Questions and Answers
Which term describes a decreased response in deep tendon reflexes?
What is the maximum grip strength for a female rated as 'G'?
Which prehension pattern involves no thumb involvement?
What is the pinch strength range for males rated as 'F'?
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Which term indicates a significantly exaggerated deep tendon reflex?
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Which type of agnosia involves difficulty recognizing familiar faces?
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What is the primary function of muscle spindles within deep sensory receptors?
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Which description corresponds to a Grade 2 on the Modified Ashworth Scale?
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How is spasticity classified when the stretch reflex occurs in the muscle end-range?
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What condition describes the inability to dress oneself due to apraxia?
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Which mechanoreceptor is primarily responsible for detecting deep touch and vibration?
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What measurement indicates the presence of edema in the muscle?
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Which grade on the Modified Ashworth Scale indicates a catch followed by minimal resistance through less than half of the ROM?
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Which type of apraxia involves the loss of knowledge about the function of tools?
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What does a description of 'considerable increase in muscle tone' correspond to on the Modified Ashworth Scale?
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R/L Discrimination is a perceptual function involving which of the following?
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In which scenario does the stretch reflex occur when the muscle is in a shortened range?
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What is the normal range of flexion for the cervical spine?
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What is the normal range for wrist ulnar deviation?
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What is the normal range of internal rotation for the shoulder?
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What is the normal maximum extension for the elbow?
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What is the normal range of hip flexion?
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What is the normal range of abduction for the fingers?
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What is the normal maximum range for ankle dorsiflexion?
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What is the normal range of DIP flexion for the thumb?
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What does a soft end-feel indicate?
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Which end-feel occurs when a joint typically has a soft end-feel but feels firm?
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What is a characteristic of a hard end-feel?
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What condition can lead to an empty end-feel?
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Which end-feel would likely be described as feeling boggy?
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Which type of aphasia is characterized by good comprehension and poor naming?
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At which Brunnstrom stage does spasticity decline and selective control of muscles outside the synergy occur?
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What Glasgow Coma Scale score reflects a patient who opens their eyes in response to speech?
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Which aphasia type exhibits fluent speech but poor comprehension?
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What is characterized by complete lack of movement in response to pain in the Glasgow Coma Scale?
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Which stage of motor recovery is described by isolated movements being performed smoothly and in a coordinated manner?
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What type of response does a score of 3 in the verbal section of the Glasgow Coma Scale indicate?
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Which type of aphasia has good repetition ability but poor performance in naming?
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What is an example of a type of in-hand manipulation?
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What grade corresponds to the inability to assume or maintain a position?
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Which type of coordination involves using both arms simultaneously?
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What sensation is classified as protopathic/protective?
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Which level allows a person to maintain balance independently for 45 minutes?
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Which grading indicates an individual can assume and maintain a position but has difficulty?
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What is the classification for a burn that affects only the superficial epidermis?
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Which functional level corresponds to a vital capacity of 50-60%?
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Which ASIA impairment grade indicates incomplete sensation with no motor functions below the neurological level?
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What type of mobility aid is typically used at the T9-T12 level?
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What is the expected healing time for a 2nd degree burn that is extremely painful?
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Which grade shows no motor and sensory functions in the sacral segments?
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What duration of loss of consciousness is classified as severe according to the Glasgow Coma Scale?
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Which Rancho Los Amigos Scale level indicates a purposeful response with assistance required only upon request?
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Which myotome is associated with the elbow flexors in the dermatomal distribution?
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What is the classification for post traumatic amnesia if it lasts less than 1 hour?
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Which dermatome corresponds to the apex of the axilla?
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Which of the following descriptions best matches a moderate severity classification in the Glasgow Coma Scale?
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What defines morning stiffness in rheumatoid arthritis?
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Which characteristic describes symmetric arthritis in rheumatoid arthritis?
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What is a systemic feature commonly associated with rheumatoid arthritis?
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What does the presence of rheumatoid nodules indicate in rheumatoid arthritis?
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Which aspect distinguishes rheumatoid arthritis from osteoarthritis regarding joint involvement?
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What common marker is used to diagnose rheumatoid arthritis?
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At what age range is the peak incidence of rheumatoid arthritis most significant?
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Which of the following best describes the disease process of rheumatoid arthritis?
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Study Notes
Range of Motion
- Cervical spine flexion, extension, lateral flexion ranges from 0-45°; rotation is 0-60°.
- Thoracic and lumbar spine flexion range is 0-80°, extension is 0-30°, and lateral flexion is 0-40°; rotation is 0-45°.
- Normal shoulder flexion is 0-170°, extension 0-60°, while abduction is also 0-170°; internal rotation reaches 0-70°.
- Elbow flexion ranges from 0-135/150°; supination and pronation both range from 0-80/90°.
- Wrist flexion is 0-80°; ulnar deviation is 0-30° while radial deviation is 0-20°.
- Thumb movements include DIP flexion at 0-80/90° and MP flexion at 0-50°; opposition does not have a defined value.
- Finger MP flexion can reach 0-90°; DIP flexion is 0-80°; abduction is 0-25°.
- Hip flexion range extends to 0-120°; internal and external rotation are both 0-45°.
- Knee flexion can reach up to 0-135°.
- Ankle plantar flexion is 0-50°; inversion reaches 0-35° while eversion can extend to 0-20°.
Abnormal/Pathologic End-feels
- Soft end-feel occurs too early in ROM; can indicate conditions like soft tissue edema or synovitis.
- Firm end-feel also occurs in an unusual time frame or joint pattern, indicating potential neurological issues.
Spasticity & Muscle Tone
- Spasticity grades range from mild, where reflex occurs at muscle end-range, to severe, where reflex occurs at shortened muscle range.
- The Modified Ashworth Scale grades muscle tone from no increase to rigidity in flexion or extension.
Muscle Bulk and Edema
- Atrophy assessment involves measuring muscle circumference; significant edema is quantified via volumeter with >25ml change in displacement.
Deep Tendon Reflexes
- Reflexes graded as areflexive, normoreflexive, hyporeflexive, hyperreflexive, and clonus.
Hand Function
Grip and Pinch Strength
- Grip strength for males is max 30 kg; for females, it is 20 kg. Grading follows set ranges down to 0.
- Pinch strength for males ranges from 4-6 kg; for females, it starts at 2.4 kg upwards.
Prehension Patterns
- Gross prehension includes spherical, cylindrical, and hook patterns.
- Fine prehension involves tip-to-tip, pad-to-pad, and palmar prehension/three-jaw chuck patterns.
Dexterity
- Eye-hand coordination stabilizes proximal arms while distal arms move.
- Arm-hand coordination involves moving proximal arms while distal arms stabilize.
- Bilateral coordination uses both arms simultaneously.
Sensation
Protective and Discriminative Sensations
- Protopathic sensations include pain and temperature.
- Epicritic sensations encompass sharp/dull perception and two-point discrimination.
Visual-Perceptual Deficits
- Deficits include kinesthesia, proprioception, body scheme, and right/left discrimination.
- Apraxia can manifest in various forms, affecting actions, functions, and movements related to tool use.
Stroke & Aphasia
- Classification of aphasia covers naming, comprehension, fluency, and repetition functionality, with global aphasia being the most severe.
Motor Recovery Stages
- Brunnstrom stages detail recovery from flaccidity to well-coordinated movements as spasticity decreases.
Glasgow Coma Scale
- Scales for eye, verbal, and motor responses categorize levels of consciousness from spontaneous eye opening to absent response.
Spinal Cord Injury & Dermatome/Myo distribution
- Dermatomes map sensory areas, while myotomes correlate to specific muscle functions.
ASIA Impairment Scale
- Grades A to E define functional level from complete loss of sensation/motor control to normal function.
Burns Classification
- Burns are classified by degree from first (superficial with slight redness) to second degree (bright red, blistering, extremely painful) with varying healing times.
Osteoarthritis vs. Rheumatoid Arthritis
- OA is a non-inflammatory degenerative condition affecting predominantly older adults; RA is an inflammatory autoimmune disorder with systemic features, significant swelling, and joint involvement.
- Morning stiffness lasts less than 30 minutes in OA and exceeds one hour in RA.
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Description
Test your knowledge on the normal ranges of motion for various joints in the upper extremities and spine. The quiz covers crucial movements including flexion, extension, lateral flexion, and rotation for the cervical, thoracic, and lumbar spine as well as the shoulder. Assess your understanding of joint mobility and its clinical implications.