Neurological System Flashcards
1
Q
What does spasticity indicate?
A
extrapyramidal tract lesions
2
Q
What can cause hypertonia?
A
loss of the inhibition of the lower motor neurones by the upper motor lesions
3
Q
What does rigidity indicate?
A
extrapyramidal tract lesions
4
Q
What can cause hypotonia?
A
lower motor neurones
5
Q
What muscles are responsible for shoulder abduction?
A
deltoid
6
Q
What muscles are responsible for shoulder adduction?
A
- teres major
- latissimus dorsi
- pectoralis major
7
Q
What myotomes are involved in shoulder abduction?
A
C5
8
Q
What myotomes are involved in shoulder adduction?
A
C6/C7
9
Q
What muscles are involved in the extension of the elbow joint?
A
triceps brachii
10
Q
What muscles are involved in the flexion of the elbow joint?
A
biceps brachii
11
Q
What myotomes are involved in elbow extension?
A
C7
12
Q
What myotomes are involved in elbow flexion?
A
C5/C6
13
Q
What muscles are involved in wrist flexion?
A
C6/C7
14
Q
How do you test the abduction of the shoulder?
A
- flex elbows outwards
- apply downwards resistance
15
Q
How do you test the adduction of the shoulder?
A
- flex elbows inwards
- apply upwards resistance
16
Q
What would score a 0/5 MRC Muscle Power Scale?
A
No movement
17
Q
What would score a 1/5 MRC Muscle Power Scale?
A
- barest flicker of movement
- not enough to move the structure
18
Q
What would score a 2/5 MRC Muscle Power Scale?
A
voluntary movement which is not sufficient to overcome the force of gravity
19
Q
What would score a 3/5 MRC Muscle Power Scale?
A
- Voluntary movement
- able to overcome gravity
- not able to overcome applied resistance
20
Q
What would score a 4/5 MRC Muscle Power Scale?
A
- Voluntary movement
- able to over come resistance
21
Q
What would score a 5/5 MRC Muscle Power Scale?
A
Normal strength
22
Q
What do you need to do in order to accurately measure the power?
A
isolate and stabilise the joint
23
Q
How do you assess the power of the musculature?
A
resist the movement by applying an opposite force and estimate the power of the contracting muscles
24
Q
What nerve roots are responsible for the biceps reflex?
A
- C5
- C6
25
Where can you test for the biceps reflex?
the medial aspect of the antecubital fossa
26
What nerve roots are responsible for the triceps reflex?
- C7
| - C8
27
Where can you test for the triceps reflex?
superior to the olecranon process of the ulna
28
What nerve roots are responsible for the supinator reflex?
- C5
| - C6
29
Where can you test for the supinator reflex?
bracioradialis tendon (posterolateral aspect of the wrist)
30
What does areflexia suggest?
a lower motor neurone lesion
31
What does hyperreflexia suggest?
an upper motor neurone lesion
32
Where is the C5 dermatome?
lateral aspect of the lower edge of the deltoid muscle
33
Where is the C6 dermatome?
the palmar side of the thumb
34
Where is the C7 dermatome?
the palmar side of the middle finger
35
Where is the C8 dermatome?
the palmar side of the little finger
36
Where is the T1 dermatome?
The medial aspect of the antecubital fossa proximal to the medial epicondyle
37
Where is the T2 dermatome?
axilla
38
How do you assess tone in the lower limb?
- leg roll
- leg lift
- ankle clonus
39
What should you do when testing for ankle clonus?
quickly dorsiflex and partially evert the foot
40
What would suggest an abnormal ankle clonus?
more than 5 is abnormal
41
What muscles are responsible for the flexion of the hip joint?
```
- Psoas Major
Iliacus
- Sartorius
- Rectus Femoris
- Pectineus
```
42
What nerve is responsible for the flexion of the hip joint?
femoral nerve
43
What muscles are responsible for the extension of the hip joint?
Gluteus maximus
44
What nerve is responsible for the extension of the hip joint?
inferior gluteal nerve
45
What muscles are responsible for the abduction of the hip joint?
- Gluteus medius
| - Gluteus minimus
46
What nerve is responsible for the abduction of the hip joint?
superior gluteal nerve
47
What muscles are responsible for the adduction of the hip joint?
- Adductor longus
- Adductor brevis
Adductor magnus
- Pectineus
- Gracilis
48
What nerve is responsible for the adduction of the hip joint?
obturator nerve
49
What muscles are involved in the circumduction of the hip?
- Psoas Major
- Sartorius
- Rectus femoris
- Pectineus
- Gluteus maximus
- Gluteus medius
- Gluteus minimus
- Adductor longus
- Adductor brevis
- Gracilis
50
What muscles are involved in the internal rotation of the hip?
```
Obturator externus
all:
- adductors
- semitendinosus
- semimembranosus
```
51
What muscles are involved in the external rotation of the hip?
- `Piriformis
- Obturator internus
- Gemellus superior
- Gemellus inferior
- Quadratus femoris
52
What muscles are involved in the flexion of the knee?
- Biceps femoris
- Semitendinosis
- Semimembranosis
- Gracilis
53
What muscles are involved in the extension of the knee?
- Quadriceps femoris
54
What happens in a Trendelenburg test?
- place hands on the patients iliac crest
| - ask patient to lift each foot in turn off the floor
55
During a Trendelenburg test, what is being tested with the right foot is lifted?
the left hip abductors
56
What will be seen during a Trendelenburg test if there is weakness in the abductors?
pelvis will sag away from the weak abductor
57
What nerve allows for knee extension?
femoral nerve
58
What nerve allows for knee flexion?
sciatic nerve
59
What muscles are involved in ankle dorsiflexion?
- Tibialis anterior
- Extensor hallucis longus
- Extensor digitorum longus
60
What innervates ankle dorsiflexion?
deep fibular nerve
61
What innervation is involved in ankle plantarflexion?
tibial nerve (S1-S2)
62
where does inversion take place?
subtalar joint
63
How do you assess for inversion of the ankle joint?
place hand laterally and ask patient to push against the resistance
64
How do you assess for eversion of the ankle joint?
place hand medially and ask patient to push against the resistance
65
What are the nerve roots responsible for the knee-jerk reflex?
- L2
- L3
- L4
66
What is the Jendrassik manoeuvre?
- clenching teeth
| - flexing fingers in a hook-like form
67
What are the nerve roots responsible for the ankle-jerk reflex?
- S1
| - S2
68
What is the impact of a femoral nerve lesion on motor control?
Quadriceps Paralysis
- weakness of the knee
- difficulty climbing up and down stairs
69
What is the impact of a femoral nerve lesion on sensory control?
loss of sensation in:
- the anterior and medial thigh
- medial side of leg
- medial border of the foot
- saphenous nerve is affected
70
What is the impact of a obturator nerve lesion on motor control?
Paralysis of all adductors
| - difficulty crossing legs
71
What is the impact of a femoral nerve lesion on sensory control?
```
Pain on the medial thigh
caused by:
- pelvic disease
- ovarian tumours
(medial cutaneous nerve of the thigh)
```
72
What is the impact of a common fibular nerve lesion on motor control?
foot extensors and evertors paralysed:
- Peroneal muscles (lateral compartment)
- Tibialis anterior, EDL, and EHL
73
What test shows the motor effects of a common fibular nerve lesion?
foot drop
74
What is the impact of a common fibular nerve lesion on sensory control?
loss of sensation in:
| - anterior and lateral side fo leg and dorsum of the foot
75
What is the impact of a tibial nerve lesion on motor control?
Paralysis of:
- Hamstrings
- all posterior muscles of the leg and sole of foot
- foot in a dorsiflexed and everted position
- Gastrocnemius
- Soleus
- Tibialis posterior
- FHL
- FDL
- Intrinsic foot flexors
- Interossi
- Lumbricals
76
What is the impact of a tibial nerve lesion on sensory control?
loss of sensation in the sole of the foot
77
What is the impact of whole sciatic nerve injury on motor control?
```
Paralysis of:
- Hamstrings
- All muscles below the knees
Knee flexion affected
Foot in plantar flexed position (foot drop)
```
78
What is the impact of whole sciatic nerve injury on sensory control?
sensory loss below the knee (except small medial area and foot - saphenous nerve)
79
What can cause whole sciatic nerve injury?
- pelvic fracture
- hip joint dislocation
- penetrating injuries
80
What is sciatica?
pain radiating from the posterior back into the buttock, posterior/lateral thigh and into the leg
81
What can cause sciatica?
- herniated lumbar intervertebral disc
| - compression of the L5-S1 component of the sciatic nerve
82
What is the superior border of the femoral triangle?
inguinal ligament
83
What is the medial border of the femoral triangle?
adductor longus
84
What is the lateral border of the femoral triangle?
sartorius
85
What are the borders of the femoral triangle?
superior: inguinal ligament
medial: adductor longus
lateral: sartorius
86
Where is the dermatome of L1?
inguinal ligament
87
Where is the dermatome of L2?
lateral side of the thigh
88
Where is the dermatome of L3?
knee (lower medial side of thigh)
89
Where is the dermatome of L4?
big toe (medial side of leg, medial foot)
90
Where is the dermatome of L5?
middle 3 toes (lateral side of leg, mid dorsum of foot)
91
Where is the dermatome of S1?
little toe (lateral foot, and sole footprint area
92
Where is the dermatome of S2?
back of the upper leg and the whole thigh
93
Where is the dermatome of S3?
gluteal fold
94
What is compartment syndrome?
where the pressure in the muscle compartment is so high that the venous drainage becomes blocked, pressure can increase to the point of muscle ischaemia and death
95
What are the possible causes of compartment syndrome?
- fractures
- burns
- infections
- prolonged limb compression
96
What des compartment syndrome present with?
- pain
- muscle tenderness
- swelling
- 6 Ps
97
What are the 6 Ps?
- Pallor
- Pulselessness
- Paralysis
- Pershingly cold
- Pain
- Paraesthesia
98
What would be seen on examination of a case of compartment syndrome?
- swollen limb
- painful passive movement
- diagnosis on clinical suspicion
99
How would you treat compartment syndrome?
- relieve pressure
(all dressings, casts and splints should be removed)
- open fasciotomy
100
What happens in a open fasciotomy?
surgical procedure:
| - skin and deep fascia are opened alone the muscle compartment to relieve the pressure
