Light touchmonofilament on feet Monofilament tool required touch bottom of foot

Light touchmonofilament on feet monofilament tool

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-Light touch/monofilament on feet *Monofilament tool required touch bottom of foot for at least 1 sec until it bends while patients’ eyes are closed in several areas of the foot and one on dorsal-pt should feel in all sites -Vibration *thick short tuning fork/close eyes Place stem of fork over bony areas-great toe bone, elbow ask pt to tell me where the buzzing or tingling sensation is felt - graphesthesia *pen light or pen Draw a letter on palm of hand and ask pt to identify, draw another figure on other hand and ask them to recognize Motor: -Strength—upper and lower extremities Upper-Grade 0-5-expect strength to be bilaterally symmetric with full resistance to opposition Have them contract the muscle by extending or flexing the joint and then resist as I apply force against the muscle contraction -Muscle tone Ask them to relax and have me passively move the joint, the muscles should have slight tension and no crepitation or tenderness noted
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-Gait Have them walk around with no shoes, gait should have a smooth, regular, rhythm and symmetric stride length, arm swing should be smooth and symmetric Cerebellar: -Test for coordination (any coordination test covered in your text readings) Tap hands up and down on knees and increase speed-maintains rhythm with increased speeds say no slowing or jerky movements noted -One test for balance Ask pt to stand with feet slightly apart-push shoulders with enough thrust to throw them off balance, recovery of balance should occur quickly -One test for meningeal irritation Nuchal rigidity- have them stand push back of head down to chin to sternum-denies pain or resistance -One test for nerve root irritation Femoral stretch test: have them lie prone and extend the hip, no pain is expected if painful on extension then positive for nerve root irritation Musculoskeletal -Inspects spine Inspect from anterior and posterior position observing for alignment of the head with the shoulders and symmetry of skin folds and muscles. Expect the cervical spine to be concave with head erect and appropriate alignment, no asymmetric skin fold apparent Thoracic spine-convex Lumbar spine-concave Have pt bend forward and touch toes while I observe from behind-should by symmetrically flat as the concave curve of the spine becomes convex with forward flexion-say no rib hump and then have them come back up slowly and reversal of the lumbar curve should be apparent -Palpates spine-pg 518 for figure 21-30 Have pt stand erect-palpate along the spinal process and paravertebral muscles with pads of fingers-no muscle spasms or tenderness should be noted -ROM of Spine Cervical: Extend and flex neck, right to left, and rotate side to side-no pain or tenderness
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Lumbar: bend forward at the waist without bending knees, try to touch toes, bend back at waist, bend side to side, stabilize pelvis and have them swing in a circular motion -Palpates major joints Shoulders-sternoclavicular joint, clavicle & acromioclavicular joint-should not be tender
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  • Summer '15
  • Left-wing politics, Political spectrum, Left-handedness, intercostal space

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