Neuro/NMSK Flashcards
Upper Motor Neuron
lesion found in descending motor tracts within cerebral motor cortex, internal capsule, brainstem, or spinal cord
hyperreflexia, hypertonicity, mild disuse atrophy
UMN Diseases
ALS (both)
MS
CP
CVA
TBI
Huntington’s chorea
brain tumors
Lower Motor Neuron
lesion that affects nerves or their axons at or below the level of the brainstem, usually within “final common pathway”
flaccidity, hypotonia, hyperreflexia, fasciculations, muscle atrophy
LMN Diseases
ALS (both)
Guillan Barre
Bell’s palsy
CTS
muscular dystrophy
spinal muscular atrophy (SMA)
poliomyelitis
Reflex Grading: Deep
0: absent
1: diminished
2: normal
3: brisk/exaggerated
4: very brisk/hyperactive
Reflex Grading: Superficial
present/absent
Superficial Reflexes
corneal (trigeminal and facial nerves)
abdominal: T8-L1
cremasteric: L1-L2
gag (glossopharyngeal and vagus nerves)
plantar/Babinski: L5-S1
Deep Tendon Reflexes
biceps brachii (C5-6)
brachioradialis (C5-6)
triceps brachii (C6-7)
patella (L3-4)
achilles (S1-2)
Modified Ashworth Spasticity Grading Scale
0: no increase in muscle tone
1: slight increase in muscle tone, manifested by catch and release or by min resistance and end range when affected part(s) moved into flexion/extension
1+: slight increase in muscle tone, manifested by a catch, followed by min resistance throughout the remainder (less than half) ROM
2: more marked increase in muscle tone throughout most of ROM, but affected part(s) still easily moved
3: considerable increase, passive movement difficult
4: affected part(s) rigid in flexion/extension
Hoehn-Yahr Scale (severity and progression of Parkinson’s)
0: no signs
1: unilateral involvement
1.5: unilateral plus axial involvement
2: b/l without impairment of balance
2.5: mild b/l disease with recovery on pull test (ability to recover from backward pull on shoulders)
3: mild to mod b/l disease, some postural instability physically independent
4: severe disability; still able to stand/walk unassisted
5: wheelchair bound, bedridden unless aided
Cranial Nerves and Function
- olfactory: sense of smell
- optic: visual acuity
- oculomotor: eye movements up, down, and medial
- trochlear: down and medial eye gaze
- trigeminal: facial sensation, muscles of mastication
- abducens: lateral eye gaze
- facial: anterior taste, facial muscle movements
- vestibulocochlear: auditory and vestibular
- glossopharyngeal: post. tongue taste and sensation, swallowing and gag
- vagus: swallow and gag, HR and breathing (ParasympNS)
- accessory: upper trap/SCM innervation
- hypoglossal: tongue protrusion
Sympathetic Nervous System
bronchodilation
vasoconstriction
increases HR
pupil dilation
inhibits stomach, gallbladder, intestines
relaxes bladder
*secretes epi and NE (from adrenal medulla)
inhibits saliva
Parasympathetic Nervous System
bronchoconstriction
vasodilation
decrease HR
pupil constriction
stimulates stomach, gallbladder, intestines
constricts bladder
stimulates saliva
Clasp-knife response
a form of resistance where the greatest resistance in a hypertonic joint is seen at the initiation of the movement and lessens throughout ROM
Cogwheel rigidity
a form of rigidity where resistance to movement has a phasic quality
- often seen with Parkinson’s disease
Lead pipe rigidity
a form of rigidity where there is uniform and constant resistance to ROM
- often associated with lesions of basal ganglia
Components of balance
somatosensory
visual
vestibular
Fluent Aphasia
word output and speech production are functional
empty speech/jargon
- speech lacks substance, use of paraphasias and neologisms
Wernicke’s aphasia/receptive aphasia
Conduction aphasia
NonFluent Aphasia
poor word output and dysprosodic speech (impaired rhythm and inflection)
poor articulation and increased effort of speech
content is present, but impaired syntactical words
Broca’s aphasia/expressive aphasia
Global aphasia
Contents of carpal tunnel
median nerve
FDP (4)
FDS (4)
FPL (1)
PNF Exercises (11)
Agonistic Reversals (controlled mobility, skill)
Alternating Isometrics (stability, strength)
Contract-Relax (mobility)
Hold-Relax (mobility)
Hold-Relax Active Movement (mobility)
Joint Distraction (mobility)
Repeated Contractions (mobility, strength)
Rhythmic Initiation (mobility, stability)
Rhythmic Stabilization (stability, controlled mobility, skill)
Slow Reversal (stability, controlled mobility, skill)
Slow Reversal Hold (stability, controlled mobility, skill)
Facilitation and Inhibition Techniques
Facilitation:
1. approximation
2. joint compression
3. icing
4. light touch
5. quick stretch
6. resistance
7. tapping
8. traction
Inhibition:
1. deep pressure
2. prolonged stretch
3. prolonged cold
4. warmth
ALS
Pain and temperature
DCML
Light touch and proprioception
