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PTFE NM Flashcards

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1
Q

in the cervical spine, nerves exit _ same number vertebrae

A
  • above
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2
Q

in thoracic and lumbar spine, nerves exit _ same number vertebrae

A
  • below
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3
Q

UE myotomes

A
  • C1/C2: neck flexion, extension
  • C3: neck lateral flexion
  • C4: shoulder elevation
  • C5: shoulder abduction
  • C6: elbow flexion and wrist extension
  • C7: elbow extension and wrist flexion
  • C8: thumb extension
  • T1: abduction/adduction of hand intrinsics
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4
Q

LE myotomes

A
  • L1/L2: hip flexion
  • L3: knee extension
  • L4: ankle df
  • L5: great toe extension
  • S1: ankle PF and EV
  • S2: knee flexion
  • S3: anal wink
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5
Q

dermatomes

A
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6
Q

axillary nerve

A
  • C5-6
  • deltoid, teres minor
  • sensory for proximal lateral arm
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7
Q

musculocutaneous nerve

A
  • C5-7
  • coracobrachialis, brachialis, biceps
  • sensory for lateral forearm
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8
Q

long thoracic nerve

A
  • C5-7
  • serratus anterior
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9
Q

dorsal scapular nerve

A
  • C5
  • rhomboids, levator scapulae
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10
Q

suprascapular nerve

A
  • C5-C6
  • supraspinatus, infraspinatus
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11
Q

neuropraxia

A
  • “it’s coming backsia”
  • transient block from stretch/pressure
  • pain, weakness, numbness, no muscle wasting
  • recovery: minutes to days
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12
Q

axonotmesis

A
  • nerve preserved but axons damaged
  • Wallerian degeneration
  • pain, complete sensory/motor/symp loss w/ muscle wasting
  • recovery: 1 inch/month or 1 mm/day
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13
Q

neurotmesis

A
  • total cut, scarred, severe/prolonged compression
  • no pain w/ muscle wasting -> complete loss
  • recovery: months, only with surgery
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14
Q

medial scapular winging due to

A
  • serratus anterior weakness
  • strengthen w/ push up plus
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15
Q

lateral scapular winging

A
  • due to damage to traps or rhomboids
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16
Q

radial nerve

A
  • C6-T1
  • A: abductor policis longus
  • B: brachioradialis
  • E: extensors
  • A: anconeus
  • S: supinator
  • T: triceps
  • posterior interosseous nerve - muscular branch for ext, sup, APL
  • sensory over dorsal arm and forarm, dorsal hand, 1st web space for thumb
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17
Q

damage to what nerve causes wrist drop

A
  • radial nerve
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18
Q

crutch use can cause injury to what nerve

A
  • radial n
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19
Q

midshaft humeral fx most likely to damage what nerve

A
  • radial nerve
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20
Q

PIN syndrome

A
  • purely motor loss of finger extension
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21
Q

median nerve

A
  • C5-T1
  • 1/2 L: lumbricals
  • O: opponens pollicis
  • A: abductor pollicis brevis
  • F: flexors - radial side
  • P/P: pronators - quadratus and teres
  • sensory for lateral hand (1st 3 digits and half of 4th)
  • anterior interosseous nerve - flexor pollcisi longus, tip to tip pinch grip
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22
Q

ape hand

A
  • thenar wasting
  • d/t median nerve damage
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23
Q

anterior interosseous nerve syndrome

A
  • inability to make OK sign - median nerve
  • tip to tip pinch grip w/ FPL and FDP
  • compensate w/ adductor pollicis (ulnar n)
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24
Q

hand of benediction

A
  • median nerve lesion
  • attempting to make a fist, fingers 1-3 do not flex
  • d/t weakness of flexor digitorum superficialis and flexor digitorum profundus on radial side - innervated by median n
  • NOT to be confused w/ ulnar claw - similar presentation but stuck d/t ulnar nerve palsy
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25
ulnar nerve
- C8-T1 - M: medial 2 lumbricals (3&4) - A: adductor pollicis - F: flexors - ulnar side - I: interossei - dorsal - A: abductor digiti minimi - sensory for little finger and medial half of 4th digit
26
froment's sign
- ulnar nerve - testing adductor pollicis (ulnar n) ability to key grip - froment's (+) - compensating w/ FPL (median n)
27
ulnar lesion hand
- ulnar claw - loss of lumbricals 3-4 that should flex MCP - hand at rest in MCP hyperextension and DIP and PIP flexion
28
erb's palsy
- upper brachial blexus injury (C5-6)
29
klumpke's palsy
- lower brachial plexus injury - C7-T1
30
humeral condylar fractures result in _ n damage
- lateral condylar - radial n - medial condylar - median n
31
no tip to tip pinch of 1st-2nd fingers is
anterior interosseous syndrome (median nerve)
32
a disc herniation is L4-L5 creates what symptoms
- L5 symptoms
33
femoral nerve
- L2-4 - Qu: quads - I: iliopsoas - P: pectineus - S: sartorius - sensory to anterior and medial thigh, medial knee, proximal leg - saphenous nerve - branch of femoral, sensory
34
obturator nerve
- L2-4 - "Hello obturator" - medial compartment - adductor longus/brevis, gracilis, adductor magnus, obturator externus - sensory to small area on medial thigh/groin
35
gluteal nerve
- **superior gluteal nerve (L4-S1)**: glute med, glute min, tensor fascia lata - deeper - **inferior gluteal nerve (L5-S2)**: glute max - superficial
36
sciatic nerve divisions
- **tibial nerve (L4-S3)**: PF, posterior compartment - gastroc, soleus, popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus - sural nerve - sensory of tibial, posterolateral lower leg and lateral foot - **common peroneal (L4-S2)**: - superficial peroneal - EV, fibularis longus/brevus, sensory over lower leg and dorsum of foot - deep peroneal - DF, tibialis ant, extensory digitorum longus, extensor hallucis longus, sensory of 1st webspace of foot
37
tibialis posterior does
- PF and inversion - TP is the issue if there is excessive pronation
38
fibularis longus does
- PF and eversion
39
tarsal tunnel syndrome
- at deltoid ligament at med ankle - pain: medial heel, medial arch, worse w/ standing and walking - medial plantar nerve - motor: weak foot intrinsics - ROM: full AROM, may have pain w/ pronation
40
weak DF and sensory loss over 1st webspace of foot
- deep peroneal n issue
41
weak ankle eversion d/t
- superficial peroneal n
42
ankle actions and corresponding nerves
- PF - tibial nerve - EV - superficial peroneal - DF - deep peroneal
43
CN VII (facial) and X (vagus) injuries
- deviation away from lesion
44
CN V (trigeminal) and XII (hypoglossal) injuries
- toward side of lesion
45
cranial nerve origins
- ce(rebrum): 1, 2 - mi(dbrain): 3, 4 - pons: 5, 6, 7, 8 - medu(lla): 9, 10, 11, 12
46
CN eye movements
- CN 3: elevate, depress, adduct - medial rectus - CN 4: eyes down and out - CN 6: abduct eye - lateral rectus
47
gag reflex
- CN 9: sensory component - CN 10: motor component
48
corneal reflex
- CN 5: sensory - CN 7: motor - if introduce stimulus to L eye and no reaction - sensory issue - if intoduce stimulus to L eye and R eye closes - motor issue
49
optic nerve vs chiasm injury
- optic nerve: blindness in ipsilateral eye - optic chiasm lesion: loss of both lateral fields - optic tract lesion: homonymous hemianopsia
50
spinal tracts that decussate in medulla
- corticospinal tract (motor) - dorsal columns (deep touch, proprioception, vibration)
51
spinal tracts that decussate at spinal level
- spinothalamic tracts (pain, temperature, light touch)
52
key dermatomes & myotomes
- T4: nipple - T10: belly button - L3: med knee - L4: to the floor
53
LE myotomes
- L1-L2: hip **flexion** - L3: knee **extension** - L4: ankle dorsi**flexion** - L5: great toe **extension** - S1: plantar**flexion**
54
central cord syndrome
- Motor > sensory - Upper extremity - Distal - Extension injury
55
anterior cord syndrome
- flexion injury - loss of motor and pain/temp - greater loss in UE than LE
56
brown sequard
- stab or GSW - ipsilat loss of motor, vibration, proprioception - contralateral loss of pain and temperature
57
posterior cord syndrome
- rare - loss of proprioception, 2 pt discrimination, stereognosis - motor function preserved
58
C1-C4 injuries
- tetraplegia or quadriplegia - require complete assistance w/ ADLs - use special controls on WC - cannot drive - 24 hr personal care
59
C5 injury
- can likely raise arms and bend elbows - some or total paralysis of wrists, hands, trunk, legs - can speak and use diaphragm but breathing weakened - need assistance w/ most ADLs but can move from one place to another independently in power WC
60
C6 injury
- paralysis in hands, trunk, legs - important to preserve tenodesis - weakened breathing - can move in/out of WC and bed with assistive equipment - may also be able to drive adapted vehicle - little/no voluntar B/B control but may manage w/ special equipment
61
C7 injury
- most can straighten arm and have normal shoulder movement - can do most ADLs alone but may need assistance for more difficult tasks - may be able to drive adapted vehicle - little/no voluntary control of B/B but can manage on their own
62
C8 injury
- nerves control some hand movement - should be able to grasp and release objects - can do most ADLs alone but may need assistance - may drive adapted vehicle - little/no control B/B but can manage w/ equipment
63
T1-T5 injuries
- arm and hand function normal - paraplegia - affects trunk and legs - usually in a manual WC - can drive modified car - can stand in frame or walk w/ braces (KAFO)
64
T6-T12 injury
- usually paraplegia - normal upper-body movement - fair-good ability to control balance of trunk while seated - should be able to cough productively - little/no control of B/B but manage on own w/ equipment - manual WC - modified car - standing frame or braces
65
L1-L5 injury
- some loss of function of hips and legs - little/no voluntary control of bowel/bladder, can manage w/ equipment - may need WC and braces (AFOs)
66
S1-S5 injury
- some loss of function of hips and legs - little/no voluntary control B/B but can manage w/ equipment - most likely able to walk - can DF, maybe not PF
67
autonomic dysreflexia
- SCI at T6 or above - strong noxious sensory input carried to SC via peripheral nerves - impulse cannot reach brain - s/s: high BP, pounding HA, flushed/red face, sweating, pale, cool skin, bradycardia - **response** - SIT, stop exercise, sit up from supine - check indwelling catheter - kinks, full or overflowing bag
68
brunnstrom stages
1. flaccidity 2. dealing with spasticity apearance 3. increased spasticity 4. decreased spasticity 5. complex movement combinations 6. spasticity disappears 7. normal function returns - flaccidity sucks, then you are dealing with spasticity. first it increases, then it decreases. it's complex but spasticity will disappear, and you will return to normal function
69
MCA stroke
- Most common - Contralateral hemiplegia - Arm (mostly UE worse than LE) - s/s: homonymous hemianopsia, aphasia, apraxia
70
broca's aphase
- Brocas - Frontal - Non-fluent - expressive | like boca - mouth issue
71
wernicke's aphasia
- Wernicke's - Temporal - Fluent | WTF
72
ACA stroke
- altered mental status - impaired judement - contralateral weakness (legs >> arms) - contralateral cortical sensory deficits - gait apraxia w/ initiation - urinary incontinence
73
PCA stroke
- acute vision loss - confusion - posterior cranium HA - paresthesias - limb weakness - dizziness - nausea - memory loss
74
ranchos los amigos levels of cognitive functioning
75
contract relax
- mobility - reach limit, contract antagonist
76
hold relax
- mobility - stretch, then isometrically contract all muscle groups at limiting point in ROM - for patients w/ a lot of pain
77
rhythmic initiation
- mobility - let me move you - help me move you - move against resistance - slow and rhythmic movements w/ correct hand placement
78
slow reversals
- stability, controlled mobility and skill - strengthen and build endurance of weaker muscles and develop co-ordination and establish normal reversal of antagonist muscles
79
joint distraction
- mobility - proprioceptive component used to increase ROM around a joint
80
2 month milestones
- hold head up - push up when on tummy - smoother arm/leg movements
81
4 month milestones
- head steady, unsupported - pushes down on legs when feet are on hard surface - feet and knees locked - may roll tummy to back - head momentum - hold toy - hands to mouth - pushes up to elbow on stomach
82
6 months milestones
- rolls over in both direction - sit w/o support - bounces when standing on legs and feet - rocks back and forth, sometimes crawl backward before moving forward (army crawl)
83
9 months milestones
- stands, holds on - can get into sitting - sits without support - pulls to stand - creeps
84
1 year milestone
- into sitting w/o helps - pulls to stand - walks w/ furniture - few steps w/o holding on - may stand alone
85
18 months
- walks alone - may walk up steps and run - pulls toys while walking - can undress - drinks w/ cup, eats w/ spoon
86
2 years milestones
- stands on tiptoe - kicks ball - begins to run - climbs onto and down from furniture w/o help - walks up and down stairs holding on

NPTE (32 decks)

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