Prac Viva

  1. What is neurological examinations testing?
    • - conduction
    • - power
    • - reflex
    • - sensations
  2. What are your dermatomes?
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  3. Posterior dermatomes
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  4. Myotomes
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    • C3,4 and 5 supply the diaphragm (the large muscle between the chest and the belly that we use to breath).
    • C5 also supplies the shoulder muscles and the muscle that we use to bend our elbow .
    • C6 is for bending the wrist back.
    • C7 is for straightening the elbow.
    • C8 bends the fingers.
    • T1 spreads the fingers.
    • T1 –T12 supplies the chest wall & abdominal muscles.
    • L2 bends the hip.
    • L3 straightens the knee.
    • L4 pulls the foot up.
    • L5 wiggles the toes.
    • S1 pulls the foot down.
    • S3,4 and 5 supply the bladder. bowel and sex organs and the anal and other pelvic muscles.
  5. What is the order of neurological examinations?
    • - screening test
    • - sensation- light touch, pin prick
    • - power- isometric strength test (mm @ mid range & try break the contraction), considr pain and wasting
    • - reflexes- test reflex arc
    • - babunski
    • - clonus
  6. What are the levels of reflex grading?
    • - 1,2,3
    • - absent, fading, normal, exaggerated, clonus (spasticity)
    • - ensure you compare to the other side
  7. What are neurodynamic test?
    • Mobility of nerve tissue
    • is placing a nerve on tension and seein if it reproduces thepts pain
    • - SLR- eg torn hammie- fibrosis, mm spasm- piriformis
    • - PKB
    • - PNF
    • +ve test diff pian, compare ROM to other side and see where P comes on
    • - buldge disc, narrowing of spinal cannal
  8. Where do disc buldges usually occur?
    L4, L5, S1
  9. How do you do a sensations test?
    • using a cotton ball- moving around in circles up and down the limb
    • Also foot and hand run down the fingers/ toes
    • Usually 2 or 3 levels are affected
    • If loss sensation pin prick only that area and map out area of loss sensation
  10. How do you test the power of the lumbar spine?
    • Pain can affect myotome strength
    • Pt does the movement and then you try to move it
    • L2- hip flexors- hold @ 90 degrees against ur resistance
    • L3- quads- pt knee on towel- hold straight leg
    • L4- DF/ IN- do separate and both feet together- compare side
    • L5- EHL- big toe
    • S1- evertors, PF in standing- walk on toes for quick screen- otherwise in supine
    • S2- toe flex- bend toes over fingers
  11. What are the clearing tests?
    relfexes tests?
  12. What are the relfexes of the lower limb and what nerve root do they test?
    • - knee jerk- L4
    • - ankle jerk- S1
  13. Perform a knee jerk
    • - over patella tendon
    • - in gap
    • - if pt resisting preoccupy them
  14. perform an ankle jerk
    • - achilles tendon
    • - small DF
  15. With testing of sensation etc if pt presents with numbness is foot do entire limb
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