extra lab info

Question 1

what is a Mongolian spot?

Answer 1

Mongolian spot (congenital dermal melanocytosis) is a benign, flat, congenital birthmark, with wavy borders and an irregular shape.

Question 2

how to assess ROM for neck?

Answer 2

ask pt to touch chin to chest, turn head right and left, try to touch ear to shoulder, and extend head backward.

• note any pain
• motions should be smooth and controlled

Question 3

how to test strength of cranial nerve XI (spinal)?

Answer 3

-resist pts movement with ur hands as the pt shrugs shoulders and turns head to each side

Question 4

How to test ROM of jaw?

Answer 4

ask pt to:

• open mouth maximally
• partially open mouth, thrust lower jaw, and move it side to side
• stick out lower jaw

Question 5

How to test ROM of shoulders?

Answer 5

• with arms at side and elbows extended, move both arms forward and up, when move all the way back
• rotate arms internally behind back, place hands as high as possible toward scapula
• make pt do streamline position, raising both arms from resting position
• touch both hands behind the head with elbows flexed and rotated posteriorly

Question 6

what is Phalen’s test?

Answer 6

• ask the pt to hold both hands back to back while flexing the wrists at 90 degrees.
• Acute flexion of the wrist for 60 seconds should normally produce no symptoms in normal hand
• Phalen’s test will produce numbness and burning in a person with carpal tunnel syndrome

Question 7

what in Tinel’s sign

Answer 7

direct percussion of the location of the median nerve at the wrist
-this will produce burning and tingling in carpal tunnel syndrome as well.

Question 8

ROM for hips?

Answer 8

• laying supine, bring one leg up with knee extended, repeat with other leg
• bend each knee up to chest while keeping the other leg straight
• with leg bend 90 degrees and other straight, swing knee internally and externally
• abduction and adduction of leg with straight leg in supine
• swing straight leg back behind body

Question 9

how to test cranial nerve 1?

Answer 9

olfactory nerve

• test sense of smell for ppl who report loss of smell, head trauma, or those with abnormal mental status
• assess patency by occluding one nostril at a time, asking pt to sniff
• with pts eyes closed, occlude one nostril and present a familiar smell

Question 10

how to test cranial nerve II

Answer 10

1) Snellen eye chart
- if person is wearing glasses, leave them on
- person should be exactly 20 feet away from chart
- cover 1 eye
2) ophthalmoscope

Question 11

how to test cranial nerve III, IV, and VI?

Answer 11

Oculomotor, Trochlear, and Abducens nerves

• check for pupil size, regularity, equality, direct and consensual light reactions, and accommodation
• ask pt to follow ur finger though the ix cardinal positions
• look for presense of Nystagmus (back and forth oscillation of eye)
• looks for pendular movements (eye jerks)

Question 12

How to test cranial nerve V?

Answer 12

Trigeminal Nerve
assess muscles of mastication by palpating the temporal and masseter muscles as person clenches teeth
-use a cotton wisp to lightly touch the persons forehead, cheeks, and skin, ask person to tell u when they feel it
-corneal reflex: only do this test if person has abdominal facial sensation or movement- ask person to take out contacts. bring cotton wisp to side of cornea, pt should blink bilaterally

Question 13

how to test cranial nerve VII?

Answer 13

facial nerve

• observe facial motility and symmetry when asking pt to:
• smile
• frown
• close eyes tightly (against ur attempt to open)
• lift eyebrows
• show teeth
• puff cheeks

Question 14

how to test cranial nerve VIII?

Answer 14

• Acoustic (vestibulocochlear nerve)
• test hearing ability through normal conversation
• whispered voiced test
• Weber and Rinne tuning fork test

Question 15

How to test cranial nerve IX and X?

Answer 15

Glossopharyngeal and Vagus nerve

• depress tongue and say ahhh, assess mouth
• gag reflex

Question 16

How to assess cranial nerve XI?

Answer 16

spinal nerve

• examine sternomastoid and trapezius muscle for equal strength
• ask pt to rotate heat forcibly against resistance of ur hand against there side of face
• ask pt to shrug shoulders against resistance

Question 17

How to assess cranial nerve XII?

Answer 17

• Hypoglossal Nerve
• inspect tongue
• no wasting or tremors present
• ask pt to protrude tongue
• ask pt to say “light, tight, dynamite”

Question 18

What is the Romberg test?

Answer 18

• ask pt to stand with feet together and arms at side
• once in stable position, ask pt to close eyes
• wait 20 sec
• positive Romberg test could mean multiple sclerosis or alcohol intoxication

Question 19

What coordination tests are there?

Answer 19

• Knee test (hands patting on knees as fast as u can)
• Finger test (touching fingers together fast)
• Finger to Finger test
• Finger to Nose test -could mean cerebellar disease
• Heel-to-shin test-could mean cerebellar disease

Question 20

What is the Weber test?

Answer 20

• valuable when pt reports hearing better with one ear than the other
• place vibrating fork in midline of persons skull
• ask whether the tone sound is the same in both ears of better in one
• if so, could mean conductive or sensorineural loss

Question 21

what is the Rinne test?

Answer 21

• Place stem of fork on persons mastoid process (BC) (behind ear) and ask him to signal when sound goes away
• quickly invert the fork to infront of the ear (AC), and pt should still be able to hear a sound
• Sound is hear longer by BC in conductive hearing loss

Question 22

positioning of ear when observing with adult vs child?

Answer 22

adult: up and back
child: straight down