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CPA > Neurological System > Flashcards

Neurological System Flashcards

1
Q

What does spasticity indicate?

A

extrapyramidal tract lesions

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2
Q

What can cause hypertonia?

A

loss of the inhibition of the lower motor neurones by the upper motor lesions

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3
Q

What does rigidity indicate?

A

extrapyramidal tract lesions

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4
Q

What can cause hypotonia?

A

lower motor neurones

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5
Q

What muscles are responsible for shoulder abduction?

A

deltoid

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6
Q

What muscles are responsible for shoulder adduction?

A
  • teres major
  • latissimus dorsi
  • pectoralis major
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7
Q

What myotomes are involved in shoulder abduction?

A

C5

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8
Q

What myotomes are involved in shoulder adduction?

A

C6/C7

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9
Q

What muscles are involved in the extension of the elbow joint?

A

triceps brachii

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10
Q

What muscles are involved in the flexion of the elbow joint?

A

biceps brachii

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11
Q

What myotomes are involved in elbow extension?

A

C7

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12
Q

What myotomes are involved in elbow flexion?

A

C5/C6

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13
Q

What muscles are involved in wrist flexion?

A

C6/C7

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14
Q

How do you test the abduction of the shoulder?

A
  • flex elbows outwards

- apply downwards resistance

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15
Q

How do you test the adduction of the shoulder?

A
  • flex elbows inwards

- apply upwards resistance

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16
Q

What would score a 0/5 MRC Muscle Power Scale?

A

No movement

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17
Q

What would score a 1/5 MRC Muscle Power Scale?

A
  • barest flicker of movement

- not enough to move the structure

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18
Q

What would score a 2/5 MRC Muscle Power Scale?

A

voluntary movement which is not sufficient to overcome the force of gravity

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19
Q

What would score a 3/5 MRC Muscle Power Scale?

A
  • Voluntary movement
  • able to overcome gravity
  • not able to overcome applied resistance
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20
Q

What would score a 4/5 MRC Muscle Power Scale?

A
  • Voluntary movement

- able to over come resistance

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21
Q

What would score a 5/5 MRC Muscle Power Scale?

A

Normal strength

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22
Q

What do you need to do in order to accurately measure the power?

A

isolate and stabilise the joint

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23
Q

How do you assess the power of the musculature?

A

resist the movement by applying an opposite force and estimate the power of the contracting muscles

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24
Q

What nerve roots are responsible for the biceps reflex?

A
  • C5

- C6

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25
Q

Where can you test for the biceps reflex?

A

the medial aspect of the antecubital fossa

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26
Q

What nerve roots are responsible for the triceps reflex?

A
  • C7

- C8

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27
Q

Where can you test for the triceps reflex?

A

superior to the olecranon process of the ulna

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28
Q

What nerve roots are responsible for the supinator reflex?

A
  • C5

- C6

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29
Q

Where can you test for the supinator reflex?

A

bracioradialis tendon (posterolateral aspect of the wrist)

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30
Q

What does areflexia suggest?

A

a lower motor neurone lesion

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31
Q

What does hyperreflexia suggest?

A

an upper motor neurone lesion

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32
Q

Where is the C5 dermatome?

A

lateral aspect of the lower edge of the deltoid muscle

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33
Q

Where is the C6 dermatome?

A

the palmar side of the thumb

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34
Q

Where is the C7 dermatome?

A

the palmar side of the middle finger

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35
Q

Where is the C8 dermatome?

A

the palmar side of the little finger

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36
Q

Where is the T1 dermatome?

A

The medial aspect of the antecubital fossa proximal to the medial epicondyle

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37
Q

Where is the T2 dermatome?

A

axilla

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38
Q

How do you assess tone in the lower limb?

A
  • leg roll
  • leg lift
  • ankle clonus
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39
Q

What should you do when testing for ankle clonus?

A

quickly dorsiflex and partially evert the foot

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40
Q

What would suggest an abnormal ankle clonus?

A

more than 5 is abnormal

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41
Q

What muscles are responsible for the flexion of the hip joint?

A 
- Psoas Major
Iliacus
- Sartorius
- Rectus Femoris
- Pectineus
42
Q

What nerve is responsible for the flexion of the hip joint?

A

femoral nerve

43
Q

What muscles are responsible for the extension of the hip joint?

A

Gluteus maximus

44
Q

What nerve is responsible for the extension of the hip joint?

A

inferior gluteal nerve

45
Q

What muscles are responsible for the abduction of the hip joint?

A
  • Gluteus medius

- Gluteus minimus

46
Q

What nerve is responsible for the abduction of the hip joint?

A

superior gluteal nerve

47
Q

What muscles are responsible for the adduction of the hip joint?

A
  • Adductor longus
  • Adductor brevis
    Adductor magnus
  • Pectineus
  • Gracilis
48
Q

What nerve is responsible for the adduction of the hip joint?

A

obturator nerve

49
Q

What muscles are involved in the circumduction of the hip?

A
  • Psoas Major
  • Sartorius
  • Rectus femoris
  • Pectineus
  • Gluteus maximus
  • Gluteus medius
  • Gluteus minimus
  • Adductor longus
  • Adductor brevis
  • Gracilis
50
Q

What muscles are involved in the internal rotation of the hip?

A 
Obturator externus
all:
- adductors
- semitendinosus
- semimembranosus
51
Q

What muscles are involved in the external rotation of the hip?

A
  • `Piriformis
  • Obturator internus
  • Gemellus superior
  • Gemellus inferior
  • Quadratus femoris
52
Q

What muscles are involved in the flexion of the knee?

A
  • Biceps femoris
  • Semitendinosis
  • Semimembranosis
  • Gracilis
53
Q

What muscles are involved in the extension of the knee?

A
  • Quadriceps femoris
54
Q

What happens in a Trendelenburg test?

A
  • place hands on the patients iliac crest

- ask patient to lift each foot in turn off the floor

55
Q

During a Trendelenburg test, what is being tested with the right foot is lifted?

A

the left hip abductors

56
Q

What will be seen during a Trendelenburg test if there is weakness in the abductors?

A

pelvis will sag away from the weak abductor

57
Q

What nerve allows for knee extension?

A

femoral nerve

58
Q

What nerve allows for knee flexion?

A

sciatic nerve

59
Q

What muscles are involved in ankle dorsiflexion?

A
  • Tibialis anterior
  • Extensor hallucis longus
  • Extensor digitorum longus
60
Q

What innervates ankle dorsiflexion?

A

deep fibular nerve

61
Q

What innervation is involved in ankle plantarflexion?

A

tibial nerve (S1-S2)

62
Q

where does inversion take place?

A

subtalar joint

63
Q

How do you assess for inversion of the ankle joint?

A

place hand laterally and ask patient to push against the resistance

64
Q

How do you assess for eversion of the ankle joint?

A

place hand medially and ask patient to push against the resistance

65
Q

What are the nerve roots responsible for the knee-jerk reflex?

A
  • L2
  • L3
  • L4
66
Q

What is the Jendrassik manoeuvre?

A
  • clenching teeth

- flexing fingers in a hook-like form

67
Q

What are the nerve roots responsible for the ankle-jerk reflex?

A
  • S1

- S2

68
Q

What is the impact of a femoral nerve lesion on motor control?

A

Quadriceps Paralysis

  • weakness of the knee
  • difficulty climbing up and down stairs
69
Q

What is the impact of a femoral nerve lesion on sensory control?

A

loss of sensation in:

  • the anterior and medial thigh
  • medial side of leg
  • medial border of the foot
  • saphenous nerve is affected
70
Q

What is the impact of a obturator nerve lesion on motor control?

A

Paralysis of all adductors

- difficulty crossing legs

71
Q

What is the impact of a femoral nerve lesion on sensory control?

A 
Pain on the medial thigh 
caused by:
- pelvic disease
- ovarian tumours
(medial cutaneous nerve of the thigh)
72
Q

What is the impact of a common fibular nerve lesion on motor control?

A

foot extensors and evertors paralysed:

  • Peroneal muscles (lateral compartment)
  • Tibialis anterior, EDL, and EHL
73
Q

What test shows the motor effects of a common fibular nerve lesion?

A

foot drop

74
Q

What is the impact of a common fibular nerve lesion on sensory control?

A

loss of sensation in:

- anterior and lateral side fo leg and dorsum of the foot

75
Q

What is the impact of a tibial nerve lesion on motor control?

A

Paralysis of:

  • Hamstrings
  • all posterior muscles of the leg and sole of foot
  • foot in a dorsiflexed and everted position
  • Gastrocnemius
  • Soleus
  • Tibialis posterior
  • FHL
  • FDL
  • Intrinsic foot flexors
  • Interossi
  • Lumbricals
76
Q

What is the impact of a tibial nerve lesion on sensory control?

A

loss of sensation in the sole of the foot

77
Q

What is the impact of whole sciatic nerve injury on motor control?

A 
Paralysis of:
- Hamstrings
- All muscles below the knees
Knee flexion affected
Foot in plantar flexed position (foot drop)
78
Q

What is the impact of whole sciatic nerve injury on sensory control?

A

sensory loss below the knee (except small medial area and foot - saphenous nerve)

79
Q

What can cause whole sciatic nerve injury?

A
  • pelvic fracture
  • hip joint dislocation
  • penetrating injuries
80
Q

What is sciatica?

A

pain radiating from the posterior back into the buttock, posterior/lateral thigh and into the leg

81
Q

What can cause sciatica?

A
  • herniated lumbar intervertebral disc

- compression of the L5-S1 component of the sciatic nerve

82
Q

What is the superior border of the femoral triangle?

A

inguinal ligament

83
Q

What is the medial border of the femoral triangle?

A

adductor longus

84
Q

What is the lateral border of the femoral triangle?

A

sartorius

85
Q

What are the borders of the femoral triangle?

A

superior: inguinal ligament
medial: adductor longus
lateral: sartorius

86
Q

Where is the dermatome of L1?

A

inguinal ligament

87
Q

Where is the dermatome of L2?

A

lateral side of the thigh

88
Q

Where is the dermatome of L3?

A

knee (lower medial side of thigh)

89
Q

Where is the dermatome of L4?

A

big toe (medial side of leg, medial foot)

90
Q

Where is the dermatome of L5?

A

middle 3 toes (lateral side of leg, mid dorsum of foot)

91
Q

Where is the dermatome of S1?

A

little toe (lateral foot, and sole footprint area

92
Q

Where is the dermatome of S2?

A

back of the upper leg and the whole thigh

93
Q

Where is the dermatome of S3?

A

gluteal fold

94
Q

What is compartment syndrome?

A

where the pressure in the muscle compartment is so high that the venous drainage becomes blocked, pressure can increase to the point of muscle ischaemia and death

95
Q

What are the possible causes of compartment syndrome?

A
  • fractures
  • burns
  • infections
  • prolonged limb compression
96
Q

What des compartment syndrome present with?

A
  • pain
  • muscle tenderness
  • swelling
  • 6 Ps
97
Q

What are the 6 Ps?

A
  • Pallor
  • Pulselessness
  • Paralysis
  • Pershingly cold
  • Pain
  • Paraesthesia
98
Q

What would be seen on examination of a case of compartment syndrome?

A
  • swollen limb
  • painful passive movement
  • diagnosis on clinical suspicion
99
Q

How would you treat compartment syndrome?

A
  • relieve pressure
    (all dressings, casts and splints should be removed)
  • open fasciotomy
100
Q

What happens in a open fasciotomy?

A

surgical procedure:

- skin and deep fascia are opened alone the muscle compartment to relieve the pressure

CPA (6 decks)

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