Neuro/sports physical Flashcards
steppage gait
drags foot or lifts leg really high they lift there leg up higher
b/c peroneal nerve inj or spinal nerve compression
B: ALS, Charcot-marie-tooth disease
Spastic Hemiparesis
drag toe, circle leg stiffly outward and forward, and lean trunk contralateral side
+ affected arm is flexed
-often with stroke
Scissors Gait
- pt advances each leg slow and the thighs tend to cross
- seen in spasticity disorders > cerebral palsy
Sensory Ataxia
unsteady gait and wide stance -throw feet forward and outward with double tap -often watch ground becuase loss proprioception > peripheral neuropathy
Parkinsonian Gait
stooped posture with head, arm, hip, knee flexion
-shufflinf short steps; slow to start
cause: basal ganglia abnormalities
>parkinsons
Trendelenburg gait
pelvic drop leadding to waddle
-due to hip abductor weakness
U: spinal nerve compression (sup glut nerve inj)
B: musclular dystrophy
Romberg test
Stand wit feet together and eyes close
+ if unable to maintain upright posture
-test position sense
*post collun disease
Pronator Drift
stand with eyes closed elevate arms to shoulder level with palms up
abnormal: unable to keep arms up and or arm pronates and drifts down
> UMN lesion= possible stroke
Heel to Shin Test
Place heel at opposite knee slide down leg and backup
-should keep contact
Ab: cerebellar disease > heel over shoots knee and foot oscillates side to side
position sese- heel lifts to hight
Finger to Nose Test
ask pt to touch their finger to there nose and to you finger quickly and youll move your arms
Ab: dystmetria( go past finger)
intention tremor -MS
cerebellar disease
Rapid alternating movements
Pt places hands on thighs and alternate palms up and down
ab= dysdiadokineasia
>cerebellar disease
Abnormality of CN III
Veritcal and hortixonal diplopia
-ptosis
CN IV abnormality
Vertical diplopia
CN VI abnormal
Hortizontal diplopia
esotropia
Peripheral vs central CN VII problem
Bells Palsy- peripheral unlateral
Central- cerebral infart
CN IX abnormal
No gag reflex, lost of posterior taste
Vagus abnormality
- poor ah quality
- asymetry palate rase
- hoarsness, dyspnea, dysarthria
- loss of gag relflex
CN XII abnormal
central lesion- toungue deviation away
Peripheral lesion- toungue deviate to affected side
Allodynia
pain elicited from non painful stimulus
C5 dermatome
lateral upper arms
C6 dermatome
radial forearm and thumb
C7 derm
middle finger
C8 derm
ring and little finger
T1 derm
ulnar forearm
T4 derm
nipple line
T10 derm
umbilicus
L1 derm
inguinal region
L3 derm
ant proximal thigh
L4 derm
knee and medial shin
L5 derm
lateral shin dorsal foot GREAT TOE
s1 serm
lateral plantar foot
Static tremors
seen at rest
“pill rolling”- parkinsons
Postural
seen when affected area maintains posture
> hyperthyroid, anxiety, fatigue, essential tremor
Intention tremor
absent at rest appears with movement
MS
Tics
breig repetative twitchings
- can be verbal or phycial
> tourettes or medications
Dystonia
twisted posture of large body parts
> medications, spasmodic torticollis
Dyskinesia
bizarre, rhythmic, repetative moements
-parkinsons diesaes psychoses or meds
Akathisia
inability to sit still
>medications
Chorea
breif jerky rapid upredictable movements
>huntingtons disease rheumatic fever
Athestosis
slow twisting writhing movements
-cerebral palsy
Shoulder abduction
C5
Axillary
Elbow flx
C5 6
musculocutaneous
elbow ext
c6 c7
radial
wrist ext
c6 c7
radial
wrist flx
C7 C8
median
finger abduction
C8 T1
ulnar
Thumb Opposition
C8 T1 Median
Bicepts DTR
C5 C6
Brachioradialis
C5 C6
Tricepts DTR
C6 C7
Patella DTR
L4
Achilles DTR
S1
CLonus
dorsi flex and plantar flex ankle repetedly
- thin briskly dorsi flex ankle
- will have rhythmic oscillations
- confirm by check at wrist
Babinski
L5 S1
stroke lateral aspect of foot from heel to ball
>normal for toes to flex
Ab: greater toe ext or fan out > suggest lesion of corticospinal tract
Superficial abdonial reflex
stroke abdomen toward umbilicus
normal- muscle contracts toward umbilicus
> central and peripheral pathologies
Cremasteric Reflex
stroke proximal medial thigh
-normal for ipsilateral testical to rise
L1 L2 nerve inj
Brudzinski Sign
Supine then flex patient neck
norm: patient remains relaxed
abnorma: hip and knee flexion > signs of menigeal inflammation
Kernig Sign
flex pt hip and knee and then straighten the knee
anormal: back pain and resistant indicating mengial irriation
