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Questions and Answers
What is the primary purpose of active motion in assessing muscle strength?
What should the patient do during passive motion assessment?
How should the healthcare professional support the patient's extremity during passive motion?
What is the purpose of asking the patient to resist the healthcare professional's applied force during muscle strength assessment?
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What does a rating of 3 on the muscle strength scale indicate?
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Why is it important to compare symmetrical muscle groups during muscle strength assessment?
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Active motion is used to assess muscle strength in lower arms or legs.
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During passive motion, the patient should contract the muscle to move the joint.
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The patient should be asked to maintain pressure during muscle strength assessment for an extended period.
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A rating of 2 on the muscle strength scale indicates full range of motion against gravity with some resistance.
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The healthcare professional should apply force against the patient's muscle contraction during muscle strength assessment.
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Muscle strength assessment is not necessary for joints with full range of motion.
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Which motion decreases the angle between the bones in a joint?
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What is the result of extension on a joint?
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Which direction of motion is classified as flexion?
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What is the result of flexion on a joint?
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Which direction of motion is classified as extension?
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What is the primary purpose of assessing LOC and orientation?
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How many pairs of cranial nerves are there?
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What is unique about the vagus nerve?
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What determines the numbering of cranial nerves?
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Which cranial nerve is the smallest?
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Which cranial nerve is responsible for transmitting information related to sense of smell?
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Which chart is commonly used to assess visual acuity?
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What is the function of Cranial Nerve VIII?
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What is the name of the cranial nerve responsible for transmitting information related to sense of taste?
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Which cranial nerves originate from the brainstem?
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What is the purpose of having the patient walk across the room and come back during gait assessment?
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In Romberg's test, what is the purpose of having the patient close their eyes?
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What is the primary observation being made during Romberg's test?
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Why is it important to observe the patient's use of assistive devices during gait assessment?
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What is the duration of Romberg's test?
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What is the primary purpose of observing the patient's use of assistive devices during gait assessment?
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What is the primary observation being made during Romberg's test?
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What is the purpose of having the patient walk across the room and come back during gait assessment?
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What is the duration of Romberg's test?
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What is the purpose of having the patient close their eyes during Romberg's test?
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What is the primary purpose of the Glasgow Coma Scale?
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What is the maximum numerical value that can be given to a patient's level of consciousness using the Glasgow Coma Scale?
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What does a score of 15 on the Glasgow Coma Scale indicate?
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What is the primary benefit of using the Glasgow Coma Scale to assess a patient's level of consciousness?
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What is the primary purpose of assessing a patient's level of consciousness using the Glasgow Coma Scale?
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Study Notes
Assessing Range of Motion (ROM)
- Active motion: Patient moves joint independently, demonstrating normal ROM; identifies muscle strength and detects limited ROM.
- Patient is taught to move each joint through its normal range; sometimes demonstration and mimicry are necessary.
Assessing Muscle Strength
- Passive motion: Joint has full ROM, but patient lacks strength to move it independently; patient relaxes, and joints are moved passively until the end of range is felt.
- Support the extremity at the joint; do not force joint if there is pain or muscle spasm.
Assessing Lower Limbs and Upper Limbs
- Assess strength of lower arms or legs by asking patient to contract the indicated muscle by extending or flexing the joint.
- Then, have patient resist as you apply force against that muscle contraction; maintain pressure until told to stop.
Comparing Muscle Strength
- Compare symmetrical muscle groups; note weakness and compare right to left.
Rating Muscle Strength
- Use a scale of 0 to 5 to rate muscle strength:
- 0: No voluntary movement
- 1: Full ROM, but no resistance
- 2: Full ROM, with some resistance
- 3: Full ROM against gravity, with some resistance
- 4: Full ROM against gravity, with full resistance
- 5: Normal muscle strength
Assessing Range of Motion (ROM)
- Active motion: Patient moves joint independently, demonstrating normal ROM; identifies muscle strength and detects limited ROM.
- Patient is taught to move each joint through its normal range; sometimes demonstration and mimicry are necessary.
Assessing Muscle Strength
- Passive motion: Joint has full ROM, but patient lacks strength to move it independently; patient relaxes, and joints are moved passively until the end of range is felt.
- Support the extremity at the joint; do not force joint if there is pain or muscle spasm.
Assessing Lower Limbs and Upper Limbs
- Assess strength of lower arms or legs by asking patient to contract the indicated muscle by extending or flexing the joint.
- Then, have patient resist as you apply force against that muscle contraction; maintain pressure until told to stop.
Comparing Muscle Strength
- Compare symmetrical muscle groups; note weakness and compare right to left.
Rating Muscle Strength
- Use a scale of 0 to 5 to rate muscle strength:
- 0: No voluntary movement
- 1: Full ROM, but no resistance
- 2: Full ROM, with some resistance
- 3: Full ROM against gravity, with some resistance
- 4: Full ROM against gravity, with full resistance
- 5: Normal muscle strength
Movement of Limbs
Lower Limbs and Upper Limbs
- Flexion: Decreases the angle between the bones, resulting in bending of the joint.
- Extension: Increases the angle and straightens the joint.
Direction of Motion
- Anterior-Going Motions: All motions that move in an anterior direction are classified as flexion.
- Posterior-Going Motions: All motions that move in a posterior direction are classified as extension.
Assessing Level of Consciousness (LOC) and Orientation
- Identify patient's name, location, day of week, and year to assess LOC and orientation
- Note patient's behavior and appearance during assessment
Cranial Nerves
- 12 pairs of cranial nerves located primarily in the head and neck, except for the vagus nerve
- Vagus nerve extends to the heart, respiratory muscles, stomach, and gallbladder
- Each cranial nerve originates from a specific part of the brainstem
- Cranial nerves are numbered based on their location on the brainstem and order of exit from the cranium
- Cranial nerves can be classified as sensory, motor, or mixed (both sensory and motor)
- Vagus nerve is the largest cranial nerve
- Trochlear nerve is the smallest cranial nerve
Assessing Cranial Nerves
- Cranial nerves are responsible for assessing changes in smell, vision, taste, hearing, and sensation.
Cranial Nerves and Their Functions
- CN II (Optic Nerve): responsible for vision
- CN VIII (Vestibulocochlear Nerve): responsible for hearing and balance
- CN 1 (Olfactory Nerve): responsible for smell
- CN VII (Facial Nerve): responsible for taste (sweet and salty)
Assessing Changes in Smell (Cranial Nerve 1)
- Use olfactory tests to assess changes in smell
- Examples of olfactory tests include presenting patients with different substances to identify
Assessing Changes in Vision (Cranial Nerve II)
- Use the Snellen Chart to assess visual acuity
- The Snellen Chart is a standardized tool used to measure visual acuity
Assessing Changes in Taste (Cranial Nerve VII)
- Use taste tests to assess changes in taste
- Examples of taste tests include presenting patients with sweet, sour, bitter, and salty substances to identify
Assessing Changes in Hearing and Balance (Cranial Nerve VIII)
- Use vestibulocochlear tests to assess changes in hearing and balance
- The vestibulocochlear nerve is responsible for both hearing and balance functions
Gait Assessment
- Evaluate patient's gait by having them walk across the room, turn, and come back
- Observe the use of assistive devices during the gait assessment
Romberg's Test
- Have patient stand with feet together and arms at sides
- Patient should keep both eyes open for 20-30 seconds, then close their eyes for the same duration
- Observe the patient for swaying during the test
Gait Assessment
- Evaluate patient's gait by having them walk across the room, turn, and come back
- Observe the use of assistive devices during the gait assessment
Romberg's Test
- Have patient stand with feet together and arms at sides
- Patient should keep both eyes open for 20-30 seconds, then close their eyes for the same duration
- Observe the patient for swaying during the test
Range of Motion (ROM)
- Active motion: Patient moves joint independently through its normal range to identify muscle strength and detect limited ROM.
- Passive motion: Joint has full ROM, but patient lacks strength to move it independently, and is moved passively until end of range is felt.
Muscle Strength Assessment
- Assess strength of lower arms or legs by asking patient to contract muscle, then resist as you apply force against that muscle contraction.
- Compare symmetrical muscle groups and note weakness and compare right to left.
- Rate Muscle Strength on a Scale: 0 (no voluntary movement), 1 (full ROM, but not against gravity), 2 (full ROM against gravity, but not against full resistance), 3 (full ROM against gravity, with some resistance), 4 (full ROM against gravity, with full resistance), 5 (normal strength).
Flexion and Extension
- Flexion: decreases the angle between the bones (bending of the joint).
- Extension: increases the angle and straightens the joint.
- All Anterior-Going Motions are flexion, and All Posterior-Going Motions are extension.
Level of Consciousness (LOC) and Orientation
- Assess LOC and orientation by asking patient to identify name, location, day of week, and year; note behavior and appearance.
Cranial Nerves
- 12 pairs of cranial nerves, primarily in the head and neck, except for the vagus nerve.
- Each cranial nerve arises from a specific part of the brainstem and is numbered by its location on the brainstem and the order of exit from the cranium.
- Some are sensory, some motor, and some are both (mixed).
Assessing for Changes in Sensation
- Cranial Nerve 1 (Olfactory): Assess smell using a specific substance.
- Cranial Nerve 2 (Optic): Assess vision using a Snellen Chart.
- Cranial Nerve 7 (Facial): Assess sense of taste using sweet, sour, bitter, and salty substances.
- Cranial Nerve 8 (Vestibulocochlear/Acoustic): Assess sense of hearing and balance.
Gait and Romberg's Test
- Assess gait by having patient walk across the room, turn, and come back, noting use of assistive devices.
- Romberg's test: Have patient stand with feet together, arms at sides, eyes open and closed, and observe for swaying.
Glasgow Coma Scale
- Used to assess the functional state of the brain in those with altered LOC.
- Assesses LOC by giving a numerical value (15 max = fully alert).
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Description
This quiz assesses understanding of active and passive motion techniques in physical therapy, including joint movement and muscle strength evaluation. It covers the differences between active and passive motion, and how to apply these techniques in rehabilitation.
