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Cram List for NPTE > MM innervation + SCI > Flashcards

MM innervation + SCI Flashcards

1
Q

SPINAL ACCESSORY NERVE (CN XI

A

Upper trapezius CN XI & C(2),3,4
Middle trapezius CN XI & C(2),3,4
Lower trapezius CN XI & C(2),3,4

SCM

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2
Q

SUPRASCAPULAR NERVE

A 
Supraspinatus C(4),5,(6)
Infraspinatus C(4),5,6
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3
Q

DORSAL SCAPULAR NERVE

A

Levator scapulae C4,5
Rhomboideus minor C(4),5
Rhomboideus major C(4),5

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4
Q

AXILLARY NERVE

innervates what two mm?
where is dermatome?

A

Deltoid (all) C5,6
Teres minor C5,6

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5
Q

MUSCULOCUTANEOUS NERVE

where is dermatome?

A

Biceps brachii C5,6
Brachialis (& radial) C5,6
Coracobrachialis C6,7

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6
Q

What innervates Teres Major?

What actions?

A

LOWER SUBSCAPULAR NERVE

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7
Q

Spinal level for (Lateral) Pectoral Nerve?

A

LATERAL PECTORAL NERVE
Pectoralis major-clavicular fibers C5,6,7
Pectoralis major-sternal fibers C5,6,7

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8
Q

LONG THORACIC NERVE - innervates and injury looks like?

A

Serratus Anterior Latissimus dorsi - C5,6,7,(8)

WINGED MEDIAL BORDER OF SCAP

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9
Q

RADIAL NERVE innervates what mm group

A

UE EXTENSOR GROUP (triceps + forearm) +

Brachioradialis C5,6
Supinator C(5),6,(7)
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10
Q

MEDIAL PECTORAL NERVE innervates?

A

Pectoralis minor C(6*),7*,8, T(1)

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11
Q

MEDIAN NERVE mm groups? Impingement site? parasthesia map area?

A

Thumb OPPOSITION, pronation, radial deviation + Wrist Flexion

Pronator Teres = impingement site

Parasthesia @ Medial forearm, thumb and first 3 fingers

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12
Q

ULNAR NERVE C? - T?

Damage looks like?

Impingement cites?

A

Flex. Ulnaris + Thumb ADDuction, pinky opposition

C8-T1

Cubital Tunnel and Tunnel of Guyon

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13
Q

MIXED MEDIAN-ULNAR = what hand actions?

A

Thumb/finger flex + wrist pronation

Flexor Pollicis Longus C(6),7,8, T1
Flexor Pollicis Brevis C(6),(7),(8), T(1)
Flexor Digitorum Profundus C(7),8, T1
Pronator Quadratus C(7),8, T1

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14
Q

FEMORAL NERVE mm group?

L2,3,(4)

A

Knee Extensors + :

Rectus FEMORIS*** (remember!)
Vastus Medialis
Vastus Lateralis
Vastus Intermedius

Sartorius =Lat rotation and ABD of hip

Pectineus = adductor

Iliacus = hip flexor (Psoas is direct fed by L1-3 )

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15
Q

What innervates psoas vs illiacus

A

Psoas major is innervated by direct branches of the anterior rami off the lumbar plexus at the levels of L1-L3, while the iliacus is innervated by the femoral nerve (which is composed of nerves from the anterior rami of L2-L4).

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16
Q

OBTURATOR NERVE –> what mm group

L2,3,4

A

Adductor Magnus*
Adductor Longus
Adductor Brevis
Gracilis

Namesake: Obturator Externus

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17
Q

SUPERIOR GLUTEAL NERVE

L4,5,S1

A

Tensor Fascia Lata
Gluteus Medius
Gluteus Minimus

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18
Q

SUPERFICIAL FIBULAR NERVE

A

Fibularis Longus L(4),5,S1
Fibularis Brevis L(4),5,S1

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19
Q

FIBULAR NERVE/”Deep Peroneal”
L5*** - where is sensation?

A

FOOT SLAP/DROP may reveal injury

***Tibialis Anterior + Toe extensors

Fibularis Tertius L4,5,S1
Extensor Digitorum Longus L4,5,S1
Extensor Digitorum Brevis L(4),5,S1
Extensor Hallucis Longus L(4),5,S1
Extensor Hallucis Brevis L(4),5,S1

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20
Q

TIBIAL NERVE

Mm groups?

L(4),5,S1,2

A

Knee flexors, Ankle/Toe flexors

Tibialis Posterior L(4),5,S1
Popliteus L(4),5,S1
Semitendinosus L(4)5,S1,2
Semimembranosus L(4),5,S1,2
Plantaris L(4),5,S1,2
Biceps Femoris-long head L(5),S1,2,(3)
Gastrocnemius-medial head S1,2
Gastrocnemius-lateral head S1,2
Soleus L(5),S1,2
Flexor hallicus Longus L5,S1,2
Flexor digitorum Longus L5,S1,2

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21
Q

INFERIOR GLUTEAL NERVE

A

Gluteus Maximus L5,S1,2

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22
Q

COMMON PERONEAL (Fibular) to what mm? (1)

A

Biceps Femoris-short head L5,S1,2

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23
Q

MEDIAL PLANTAR NERVE = aspect of what body part

A

MEDIAL FOOT FLEXORS

Abductor Hallucis L(4),5,S1
Flexor Digitorum Brevis L(4),5,S1
Lumbricals- I L(4),5,S1
Flexor Hallucis Brevis L(4),5,S1

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24
Q

SPINAL ACCESSORY (CN #11) + C1/C2 innrvates….

A

Sternocleidomastoid

Trapezius

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25
Q

CN 8 =?

A

VIII brings sound and information about one’s position and movement in space into the brain.

Vestibulococlear

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26
Q

CN VII = ???

A

FACIAL NERVE!!

Stylohoid
F CN VII
Platysma
Orbicularis Oculi
Frontalis
Nasalis
Orbicularis Oris
Zygomaticus Major & Minor
Levator Labii Superioris
Depressor Anguli Oris
Mentalis
Levator Anguli Oris
Depressor Labii Inferioris (with Platysma)
Buccinator
Corrugator Supercilii

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27
Q

What C-sections and nerve innervate diaphragm?

A

Phrenic nerve - C3-5 keeps diaphragm alive!

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28
Q

List the general order of nerves (Traps - UE) from cervical area (9)

A

1) Accessory (CN 11)
2) Phrenic (C3-5)
3) Supra/Dorsal scap (C4)
4) Axillary (Delts/Tmjr) C5
5) Musculotaneous/Subscap (C6)
6) Lateral Pectoral/Radial (C5-7/C5-T1)
7) Long thoracic (C7)
8) Medial pectoral (C8)
9) Ulnar (C8-T1)

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29
Q

Innervation of scalenes?

A

C3 to C8. Scalene muscles involve the cervical plexus and the brachial plexus;

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30
Q

Innervation of Longus Colli

A

anterior rami of C2-C6 from the cervical plexus.

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31
Q

Nerve roots for Long Thoracic N

A

DIRECT from C5-6-7 - NOT the brachial plexus!

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32
Q

The middle subscapular nerve or the long subscapular nerve is also known as what?

Supplies what mm?

A

thoracodorsal nerve

Lats

33
Q

The _______ nerve from C5 to C6 roots innervates the teres major muscle.

A

subscapular

34
Q

What CRUCIAL mm action does C7 control? What name is this nerve?

A

C7 helps control the triceps + wrist extensor muscles. = TENODESIS

radial nerve*

35
Q

Generally, those with ___ or ____ spinal cord injuries can benefit most from tenodesis grasp because they can control their wrist movements, but have limited finger control. The biomechanical pulling allows individuals to grab and release items despite having limited or no control over their hands.

A

C6-C7

36
Q

C? preserves the ability to flex the elbows. Injuries at this level is likely to have some or total paralysis of wrists, hands, trunk and legs. Can speak and use diaphragm, but breathing will be weakened. No tenodesis grip

A

C5 - deltoid and biceps preserved

37
Q

What cord syndrome?

Damage to the___ of the spinal cord, affecting pain, temperature and touch sensation, but leaving some pressure and joint sensation. Often motor function is unaffected.

A

Anterior cord syndrome

38
Q

MOST COMMON spinal cord injury; incomplete; characterized by impairment in the arms and hands and, to a lesser extent, in the legs. Sensory loss and loss of bladder control may occur.

A

Central Cord Syndrome

39
Q

Contralateral altered sensation/anesthesia to pain and temperature, ipsilateral loss of proprioception + motor paralysis. Tactile sensation spared.

A

Brown-Sequard Syndrome

40
Q

The most common type of spinal cord injury. The spinal cord is bruised but not severed. Inflammation and bleeding occurs near the injury as a result of the injury; extended periods of long-term hospitalization and rehabilitation needed for up to six to 12 months.

A

Spinal Contusion

41
Q

____ = no motor or sensory function is preserved in the sacral segments S4-S5 below injury

A

Asia A - COMPLETE

42
Q

sensory ONLY function is preserved below the neurological level and includes the sacral segments S4-S5. This is typically a transient phase and if the person recovers any motor function below the neurological level, that person essentially becomes a motor incomplete

A

Asia B - Sensory INCOMPLETE

43
Q

motor function is preserved below the neurological level, and MORE than half of key muscles below the neurological level of injury have a muscle grade less than 3 (gravity elimitated)

A

Asia C - motor incomplete

44
Q

motor function is preserved below the neurological level and at least half of the key muscles have a muscle grade of 3 or more (can move against gravity (3) or with additional resistance (4 & 5)).

A

Asia D - motor incomplete

45
Q

Both syndromes are neurosurgical emergencies as they can present with back pain radiating to the legs, motor and sensory dysfunction of the lower extremities, bladder and/or bowel dysfunction, sexual dysfunction and saddle anesthesia.

A

Cauda Equina + Conus Medularris Syndrome

46
Q

Decerberate rigidity

A

Legs/arms straight

result of a midbrain lesion

47
Q

LE flexion synergy - hip, knee, ankle, toes

A

hip Flexed. Abducted. Externally rotated

Knee flexed

Ankle DF + Inversion

Toes EXTENDED (opposite of flexion)

48
Q

UE Flexion synergy - scapula, shoulder, elbow, forearm, wrist/fingers

A

Scapula retracted/elevated

Shoulder abducted and externally rotated

Elbow flexed

Forearm Supinated

Wrist/fingers flexed

49
Q

LE extension synergy - hip/knee/ankle/toes

A

hip - Extension, ADD, IR

Knee extended

Foot PF + Inversion

Toes curled

50
Q

UE extension synergy - Scapula, Shoulder, Elbow, Forearm, Wrist/hand

A

Scap protracted
Shoulder ADD/IR
Elbow Extended
Forearm PROnated
Wrist/Finger Flexion

51
Q

Decortiate rigidity

A

bent arms, clenched fists, and legs held out straight.

52
Q

Clinical outcomes for decerberate v decortiate posturing

A

decerebrate posturing is usually indicative of a lesion lower in the brainstem;

about 10% of individuals who demonstrate decerebrate posturing survive.

53
Q

Mild/Moderate/severe coma ratings (high to low indicates what?)

A

The Glasgow Coma Scale (GCS) classifies Traumatic Brain Injuries (TBI) as Mild (14–15); Moderate (9–13) or Severe (3–8).

54
Q

Brachial Plexus roots and order of structures (roots to ?)

A

Robert Taylor Drinks Cold Beer from 5 to 1

55
Q

Differentiation between ulnar nerve compression at Guyon canal (wrist) vs. cubital tunnel (elbow)

What is ulnar nerve vulnerable to?

A

guyon = burning pain in the wrist and hand followed by decreased sensation in the ring and little fingers

Cubital Tunnel = Numbness and tingling in the hand when the elbow is bent.
Weak grip and clumsiness due to muscle weakness in the affected arm and hand.
Aching pain on the inside of the elbow.

vulnerability = traction, friction and compression.

56
Q

The ? tracts are part of the UMN system and are a system of efferent nerve fibers that carry signals from the cerebral cortex to either the brainstem or the spinal cord. It divides into two tracts: the corticospinal tract and the corticobulbar tract.

A

pyramidal tracts

57
Q

?? tracts are chiefly found in the reticular formation of the pons and medulla, and target lower motor neurons in the spinal cord

serves an essential function in maintaining posture and regulating involuntary motor functions

A
58
Q

These tracts originate in the cerebral cortex, carrying motor fibres to the spinal cord and brain stem. They are responsible for the voluntary control of the musculature of the body and face.

A

pyramidal

59
Q

all the neurones within the descending motor system are classed as

A

upper motor neurones

Their cell bodies are found in the cerebral cortex or the brain stem, with their axons remaining within the CNS

At the termination of the descending tracts, the neurones synapse with a lower motor neurone

60
Q
  • Inhibition of involuntary movements (hyperkinesias), which are particularly evident in ? diseases.
A

extrapyramidal

61
Q

Cardinal signs of UMN damage/lesion

A
  • Hypertonia – an increased muscle tone
  • Hyperreflexia – increased muscle reflexes
  • Clonus – involuntary, rhythmic muscle contractions
  • Babinski sign – extension of the hallux in response to blunt stimulation of the sole of the foot Muscle weakness
62
Q

Conscious proprioception includes what nerve organs

A
63
Q

Tactile mechanoreceptors include:

A
  • Meissner’s corpuscles, which are concerned with a fine touch and two-point discrimination
  • Free nerve endings on hair follicles, which is concerned with a fine touch, and
  • Pacinian corpuscles deal with pressure sense and vibration sense.
64
Q

The primary function of the dorsal column pathway is to convey

The dorsal column nuclei also transmit

A
  • sensory information regarding fine touch, two-point discrimination, conscious proprioception, and vibration sensations from our skin and joints, excluding the head.
  • visceral nociceptive information to the contralateral ventral posterior lateral (VPL) thalamic nucleus, which in turn relays the information to the somatosensory cerebral cortex
65
Q
  • Posterior cord syndrome, also known as posterior spinal artery syndrome- an infraction to posterior spinal artery. This artery supplies the _______

how to test?

A

DORSAL COLUMN PATHWAYS (SENSORY)

Romberg test is part of a neurological exam used clinically to test for the integrity of the posterior column pathway.

Tested features: fine touch, 2-point discrimination, conscious proprioception, and vibration sensation.

66
Q

C5 myo + mvmnt Test where? Root of what nerves? Derm where?

A

Deltoid - Sh ABD Biceps - Elbow Flex TEST @ Biceps tendon Root of musculo + Axillary N (delt) Derm @ lateral shoulder to the elbow

67
Q

C6 myo + derm Where to test? Root of what nerve?

A

C6 = WRIST ext, derm @ prox lateral forearm + thumb Where to test: brachioradialis tendon (medial forearm proximal to radial styloid) Root of MUSCULOCUTANEOUS (+C5) and RADIAL (wrist ext)

68
Q

C7 myo / dermo / test Root of what nerve?

A

Myo = Elbow ext, wrist FLEX, finger ext Derm = mid finger Test @ triceps Root of ULNAR N

69
Q

C8 myo, dermo

A

C8 = finger flexion, sense at Ulnar palm and pinky

70
Q

T1 myo dermo

A

T1 = finger ABD Derm @ medial Elbow

71
Q

L2 myo + movement

A

Iliopsoas - hip flexion

72
Q

L4 myo/dermo , where to test?

A

L4 = knee ext, derm at Med malleolus Test @ patellar tendon

73
Q

L5 myo/mvmnt, dermo

A

5 = 5 toes = DORSIFLEX / Tib A Derm @ dorsum

74
Q

S1 myo/dermo/test site

A

1 = gastroc = PF = Achilles’ tendon

75
Q

L5 myo dermo

A

Myo = Hamstrings - knee flexors + Great toe Ext Derm @ lateral calf and under great toe

76
Q

S2-S5 dermo and reflex

A

S2 = back of thigh, buttocks, genitals S3 = buttocks, gentials S4-5 = buttocks and anal ;)

77
Q

 A fracture of the distal 1/3 of the humerus may cause injury to what nerve with what symptoms

A

Radio nerve injury, wrist drop, inability to extend fingers, sensory loss at dorsum of hand

78
Q

What is the most common nerve injury to occur with an anteriorly dislocated shoulder

A

Axial nerve palsy, inability to ABD shoulder (deltoid loss)

Cram List for NPTE (22 decks)

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