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Neurological System Flashcards

(62 cards)

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1
Q

Tone assessment (arm)

A

Assess in muscle groups of shoulder, elbow and wrist
1. Support patient’s arm by holding hand and elbow
2. Ask patient to relax and allow full control of their movement
3. Shoulder (circumduction), elbow (flexion/extension) and wrist (circumduction)

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2
Q

Tone abnormalities?

A

Spasticity
Rigidity
Cogwheeling hypotonia

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3
Q

Spasticity?

A

Pyramidal tract lesions

upper motor neurones exhibit inhibitory effect on lower motor neurones, so inhibition of upper MN = exaggerated muscle tone = hypertonia

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4
Q

Rigidity?

A

Extrapyramidal tract lesions (Parkinson’s)

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5
Q

Hypotonia?

A

Lower motor neurone lesion

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6
Q

Shoulder abduction myotome, muscle and instruction?

A

Myotome - C5

Muscles - deltoid

Instruction - flex elbows, apply downward resistance

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7
Q

Shoulder adduction myotome, muscles and instruction?

A

Myotome - C6 + C7

Muscles - teres major, lat. dorsi, pec. major

Instruction + bring elbows closer to body and apply upwards resistance

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8
Q

Elbow flexion myotome, muscles and instruction?

A

Myotome - C5/C6

Muscles - biceps brachii

Instruction - apply resistance by pushing forearm away

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9
Q

Elbow extension myotome, muscles and instruction?

A

Myotome - C7

Muscles - triceps brachii

Instruction - apply resistance by pushing towards

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10
Q

Wrist flexion myotome, muscles and instruction?

A

Myotome - C6/7

Muscles - flexors of wrist

Instruction - apply resistance downwards

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11
Q

Power scale?

A

MRC Muscle Power Scale

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12
Q

MRC 0/5?

A

No movement

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13
Q

MRC 1/5

A

Barest flicker of movement of muscle, though not enough to move the structure to which it’s attached

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14
Q

MRC 2/5

A

Voluntary movement which is not sufficient to overcome the force of gravity

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15
Q

MRC 3/5

A

Voluntary movement capable of overcoming gravity, but not applied resistance

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16
Q

MRC 4/5

A

Voluntary movement capable of overcoming resistamce

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17
Q

MRC 5/5

A

Normal strength

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18
Q

Biceps reflex

A

C5 + 6

Medial aspect of antecubital fossa

place non-dominant hand over tendon and tap thumb with tendon hammer

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19
Q

Triceps reflex?

A

C7 + 8

Superior to olecranon process of ulna

triceps tendon relaxed, rest elbow in 90 flexion on lap

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20
Q

Supinator reflex

A

C6

Brachioradialis tendon, found on posterolateral aspect of wrist, 4 inches away proximal to base of thumb

position 2 fingers over tendon, tap fingers with tendon hammer

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21
Q

LMN lesion?

A

Areflexia

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22
Q

UMN lesion?

A

Hyperreflexia

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23
Q

C5 sensation?

A

Lateral aspect of lower edge of deltoid muscle

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24
Q

C6 sensation?

A

Palmar side of thumb

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25
C7 sensation?
Palmar side of middle finger
26
C8 sensation?
Palmar side of little finger
27
T1 sensation?
Medial aspect of antecubital fossa, proximal to medial epicondyle
28
Tone steps (leg)
1. Leg roll 2. Leg lift - quickly lift leg off bed at knee joint, heel should remain in contact with the bed 3. Ankle clonus - quickly dorsiflex and partially evert foot, clonus is felt but more than 5 is normal
29
T2 sensation?
Axilla
30
Hip joint flexion muscles and nerve?
Psoas major Iliacus (sartorius, rectus femoris, pectineus) *Femoral nerve*
31
Hip extension muscle and nerve?
Gluteus maximus *inferior gluteal nerve*
32
Hip abduction muscles and nerve?
Gluteus medius and gluteus minimus *superior gluteal nerve*
33
Hip adduction muscles and nerve?
Adductor longus, adductor brevis, adductor magnus (pectineus, gracilis) *obturator nerve*
34
Internal rotation muscles
Obturators externus (all adductors, semitendinosus, semimembranosus)
35
External rotation muscles?
Piriformis, obturator internus, gemellus superior and inferior, quadratus femoris
36
Knee joint flexion muscles?
Biceps femoris, semitendinosus, semimembranosus and gracilis
37
Knee joint extension muscles?
Quadriceps femoris
38
Tremdelenburg test?
1. Position hands on iliac crests 2. Ask patient to life each foot in turn off of floor 3. When right foot is raised, left hip abductors are tested. When left foot is raised, right hip abductors tested. *if there is weakness in abductors, will be unable to stabilise hip on weight bearing femur so pelvis will sag towards unsupported side*
39
Quadriceps examination?
Knee extension - bend knee and ask patient to straighten whilst applying resistance *femoral nerve*
40
Hamstrings examination?
Instruct patient to begin flexing the knee towards themselves against resistance *sciatic nerve*
41
Assessing doriflexion?
Resist by pushing foot downwards Tibialis anterior, extensor hallucis and extensor digitorum longus Innervated by deep fibular nerve
42
Assessing plantarflexion?
Resist by pushing foot upwards and ask patient to point foot downwards Innervated by tibial nerve (S1-2)
43
Assessing inversion?
Place hand laterally and instruct patient to push against applied resistance *takes place at subtalar joint*
44
Assessing eversion?
Place hand medial and instruct patient to push against applied resistance
45
Patellar reflex tendon assessment?
Assess knee jerk (L3-L4) *legs hanging freely over base* Jendrassik manoeuvre (gritting teeth and flexing both sets of fingers) Tap patellar tendon with tendon hammer
46
Ankle jerk reflex
S1-2 at Achilles tendon Support leg so hip is slightly abducted, knee is flexed and ankle dorsiflexed
47
Sciatica
Caused by herniated lumbar intervertebral disc which compresses on L5-S1 component of sciatic nerve
48
Borders of femoral triangle
1. Inguinal ligament (superior) 2. Adductor longus (medial) 3. Sartorius (lateral)
49
Dermatomes L1-S3 innervation?
L1 Area of inguinal ligament L2 Lateral side of thigh L3 Lower medial side of thigh L4 Medial side of leg, medial foot and great toe L5 Lateral side of leg, mid dorsum of foot and middle three toes S1 Little toe, lateral foot, and sole footprint area S2 Back of upper leg and whole thigh S3 Area of gluteal fold
50
Compartment syndrome meaning?
Pressure in muscle compartment is so high that the venous drainage becomes blocked - pressure increases such that muscle ischaemia and death can arrive
51
Femoral nerve lesion motor loss?
Quadriceps paralysis - weakness of knee Difficulty climbing up or down stairs
52
Femoral nerve lesion sensory loss?
Anterior and medial thigh, medial side of leg and medial border of foot. Saphenous nerve affected.
53
Obturator nerve lesion motor loss?
Paralysis of all adductors Cross legging affected
54
Obturator nerve lesion sensory loss?
Pelvic disease, ovarian tumours may cause pain on medial thigh Medial cutaneous nerve of thigh
55
Common fibular nerve lesion motor loss?
Foot extensors and evertors paralysed Foot flop Perineal muscles (lateral compartment) Tibialis anterior, EDL and EHL
56
Common fibular nerve lesion sensory loss?
Loss in anterior and lateral side of leg and dorsal of foot
57
Tibial nerve lesion motor loss?
Hamstrings and all posterior muscles of leg and sole of foot Foot - in dorsiflexed and everted position Gastrocnemius, soleus, tibialis posterior, FHL + FDL Intrinsic foot flexors, interossei and lumbricals
58
Tibial nerve lesion sensory loss?
Sole of foot
59
Compartment syndrome causes?
Fractures, burns, infections or prolonged limb compression Present with pain, muscle tenderness and swelling
60
Compartment syndrome 6 Ps?
Pallor Pulselessness Paralysis Perishingly cold Pain Paraesthesia
61
Compartment syndrome examination?
Swollen limb and passive movement painful
62
Compartment syndrome treatment?
Relieve pressure, all dressings, casts and slings removed Open fasciotomy - surgical procedure where skin and deep fascia opened along the length of a muscle compartment to relieve pressure

CPA (9 decks)

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