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Neuromuscular and Nervous System > Peripheral Nervous System > Flashcards

Peripheral Nervous System Flashcards

1
Q

A fibers

A

Large, myelinated, high conduction rate
Alpha - muscle spindle primary endings, alpha motor neurons, golgi tendon organs, touch
Beta - muscle spindle secondary endings, touch, kinesthesia, gamma, delta subsets
Gamma – touch, pressure, gamma motor neurons
Delta – pain, touch, pressure, temperature

Sensory components include:
Muscle spindle (primary afferent ending) – primary for low threshold stretch
Muscle spindle (secondary afferent endings) – receptors that respond to changes in length
Golgi tendon organ – responds to tension/stretch of a tendon
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2
Q

B fibers

A

Medium fibers, myelinated, reasonably fast conduction

Preganlionic fibers of the autonomic system

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3
Q

C fibers

A

Small fibers, poorly myelinated or unmyelinated, slowed conduction rate
Postganglionic fibers of the sympathetic system
Exterereceptors for pain, temperature, and touch

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4
Q

CN I

A

Olfactory

Test ability to identify familiar odors with eyes closed.

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5
Q

CN II

A

Optic

Identify/read objects on a chart or diagram. Positive test is inability to identify objects at a reasonable distance.

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6
Q

CN III

A

Oculomotor
Pt asked to follow finger with eyes vertically, horizontally, and diagonally. Inspect eyes for asymmetry or ptosis (eyelid drooping)

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7
Q

CN IV

A

Trochlear

Pt follows finger in downward direction. Positive test indicated by inability to depress the eyes/complains of diplopia.

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8
Q

CN V

A

Trigeminal
Pt closes eyes and PT touches face with cotton or safety pin. Pt asked to classify as sharp or dull. Motor component tested by mandibular protrusion, retrusion, and lateral deviation.

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9
Q

CN VI

A

Abducens

Pt follows finger in lateral direction (abduction).

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10
Q

CN VII

A

Facial
Pt distinguishes between sweet and salty substances placed on anterior portion of tongue. Motor component tested by performing facial expressions (close eyes tight, smile, whistle, and puff cheeks).

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11
Q

CN VIII

A

Vestibulocochlear
Bring ticking watch to ear while standing behind pt. Record distance from ear when pt is able to identify ticking sound. Positive test indicated by inability to hear at 18-24 inches or significant difference between ears. Can also perform Weber and Rinne tests.

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12
Q

CN IX

A

Glossopharyngeal
Touch pharynx with tongue depressor. Positive if no gagging or inability to feel back of throat with depressor. Sensory component tested by ability to distinguish taste, especially sour and bitter, on the posterior third of tongue.

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13
Q

CN X

A

Vagus
Touch pharynx with tongue depressor. Positive if no gagging or inability to feel back of throat with depressor. Also assess movement of soft palate and uvula. Taste of tongue and epligottis

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14
Q

CN XI

A

Accessory

Positive test is inability to maintain shoulder shrug against resistance.

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15
Q

CN XII

A

Hypoglossal
Ask pt to protrude tongue. Positive test indicated by inability to fully protrude or tongue deviation to one side (deviates to affected side)

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16
Q

Abdominal Reflex

A

T8-L1

Normal response is contraction of abdominals and deviation of umbilicus in direction of stimulus

17
Q

Corneal “blink” reflex

A

Trigeminal and facial nerves
Ask pt to look up and away from you then stroke cornea with cotton. Normal response is both eyes will blink with contact to 1 eye.

18
Q

Cremasteric reflex

A

L1-2

Scratch the skin of the upper medial thigh. Brisk and brief elevation of ipsilateral testicle is normal.

19
Q

Gag reflex

A

Glossopharyngeal and vagus nerves

Lightly stimulate each side of the back of the throat. Normal reaction is a gag in most of people.

20
Q

Plantar/Babinski reflex

A

L5-S1

Flexion of toes is abnormal and indicates CNS lesion.

21
Q

Biceps DTR

A

C5-6

22
Q

Brachioradialis DTR

A

C5-6

23
Q

Triceps DTR

A

C6-7

24
Q

Patellar tendon DTR

A

L3-4

25
Q

Achilles tendon DTR

A

S1-2

26
Q

Superficial sensation

A

Temperature, light touch, pain

27
Q

Deep sensation

A

Proprioception, kinesthesia, vibration

28
Q

Cortical

A

Bilateral simultaneous stimulation, stereognosis, barognosis, two-point discrimination, localization of touch.

29
Q

Neurapraxia

A

Mildest form of nerve injury; axon is intact
Conduction block due to myelin dysfunction but nerve conduction preserved
Symptoms include pain, minimal muscle atrophy, numbness or greater loss of motor and sensory function, diminished proprioception
Recovery takes 4-6 wks
Usually due to pressure injury

30
Q

Axonotmesis

A

More severe injury to peripheral nerve
Damage to axons with preservation of endoneurium, epineurium, schwann cells, and supporting structures
Distal Wallerian degeneration may occur
Nerve can regenerate distal to site of lesion at 1 mm/day
May or may not recover; may require surgery to repair
Usually due to traction, compression, and crush injuries

31
Q

Neurotmesis

A

Most severe injury to peripheral nerve
Axon, myelin, and connective tissue all damaged
Irreversible injury, no regeneration
Flaccid paralysis and wasting of muscles; total loss of sensation distal to lesion
May recover with surgical reattachment, proximal before distal
Due to complete transection of nerve trunk

32
Q

Upper Motor Neuron Disease

A

Lesion found in descending motor tracts within the cerebral motor cortex, internal capsule, brainstem, or spinal cord (lateral white column)
Weakness of muscles, hypertonicity, hyperreflexia, mild disuse and atrophy, and abnormal reflexes
Examples: cerebral palsy, hydrocephalus, ALS (both upper and lower), CVA, birth injuries, MS, Huntington’s chorea, TBI, pseudobulbar palsy, brain tumors

33
Q

Lower Motor Neuron Disease

A

Affects nerves or their axons at or below the level of the brainstem; can be within ventral gray column of spinal cord
Flaccidity or weakness of involved muscles, decreased tone, fasciculations, muscle atrophy, decreased or absent reflexes
Examples: poliomyelitis, ALS (both upper and lower), GBS, tumors involving spinal cord, trauma, progressive muscular atrophy, infection, Bell’s palsy, carpal tunnel syndrome, muscular dystrophy, spinal muscular atrophy

Neuromuscular and Nervous System (16 decks)

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