Nervous

Question 1

Where do motor nerves exit?

Answer 1

anterior nerve root

Question 2

Where do sensory nerves exit?

Answer 2

posterior nerve root

Question 3

How many pairs of spinal nerves do we have?

Answer 3

31

Question 4

What is a pyramidal or corticospinal pathway also called?

Answer 4

motor pathway

Question 5

What happens with damage in the corticospinal tract?

Answer 5

weakness

Question 6

What can damage to the basal ganglia cause?

Answer 6

rigidity, slowness, involuntary movements, posture/gait disturbances

Question 7

What does damage to the cerebellar system cause?

Answer 7

impaired coordination, gait, equilibrium, decrease muscle tone

Question 8

Which tract does pain, temperature, crude touch reach the brain?

Answer 8

spinothalamic tract

Question 9

Which tract does vibration, proprioception, kinesthesia, pressure, fine touch do to reach the brain?

Answer 9

posterior column system

Question 10

What should you ask about numbness?

Answer 10

pattern of sensory loss == stocking-glove distribution, patchy or non-dermatomal, occuring on one limb?

Question 11

What does mental status include?

Answer 11

• alertness
• language function
• memory
• calculation
• visuospatial processing
• abstract reasoning

Question 12

What should you watch for in involuntary movements?

Answer 12

• tics
• chorea
• fasciculations

Question 13

What is pronator drift?

Answer 13

checking for corticospinal tract lesion

Question 14

What is normal muscle strength on the 0 to 5 scale?

Answer 14

5

Question 15

What nerves test shoulder abduction?

Answer 15

C5, C6

Question 16

What nerves supply elbow flexion?

Answer 16

C5, C6

Question 17

What nerves supply elbow extension?

Answer 17

C6, C7, C8

Question 18

What nerves supply wrist extension?

Answer 18

C6, C7, radial nerve

Question 19

What nerves supply finger extension?

Answer 19

C7, C8, radial nerve

Question 20

What nerves supply finger abduction?

Answer 20

C8, T1, ulnar nerve

Question 21

What nerves supply thumb abduction?

Answer 21

C8, T1, median nerve

Question 22

What nerves supply hip flexion?

Answer 22

L2, L3, L4, iliopsoas

Question 23

What nerves supply hip adduction?

Answer 23

L2, L3, L4

Question 24

What nerves supply hip abduction?

Answer 24

L4, L5, S1

Question 25

What nerves supply hip extension?

Answer 25

S1

Question 26

What nerves supply knee extension?

Answer 26

L2, L3, L4

Question 27

What nerves supply flexion at knee?

Answer 27

L4, L5, S1, S2

Question 28

What nerves supply ankle dorsiflexion?

Answer 28

L4, L5

Question 29

What nerves supply plantarflexion?

Answer 29

S1

Question 30

What four areas need to function for coordination?

Answer 30

* motor system * vestibular system * sensory system * cerebellar system

Question 31

How do you assess coordination?

Answer 31

* rapid alternating movements * point to point movements * gait stance

Question 32

What's the Romberg test?

Answer 32

Standing without support and ability to maintain an upright posture

Question 33

What should you do when detecting sensory loss?

Answer 33

map out boundaries in detail

Question 34

What should you do for pain, temperature and touch sensation?

Answer 34

compare distal to proximal areas: * both shoulders (C5) * inner and outer forearms (C6 and T1) * thumbs and fingers (C6 and C8) * fronts of both thighs (L3) * ankle at medial malleous (L4) * dorsum of foot (L5) * fifth toes (S1) * medial aspect of buttock (S3)

Question 35

What is stereognosis?

Answer 35

identifying object by feeling it

Question 36

What is graphesthesia?

Answer 36

identify number drawn in hand

Question 37

What does two point discrimination test?

Answer 37

how finely innervated the skin is

Question 38

What should you test for if hyperactive reflex?

Answer 38

clonus

Question 39

How do you grade reflexes?

Answer 39

0-4; 2 = normal

Question 40

What is nuchal rigidity?

Answer 40

laying down, flex patient's neck forward until chin touches chest normally is easy — if difficult could be sign of meningitis

Question 41

What is the Brudzinski sign?

Answer 41

when the neck is flexed, the knees come up to compensate too

Question 42

What's the Kernig sign?

Answer 42

flex the hips and knees --> slowly extend and watch for pain

Question 43

What's the straight leg raise?

Answer 43

patient is supine, and raise the relaxed and strained leg -- assess degree of elevation where pain occurs

Question 44

What is pain in the ipsilateral leg positive for?

Answer 44

lumbosacral radiculopathy

Question 45

What is pain in the contralateral leg positive for?

Answer 45

Cross straight leg raising sign

Question 46

What is asterixis?

Answer 46

metabolic encephaopathy with mental function impairment test with patients in stop sign and sudden movement = positive

Question 47

What puts someone at risk of asterixis?

Answer 47

alcohol, liver disease, uremia, hypercapnia

Question 48

What are two things to never do with comatose patients?

Answer 48

1. don't dilate the pupils 2. don't flex the neck

Question 49

What are five ways to check the level of consciousness?

Answer 49

1. alertness (normal) 2. lethargy (speak loud) 3. obtundation (shake) 4. stupor (pinch tendon) 5. coma (painful stimuli)

Question 50

What's the glasgow coma scale?

Answer 50

higher number = best level of consciouness with eyes open spontaneously - 4 obeys orders - 6 oriented, conversant - 5

Question 51

What do doll's eyes movement indicate?

Answer 51

intact brainstem

Question 52

In a healthy patient, what is COWS?

Answer 52

Cold goes opposite with warm going to the same

Question 53

In a comatose patient how are COWS different?

Answer 53

cold stays same and warm goes opposite CSWO