4Part II – Neurological examination 71 Part II – Neurological examination (relating to Gogelová: Angličtina pro fyzioterapeuty, p. 98–117) 1. Provide the missing word class: If the verb is given, complete the noun. If the noun is given, complete the verb. Define the word class of both words – noun (n.) or verb (v.). Translate the first word into Czech. 1.1. Comprehension 1.2. Neglect 1.3. Consideration 1.4. Tremor 1.5. Impairment 1.6. Fasciculation 1.7. Attend 1.8. Examiner 1.9. Eversion 1.10. Response 1.11. Suspect 1.12. Stroke 1.13. Tap 1.14. Sensation 1.15. Close 1.16. Swab 1.17. Distinguish 1.18. Droop 1.19. Assume 1.20. Extent Eva Jansa (eva.jansa.eu@gmail.com) [1566824] 4 Angličtina pro fyzioterapeuty 72 2. Fill in the missing letter/letters in the words below. Make sentences including these words. 2.1. take a S.P of water 2.2. .ESTIN. position 2.3. SN.P one’s fingers 2.4. TO..UE B.ADE 2.5. SL…ED speech 2.6. SH.UG (one’s shoulders) 2.7. Two-point DISCRI…ATION 2.8. TUN..G .ORK 2.9. DA.A.E .O the spinal CO.. 2.10. ..BRATORY ..NSATION 2.11. VI..AL AC..TY 2.12. …SORY .OSS 2.13. REIN..RCE 2.14. .EVIATIO. 2.15. J.W-JER. REFL.. 3. Match the appropriate sentence halves: 3.1. This is a test 3.2. This allows cervical 3.3. Pain in the anterior thigh 3.4. Ask the patient 3.5. Assess the gag 3.6. The hypoglossal nerve 3.7. The slump test may be quite uncomfortable and 3.8. The slump test helps the therapist 3.9. Dim 3.10. Note what happens 3.11. Have the patient 4Part II – Neurological examination 73 a. extension to be added as a desensitizing test. b. to turn their head against resistance. c. differentiate between local and distant causes. d. indicates a shortening of the hip flexors or irritation of the L4 nerve root. e. to the pupil. f. is the motor to the tongue. g. close their eyes. h. for sciatic nerve irritation. i. challenging, so care must be taken with the test. j. reflex by gently stroking the soft palate on each side. k. the lights and ask the patient to look into the distance. 4. True (= T) or False (= F)? 4.1. A flaccid muscle is a muscle that has reduced its tone, and appears soft, loose and droopy. 4.2. Myotome is a group of muscles supplied by a group of nerve roots. 4.3. Fasciculation often causes a flicker of movement under the skin. 4.4. If somebody’s perception is impaired, it is weakened or damaged. 4.5. A lesion is a sort of damage,a tissue that has suffered a trauma, a site of abnormal tissue change. 4.6. An impairment of cognitive functioning always dramatically interferes with daily life, functioning, and independence. 4.7. Hemiballism is a violent form of dyskinesia. 4.8. The clasp knife phenomenon relates to corticospinal spas- ticity. 4.9. Dyskinesia doesn’t involve chorea. 4.10. The gag reflex is marked by chorea. 4.11. The cogwheel phenomenon can also be observed in respi- ration. 4 Angličtina pro fyzioterapeuty 74 4.12. The cogwheel is typical of parkinsonism. 4.13. In isometric contractions, movement occurs around the joint. 4.14. In isotonic contractions, the muscle’s length remains the same. 4.15. Patients with a suspected injury to T4-T5 should be tested for a plantar response. 5. Fill in a missing word in each blank, the first letter/letters may help you identify the word: 5.1. If reflexes seem hyperactive, it is recommended to test for ankle c……………………………………… . 5.2. An exaggerated reflex response may be b …………………… about by anxiety. 5.3. Exaggerated reflex responses may also indicate an u ……… …………………… motor neuron lesion. 5.4. Ha…………………………………. the patient alternately touch their nose with their right and left index fingers. 5.5. The ta………………………………. stance test is used to assess static balance. 5.6. While doing it, the patient should be asked to pl……………………………. one foot directly in front of the other. 5.7. To test vibratory sensation, a low-pitched tuning f………………………….. should be used. 5.8. If you move a part of your body up and down or from side to side, performing little movements, you w……………………………… it. 5.9. The fleshy underside of a finger is referred to as a finger p…………………………………….. . 5.10. Thepatientisnotina positiontodis…………………………… these two sensations,i.e.to t……………………………one from the other. 4Part II – Neurological examination 75 5.11. The physiotherapist st…………………………………. a wisp of cotton across the patient’s left cornea to test the patient’s corneal reflex. 5.12. During the Rinne test, place the vibrating tuning fork against the m……………………………………. process. 6. Identify which word the underlined word collocates with, i.e. which word the underlined word occurs typically together with: 6.1. Wrinkle – forehead? soft palate? 6.2. Visual – acuity? swab? 6.3. Puff out – one’s teeth? one’s cheeks? 6.4. Dilated – eyelid? pupil? 6.5. Take? Place? – a sip of water 6.6. Tongue – blade? sheet? 6.7. Slurred – vision? speech? 6.8. Blurred – vision? speech? 6.9. Purse – one’s lips? one’s jaws? 6.10. Clench – one’s teeth? one’s neck? 6.11. Sense – for position? of position? 6.12. Mary slumped? hung down? into the armchair,she had used up all her energy. 6.13. If there is a substantial loss of facial muscle tone in somebody, we refer to a sagging of the face, i.e. facial drop? droop? 7. Choose the correct answer if a correct answer exists.Each question may have none, one or more correct answers. 7.1. Which of the following are general things to consider during a neurological examination? a. The patient likely already knows what will happen 4 Angličtina pro fyzioterapeuty 76 b. There are no differences between central and peripheral defects c. Side-to-side asymmetry should be something to look for d. All patients may display slightly different symptoms 7.2. Which of the following are involuntary movements? a. Jumps b. Clapping c. Running d. Tremors 7.3. Resistance training mainly helps prevent: a. Muscular atrophy b. Muscular hypertrophy c. Muscular tonus d. Psychological disturbances 7.4. Muscle spasticity should be assessed using: a. Quick movements b. Slow movements c. Quick or slow movements d. Both, quick and slow movements 7.5. Which of the following are steps in the Berg Balance Test? a. Tandem standing b. Table stepping c. Reaching backwards with the arms stretched back d. Putting an object on the ground 7.6. Which of the following typically falls outside of the scope of practice for a physiotherapist? a. Strength testing b. Balance testing c. Olfactory testing d. Reflex testing 7.7. When conducting a sensory assessment, lightly touching the forearms tests the nerves originating from which area? a. C4 b. L2-L3 4Part II – Neurological examination 77 c. C1 and T6 d. C6 and T1 7.8. Which of the following are not standard tests for the Cochlear nerve? a. Weber test b. Rinne test c. Smith test d. Janda test 7.9. Which of the following is hardest? a. To touch something b. To tap something c. To hit something d. To stroke something 7.10. Which of the following can you hear? a. A click of the tongue b. A snap of the fingers c. A blink of the eye d. A droop of the face