PT Fundamentals Week 4 - Systems Review 2

Questions and Answers

Which components are part of the Lower Quarter (LQ) assessment in the neuromuscular system screen?

Pelvis (correct)

Wrist and hand

Shoulder

Cervicothoracic spine

What is the primary purpose of conducting a neuromuscular systems review?

To assess the function of central and peripheral nervous systems (correct)

To determine the patient's age and gender

To collect patient history regarding injuries

To diagnose chronic illnesses exclusively

Which of the following is NOT typically observed in a general coordinated movement and balance assessment?

Gait

Toe walk

Heel walk

Blood pressure monitoring (correct)

Which test specifically assesses muscle performance in the neuromuscular system review?

5 Times Sit to Stand Test Signup and view all the answers

During a neuromuscular system review, what does the assessment of 'fluidity of motion' refer to?

The consistency and adaptability of movements Signup and view all the answers

Which of the following aspects is NOT typically evaluated in gait analysis as part of the neuromuscular review?

Cognitive function Signup and view all the answers

Which grading indicates an absent reflex response?

0 Signup and view all the answers

What is the primary purpose of sensation screening in a neuromuscular system examination?

To assess sensory perception and sensitivity Signup and view all the answers

What is the normal response for the Achilles reflex?

Ankle plantarflexion Signup and view all the answers

Which nerve root corresponds with the key sensory point of the medial femoral condyle?

L3 Signup and view all the answers

What does a grade of 5+ in reflex grading indicate?

Sustained clonus Signup and view all the answers

During a sensation screening, if a patient reports that they do not feel a light swipe on their skin, how would this finding be graded?

Absent Signup and view all the answers

Which maneuver is used to reinforce reflex testing?

Jendrassik Maneuver Signup and view all the answers

The dorsal surface of the proximal phalanx of the 3rd digit is associated with which nerve root?

C7 Signup and view all the answers

What does a 'strong and painful' muscle testing result indicate?

Local, minor lesion in contractile tissue Signup and view all the answers

Which of the following is NOT a factor that may negatively affect gross strength screening?

High energy levels Signup and view all the answers

What are the primary components examined in the musculoskeletal system review?

Gross ROM, strength, and asymmetries Signup and view all the answers

What does cyanotic hands indicate in the integumentary system assessment?

Low oxygen levels in the blood Signup and view all the answers

Which is an important aspect of assessing skin integrity in post-operative patients?

Check incision sites for skin tears Signup and view all the answers

During a gross strength assessment of the cervical spine, which motion is NOT included?

Abduction Signup and view all the answers

What does a positive Clonus Reflex test indicate?

<blockquote> 3 beats </blockquote> Signup and view all the answers

Which grading indicates a normal finding in the Babinski reflex test?

Flexion of the Big Toe Signup and view all the answers

During a musculoskeletal system screen, what is primarily assessed?

Joint function and muscle performance Signup and view all the answers

What symptom is expected when a joint is assessed as hypermobile?

Excessive range of motion Signup and view all the answers

Which statement about active range of motion (AROM) is correct?

It reflects voluntary muscle contraction. Signup and view all the answers

Which of the following findings indicates an upper motor neuron lesion?

Present pathological reflexes Signup and view all the answers

What should be observed when assessing symmetry in a patient?

Side-to-side movement quality Signup and view all the answers

What is indicated by the presence of decreased reflexes?

Peripheral nervous system LMN lesion Signup and view all the answers

What is a clinical pearl when assessing painful motions?

Consider suspected painful motions last Signup and view all the answers

What does an observation of a patient’s posture screening involve?

Viewing from multiple angles Signup and view all the answers

Study Notes

Learning Objectives

Identify primary components of the neuromuscular and musculoskeletal systems during a systems review.
Explain normal vs. abnormal findings during the systems review.
Demonstrate neuromuscular and musculoskeletal systems review in mock examinations.

Neuromuscular System Screen

Purpose: Assess central and peripheral nervous system function; guide in-depth testing.
Components include upper and lower quarters (UQ/LQ) encompassing specific regions such as the cervicothoracic spine, shoulder, pelvis, hip, knee, and foot.

General Movement and Balance Assessment

Observation includes gait, balance in sitting and standing, and various movements (heel walk, toe walk, squat).
Evaluates general motor function, coordination, fluidity of motion, and balance.

Clinical Decision-Making

Tests include Functional Gait Assessment, Berg Balance Scale, and Timed Up and Go Test.
Sensation screening involves patient feedback on sensitivity and detection capability.

Dermatomes for Sensation Screening

Upper Quarter Sensory Points:
- C4 - Superior lateral shoulder
- C5 - Lateral antecubital fossa
- C6 - Dorsal surface of thumb
- C7 - Dorsal surface of 3rd digit
- C8 - Dorsal surface of 5th digit
Lower Quarter Sensory Points:
- L2 - Anteromedial mid-thigh
- L3 - Medial femoral condyle
- L4 - Medial malleolus
- L5 - Dorsal 3rd MTP joint
- S1 - Lateral calcaneus

Reflex Testing

Deep Tendon Reflexes (DTRs) assessed, revealing both lower and upper motor neuron conditions.
Normal response varies for DTRs, with grading from 0 (absent) to 5+ (sustained clonus).

Pathological Reflexes

Clonus and Babinski reflexes noted as signs of upper motor neuron lesions.
Babinski: Positive indicates toe extension; negative shows flexion or no response.

Musculoskeletal System Screen

Purpose: Assess joint function, muscle performance, and connective tissue integrity.
Observation includes height, weight, posture, and symmetry assessment.

Gross Range of Motion (AROM)

Screening evaluates voluntary movements across various body regions.
Identifies gross AROM in upper and lower extremities as well as spinal motion.

Strength Assessment

Gross strength screening indicates general muscle function; weakness prompts further evaluation.
Contractile testing involves isometric contractions and assessing individual nerve root strengths (e.g., C5 for shoulder abduction).

Differential Diagnosis

Distinguish between mobility impairments (joint looseness) and strength impairments (muscle functionality).
Recognize patterns indicative of specific neurological lesions.

Integumentary System Assessment

Focuses on skin condition, integrity, and any signs of abnormalities.
Assessment includes skin coloration, moisture levels, lesions, and texture.

Communication, Cognition, and Orientation

Four components of orientation: person, place, time, situation.
Effective communication starts with clear introductions and evolves through patient interactions and assessments of alertness, demeanor, and cognitive processes.

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Description

This quiz focuses on the neuromuscular system, targeting its primary components and the significance of conducting thorough assessments during a systems review. It includes the identification of normal and abnormal findings that may arise in the neuromuscular system. Participants will also have the opportunity to demonstrate their understanding through a mock physical therapy examination.