Week 2 Portfolio Questions

1. What does the mnemonic ‘LODCTRRAPPA” stand for? When is it used?

- This mnemonic is used when taking a patients history with the purpose of
pinpointing the location and origin of the pain via this process of elimination.
 Location
 Onset
 Duration
 Course (better or worse)
 Type of pain
 Radiation
 Relieving factors
 Aggravating factors
 Previous treatment
 Associated signs and symptoms

2. Describe what is meant by a system’s review.

 A brief overview of all the systems of the body, looking for any related/
unrelated or new information pertaining to the patients conditions.

3. What does VIPPIRONEL stand for? When is it used?

 V- Vitals
 I - Inspection (posture, gait, habitus, alertness etc.)
 P- Palpation
 P- Percussion (if appropriate)
 I- Instrumentation (charts, goniometers, inclinometers, scanning devices)
 O- Orthopaedic tests
 N- Neurological tests
 E- Extra studies (x-rays, CT, MRI)
 L- Lab studies
- It is used after taking a patients history to evaluate all body systems.

4. Describe the difference between dermatomes, sclerotomes and myotomes.

 A dermatome is the skin area supplied by the sensory component of

a single spinal nerve root. Pain will be radiating, sharp, stabbing and well
demarcated; area of sensation attributed to a particular nerve root level.
  A myotome is the group of muscles innervated by the motor component of
a single spinal nerve root. Pain will refer within muscular or fascial tissue.

 A sclerotome is an area of a bone innervated from a single nerve segment.

Pain pattern will be dull, achy, diffuse and difficult to pinpoint; referred pain
from somatic structures (cartilage, ligament, joint capsule or bone).

5. Describe the differences between nerve root pressure and nerve trunk
pressure.

 Nerve root pressure is called a radiculopathy and will have either sensory
or motor deficits depending on if the ventral or dorsal root has been
pressured. A Nerve truck is the junction where the sensory fibers (afferent
fibres) and motor (efferent fibres) come together and become mixed for
the first time since leaving the spinal cord so pressure on this area can
have both sensory and motor deficits.

6. Describe the differences between spinal cord pressure and peripheral

nerve pressure.

 Spinal cord pressure results myelopathy which is the result of trauma,

congenital stenosis, degenerative disease or disc herniation. Myelopathy’s
will have both upper and lower motor neuron type of lesions
 Peripheral nerve pressure results neuropathy, which is a general term
describing disease affecting the peripheral nerves (nerves outside of the
CNS). Neuropathy’s will only result in lower motor neuron types of lesions.

7. What are tension signs?

 Hypertonicity
 Decreased ROM

8. Describe what you would find in a typical feature of irritation of

the C5 nerve root.
 Neck, shoulder, scapula pain. Lateral arm paraethesia. Affects
shoulder abduction and elbow flexion: May be weak shoulder
flexion, external rotation & forearm supination. Decreased bicep
reflex.
9. What spinal nerve has no dermatome associated with it?

C1 nerve root
10. Dermatomes, sclerotomes and myotomes are derived from embryological
structures?

Somites

11. Between which two vertebrae does the spinal nerve C7 exit the
intervertebral foramen (IVF)?

C6 & C7

12. Which choice best describes C7 muscle test, Deep tendon reflex and
sensory testing?

a) finger abduction, pectoralis deep tendon reflex, and medial upper

arm sensory from the elbow to the axilla
b) wrist extension, brachial radialis deep tendon reflex, and lateral
forearm and digits 1 and 2 sensory from the elbow to the tip of the
fingers
c) wrist flexion, triceps deep tendon reflex, and anterior and
posterior middle finger sensory from the wrist to the tip
d) shoulder abduction, biceps deep tendon reflex, and lateral upper
arm sensory from the shoulder to the elbow.

13. 25-year-old AFL player fell on his shoulder vertically and violently
stretched his neck in the opposite direction. He was later
diagnosed with a brachial plexus injury. His arm is hanging at his
side in medial rotation in the ‘waiter’s tip” position. What results
are expected from the neurological examination?

a) Paralysis of the deltoid, triceps, wrist extensors (long and short carpi
radialis) and finger extensors
b) Paralysis of all intrinsic muscles of the hand, flexor muscles (claw
hand), loss of sensation over C8-T1 dermatomes and Horner’s
syndrome
c) Hypoesthesia over C5-C6 and weakness of the deltoid,
supraspinatus and infraspinatus, biceps and brachioradialis muscle
d) Klumpke paralysis caused by forced hyperabduction of the arm