Neurological Testing Flashcards
Impairment of a motor neuron
Loss of control/coordination, weakness, paralysis
Impairment of a sensory neuron:
Pins and needles, numbness, loss of specific sensation. (e.g. temperature, nociception, deep pressure, light touch ect.)
What does impact depend on?
Impact also depends on whether the damage occurs at the central or peripheral nervous systems.
Neurological impairments?
- traumatic damage (tear, crush, stretch)
- compression (e.g. under a muscle)
- Ischemic damage (e.g. stroke)
- Disease (e.g. MS, Parkinsons, ALS, diabetic peripheral neuropathy.)
When would you do neurological testing?
when you suspect neural injury or want to rule it out due to patient report of:
- paraesthesia
- numbness
- marked weakness
- disturbance of gait
- bilateral, symmetrical symtoms.
Or when you want to know the extent of neural impairment and/or its impaction function.
sensory testing outline:
- neuroanatomy review.
- peripheral nerve distributions
- myotomes (nerve robots)
- upper and lower motor neuron dysfunction
Motor Testing outline:
- neuroanatomy review
- peripheral nerve distributions
- myotomes (nerve roots)
- upper and lower motor neuron dysfunction.
C2 to C4 supplies?
the skin of the neck
C5 to T1 supplies?
nerves supply the arms
T2 to L2 supplies?
The chest and abdomen
L3 to S1 supplies?
nerves supplies the chest and abdomen
L3 to S1 supplies?
nerves suppley the low back and anterior lower ribs.
S1 ro S4?
Nerves go to the groin and posterior lower limbs.
Sensory symptoms of neural injury are usually:
numbness, buzzing, pins and needles.
neuropathic pain may follow…
dermatomal or peripheral nerve distribution patterns.
nerve distribution:
Axillary?
the axillary is in charge of the deltoid and series minor (armpit)
nerve distribution:
Musculocutaneous?
The musculocutaneous is in charge of the anterior arm (mostly elbow flexors)
nerve distribution:
Radial?
radial nerve is in charge of the posterior arm and forearm (mostly elbow and wrist)
nerve distribution:
median?
median is in charge of the anterior forearm, radical lumbricals and thenar eminence (mostly wrist flexors)
nerve distribution:
Ulnar?
ulnar is in charge of the hand intrinsics + ulnar lumbricals and forearm.
what happens to the spinal cord once it ends at L2-3?
It then becomes a bundle of peripheral nerves within the vertebral column called the caudal equina (horse tail)
what do the peripheral nerves in the cauda equina do?
They supply sensation and motor control to the lower limbs, genitals, bladder and bowels.
LMN - lower motor neuron.
LMN is a motor nerve originating in the spinal cord, prior to the root. (PNS)
LMN disease results in axon loss and therefore loss of motor control, weakness, muscle atrophy. - Often follows myotomal patterns.
UMN (upper lower neuron)
- motor nerve originating in the motor cortex. (CNS)
- pattern of symptoms is more variable
- UMN diseases disrupt descending motor pathways causing loss of motor control, weakness, and muscle atrophy.
What is the major difference between UMN and PNS?
The major difference between UMN and all the PNS motor dysfunctions is the impact on reflexes.
What can UMN dysfunction result in?
exaggerated reflexes (hyperreflexia)
flexor reflex:
flexors contract to move away from the sharp object before further damage occurs.
Reflex inhibition:
the reticulospinal tract inhibits reflexes depending on the context of the situation.
