musculo and nervous
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What is osteoporosis?
porous bones, loss of bone density
What are risk factors for osteoporosis?
- small frame
- short stature
- family history
- diet deficient in CA++ and vitamin D
- prolonged corticosteriod usage
- sedentary lifestyle
- chemo or breast cancer
What is the difference between osteoarthritis and rheumatoid arthritis?
- Osteoarthritis - degeneration of movable joints causing deterioration of articular tissue and new bone formation, asymmetrical, crepitus, joint enlargement
- Rheumatoid - chronic inflammatory disease, symmetrical, constitutional symptoms, swelling
What is distal kyphosis?
hunchback. often occurs with osteoporosis
What is lordosis?
Swayback - accentuation of concavity in lower back
What is scoliosis and how is it assessed?
lateral deviation of the spine, assessed with forward flexion
What is the scale for measuring muscle strength?
- 0 - no contraction
- 1 - contraction but no movement
- 2 - passive ROM without gravity
- 3 - AROM
- 4 - AROM with light to moderate resistance
- 5 - AROM with full resistance
How do you assess cranial nerve X (spinal accessory)
put hands on shoulders and have patient shrug (checks trapezius muscle)
What are the types of range of motion of joints?
- active assistive
What is ankylosis?
abnormal joint mobility and consolidation
What are the types of joints?
- ball and socket - shoulder, hip
- hinge - elbow, ankle, knee
- saddle - thumb
- gliding - foot
- pivot - neck
- slightly movable - vertebral
What are sports medicine recommendations to prevent injury?
warm up, exercise at least 150min/week in 20 min intervals, cool down
What are the 5 assessment components of a neuro. assessment?
mental status, sensory system, motor system, reflexes, 12 pairs of cranial nerves
What is the order of neuro. loss?
- sensory, motor, autonomic - bowel, bladder, sexual.
- Recovery if effective occurs in reverse order
What are 6 parameters evaluated in formal mental status evaluation?
- spatial perception
what behaviors should be noted to evaluate emotional status?
- inability to sense emotions in others
- loss of sympathetic reactions
- unusual docility
- rage reactions
- excessive irritability
What are tests of cognitive abilities?
- State of conciousness
- attention span
- abstract reasoning
- arithmetic calculations
- thought processes and content
What are the levels of consciousness?
- alert and oriented to time place and person
- awake (may sleep more or be somewhat confused when first awakened)
- Lethargic (drowsy but able to follow simple commands)
- Stuporous (very hard to arouse, inconsistantly may follow simple commands or speak short words/phrases)
- Semicomatose (movements purposeful when stimulated, does not follow commands or speak clearly)
- Comatose (reflexive posturing or no response)
What is tested in a quick orientation and short term memory assessment?
- orientation to person
- orientation to place
- orientation to time
- short term memory of facts
- short term recall
What are signs of possible cognititive impairment?
- significant memory loss
- difference in personality
- hazardous behavior
- getting lost in familiar places
- impaired communication
- nocturnal confusion
- personal self care difficulties
- rambling speech
- catastrophic reactions (rage)
How do you apply stimulus to test sensory system?
side to side, distal to proximal with patient's eyes closed
What cranial nerve innervates sensory reception on the face?
Cranial nerve V
How do you test primary sensory functions?
- Light touch with a wisp of cotton
- sharp and dull sensation
- vibratory sensation
How do you test cortical sensory functions?
- stereogenesis (ability to recognize familiar objects by feel)
- graphesthisia (ability to id shapes, # or letters traced onto palm)
- two point discrimination
What is a tandem walk
- tests motor system (cerebellar) function
- heel to toe walk
What is a romberg test?
- patient stands, feet together with arms at sides, with eyes open and then closed for 20-30 seconds
- + with staggering or loss of balance
What are locations for deep tendon reflexes?
tricep, bicep, brachioradialis, pateller, achilles
What spinal nerves are tested in the biceps reflex?
What spinal nerves are tested in the triceps reflex?
What spinal nerves are tested in the brachioradialis reflex?
What spinal nerves are tested in the patellar reflex?
What spinal nerves are tested in the achilles reflex?
How do you score deep tendon reflexes?
- 0 - no response
- 1+ - sluggish, diminished response
- 2+ - active or expected
- 3+ - slightly hyperactive
- 4+ brisk, hyperactive
What kind of reflex is the plantar reflex and what spinal nerve does it test?
superficial, tests L 4,5, S1,2
What is the babinski sign?
- A response to the plantar reflex
- Expected in adult - all toes curl down
- Positive in adult - big toe dorsiflexes and other toes fan
- Expected in children under 2 - big toe dorsiflexes and all other toes fan
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