Chrissy Durrough Lugge
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Hi Stephanie,
Thank you for this question! We concluded that a posterior leaf spring AFO would be appropriate by following the Rancho ROADMAP that is reviewed in the course. However, clinical judgement definitely plays a role in determining the best orthosis for individual patients. If weakness of the ankle evertors is interfering with foot placement and stability during gait, a rigid AFO may be preferable to a posterior leaf spring AFO.
Chrissy
Hi Crystal,
Thank you for this question! Upon further review, our wording on this question was confusing. Axonotmesis is quite variable – it can range from injury to only the axon with complete recovery up to a very severe disruption of the axon, endoneurium, and perineurium requiring surgical intervention. I edited our question to make this more clear.
Thanks again!
Chrissy
Hi Christina,
When I took the NCS exam, there was very little content on pediatrics. A familiarity with the most common pediatric diagnoses and outcome measures will probably suffice for study purposes and be the most effective use of your time (i.e., there’s a chance you could be asked one or two obscure pediatrics questions, but the time you would commit to learning those obscure answers could be better spent learning broader topics that will apply to many questions). Hope this helps!
ChrissyHi Robyn,
For the ASIA exam, one muscle group was selected to represent each spinal segment. However, each muscle group is innervated by at least two spinal nerves – the more rostral spinal nerve is assigned to the muscle group. So, while the elbow flexors are innervated by C5 and C6, they represent C5 for purposes of the ASIA.If someone has the C5 nerve root intact but not C6, they will have some strength (but not 5/5) in their elbow flexors. If C5 and C6 are intact, they will likely have 5/5 strength in their elbow flexors. This makes sense when determining the motor levels of injury: someone with C5 only may score 3/5 at their elbow flexors and would have a motor level of C5 whereas someone with C5 and C6 would score 5/5 on their elbow flexors and likely at least 3/5 on their wrist extensors and would have a motor level of at least C6. Does that make sense?
The ASIA e-Learning Center (http://asia-spinalinjury.org/learning/) is a good resource for more details about testing, if you are interested in learning more.
The ASIA exam is a bit different than traditional myotome testing for upper and lower quarter screens in the absence of spinal cord injury, for which it is still reasonable to use elbow flexion/wrist extension for C6 and elbow extension/wrist flexion for C7.
Let us know if you have any other questions. Thanks!
Hi Christina,
I’m so sorry for the delay! This post was directed to our spam folder for some reason and I am just finding it. The take-aways/conclusions of articles are much more important for the NCS exam than memorizing study design or statistical methods. There may be questions asking you to analyze a given statistic to assess your knowledge of statistical terms, but it is less important to memorize results of specific studies. Hope this helps!Hi Lauren,
I don’t believe the NCS will ask questions that vary from state to state. Being familiar with recommended return to play guidelines is likely sufficient to think through questions on the exam. In my practice, I defer decisions regarding when to return to play to the physician, but I will advise patients who have yet to complete all stages in the return to play protocol to not return to sport. Hope this helps!Hi Tess,
I’ve typically used YouTube to practice identifying nystagmus in BPPV. There are lots of videos out there using combinations of search terms like “BPPV”, “nystagmus”, “Dix-Hallpike”, and “eyes”. Some of these videos will specify the affected canal in the descriptions, although I’ve found that these are sometimes inaccurate – so use caution. Hope this helps!Articulate Mobile Player. Once you download this free app, return to the course homepage, select the lecture you wish to view, and click the blue “Launch” button. This extra step is required for viewing on iPads and mobile devices. Sorry for the extra step!
Hi Meredith! Unfortunately, we haven’t found a good way to block all the spam posts while preserving access to everyone. I manually remove the spam posts a couple time a week to keep the forums as clean as possible. Hopefully we will find a solution soon!
My advice regarding prioritization of the modules and organizing your study process is to review the neuro-anatomy module first without investing too much time – just to have some of the divisions of the nervous system fresh in your mind. Then, it helped me to delve into specific diagnoses, including the affected pathways, as well as physical therapy evaluations and treatment ideas. I found it was easier to attend to specific diagnoses that I could “see” in my patients. When I was studying for the NCS exam, I thought about specific patients I was working with or had treated in the past and tried to map out which pathways, etc. were affected. This forced me to learn neuro-anatomy in a way that didn’t feel as overwhelming as trying to learn all the pathways at once. Also, the NCS exam has more clinical-based questions, so you will be asked to apply knowledge about neuro-anatomy more often than to name specific axonal connections. Does that make sense?
Also, it would be awesome if you could forward the CEU confirmation email to ncsadvantage@rehabknowledge.com. Thanks so much!
Hi Andrew,
Thanks for posting to the discussion forum! We’ll work through your comments one by one:
1. You are correct about the tectospinal tract. It serves to turn the head toward visual stimuli, in addition to sound. The handouts have been updated to reflect this.
2. You are 100% right about the autonomic nervous system. The sympathetic nervous system causes pupillary dilation and the parasympathetic nervous system causes pupillary constriction. We have corrected the handouts.
3. We double checked the blood supply for the posterior limb of the internal capsule and found some conflicting opinions – but, you are right, most sources cite the lenticulostriate branches of the MCA and the anterior choroidal artery (branch of the internal carotid artery) as the primary blood supply. The posterior cerebral artery supplies much of the diencephalon (including the thalamus), as well as portions of the temporal and occipital lobes.We apologize for these errors and appreciate you pointing them out. We are constantly re-evaluating the material to make sure you have the best material possible. Thank you for your patience as we continue to develop the course!
Hi Suzanne! When you enter your e-mail address on that page, you’ll get two e-mails. The first e-mail will confirm that you actually requested the 5 Keys to Passing the NCS Exam – once that is confirmed, you’ll get a second e-mail containing the resource. We don’t have a newsletter or anything, so we won’t spam your inbox. This is just the best way to distribute the resource. Hope it helps! Let us know if you have any other questions!
