neuro Flashcards
observation of upper limbs
muscle atrophy fasciculations skeletal deformity scars tremors involuntary movements
physiological tremor
fine, fast upper limb tremor
increased by anxiety, alcohol excess, hyperthyroidism
parkinsonian tremor
slow, coarse, greater at rest, usually asymetrical
dystonia
sustained muscle contractions
twisting + repetitive
chorea + athetosis
writhing movements
ballismus
violent swinging movements
ticks
repetitive + stereotyped
can be suppressed by patient
when assessing tone of upper limbs what movements are looked at
passive movement of elbow flexion + extension, forearm supination + pronation and wrist flexion + extension
spasticity
form of hypertonia
velocity dependent - worse when moved quicker
varies throughout joint motion
UMN lesion, may be accompanied by weakness and hyperreflexia
rigidity
form of hypertonia
sustained resistance even with slow movement and present throughout full joint motion
lead-pipe rigidity
cog-wheel rigidity
what movements are tested during upper limb power
shoulder abduction elbow flexion + extension wrist flexion and extension finger extension finger flexion finger abduction thumb abduction
what nerves + muscles being tested during resistance of shoulder abduction
C5
axillary nerve
deltoid and other shoulder abductors
what nerves + muscles being tested during power of elbow flexion
C5/6
musculocutenous and radial nerves
biceps brachii, coracobrachialis, brachialis
what nerves + muscles being tested during resistance of elbow extension
C7
radial nerve
triceps brachii
what nerves + muscles being tested during power of wrist extension
C6
radial nerve
extensors of wrist
what nerves + muscles being tested during power of wrist flexion
C6/7
median nerve
flexors of wrist
what nerves + muscles being tested during resistance of finger extension
C7
radial nerve
extensor digitorum
what nerves being tested during resistance of finger flexion
median and ulnar nerves
what nerves + muscles being tested during resistance of finger abduction
T1
ulnar nerve
intrinsic muscles hanfd
what nerves + muscles being tested during resistance of thumb abduction
T1
median nerve
abductor pollicis brevis
UMN lesion pattern of weakness
pyramidal pattern of weakness that disproportionately affects upper limb extensors and lower limb flexors
LMN lesion pattern of weakness
focal pattern of weakness
only muscles directly innervated by damaged neurones affected
what does presence of pronator drift indicate
contralateral pyramidal tract lesion
co-ordination tests upper limb
outstretched arms
finger-nose test
rapid alternating hand movements
biceps reflex
C5/6
supinator reflex
C6
triceps relfex
C7
what is hyperreflexia suggestive of
UMN lesion e.g. stroke
C5 dermatome area
regimental badge area
c6 dermatome area
palmar side thumb
c7 dermatome area
palmar side middle finger
c8 dermatome area
palmar side little finger
t1 dermatome area
medial aspect antecubital fossa
proximal to medial epicondyle humerus
sensation tests upper limb
light touch
pinprick
vibration sense
joint position sense
checking tone lower limbs
hip rotation: roll thighs
knee flex and extend
lift knee and drop quickly
ankle flex and extend
ankle clonus
brisk rhythmic contraction of calf muscles
UMN lesion