CSRS CORE EXAM TEST UPDATED QUESTIONS AND
SOLUTIONS RATED A+
✔✔Edema Causes: Prevalence: Treatment - ✔✔Causes:
-Dysregulation of autonomic nervous system
-Venous congestion d/t immobility (-33% of chronic stroke survivors) (37% of chronic
stroke survivors)
-Vascular Changes alteration of filtration and reabsorption of fluid (18.5% in acute
stroke)
Other causes of Edema:
-NSAIDS
-High salt intake
-Corticosteroids (predisone)
-Some DM2 medications
Treatment
-Lycra pressure garments (glove/splint) bilateral PROM UE exercises, laser therapy,
acupressure (train caregiver)
✔✔Gold Standard Measure: Edema - ✔✔VOLUMERY
-Measure amount of displacement water after limb is placed in container
Pitting Edema Measurement
-1+ Barely detectable impression
-2+ Slight indentation 15 second rebound
-3+ Deeper indentation 30 second rebound
-4+ > 30 seconds to rebound
✔✔Balance Introduction
(Lesson 10) - ✔✔Balance: The ability to orient the body in space, maintain an upright
posture, under both static/dynamic conditions, and move without falling . The ability to
respond to internal and external disturbances to realign body segments, and to protect
oneself from falling is essential in everyday task.
-Falls: stroke is among the leading risk factors for falls in older adults and inc the risk for
falling 2 to 6 fold
-The population is more than 7x the risk of experiencing a fracture
-40-70% of post-stroke survivors fall within the 2st 12mths post-stroke
✔✔Postural Control (Balance) - ✔✔Postural control is what allows balance-balance is
the output of having postural control (requires many systems and is very complex)
-This includes interactions between individuals, task the individual is performing, and
the environment with more than 300 risk factors that can contribute to falling
✔✔Dynamic Balance - ✔✔-The ability to maintain a position while moving, such as
while walking, running, or standing up and throwing a ball.
-Requires the persons center of mass to be balanced over his or her base of support.
Question:
, 1. Can the patient move within a posture
2. Can the patient maintain posture when walking
3. Can the patient move within varying environments
4. Can the patient move with varying sensory inputs
REMEBER: Muscle used for dynamic balance are being activated distal to proximal
✔✔What should be considered for evaluation of BALANCE - ✔✔Fall History: onset
sudden vs gradual (frequency),
-Environmental Factors
-Activities at the time of fall
Sensory: where am I? : somatosensory, vestibular, vision
Motor: where do i go?: strength, ROM flexibility, endurance
Dizziness: description: when, how long what kind?
✔✔Cognition : BALANCE - ✔✔Psychological trauma & fear of falling cause self-
imposed activity reduction
consider: strength, flexibility, mobility, and Further Risk of FUTURE FALLS
Controlling Cognitive Risk Factors:
-lightening problems, floor clutter, rugs, bathroom safety, tubs, unstable furniture,
shelves (high/low), regular bathroom schedules, check-off list for your family to take
home and review/bring back.
-Have the family take pictures of the home environment and bring them to show you
✔✔Trail Making Test-B (TMT-B) - ✔✔a neuropsychological test of visual attention and
task switching. It can provide information about visual search speed, scanning, speed of
processing, mental flexibility, as well as executive functioning.
-evaluate limitations in executive function which can result in slower gait speed and
decreased mobility skills
-Utilize visual scanning, speed and attention
-Incorporate this test into your screening for cognition and balance risk
*Understand how balance/ executive functioning can impact a patient ability to complete
a functional task
✔✔Vision : BALANCE - ✔✔People become more visually dependent with age
Problems with the following can hinder balance:
-depth perception: the ability to perceive the relative distance of objects in one's visual
field (eg. stairs)
-contrast sensitivity: your ability to distinguish the foreground from the background
-low contrast visual acuity:sharpness of vision, measured by the ability to discern letters
or numbers at a given distance according to a fixed standard
Therapist: should tease out if the patient is perceiving correctly: distorted vision, neglect
Visual Test: Complete at evaluation
-Smooth Pursuits: "Follow the pen with your eyes" (move been side-to-side horizontally)
are you experiencing any increased effort, dizziness or pain (assessing the patient's
ability to accurately track a visual target in a smooth) CN 3,4,6
SOLUTIONS RATED A+
✔✔Edema Causes: Prevalence: Treatment - ✔✔Causes:
-Dysregulation of autonomic nervous system
-Venous congestion d/t immobility (-33% of chronic stroke survivors) (37% of chronic
stroke survivors)
-Vascular Changes alteration of filtration and reabsorption of fluid (18.5% in acute
stroke)
Other causes of Edema:
-NSAIDS
-High salt intake
-Corticosteroids (predisone)
-Some DM2 medications
Treatment
-Lycra pressure garments (glove/splint) bilateral PROM UE exercises, laser therapy,
acupressure (train caregiver)
✔✔Gold Standard Measure: Edema - ✔✔VOLUMERY
-Measure amount of displacement water after limb is placed in container
Pitting Edema Measurement
-1+ Barely detectable impression
-2+ Slight indentation 15 second rebound
-3+ Deeper indentation 30 second rebound
-4+ > 30 seconds to rebound
✔✔Balance Introduction
(Lesson 10) - ✔✔Balance: The ability to orient the body in space, maintain an upright
posture, under both static/dynamic conditions, and move without falling . The ability to
respond to internal and external disturbances to realign body segments, and to protect
oneself from falling is essential in everyday task.
-Falls: stroke is among the leading risk factors for falls in older adults and inc the risk for
falling 2 to 6 fold
-The population is more than 7x the risk of experiencing a fracture
-40-70% of post-stroke survivors fall within the 2st 12mths post-stroke
✔✔Postural Control (Balance) - ✔✔Postural control is what allows balance-balance is
the output of having postural control (requires many systems and is very complex)
-This includes interactions between individuals, task the individual is performing, and
the environment with more than 300 risk factors that can contribute to falling
✔✔Dynamic Balance - ✔✔-The ability to maintain a position while moving, such as
while walking, running, or standing up and throwing a ball.
-Requires the persons center of mass to be balanced over his or her base of support.
Question:
, 1. Can the patient move within a posture
2. Can the patient maintain posture when walking
3. Can the patient move within varying environments
4. Can the patient move with varying sensory inputs
REMEBER: Muscle used for dynamic balance are being activated distal to proximal
✔✔What should be considered for evaluation of BALANCE - ✔✔Fall History: onset
sudden vs gradual (frequency),
-Environmental Factors
-Activities at the time of fall
Sensory: where am I? : somatosensory, vestibular, vision
Motor: where do i go?: strength, ROM flexibility, endurance
Dizziness: description: when, how long what kind?
✔✔Cognition : BALANCE - ✔✔Psychological trauma & fear of falling cause self-
imposed activity reduction
consider: strength, flexibility, mobility, and Further Risk of FUTURE FALLS
Controlling Cognitive Risk Factors:
-lightening problems, floor clutter, rugs, bathroom safety, tubs, unstable furniture,
shelves (high/low), regular bathroom schedules, check-off list for your family to take
home and review/bring back.
-Have the family take pictures of the home environment and bring them to show you
✔✔Trail Making Test-B (TMT-B) - ✔✔a neuropsychological test of visual attention and
task switching. It can provide information about visual search speed, scanning, speed of
processing, mental flexibility, as well as executive functioning.
-evaluate limitations in executive function which can result in slower gait speed and
decreased mobility skills
-Utilize visual scanning, speed and attention
-Incorporate this test into your screening for cognition and balance risk
*Understand how balance/ executive functioning can impact a patient ability to complete
a functional task
✔✔Vision : BALANCE - ✔✔People become more visually dependent with age
Problems with the following can hinder balance:
-depth perception: the ability to perceive the relative distance of objects in one's visual
field (eg. stairs)
-contrast sensitivity: your ability to distinguish the foreground from the background
-low contrast visual acuity:sharpness of vision, measured by the ability to discern letters
or numbers at a given distance according to a fixed standard
Therapist: should tease out if the patient is perceiving correctly: distorted vision, neglect
Visual Test: Complete at evaluation
-Smooth Pursuits: "Follow the pen with your eyes" (move been side-to-side horizontally)
are you experiencing any increased effort, dizziness or pain (assessing the patient's
ability to accurately track a visual target in a smooth) CN 3,4,6
