Neuro Flashcards
What gives taste to anterior 2/3 of tongue
facial n (CN 7)
What gives taste to posterior 1/3 of tongue
Glossopharyngeal n (CN 9)
If Oculomotor n (CN 3) is down then what will occur
- inability to elevate eye
- inability to depress eye
- inability to adduct eye
If Trochlear n (CN 4) is down then what will occur
inability to depress and adduct the eye
What muscle does the trochlear n (CN 4) innervate
superior oblique
What will occur if the Trigeminal n (CN 5) is down
- loss of facial sensation
- loss of jaw reflex
- jaw deviation toward side of lesion
- loss of corneal reflex
- loss of masseter and temporalis contraction with active jaw closing
What will occur if the Abducens n (CN 6) is down
adduction of the eye (due to loss of ability to abduct the eye)
What will occur if the Facial N (CN 7) is down
- loss of taste to ant 2/3 of tongue
- loss of facial expressions
Gag reflex will be impacted by what nerve being down
Glosspharyngeal (CN 9) or Vagus n (CN 10)
Uvular deviation AWAY from lesion will be seen by what CN being down
CN 10: Vagus N
Inability to protrude tongue and lateral deviation of tongue TOWARDS the lesion will be seen with what CN being down
CN 12: Hypoglossal
Which two cranial nerves will have CL deviation (away from side of lesion) when down
- Facial (CN 7)
- Vagus (CN 10)
Which two cranial nerves will have IL deviation (towards side of lesion) when down
- Trigeminal (CN 5)
- Hypoglossal (CN 12)
Lack of awareness of the body structure or relationship of body parts
Somatoagnosia
Severe condition lack of awareness of one’s paralyssi
Anosagnosia
Cannot recognize objects presented
Visual agnosia
No idea of how to perform an action (no concept of what to do)
Ideational apraxia
Can only perform a task automatically and cannot perform it on demand
Ideomotor apraxia
Clinical findings with Spinal Accessory nerve (CN 11) injury
- Decr cervical lordosis
- Downwardly rotated scap
- Lateral winging of scapula
- Neck, shoulder, medial scapular pain
What innervates the supraspinatus, infrapsinatus
Suprascapular N (C5-C6)
What nerve levels are impacted with Erb’s palsy
C5-C6
What will be seen with suprascapular nerve injury
- Dull ache in lateral shoulder
- Atrophy/weakness with supraspinatus and infraspinatus
- Incr scapular elevation with arm elevation
What does the Musculocuteaneous nerve (C5-C6) innervate
Coracobrachialis, Brachialis, and Biceps brachii
What provides sensory input to lateral forearm
Musculocutaneous n (C5-C6)
What will be seen with injury to Musculocutaneous n (C5-C6)
- Lateral arm sensory changes
- Weakness/atrophy with elbow flexors
- Diminished biceps reflex
What does tha axillary n (C5-C6) innervate
- Teres Minor
- Deltoid
What will be seen with axillary n injury
- Axillary pain
- Deltoid area paresthesia
- Atrophy of deltoid and teres minor
- Elevation weakness
- Abd weakness
- ER weakness
What innervates serratus
Long thoracic n (C5-C7)
What would cause medial winging of scapula nerve wise
Injury to the long thoracic n
Crutch use would cause issues with what nerve
Radial N (C6-T1)
Posterior interosseous nerve innervatees what and is a branch of what nerve
supintor
branch of radial n
Thenar wasting (ape hand) is seen with what nerve injury
Median n injury (C5-T1)
Inability to do the OK sign is weakness with what nerve
Anterior Interosseous n (branch of median)
What muscles and nerve does the OK sign (tip to tip) test
FPL and FDP
-Anterior Interosseous n
What nerve is injured if you attempt to make a fist and the first 3 fingers do not flex but the last 2 do flex
Median n
What neve is injured if at rest the last 2 fingers are flexed and the others are extended
Ulnar n
Froment’s sign tests what
Ulnar n
Adductor Pollicis
What innervates the adductor pollicis
Ulnar N
Inability to extend the PIP/DIP will be seen with a lesion to what nerve
Ulnar N
Hypothenar wasting seen with what nerve injury
Ulnar
Loss of key pinch grip is called what and means what muscle and nerve is down
Froment’s sign
Loss of Adductor Pollicis
Loss of ulnar n
What neerve levels of affected with Klumpke’s Palsy
C7-T1
What is Klumpke’s palsy also known as
claw hand
What is impacted in Klumpke’s palsy
loss of intrinsics of the hand
What is the differentiating factor between lateral epicondylitis and posterior interosseous nerve lesion
- No sensory for posterior interosseous nerve lesion
- Lateral epicondylitis will have true sensory issues due to pain
What muscle will subsittue in the loss of musculocutaneous nerve
brachioradialis
What nerve innervates the supinator
radial
Ape hand = issue with what nerve
median
Weakness with elbow flex, wrist ext, and diminished brachioradialis reflex
C6 myotome
What nerve is the issue when there is weakness with shoulder abd and ER =
axillary n
No tip-to-tip piinch of 1st and 2nd fingers
anterior interosseous n syndrome
Weakness with elbow ext and diminished tricpes reflex
C7 or radial n
If the L4/L5 disk is herniated which nerve root is more likely to be impacted
L5
What is a compensation for weak quads
Forward trunk lean
What does the Femoral n (L2-L4) innervate
- Illiopsoas
- Sartorius
- Pectineus
- Quads
Sensory: to medial thigh, medial knee, proximal leg
What will be seen with injury to femoral n
- knee buckling
- knee ext weakness
- anterior knee pain
- sensory loss medial aspect of leg
- forward trunk lean (compensatory for weak quads)
Saphenous n is a branch of what nerve and where does it supply sensation to
Femoral n
sensory to medial calf
Sural n is a branch of what nerve and where does it supply sensation to
tibial n
sensory to lateral calf
What will be seen if obturator n is injured
- Loss of hip ER
- Loss of hip add
What innervates gluteus medius, glut min, and TFL (deep muscles)
Superior glueteal n (L4-S1)
What innervates glut max
-Inferior gluteal n (L5-S2)
What will be seen with inferior gluteal n (L5-S2) injury
posterior trunk lean at IC
What will be seen with superior gluteal (L4-S1) n injury
Trendelenburg
What innervates TA
deep peroneal n
What provides sensory input to first webspace of foot
deep peroneal n
foot slap will be seen with injury to what nerve
deep peroneal
What provides input to fibularis longus, fibularis brevis
superficial peroneal n
What provides input to gastroc/soleus, popliteus, tibilais posterior, flexor digitorum longus, and flexor hallucis longus
Tibial n (L4-S3)
What provides sensation to dorsum of foot
superficial peroneal n
what will be seen with tarsal tunnel syndrome
weak foot intrinsics
full active ROM but may have pain with foot pronation
Weak toe flex and lateral foot paresthesia
tibial n
What nerve is impacted if someone has weak eversion
superficial peroneal n
Weak DF and sensory loss over first webspace of foot
deep peroneal n
1+ patellar tendon reflex, weak hip flex, loss of sensation on medial malleolus
femoral n
Occurs during first trimester during utero; fibrosis of muscles; caused by poor movements in early development
Arthrogryposis Multiplex Congentia (AMC)
What is the cause of Bell’s palsy
autoimmune
Is full recovery likely for cauda equina syndrome
No
Caused by non-closure of neural tube by 28th day of gestation
Spina Bifida
What is TOS caused by
- Enlarged first rib
- Tight SCM, scalenes
- Tumor
- Pregnancy
SCIs above what level can lead to AD
T6 or higher can be prone to AD
What will be seen with Brown Sequard lesion
- CL pain and temp loss
- IL motor loss
- IL loss of fine touch/proprioception
What will be seen with central cord syndrome
UE more affected than LE
Distal more affected than proximal
MOI for central cord injury
forced hyperextension
MOI for anterior cord injury
flexion or vascular
What will be seen with anterior cord syndrome
BL loss of motor
BL loss of pain and temp
What type of bladder seen with a lesion to S2-S4 above conus medullaris (L1)
spastic/hyperreflexive
What type of bladder seen with a lesion to S2-S4 below the conus medullaris (L1)
flaccid/areflexive bladder
_____ or less on Glasgow coma scale = coma
8 or less
What are the 3 categories on the Glasgow coma scale
- ) Eye opening response
- ) Best verbal response
- ) Best motor response
UE Flexion Synergy pattern
- Scapular Retraction and elevation
- Shoulder abduction
- Shoulder ER
- Forearm supination
- Wrist flexion
- Finger flexion
UE Extension synergy pattern
- Scapular protraction
- Shoulder adduction
- Shoulder IR
- Elbow Ext
- Forearm pronation
- Wrist flexion
- Finger flexion
LE Flexion synergy pattern
- Hip flexion
- Hip ER
- Knee flexion
- Ankle DF
- Ankle Inv
- Toe DF
LE Extension synergy pattern
- Hip extension
- Hip adduction
- Hip IR
- Knee ext
- Ankle PF
- Ankle Inv
- Toe PF
When would be best for someone with MS to have PT
mornings…..due to fatigue in afternoons
What position will someone’s UE be in if they have Erb’s palsy (C5-C6 brachial plexus injury)
“Waiter’s tip”
- Scapular depression
- Shoulder ADD
- Shoulder IR
- Elbow extension
- Forearm pronation
Supplies the entire medial of the medulla, including the anterior part of the spinal cord
Anterior spinal artery
supplies the cerebellum
posterior inferior cerebellar artery
Reflex grade:
No response
0
Reflex grade:
Diminished response; may or may not be abnormal
1+
Reflex grade:
Normal
2+
Reflex grade:
Brisk/exagerrated; may or may not be normal
3+
Reflex grade:
hyperactivie; always abnormal
4+
What level does biceps tendon reflex test
C5-C6
What level does brachioradialis tendon reflex test
C5-C6
What level does Triceps tendon reflext test
C6-C7
What level does patellar tendon reflex test
L3-L4
What level does Achilles tendon reflex test
S1-S2
Dermatome/Myotome:
C1
Top of skull, N/a
Dermatome/Myotome:
C2
Forehead, N/a
Dermatome/Myotome:
C3
Neck, breathing
Dermatome/Myotome:
C4
Shoulder, shoulder shrug
Dermatome/Myotome:
C5
Radial styloid process, Deltoid
Dermatome/Myotome:
C6
Tip of thumb, Biceps or wrist ext
Dermatome/Myotome:
C7
Tip of middle finger, Triceps or wrist flex
Dermatome/Myotome:
C8
Tip of pinky, thumb ext
Dermatome/Myotome:
T1
Medial forearm, interossei
Dermatome/Myotome:
T2
Subclavicle/armpit area, n/a
Dermatome/Myotome:
T4
Nipple line
Dermatome/Myotome:
T10
Belly button, n/a
Dermatome/Myotome:
T12
ASIS
Dermatome/Myotome:
L1
Upper groin, n/a