptosis, ipsilateral, diplopia, loss of reflex, loss of constriction  
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CN 4 lesion   midbrain - double vision  
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CN 5 lesion   pons - blink reflex, jaw deviates to side  
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CN 6 lesion   pons - can't abduct eye, double vision, eye looks inward  
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CN 7 lesion   pons - paralysis of facial expression, one side face droop, bells palsy  
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CN 9 lesion   medulla - gag reflux, salvation decreased  
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CN 10 lesion   medulla - difficulty speaking, asymmetrical palate elevation, hoarseness  
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CN 8 lesion   medulla - deafness  
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CN 11 lesion   medulla - SCM, trap weakness (same side)  
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CN 12 lesion   medulla - atrophy of tongue - deviate to same side  
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cerebellum   funct: voluntary movement, control equillibrium, postural control, muscle tone Disorder: hypotonia, ataxia  
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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  
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dorsal columns (posterior)   Funct: coordinated movements, posture, input from muscles and joint receptors Disorders: lack proprioceptive feedback, disturbances of gait, dysmetria  
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4 basic motor task requirements   1. mobility 2. stability 3. controlled mobility 4. skill  
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superficial tests of sensation   pain, temp, light touch, pressure  
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deep sensation tests   kinesthesia (movement), proprioception (at rest), vibration, recognition of weight (barognosis), traced figure (graphesthesia), recognition of texture  
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combined cortical sensation tests   tactile object recognition (stereognosis), tactile location, 2 pt discrimination, double stimulation  
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isotonic   constant external force - constant muscle tension **1 rep max, test with free weights  
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isokenetic   pt provides resistance thru range of motion at constant velocity  
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isometric   against an immovable resistance, so muscle length remains the same - MMT, HHD (hand held dynamometry  
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anterolateral spinothalmic pathway   self protective, harmful stimuli, slow-conducting fibers, small in diameter, thermal and pain, touch (tickle, itch and sexual)  
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when to sensory test?   edema, impaired: gait, mobility, motor function, muscle performance, reflexes, posture, respiration and pain  
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hypertonia   muscles feel taut and harder then normal, caused by: clasp knife, clonus, babinksi sign - lesion: UMN or CNS  
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clasp knife   high resistance, followed by sudden inhibition or letting go  
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clonus   spasmodic alteration of muscle contraction  
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hypotonia   (flaccidity) decreased or absence of muscle tone, soft and flabby - lesion: LMN  
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dystonia   hyperkinetic movement disorder, twisting and writhing movements - lesion: CNS(basal ganglia)  
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decorticate rigidity   LE in extension, UE flexed diencephalon  
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decerebrate rigidity   All extremities extended brainstem  
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opisthotonus   contraction of extensor muscles of neck tetanus  
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cogwheel rigidity   rachetlike fell to passive movement  
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leadpipe rigidity   constant rigidity, independent to velocity  
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Tone Scale   0: none (flaccid) 1+: decreased (hypotonia) 2+: normal 3+: exaggerated (hypertonia) 4+: sustained response (severe hypertonia)  
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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  
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sagittal plane   flexion and extension  
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frontal plane   abduction and adduction  
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transverse plane   medial and lateral rotation  
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arthrokinematics   actual joint movements in relation to each other - (roll, glide, slide or spin) ex: shoulder flex -> humerus rolls and glides on glenoid fossa  
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3 components of an exam   history, systems review & tests and measures (formal observation - analysis of posture)  
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posture   relative positions of different joints at any given moment OR ideal skeletal alignment involves minimal stress and strain and maximum efficiency of body  
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factors influencing posture:   heredity, environment, disease, habit, muscle length and dysfunction  
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outcomes assessment   screen, assess, monitor, description, prediciton  
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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)  
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