Neuromusculoskeletal Flashcards
what are characteristics of the following lesions: radiculopathy, neuropathy, myelopathy
UMN or LMN
describe symptoms
radiculopathy - LMN. dermatomal. lateral flexion and rotation. IVF
neuropathy - LMN. peripheral nerve. extremity. causalgia (burning nerve pain)
myelopathy - UMN. neck flexion. bilateral symptoms
what is charcots triad
scanning speech
intention tremor
nystagmus
(cerebellum)
cerebellum is responsible for what
tests
disease that effect structure and cause what
motor speech gait
heel to shin
diadochokinesia
finger to nose
motor ataxia
alcohol
MS
posterior columns are responsible for what
tests
disease that effects structure and cause what
sensory, 2 point discrimination. vibration, proprioception
rombergs, 2 pins, 128 tuning fork, toe placement
sensory ataxia
syphilis
MS
PLS
DM
corticospinal tract are responsible for
tests
what effects this
motor
muscle test
UMN lesion
pyramidal tracts are responsible for
test
LMN
voluntary motor
DTR
LMN
what are characteristics of UMN
spastic paralysis increase DTR pathological reflex clonus hypertrophy
CNS BILATERAL
what are characteristics of LMN
flaccid paralysis
decrease DTR
muscle atrophy
PNS UNILATERAL
what is PLS
due to
what are symptoms
posterolateral sclerosis
not enough b12
stocking and glove paresthesia
what are UMN lesions
what are LMN lesions
UMN - CVA, tumor, MS, ALS
LMN - DISC, PNE, IVF, MS, ALS
ALS and MS are BOTH UMN and LMN
what are 5 motor neurological diseases
Erb Duchennes Myasthenia Gravis ALS Cerebral palsy Parkinsons
what are 6 motor and sensory diseases
syringomyelia MS PLS brow sequard Gillian barre charcot marie tooth
gowers sign is seen in what
erb duchennes
what condition is seen in young boys that display difficulty walking or waddling with weak muscles
blood panel
erb Duchennes
cpk-mm, creatinuria, albuminuria
what are the symptoms of myasthenia gravis
diplopia* masked faces* fatigue difficulty swallowing intermittent*
where does ALS symptoms start
intrinisc hand muscles
what disease effects the myoneural junction
myasthenia graves
which conditions are UMN and LMN effectors
MS and ALS
what are the movements seen in cerebral palsy
athetoid and choreiform movement
scissors gait
what is another term for Parkinson’s
paralysis agitans
syringomyelia has unilateral or bilateral symptoms
bilateral
what parts of the brain are affected by Parkinson’s
substantia nigra and basal ganglia (dopamine)
what type of tremor is seen in parkinsons
resting tremor
pill rolling tremor
what are symptoms of Parkinsons
blank stare
masked faces
festinating gait*
resting tremor*
what is a cavitation that expands into other tracts
where is it usually found
syringomyelia
cervicals
what is typically lost first in syringomyelia
pain and temperature loss in a CAPELIKE or SHAWL like distribution
what disease causes demyelination of the cord and plaques form
MS
symptoms of MS
diplopia
intention tremor
speech
L hermittes is positive in what condition
MS and myelopathy
how does PLS occur
gastritis leads to anemia which leads to PLS (b12)
symptoms of PLS
glove and stocking paresthesia
weakness
pain and temp loss
what is hemisection of the cord with ipsilateral loss of motor function and contralateral loss of pain and temp
brown sequared
what is a rapidly ascending polyneuropathy after a viral infection
Guillian barre
what is another term for charcot Marie tooth disease
peroneal disease
what condition is characterized by calf weakness and sensory loss with steppage gait
charcot marie tooth
what are vertiginous diseases
menieres - CN7 - tinnitus, vertigo, deafness, unilateral
barre lieous - post trauma - same symptoms as menieres
labyrinthritis - post trauma and motion dizziness
BPPV - post trauma with fatigable nystagmus and vertigo
what is inflammation of the costal cartilages along the anteromedial chest wall that mimics a heart attack
tietzes
aka costochondritis
what causes upper and lower extremity symptoms neurologically
cord compression
myelopathy
people with severe cord injuries often die of __ during bedridden
pneumonia
what are the symptoms of cauda equine
s2-4
lose bowel and bladder control
saddle paresthesia
what interupts the sympathetics to the face and what are the causes
symptoms
horners syndrome
whiplash, TOS, birth, tumor
anhydrosis
ptosis
miosis
flushing of the face
wrist extensors cord segment
C6
wrist flexors cord segment
C7
finger extensors cord segment
C7
finger flexors cord segment
C8
interossei cord segment
T1
gluteus medius cord segment
L5
gluteus maximus cord segment
S1
what’s the LIC rule
nerve root - disc - IVF
cervical - L - 433
thoracic - I - 444
lumbar - C - 434
dermatomal landmarks
C2 C3 T2 T4 T7 T10 L1 L2 L3 L4 L5 S1 S2 S3
C2 - SCALP C3 - NAPE NECK T2 - AXILLA T4 - NIPPLE T7 - XIPHOID T10- UMBILLICUS L1 - INGUINAL LIG AND UPPER THIGH L2- MIDDLE THIGH L3- KNEE L4- MEDIAL LEG L5- TOP OF FOOT S1- LITTLE TOE S2- POSTERIOR THIGH S3-4 - BULLS EYE
what is the muscle test grading scale
5 - full ROM and resistance 4 - full ROM and some resistance 3 - full ROM against gravity 2 - movement without gravity 1 - contraction no movement 0 - nothing
what lumbar disc lesion causes bilateral symptoms
central
medial lumbar disc herniation antalgia to what side
ipsi side of lesion
lateral lumbar disc herniation antalgia to what side
contra side of lesion
subrhizal (aka ___) lumbar disc herniation antalgia to what side
posterior
antalgia foraward
what is the reflex grading system
5 - sustained clonus 4 - transient clonus 3 - hyperreflexia 2- normal 1- hyporelfexia 0- nothing
what’s DRCUMAB
drop hand - radial
claw hand - ulna
able and benediction hand - median
what are the pathological reflexes
BCOGS - extensor toe response
RH
babinski chaddocks oppenheims gordons schaefers rossolimos hoffmans
what reflex occurs when you stroke around the lateral malleolus
chaddocks
what reflex occurs when you stroke down the tibia
oppenheims
what reflex occurs when you squeeze the calf
gordons
what reflex occurs when you squeeze the Achilles
schaefers
what reflex occurs when you tap the ball of the foot
rossolimos
what reflex occurs when you flick the phalanx down and it causes flexion of finger and thumb
Hoffmans
scapular flaring is caused by what nerve entrapment
dorsal scapular
psoas spasm can cause what nerve entrapment
lateral femoral cutaneous nerve
Mortons neuroma can cause what nerve entrapment
tibial
flexed 4th and 5th digit which is caused by a red ropey fascia
dupuytrens
describe the gait disturbances
festination motor ataxia sensory ataxia steppage glut med lurch glut max lurch curcumduction waddling scissors
festination - shuffling, propulsion, mincing, resting tremors
motor ataxia - staggering, cerebellum, intention tremors
sensory ataxia - slappage
steppage - L4 foot drop
glut med lurch - L5 sway over weight bearing leg
glut max lurch - S1 AP sway
curcumduction - CVA, weak quads
waddling - MD, clumsy, weak, toe walker
scissors - CP, adductor spasm, toe walker
causalgia describes what kind of pain
burning nerve pain
ulcer pain is described as
gnawing
what is normal femoral angle
120-130
what is runners knee
chondromalacia patella
what is jumpers knee
patellar tendonitis
what is hoffa sign
infrapatellar fat pad
what hip condition clicks when bicycling and walking stairs
trochanteric bursitis
hypertension and metabolic headaches are worse when
in the morning
when do hypoglycemic headaches occur
2 hours after eating
tension headaches are described as
occur when
bilateral and band like
stress related
afternoon
what two signs are positive for meningitis
brudzinskis sign
kernigs sign
nocturnal head pain indicates what
tumor
worse headache ever felt indicates what
CVA
constant head pain related to polymyalgia rheumatica
temporal arteritis
describe meningitis pain
what hurts them
constant and generalized
can’t flex
what are characteristics of classical migraines
aura
nausea
vomiting
3-5 days long
made worse by tyramine
cluster headaches occur when
every 1-2 hours
wakes you up two hours after sleeping
what causes causalgia when you squeeze the foot
Mortons neuroma
what causes non burning pain when you squeeze the foot
metatarsalagia
what is tic douloureux
trigeminal neuralgia
15 seconds of pain
episodic
trochlear nerve damage causes what
eye down and in
what is Allens test
patency of radial and ulnar pulse
