Neurological Disorders Flashcards
What sensory receptor in the spinal cord monitors internal organs?
Interoceptors
What sensory receptor in the spinal cord monitors body position/change
Proprioceptors
What sensory receptor in the spinal cord monitors external environ, perceive pain, tactile stimulation
Exteroreceptors
Damage depends on nature, length of time and intensity
Neuropraxia: temporary
Axonotmesis: prolonged pressure nerve grows 1mm per day
Neurotmesis: axon and sheath are damaged
Peripheral nerve lesions
what are these classifications of?
- Neuropraxia
- Axonotmesis
- Neurotmesis
3 classifications of injuries
Nerve injuries
classification of an injury: temporary, no structural change
Neuropraxia
classification of an injury: prolonged pressure with atrophy of mm, degeneration of neuronal axon
Axonotmesis
classification of an injury: no path to follow to grow back
Neurotmesis
Inflammation, tumor, space occupying lesion
Compression
Compression where nerve root exits
Radiculopathy
What types of injuries are these?
- Compression
- Radiculopathy
- **may affect blood vessels
Nerve injuries
What nerve is being injured below?
- Repetitive stress
- Pregnancy
- Narrowing of carpel tunnel
Median nerve; injuries
What is happening when there is weakness, atrophy of intrinsic muscle of thenar eminence of hand?
Narrowing of carpel tunnel
What nerve is being injured below?
- Damaged by pressure leaning against wall or hard object
- **Aka Saturday night palsy
- Crutch palsy”WB through palsy
- Fractured humerus
Radial nerve: injuries
Brachial plexus compression, subclavian blood vessels compressed Pressure between clavicle and first rib Cervical rib Pallor of skin of upper extremity Reduced temp Weak/absent pulse Weakness Pain
Thoracic Outlet Syndrome
- Compressed at head of fibula
- casts
Common Peroneal nerve
Tests for neurological system
- Bleeding, damage, change in brain tissue
- Determine location of damage
- Tumors
- CVA
CT
Tests for neurological system Looks at integrity of nerve roots
Deep tendon reflex
Tests for neurological system
- Rate of transmission along nerve
- Slow= damaged
- Helps determine site of damage
Electrodiagnostics/Nerve conduction
Tests for neurological system
-Measure level of consciousness, assess progress
-Eye opening, verbal response, motor response
Pg 293
Glasgow Coma Scale
Tests for neurological system
- Usually better image than CT
- Cannot use with metal or pacemakers
MRI
Tests for neurological system
- Manual or dynamometer
- Grip strength with dynamometer
- Isokinetic testing (cybex, biodex)
Muscle testing
Tests for neurological system
-Evaluate level of nerve damage pg 296
Myotomes
Tests for neurological system
- Mobility of nervous system
- Place nervous system on a stretch
- Look for tethering, damage or inflammation
Neural tension testing
Tests for neurological system
-Abnormal tightness or density, temperature, joint effusion
Palpation
Tests for neurological system
-Help determine severity
Posttraumatic amnesia scales
Tests for neurological system
-Level of consciousness and ability to problem solve, concentrate, behave appropriately
Rancho Los Amigos Levels of Cognitive Function
Tests for neurological system
- Used to measure joint motion
- Measure progress
- May use goniometer, tape measure
Range of Motion
- Phalen’s wrist flex test
- Reverse Phalen’s
Specific testing
Hands in pray test
- Median nerve injury
- Tingling along median nerve distribution
Phalen’s wrist flex test
backs of hands together in reverse prayer-
- Creates pressure over carpel tunnel
- Parasthesia in median nerve distribution
Reverse Phalen’s
Can use over any nerve
Irritation of nerve (compression or injury)
Tap over nerve
Pins and needles distal
Tinel sign
pt sitting: shoulder abd to 90, horizontally extend and lat rotate arm with elbow flexed. Positive if radial pulse disappears when rotate head opp side
Allen test: Thoracic Outlet Test
Pt rotates head to side to be tested. Extend, lat rotate shoulder, arm in full ext. Positive test if radial pulse disappears when take a deep breath
Adsons maneuver: Thoracic Outlet Test
Thoracic Outlet Test
-Pt elevates arms over head, make fist and open x 15 times. Positive test: cramping, fatigue, tingling in forearms and arms
Provocative elevation test
Thoracic Outlet Test:
Skin sensation
2 Pt discrimination
Thoracic Outlet Test:
Passive neck extension with rotation: compress vertebral arteries, positive if dizzy, lightheaded, change in vision, speech, swallowing problems
Vertebral Artery test
