ABPMR PM&R flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

ASIA Impairment Scale Grade A

A complete spinal cord injury: no sensory or motor function is preserved in the sacral segments S4-S5, including absent anal sensation and absent deep anal pressure.

NASCET 70 percent stenosis

In symptomatic carotid stenosis of 70-99% measured by the NASCET method, carotid endarterectomy plus medical therapy lowers ipsilateral stroke risk more than medical therapy alone.

Rancho Los Amigos Level IV

Confused-agitated: the patient is alert and highly active but disoriented, with agitation, inconsistent memory, and poor attention, requiring maximal supervision for safety.

Guillain-Barre syndrome features

Acute ascending areflexic weakness with albuminocytologic dissociation (high CSF protein with normal cell count), nadir within 2-4 weeks, treated with IVIG or plasma exchange.

Hoehn and Yahr scale

A five-stage clinical scale for Parkinson disease: stage 1 is unilateral involvement, stage 3 adds postural instability, and stage 5 is wheelchair-bound or bedridden.

Upper motor neuron bladder

After a suprasacral spinal cord injury the bladder shows detrusor overactivity with incomplete emptying and detrusor-sphincter dyssynergia, risking high pressures and upper tract damage.

Lachman test

With the knee flexed 20-30 degrees, anterior tibial translation with a soft endpoint indicates an anterior cruciate ligament tear; it is the most sensitive maneuver for ACL deficiency.

Finkelstein test

Wrist and thumb flexion combined with ulnar deviation reproduces pain over the first dorsal compartment, indicating de Quervain tenosynovitis of the abductor pollicis longus and extensor pollicis brevis.

Ottawa ankle rules

Ankle radiographs are indicated only with malleolar pain plus bone tenderness at the posterior malleolar edge or tip, navicular, or fifth metatarsal base, or inability to bear weight four steps.

Jobe empty can test

The shoulder is abducted 90 degrees in the scapular plane with the thumb pointing down; pain or weakness suggests supraspinatus tendinopathy or a rotator cuff tear.

FADIR hip test

The hip is flexed to 90 degrees, then adducted and internally rotated; reproduction of groin pain suggests femoroacetabular impingement or labral pathology.

Prolonged F wave latency

Indicates slowed conduction in the proximal segment of a motor nerve, as in radiculopathy or demyelinating neuropathy; F waves assess proximal conduction rather than the distal segment.

H reflex

An electrically elicited monosynaptic stretch reflex recorded over the soleus; an absent or prolonged H reflex supports an S1 radiculopathy.

Fibrillation potentials

Spontaneous single muscle fiber discharges that appear two to three weeks after nerve injury and indicate active denervation; they are not recorded in normal muscle.

Repetitive nerve stimulation decrement

A greater than 10 percent decline in compound muscle action potential amplitude with 2-3 Hz stimulation indicates a postsynaptic neuromuscular junction disorder such as myasthenia gravis.

Median sensory conduction criteria

A median sensory peak latency above 3.5 ms over 8 cm, or a median-ulnar palmar mixed nerve latency difference above 0.3 ms, supports carpal tunnel syndrome.

Ulnar neuropathy at elbow

Focal slowing across the elbow segment exceeding 10 m/s compared with the forearm segment, or conduction block there, localizes ulnar neuropathy to the cubital tunnel.

Autonomic dysreflexia

In spinal cord injury at T6 or above, noxious stimuli trigger paroxysmal hypertension, headache, and sweating; treatment is sitting upright, removing the stimulus, and antihypertensives if needed.

Heterotopic ossification

Ectopic bone formation, most often about the hip after spinal cord injury or traumatic brain injury; alkaline phosphatase rises early and bone scan is positive before plain films.

Stage 3 pressure injury

Full-thickness loss of skin and subcutaneous tissue without exposed fascia, muscle, tendon, or bone; slough may be present but does not obscure the depth of tissue loss.

DVT prophylaxis after stroke

Acute stroke with impaired mobility warrants pharmacologic prophylaxis using heparin or low-molecular-weight heparin plus intermittent pneumatic compression unless hemorrhage contraindicates anticoagulation.

Reflex neurogenic bowel

Suprasacral spinal cord lesions preserve anorectal reflexes, producing an upper motor neuron bowel managed with a scheduled program of suppositories or digital stimulation, often after meals.

GMFCS Level I

In cerebral palsy, the child walks independently without limitations but may show reduced speed, balance, or coordination; higher levels indicate progressively greater mobility restriction.

Erb palsy posture

Upper trunk brachial plexus birth injury (C5-C6) produces the waiter's tip posture with the arm adducted and internally rotated, elbow extended, and forearm pronated.

Duchenne muscular dystrophy

X-linked dystrophin deficiency causing proximal weakness, Gowers sign, calf pseudohypertrophy, markedly elevated creatine kinase, and cardiomyopathy; corticosteroids slow progression of weakness.

Denver screening test domains

The Denver Developmental Screening Test screens four areas: personal-social, fine motor-adaptive, language, and gross motor skills in children from birth to about six years.

Myelomeningocele associations

Open spinal dysraphism is associated with Chiari II malformation, hydrocephalus requiring shunt, neurogenic bladder and bowel, tethered cord, and latex allergy from repeated early exposures.

Modified Ashworth Scale

Grades resistance to passive movement from 0 (no increase in tone) to 4 (rigid limb), with 1+ indicating a catch followed by minimal resistance through less than half the range.

Botulinum toxin mechanism

It cleaves presynaptic SNARE proteins to block acetylcholine release, producing focal chemodenervation that weakens spastic muscles for roughly three months after a latency of several days.

Intrathecal baclofen withdrawal

Abrupt cessation causes rebound spasticity, hyperthermia, rigidity, and autonomic instability that can be fatal; it requires urgent restoration of intrathecal dosing or benzodiazepines and supportive care.

Budapest criteria for CRPS

Complex regional pain syndrome is diagnosed when continuing pain disproportionate to an inciting event is accompanied by reported symptoms in three or more categories and observed signs in two or more.

Tilt-in-space wheelchair

The seat and backrest rotate together about a fixed pivot, redistributing pressure and improving tolerance of upright posture without changing hip or knee joint angles.