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NMS 1 > Unit 2 Info > Flashcards

Unit 2 Info Flashcards

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0
Q

Dermatome: posterior aspect of the shoulders

A

C4

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1
Q

Primary sensory modality is not in working order deficit referred to as

A

Analgesia

Anesthesia

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2
Q

Dermatome: lateral aspect of the upper arms

A

C5

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3
Q

Dermatome: medial aspect of the lower arms

A

T1

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4
Q

Dermatome: tip of the thumb

A

C6

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5
Q

Dermatome: tip of the middle finger

A

C7

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6
Q

Dermatome: tip of the pinky finger

A

C8

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7
Q

Sensory distribution: AXILLARY NERVE

A

LATERAL DELTOID

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8
Q

Sensory distribution: MUSCULOCUTANEOUS

A

LATERAL FOREARM

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9
Q

Sensory distribution: RADIAL NERVE

A

WEB SPACE, THUMB AND INDEX FINGER

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10
Q

Sensory distribution: ULNAR NERVE

A

DISTAL ULNAR ASPECT OF 5TH DIGIT

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11
Q

Sensory distribution: MEDIAN NERVE

A

DISTAL RADIAL ASPECT OF PALM AND DIGITS 1-3

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12
Q

Superficial sensory exams test for which modalities and what is used to test each modality?

A

Pain (sharp, pin prick)
Temperature (test tubes with hot or cold water)
Light touch (cotton swab, small brush)

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13
Q

Neuro-pathway for light touch would be thru the __________ of the cord to the thalamus.

A

anteriorlateral columns (anterior spinothalamic tract)

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14
Q

Deficits to light touch in dermatomal pattern may indicate __________ or ____________.

A

Nerve Root compression

Peripheral nerve lesions

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15
Q

Pain examination finds problems in the _________ tract.

A

lateral spinothalamic

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16
Q

Deficits to pain in dermatomal pattern may indicate _____________ or ___________.

A

Nerve Root compression

Peripheral nerve lesions

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17
Q

Alganesthesia/analgesia:
Hypalgesia:
Hyperalgesia:

A

areas insensitive to pain
decreased sensation
increased sensitivity

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18
Q

Pallanathesia

A

Loss of vibratory sense

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19
Q

Tractus ________ for upper extremity

Tractus ________ for lower extremity

A

Cuneatus

Gracilis

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20
Q

Temperature examination:
Cold: ________ degrees F
Hot: ________ degrees F

A

41-50

104-113

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21
Q

Compression of dorsal nerve root signs/symptoms

A

Numbness and tingling are most common
Loss of vibration or position sense
Hyporeflexia with no muscle atrophy- No sensory input of stretch, but muscle can shorten and work normally

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22
Q

Compression of the anterior nerve root (motor) signs/symptoms

A

Muscle weakness
Loss of DTR – Muscle not responding, could have atrophy
No pathologic reflexes are present
Vasomotor changes due to autonomic nervous system being affected

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23
Q

Causes of nerve root compression

A 
Disc herniation 
Degenerative joint disease
Recent trauma 
Inflammatory changes 
Tumors
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24
Strength testing 0/5
Complete paralysis, 0% of normal movement | No evidence of contraction
25
Strength testing 1/5
A twitch of the muscle, trace, 0-10% of movement | Dr. can feel muscle action but no movement seen
26
Strength testing 2/5
Moderate to severe paresis, active movement is available when gravity eliminated 11-25% of normal movement Patient lay on side and move joint through full range without gravity
27
Strength testing 3/5
Moderate paresis, active movement against gravity 26-50% of normal movement Complete range of motion against gravity
28
Strength testing 4/5
Mild paresis, active movement against gravity andmild resistance 51-74% of normal movement Usually resistance of two fingers
29
Strength testing 5/5
Normal strength | 76-100% of normal movement
30
Muscle tests for C5
DELTOID, BICEPS
31
Muscle tests for C6
BICEPS, WRIST EXTENSORS
32
Muscle tests for C7
WRIST FLEXORS, FINGER EXT
33
Decreased muscle tone indicates what kind of lesion?
LMNL
34
Increased muscle tone indicates what kind of lesion?
UMNL
35
Spasticity
increased muscular resistance felt by the examiner during quick joint movement which quickly fades away aka “clasped knife”
36
Spasticity is associated with ______ or _______ lesions (_MNL).
cortical pyramidal (UMNL)
37
Rigidity
involuntary muscular resitance felt when moving a resting joint and persists as the joint is moved through its entire range of motion. Aka “gooseneck” rigidity, like bending a microphone holder
38
Rigidity is consistent with _________ pathways related to muscle spindle mechanism interference from diseased __________ structures (_MNL)
extrapyramidal extrapyramidal UMNL
39
Hypotonia is usually indicative of neurologic issues at the level of the ___________ (_MNL).
reflex arc | LMNL
40
Neural shock may occur following acute severe ________ motor neuron damage in the brain or spinal cord. Unique because suddenly occurring _______ first causes only _______ type symptoms
upper UMNL peripheral
41
Deficit Phenomenon
Loss of normal neurological function.Reduced muscle tone, muscle stretch reflexes, muscle strength, volume, (LMNL).
42
Release Phenomena
Exaggerations or perversions of normal neurological function due to a loss of cortical inhibition. Hyper-reflexia, hypertonia, and pathologic reflexes.
43
Biceps Reflex nerve supply
C5 | Musculocutaneous
44
Nerves tested in the Brachioradialis Reflex
C6 | Radial
45
Nerves tested in the Triceps Reflex
C7 | Radial
46
Nerves tested in the Finger flexion reflex
C8 | Median/ulnar
47
C5 Reflex
Biceps Reflex, Musculocutaneous
48
C6 Reflex
Brachioradialis Reflex, Radial
49
C7 Reflex
Triceps Reflex, Radial
50
C8 Reflex
Finger Flexion Reflex, Median/ulnar
51
Musculocutaneous Reflex
Biceps Reflex, C5
52
Median/ulnar Reflex
Finger flexion Reflex, C8
53
Radial Reflex
Brachioradialis Reflex, C6 | Triceps Reflex, C7
54
``` Reflex Grading System 0= 1= 2= 3= 4= ```
``` 0 = Absent 1 = hypoactive 2 = normal 3 = hyperactive 4 = hyperactive with sustained or transient clonus-specify ```
55
Superficial reflexes are graded as ________.
Either present or absent
56
Gag Reflex Segmental/peripheral innervation: Method: Normal:
Segmental/peripheral innervation: CN IX, X Method: Touch posterior tongue or back of throat Normal: Gag and elevation of soft palate, constriction ofpharyngeal muscles
57
Corneal blink reflex Segmental/peripheral innervation Method: Normal finding:
Segmental/peripheral innervation CN V, VII Method: Touch cornea with cotton wisp Normal finding: Blinking of eyes
58
``` Epigastric reflex Segmental innervation Peripheral nerve Method Normal finding ```
Segmental innervation (T5-T7) Peripheral nerve (intercostal) Method: Stimulate from sternum to umbilicus Normal finding: Contraction of upper ab muscles, move umbilicus upward
59
``` Upper Abdominal Reflex Segmental innervation Peripheral innervation Method Normal finding ```
``` Segmental innervation (T7-T9) Peripheral innervation (intercostal) Method: Stimulate upper abs down and out, out to in Normal finding: Contraction of the upper abs, moves umbilicus upand out ```
60
``` Middle Abdominal reflex Segmental innervation Peripheral innervation Method Normal finding ```
Segmental innervation (T9-T11) Peripheral innervation (intercostal) Method: Stimulate skin from level of umbilicus out to in and vertical Normal finding: Contraction of middle abs moving umbilicus laterally
61
``` Lower Abdominal Reflex Segmental innervation Peripheral innervation Method Normal findings ```
``` Segmental innervation (T11-T12) Peripheral innervation (intercostal, iliohypogastric, ilioinguinal) Method Stimulate the skin of lower abs from out to in and up to down Normal findings Contraction of lower abs moving umbilicus down and out ```
62
``` Cremasteric reflex Segmental innervation Peripheral innervation Method Normal findings May not be seen in ```
Segmental innervation (L1-L2) Peripheral innervation (ilioinguinal, genitofemoral) Method: Stroke inner thigh from superior to inferior direction Normal findings: Ipsilateral elevation of the testicle May not be seen in: elderly or hydrocele and varicocele
63
``` Gluteal Reflex Segmental innervation Peripheral innervation Method Normal finding ```
Segmental innervation (L4-S2) Peripheral innervation (inferior gluteal) Method: Stroke skin over glute max Normal finding: contraction of gluteal muscles
64
``` Plantar Reflex Segmental innervation Peripheral innervation Method Normal Abnormal ```
Segmental innervation (L4-S2) Peripheral innervation (tibial) Method: Stroke plantar foot from heel to metatarsals to big toe Normal: plantar flexion of toes and foot Abnormal: dorsiflexion of great toe and flairing of the other toes
65
``` Anal Reflex (wink) Segmental innervation Peripheral innervation Method Normal finding ```
``` Segmental innervation (S2-S5) Peripheral innervation (hemorrhoidal) Method: Stroke skin of perianal area Normal finding: Contraction of external sphincter ```
66
CN IX, X Reflex
Gag reflex
67
CN V, VII reflex
Corneal blink reflex
68
T5-T7 intercostal nerve reflex
Epigastric reflex
69
T7-T9 intercostal nerve reflex
Upper abdominal reflex
70
T9-T11 intercostal nerve reflex
Middle abdominal reflex
71
T11-T12 intercostal/iliohypogastric/ilioinguinal reflex
Lower abdominal reflex
72
L1-L2 or ilioinguinal/genitofemoral reflex
Cremasteric reflex
73
L4-S2 or inferior gluteal reflex
Gluteal reflex
74
L4-S2 or tibial reflex
Plantar reflex
75
S2-S5or hemorrhoidal reflex
Anal reflex (wink)
76
The primitive responses seen with reflexes are pathological if found in _______, but may be normal in _______ up to about _________ of age (or even up to _______ for certain reflexes, such as Babinski’s sign).
Adults Infants up to 6 months of age 2 years
77
Hoffman Sign Method Positive sign Lesion location
Method: Sharp forcible flick of thumb against patient’s middle finger Positive sign: Flexion of fingers and adduction of thumb Lesion location: Segmental (above C5 in corticospinal tract)
78
Tromner Sign Method Positive sign Lesion location
Method: Tap the volmar surface of the middle finger Positive sign: Flexion of fingers and adduction of the thumb Lesion location: above C5 corticospinal tract
79
Rossolimo Sign Method Positive sign Lesion Location
Method: Tap the ball of the foot or tap the tips of the toes Positive sign: Plantar flexion of the toes Lesion Location: Corticospinal tract
80
``` Babinski Sign Method Normal Abnormal Lesion location ```
Method: Stroke plantar foot from heel to metarsals to big toe Normal: plantar flexion of toes and foot Abnormal: dorsiflexion of great toe and flaring of other toes Lesion location: Corticospinal tract; UMNL
81
``` Chaddock Sign Method Normal Abnormal Lesion location ```
Method: Stroke from lateral malleolus on heel to toe Normal: no motion of toes and foot Abnormal: dorsiflexion of great toe and flaring ofthe other toes Lesion location: Corticospinal tract, UMNL
82
``` Oppenheim Sign Method Normal Abnormal Lesion location ```
Method: Stroke anterior tibial surface from superior to inferior Normal: no motion of toes and foot Abnormal: dorsiflexion of great toe and flaring of the other toes Lesion location: Corticospinal tract UMNL
83
``` Gordon Sign Method Normal Abnormal Lesion location ```
Method: Squeeze the calf Normal: no motion of the toes and foot Abnormal: dorsiflexion of great toe and flaring ofthe other toes Lesion location: UMNL, Corticospinal tract
84
``` Schaefer Sign Method Normal Abnormal Lesion location ```
Method: Squeeze the achilles Normal: no motion of thetoes and foot Abnormal: dorsiflexion of great toe and flaring of other toes Lesion location: UMNL, Corticospinal tract
85
Pupillary Light Reflex Segmental innervation Method Normal finding
Segmental: Afferent CN II/Efferent CN III Method: Shine light into one eye watch for constriction in both Normal: bilateral pupil constriction
86
Accomodation Reflex Segmental innervation Method Normal findings
Segmental: CN III Method: Patient look at finger about 2 ft away then follow it in to about 6” away from the nose and then back at an object further away Normal: Convergence of eyes and constriction of the pupils with lens thickening
87
``` Ciliospinal Reflex Afferent Efferent Method Normal finding May signify ```
Afferent: cervicals and CN V Efferent: cervical sympathetics Method: Painful stimulus to side of the neck, pinching the skin Normal finding: Dilation of the pupil on the painful side May signify: cervical sympathetic problem
88
``` Oculocardiac Reflex Afferent Efferent Method Normal finding ```
Afferent: CN V Efferent: CN X Method: Press thumb pressure on eyeball Normal finding: Decrease in heart rate
89
``` Carotid Sinus Reflex Afferent Efferent Method Normal finding ```
Afferent: CN IX Efferent: CN X Method: Pressure on carotid sinus Normal finding: Decrease in heart rate and a fall in the blood pressure
90
Bulbocavernosus Reflex Segmental Innervation Method Normal finding
Segmental Innervation: S3-S4 Method: Stroke, pinch, prick the dorsum of the glans of penis Normal finding: Contraction of the bulbocavernosus muscle, urethral constriction and contraction of anal sphincter

NMS 1 (4 decks)

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