Neurology Flashcards

1
Q

Scapulothoracic elevation

A

Superior trapezius, levator scapulae, rhomboids

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2
Q

Scapulothoracic Depression

A

Inferior trapezius, pectoralis minor, serratus anterior

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3
Q

Scapulothoracic Protraction

A

Pectoralis minor, serratus anterior

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4
Q

Scapulothoracic Retraction

A

Rhomboids, middle trapezius, latissimus dorsi

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5
Q

Scapulothoracic Rotation

A

Glenoid fossa faces upwards or downwards as scapula rotates

Superior trapezius, inferior trapezius, serratus anterior - up

Pectoralis minor, latissimus dorsi, rhomboids and levator scapulae - down

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6
Q

Scapulothoracic movements

A
Elevation 
Depression
Protraction
Retraction
Rotation
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7
Q

Glenohumeral flexion

A

Pectoralis major, deltoid (anterior fibres)

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8
Q

Glenohumeral extension

A

Deltoid (posterior fibres)

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9
Q

Glenohumeral abduction

A

Supraspinatus initially and then central deltoid

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10
Q

Glenohumeral adduction

A

Pectoralis major, latissimus dorsi

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11
Q

Glenohumeral internal rotation

A

Subscapularis

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12
Q

Glenohumeral external rotation

A

Infraspinatus

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13
Q

Glenohumeral movements

A
Flexion
Extension
Abduction
Adduction
Internal and external rotation
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14
Q

Elbow joint flexion

A

Biceps, brachialis, brachioradialis (pronator teres)

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15
Q

Elbow joint extension

A

Triceps

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16
Q

Radio-ulnar joint supination

A

Supinator, Biceps

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17
Q

Radio-ulnar joint pronation

A

Pronator quadratus, Pronator teres

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18
Q

Radio-ulnar movements

A

Supination and pronation

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19
Q

Muscle power scale

A

0/5: no movement

1/5: Barest flicker of movement of the muscle, though not enough to move the structure to which it’s attached

2/5: Voluntary movement which is not sufficient to overcome the force of gravity.

3/5: Voluntary movement capable of overcoming gravity, but not any applied resistance.

4/5: Voluntary movement capable of overcoming “some” resistance

5/5 Normal strength

20
Q

Atrophy

A

Lower motor neurone lesion

21
Q

Muscle tone

A

Amount of tension in muscle

22
Q

Reflex

A

Spinal segmental reflex arc

23
Q

Biceps tendon reflex

A

C5 & C6

24
Q

Triceps tendon reflex

A

C7 & C8

25
Q

Brachioradialis (supinator) reflex

A

C5 & C6

26
Q

Reflex grading

A
0 - absent
1+ - decreased
2+ - normal
3+ - hyper-reflexic
4+ - clonus
27
Q

Upper Brachial injury

A

Extreme lateral flexion of the head
Stretch on upper roots (C5 & C6) and or superior trunk

Erb’s palsy

28
Q

Lower Brachial injury

A

When upper limb is pulled superiorly
Stretch on lower roots (C8 & T1) and or inferior trunk

Klumpke’s Palsy
Small muscles of the hand are affected
May get clawed hand and wasting

29
Q

Musculocutaneous

A

Stab wound to upper arm

Lateral forearm sensory loss

Weak elbow flexion
Weak wrist supination
Absent bicep reflex

Wasting of Biceps

30
Q

Axillary

A

Fracture of surgical head of humerus
Compression injury from shoulder dislocation or crutches in armpit

Sergeant’s patch

Markedly weak shoulder abduction (15-90 degrees)
Weak shoulder flexion, extension and external rotation

Wasting of Deltoid

31
Q

Median

A

Supra condylar fracture of humerus
Compression in carp

Median distribution of hand and thenar eminence

Weak forearm pronation
Weak wrist flexion
Weak wrist abduction
Weak finger flexion (DIP joint of ring and littler finger preserved)
Weak thumb abduction and opposition 

Wasting of anterior forearm
Wasting of thenar eminence
Hand of Benediction (on attempted finger
flexion)

32
Q

Radial

A

Fracture of proximal/shaft humerus, proximal radius
Compression from crutches on armpit sleeping on arm or armpit on chair (Saturday night palsy)

Posterior arm and forearm
Radial area of hand

Weak elbow extension
Absent triceps reflex
Weak wrist extension
Weak finger MCP joint extension

Wasting of triceps and posterior compartment of forearm
Wrist drop (on attempted wrist extension)
33
Q

Ulnar

A

Medial epicondylar fracture
Compression at Guyons tunnel in wrist

Ulnar distribution of hand and hypothenar eminence

Weak wrist flexion
Weak wrist adduction
Weak finger flexion of ring and little finger at the MCP and DIP joints
Weak extension at the IP joints in ring and little finger
Weak finger abduction, adduction and opposition

Wasting of hypothenar eminence and intrinsic muscles of hand
Claw Hand (on attempted finger flexion)
34
Q

Hip joint movements

A

Flexion extension
Abduction adduction
Medial lateral rotation
Circumduction

35
Q

Knee joint

A

Flexion extension

Slight medial and lateral rotation

36
Q

Ankle joint

A

Dorsi and plantarflexion

37
Q

Intertarsal joints

A

Inversion eversion

Supination pronation

38
Q

Tarsometatarsal movements

A

Limited sliding

39
Q

Metatarsalphalangeal movements

A

Flexion extension

Limited other

40
Q

Interphalangeal movements

A

Flexion extension

41
Q

Trendelenburg test

A

First the subject is asked to stand on both legs. Both right and left pelvis should remain at same level without any tilt. The examiner should stand behind the subject and feel their pelvis. Then ask the subject to raise one leg off the ground. The pelvis should remain horizontal on one leg. If the pelvis on the unsupported side drops downward then the Trendelenberg test is said to be positive. A positive test indicates a loss or weakness of the motor function of the hip abductors in the leg the subject is standing on.

42
Q

Femoral nerve injury

A

L2-4

Quadriceps paralysis
Weakness of knee
Difficulty up or down stairs

Anterior and medial thigh, medial side of leg, medial border of foot - big toe

43
Q

Obturator nerve injury

A

L2-4

Paralysis of all adductors

Insignificant loss on medial side of thigh

44
Q

Common fibular nerve injury

A

L4-S2

Foot extensor and evertors paralysed
Foot drop

Anterior and lateral side of leg and dorsum of foot

45
Q

Tibial nerve injury

A

L4-S3

Hamstring and all muscles of back of leg and sole of foot
Foot in dorsiflexion and everted

Sole of foot

46
Q

Sciatic nerve injury

A

Hamstring and all muscle below the knee are paralysed
Knee flexion
Plantarflexed

Below knee except on narrow area except on medial and big toe

47
Q

Sciatica

A

Pain from lower back into buttock, posterior/lateral thigh into leg