BPK 448 Post Quiz well answered
already passed
What is the basis of the frailty trajectory? - correct answer ✔✔evolution of inevitable frailty
trajectory
- Impairment - physiological or neurological events. events that caused impairments (top).
- may not know person have neurological impairment (may not be visible)
Disabilities (bottom) - different extensive levels. Function measurement
What is the difference between impairment and disability? What are functional measures used
for? - correct answer ✔✔Impairment relates to physiological deficit.
- Impairment is rated using neurological examination and assessment scales such as ASIA,
Frankel or Fugl-Meyer.
Disability relates to functional deficit.
- Measures such as Functional independence measure (FIM) or Quadriplegia index of function
(QIF) assess quality of life and ability to perform typical daily activities.
- The extent of disability may differ greatly in subjects diagnosed with the same impairment.
- all has to do with extent of person hampered with disability
Functional measures are used to:
- select appropriate therapy or assistive systems - assess progress during the rehabilitation
process
- predict long-term outcomes.
,- need to quantify how bad a deficit is and how bad disability is to decide best way to help a
person.
1)What to do in this case.
2) Assess whether what doing therapeutically is helping or not. Ensure not drawbacks.
3) Useful to know status of person as time evolves in order to predict end point.
- realistically what is going to be the level of recovery (neurological) or functional dependence.
Based on statistics
Explain the neurological examination of Sensory Impairment. What is the rating system? -
correct answer ✔✔Sensory examination requires testing of key points in each of the 28
dermatomes on the right and left sides of the body.
- At each of these key points, two aspects of sensation are examined:
- sensitivity to pin prick with a safety pin and to light touch using cotton.
- Appreciation of pin prick and of light touch at each of the key points is separately scored on a
three-point scale:
0 - absent
1 - impaired (partial or altered appreciation including hyperaesthesia)
2 - normal
NT - not testable. (could be in case of burns or other harms to skin)
- Test points to determine sensory loss due to spinal cord injury
- The examination includes both left and right sides of the body
- Rows of dots coming vertically and how fall within dermatome. Important to test same point
to observe if there was a change
(Check Slide 5)
- Composed by sensory and motor examinations looking for deficits.
,- Sensory based on testing of key points in each 28 dermatomes (C1 to sacral).
- Done twice, on left and right side cause impairments not always symmetric.
- two modalities tested at each key point (point in skin): testing for sensitivity to painful input
(mild- pin prick), sensitive to light touch (cotton cue tip).
- For each modality going to be rating from 0 to 2.
- Add up all points = 56 x2 = 112 x2 = 224 (perfect score) more impairment there is the lower
the result.
- Number can change (depending on immediate or weeks after injury) can get better.
- Could be sign of some level of spontaneous recovery.
- Initial injury, secondary damage more temporary caused by edema. Some sensation may be
gained.
How are the sensory scores and sensory levels determined from the neurological test? - correct
answer ✔✔Sensory scores and sensory level are obtained by using four sensory modalities per
dermatome:
- R-pin prick, R-light touch, L-pin prick, and L-light touch.
- These scores are summed across dermatomes and sides of body to generate 2 summary
sensory scores:
- pinprick and light touch.
- The sensory scores provide a means of numerically documenting changes in sensory function
over time.
Explain the neurological examination for motor impairment. What additional test is required? -
correct answer ✔✔Motor examination is performed by testing key muscles in 10 paired
myotomes that should be examined in a rostral-caudal sequence.
- The strength of each muscle is graded on a 6-point scale (American Spinal Injury Association -
ASIA Classification):
0 - total paralysis
1 - palpable or visible contraction (no functional strength)
, 2 - active movement, full ROM with gravity eliminated (could be horizontal plane)
3 - active movement, full ROM against gravity
4 - active movement, full ROM against moderate resistance
5 - normal active movement, full ROM against full resistance
NT - not testable
- In addition, the external anal sphincter should be tested for presence or absence of tonic
contraction. This latter information is used solely for determining the completeness of injury.
(no numerical score - yes or no)
- Other muscles may be examined but their grades do not contribute to ASIA score.
- not possible to test all myotomes - motor counterpart of dermatome.
- Myotome - group of muscles supplied by single ventral root.
- Myotomal overlap - one ventral root does not own any muscles by itself, shares innervation of
muscles.
- Can be up to 4-6 roots per muscle.
- Key muscles: 10 myotomes that matter 5 supply upper limb 5 supply lower limbs, other
myotomes supply chest and abdominal musculature but hard to test so largely ignored.
- Anal sphincter supplied by last sacral output important to determine if spinal cord injury
complete or not.
- graded on 6 point scale.
- paralysis - voluntarilty activation (inability), strength of each muscles deetrmine on voluntary
activation (neurological connectivity is what matters).
Which muscles and myotomes are examined bilaterally? - correct answer ✔✔The following
myotomes and muscles are examined bilaterally: RL
C5 - elbow flexors (biceps, brachialis)
C6 - wrist extensors (extensor carpi radialis longus and brevis)
already passed
What is the basis of the frailty trajectory? - correct answer ✔✔evolution of inevitable frailty
trajectory
- Impairment - physiological or neurological events. events that caused impairments (top).
- may not know person have neurological impairment (may not be visible)
Disabilities (bottom) - different extensive levels. Function measurement
What is the difference between impairment and disability? What are functional measures used
for? - correct answer ✔✔Impairment relates to physiological deficit.
- Impairment is rated using neurological examination and assessment scales such as ASIA,
Frankel or Fugl-Meyer.
Disability relates to functional deficit.
- Measures such as Functional independence measure (FIM) or Quadriplegia index of function
(QIF) assess quality of life and ability to perform typical daily activities.
- The extent of disability may differ greatly in subjects diagnosed with the same impairment.
- all has to do with extent of person hampered with disability
Functional measures are used to:
- select appropriate therapy or assistive systems - assess progress during the rehabilitation
process
- predict long-term outcomes.
,- need to quantify how bad a deficit is and how bad disability is to decide best way to help a
person.
1)What to do in this case.
2) Assess whether what doing therapeutically is helping or not. Ensure not drawbacks.
3) Useful to know status of person as time evolves in order to predict end point.
- realistically what is going to be the level of recovery (neurological) or functional dependence.
Based on statistics
Explain the neurological examination of Sensory Impairment. What is the rating system? -
correct answer ✔✔Sensory examination requires testing of key points in each of the 28
dermatomes on the right and left sides of the body.
- At each of these key points, two aspects of sensation are examined:
- sensitivity to pin prick with a safety pin and to light touch using cotton.
- Appreciation of pin prick and of light touch at each of the key points is separately scored on a
three-point scale:
0 - absent
1 - impaired (partial or altered appreciation including hyperaesthesia)
2 - normal
NT - not testable. (could be in case of burns or other harms to skin)
- Test points to determine sensory loss due to spinal cord injury
- The examination includes both left and right sides of the body
- Rows of dots coming vertically and how fall within dermatome. Important to test same point
to observe if there was a change
(Check Slide 5)
- Composed by sensory and motor examinations looking for deficits.
,- Sensory based on testing of key points in each 28 dermatomes (C1 to sacral).
- Done twice, on left and right side cause impairments not always symmetric.
- two modalities tested at each key point (point in skin): testing for sensitivity to painful input
(mild- pin prick), sensitive to light touch (cotton cue tip).
- For each modality going to be rating from 0 to 2.
- Add up all points = 56 x2 = 112 x2 = 224 (perfect score) more impairment there is the lower
the result.
- Number can change (depending on immediate or weeks after injury) can get better.
- Could be sign of some level of spontaneous recovery.
- Initial injury, secondary damage more temporary caused by edema. Some sensation may be
gained.
How are the sensory scores and sensory levels determined from the neurological test? - correct
answer ✔✔Sensory scores and sensory level are obtained by using four sensory modalities per
dermatome:
- R-pin prick, R-light touch, L-pin prick, and L-light touch.
- These scores are summed across dermatomes and sides of body to generate 2 summary
sensory scores:
- pinprick and light touch.
- The sensory scores provide a means of numerically documenting changes in sensory function
over time.
Explain the neurological examination for motor impairment. What additional test is required? -
correct answer ✔✔Motor examination is performed by testing key muscles in 10 paired
myotomes that should be examined in a rostral-caudal sequence.
- The strength of each muscle is graded on a 6-point scale (American Spinal Injury Association -
ASIA Classification):
0 - total paralysis
1 - palpable or visible contraction (no functional strength)
, 2 - active movement, full ROM with gravity eliminated (could be horizontal plane)
3 - active movement, full ROM against gravity
4 - active movement, full ROM against moderate resistance
5 - normal active movement, full ROM against full resistance
NT - not testable
- In addition, the external anal sphincter should be tested for presence or absence of tonic
contraction. This latter information is used solely for determining the completeness of injury.
(no numerical score - yes or no)
- Other muscles may be examined but their grades do not contribute to ASIA score.
- not possible to test all myotomes - motor counterpart of dermatome.
- Myotome - group of muscles supplied by single ventral root.
- Myotomal overlap - one ventral root does not own any muscles by itself, shares innervation of
muscles.
- Can be up to 4-6 roots per muscle.
- Key muscles: 10 myotomes that matter 5 supply upper limb 5 supply lower limbs, other
myotomes supply chest and abdominal musculature but hard to test so largely ignored.
- Anal sphincter supplied by last sacral output important to determine if spinal cord injury
complete or not.
- graded on 6 point scale.
- paralysis - voluntarilty activation (inability), strength of each muscles deetrmine on voluntary
activation (neurological connectivity is what matters).
Which muscles and myotomes are examined bilaterally? - correct answer ✔✔The following
myotomes and muscles are examined bilaterally: RL
C5 - elbow flexors (biceps, brachialis)
C6 - wrist extensors (extensor carpi radialis longus and brevis)
