Anatomic Basis of Clinical Testing Pt. 1 (9/3a) Flashcards
How we understand patient anatomy
Observing, palpatings, imaging, clinical tests (EX: PT kits)
Studying Anatomy (Anatomy Approaches)
Regional approach
Systemic approach
Clinical anatomy
Regional approach (Anatomy Approaches)
Head, Neck, Trunk (abdomen, thorax, pelvis/perineum, back), Upper limbs, Lower Limbs
Regions further subdivided
We will do this each unit
Systemic approach (Anatomy Approaches)
Cardiovascular, digestive, endocrine, immune, integumentary, lymphatic, muscular, nervous, reproductive, respiratory, skeletal, urinary
1 I, 2 S, 3 A, 4 M, 5 N, 6 C, 7 D, 8 R, 9 U, 10 G, 11 E
No systems function in isolation
Clinical anatomy (Anatomy Approaches)
Stresses clinical application
Consider how the systems interrelate
EX: Ulnar nerve at the elbow - Instead of “the nerve innervates…..” ask “numbness in this location indicates what nerve?”
3 main planes of the body
Sagittal, frontal, transverse
Relationships in plane movement
Superior/Inferior Proximal/Distal Anterior/Posterior Medial/Lateral Superficial/Deep Dorsal/Ventral
Motions related to anatomic neutral
Flexion/Extension
Abduction/Adduction
Medial Rotation/Lateral Rotation
Supination/Pronation
Major divisions of the nervous system
Central NS/Peripheral NS
Somatic/Autonomic
Afferent/Efferent
Functional unit of the nervous system
neuron
Cell body (neuron)
cell’s life support center
Dendrites (neuron)
receive messages from other cells
Axon (neuron)
passes messages away from the cell body to other neurons, muscles, or glands
Neural impulse (neuron)
electrical signal traveling down the axon
Myelin sheath (neuron)
covers the axon of some neurons and helps speed up neural impulses
Terminal branches of axon (neuron)
form junctions with other cells
Spinal cord segments
31 spinal cord segments:
8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
Spinal nerves arise from rootlets into
Anterior (ventral) nerve root – efferent fibers
Posterior (dorsal) nerve root – afferent fibers
Mixed nerves
“Sensory nerve” mostly sensory afferents some motor fibers
sweat and smooth muscle vessels
“motor nerve’ mostly motor some sensory: pain and proprioception info
Dermatomes
provide surface sensory innervation
Segmental cutaneous (skin) innervations (afferent)
Myotomes
provide muscle innervation
Segmental innervation of muscles (efferent)
Axons from spinal nerves combine to ultimately form ___ ___
peripheral nerves
Symptoms of nervous system impairment
Paresthesia
Diminished/lost sensation
Weakness (decreased innervation to muscle)
Pain
Movement dysfunction
Paresthesia
sensation of tickling, tingling, burning, pricking, or numbness of a person’s skin
Causes of nervous system impairment
Too much pressure
Ischemia (blood loss)
Metabolic/chemical changes (EX: diabetic neuropathy)
Disease
Trauma
Pattern recognition - Sensory
Spinal nerve distribution - dermatome
Peripheral nerve distribution - myotome
Spinal cord distribution (later)
Brachial plexus (trunk, cord) distribution (later)
Brain distribution (later)
3 types of sensory testing
Superficial
Deep
Combined cortical
Superficial Sensory Testing (exteroceptors)
Pain, temperature, light touch, pressure
Deep Sensory Testing (proprioceptors)
Position sense, kinesthesia, vibration
Combined Cortical Sensory Testing
Stereognosis, 2-pt. discrimination, graphesthesia, texture, barognosis
