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NMS Flashcards

1
Q

What are the Cranial nerves?

A
  1. oflactory
  2. optic
  3. oculomotor
  4. trochlear
  5. trigeminal
  6. abducens
  7. facial
  8. vestibulocochlear
  9. glossopharengeal
  10. vagus
  11. spinal accessory
  12. hypoglossal
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2
Q

Olfactor (I)
* S/M
* T
* dx

A
  • S/M : sensory
  • T : smell is tested one nostril at a time with eyes closed
  • dx : Anosmia = lost sense of smell
    : parosmia = distorted sense of smell
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3
Q

Optic (II)
* S/M
* T

A
  • S : sensory
  • T : Snellen chart =visual acuity
    :Visual fields = peripheral vision
    : Direct light reflex = CN2 (s) + CN3(m)
    : Indirect (consensual ) light reflex CN 2 +CN3
    : Accomodation = eyes converge, pupuls contrict , lens
    convexity
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4
Q

Oculomotor (III)
* S/M
* T
* detail
* dx

A
  • M : Levator palpebrae, Inferior oblique , Superior+medial+inferior rectus
    : Ciliary muscles = parasympathetic
    = for lense shape
    : constrictor papillae
  • T : Direct light reflex, indirect light reflex, accomodation
  • dx : strabismus = deviation of one or both eyes
    : ptosis = eyelids droop d/t weakness or paralysis of
    levator palpabrea
    : Myastenia gravis = when ptosis is bilateral
    : Horner’s syndrome = when ptosis is unilateral
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5
Q

What is tested with six cardinal fields of gaze?

A

SO4LR6I3

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6
Q

Trochlear (IV)
* S/M
* T

A
  • M : Superior Oblique (down and in)
  • T : six cardinal fields of gaze
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7
Q

Trigeminal (V)
* S/M
* T

A
  • S: sensory to face : V1-V3
    : Corneal reflex (V and VII )
    = touch cornea w/ cotton wisp, both
    needs to link or tear normally
    : Oculocardiac reflex (V and X)
    = press on eye, heart rate should
    decrease
    : general sensation to ant 2/3 of tongue
  • Motor : muscles of mastication ( T I M E ) E = only one that
    open jaw = Temporalis , Internal Pterygoid, Masseter
    external pyterygoid
  • dx : Tic Douloureaux
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8
Q

Tic Douloureaux
* AKA:
* symptom:
* What CN :
* Age :

A
  • AKA: trigeminal neuralgia
  • symptom : burning, shock- like face pain that last up to 2
    minutes
    : pain is felt on one side of jaw or cheek
  • What CN : 5
  • Age : Over 50
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9
Q

Abducens (VI)
S/M

A

M : LR 6

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10
Q

Facial (VII)
S/M :
Dx:

A
  • Sensory : taste to ant 2/3 of tongue ( sweet sour salty
  • Motor : muscles of facial expression
    : wrinkles on forehead
  • Dx : bells palsy
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11
Q

Sensory for tongue?
ant 2/3 of tongue
posterior 1/3 ?

A
  • ant 2/3 Facial
  • post 1/3 glossopharyngeal
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12
Q

Bells palsy
* detail
* CN
* symptom

A
  • Detail : Unilateral facial paralysis caused by trauma, virus or immune mediated response
    : not permanent
  • CN
  • symptom : initial pain behind the ipsilateral ear
    : twitching, weakness or parlysis, drooping of
    eyelid, drooping corner of mouth and drooling,
    dry eyes and impairement on taste
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13
Q

Bells palsy vs Stroke
* where is motor loss
* wrinke or not
* where is lesion

A
  • bells palsy = ipsilateral motor loss on ENTIRE face
    = forehead does not wrinkle ( because entire face is not working )
    = LMNL CN 7
  • stroke = contralateral motor loss BELOW the eyes
    = forehead does wrinkle
    = UMNL CN 7
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14
Q

Vestibulochlear (VIII)
Sensory :
Dx :

A
  • Sensory : balance = Mittlemeyer
    = barany caloric test
    = rhomberg test
    Hearing : Weber, Rinne, whisper, auditory acuity /watch
  • DX : meniere’s dx
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15
Q

Mittlemeyer
* CN
* test

A
  • 8
  • patient marching
  • open eyes = cerebellum
  • closed eyes = posterior column
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16
Q

Barany Caloric test
*

A
  • COWS = cold opossite warm same
  • patient will have nystagmus to the side to side up or down
  • COWS = normal
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17
Q

Rhomberg

A
  • standing, arms out, head back
  • open eyes = cerebellum
  • closed = posterior column
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18
Q

Meniere’s dx
* AKA :
* cause :
* symptom :
* management :

A
  • AKA : endolymphatic hydrops
  • cause : unknown, but could be from abnormality in fluids of
    inner ear
  • symptom : rotational vertigo, hearing loss, tinnitus
  • management :ENT adjust
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19
Q

Glossopharngeal (IX)
* S/M
*

A
  • Sensory : Gag reflex ( pharyngeal) IX and X
    : Uvula reflex IX and X, uvula will move contralateral from side of lesion when patient says “AHHH”
    : carotid reflex IX and X , massage carotid and heart rate drops
    : posterior 1/3 taste of tongue ( bitter)
  • Motor : stylopharngeus muscle : elevates pharynx and larnyx; dilates pharynx to permit swallowing
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20
Q

Vagus (X)
* S/M
*

A
  • sensory : epiglotis
  • Motor : gag reflex IX & X
    : uvular reflex IX & X
    : laryngeal muscles of swallowing ( palate ,pharynx , contracting muscles )
    : occulocardiac V & X
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21
Q

Spinal accessory (XI)
* S/M
*

A
  • trapezius
  • SCM
  • shoulder shrug
    *
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22
Q

Hypoglossal

A
  • tongue muscles
  • stick out tongue
  • deviation to side of lesion, look for atrophy and fasciculations
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23
Q

Reflex

A
  • involuntary motor response to potentially harmful stimuli
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24
Q

Wesphalt’s sign

A
  • absense of DTR, especially patellar (LMNL)
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25
Jendrassik's maneuver *AKA * test
Reinforcement test bring out reflex bt cortical distraction
26
What is the test for DTR
Wexler scale
27
Tell the DTR scale and its Lesion and disease
* 0= absent with reinforcement ( wesphalt's ) * 1= hypoactive with no reinforcement or normal w/ reinforcement * 2 = normal * 3 = hyperactive * 4 = hyperactive w/ transient clonus * 5 = hyperactive with sustained clonus * LMNL = 0, 1 * UMNL = 3 4 5
28
DTR : jaw jerk * nerve * nerve root
Nerve : trigeminal Nerve root : CN 5
29
DTR : bicep * nerve * nerve root
musculocutaneous C5
30
DTR : brachioradialis * nerve * nerve root
radial c6
31
DTR : triceps * nerve * nerve root
radial c7
32
DTR : patellar * nerve * nerve root
femoral L4
33
DTR : medial hamstring * nerve * nerve root
sciatic l5
34
DTR : ankle jerk / achilles * nerve * nerve root
tibial S1
35
Superficial reflex * Definition * what are they? 7 * where is the lesion
* withdrawal reflex to noxious stimuli * corneal, pharyngeal, cremasteric, geigel's, plantar, abdominal, beevor's * Both UMNL & LMNL
36
Corneal reflex * how to do : * Afferent : * efferent :
* how to do : touch w/ cotton, blink or tear * Afferent : V * efferent : VII
37
Pharyngeal / gag * how to do : * Afferent : * efferent :
* how to do : touch back of tongue with tongue blade = produce gagging * Afferent : IX * efferent : X
38
Cremasteric * how to do : * Afferent : * efferent :
* how to do : stroke inner thigh of male , ipsilateral rise in testes * Afferent : Femoral * efferent : genitofemoral
39
Geigel's * how to do : * Afferent : * efferent :
* how to do : stroke up in the inner thighm poupart's ligament contracts. * Afferent : femoral * efferent : genitofemoral nerve
40
Plantar * how to do : * Afferent : * efferent :
* how to do : stroke up sole of foot, curling of toes and pulling away is normal * Afferent : tibial * efferent : tibial
41
Abdominal * how to do : * Afferent : * efferent :
* how to do : stroke all 4 abdominal quadrants away from umbilicus, umbilicus move toward side stroked * Afferent : Upper T7 to T9 Lower T10 to T12 * efferent : same
42
Beevor's * how to do : * Afferent : * efferent :
* how to do : observe patient do sit up normal ubilicus stay midline * Afferent : Upper = T7 to T9 Lower = T10 to T12 * efferent : same
43
UMNL * definition
brain, spinal cord
44
LMNL
Anterior horn cells of to the myoneural junction
45
UMNL VS LMNL * paralysis
Spastic vs flaccid
46
UMNL VS LMNL * DTR
* hyperactive ( 3 4 5 ) vs hypoactive/basent ( 0 1 )
47
UMNL VS LMNL * Pathological reflex
Present vs absent
48
UMNL VS LMNL * clonus
present vs absent
49
UMNL VS LMNL * Tone
hypertonic vs hypotonic ( soft /squishy)
50
UMNL VS LMNL * Reaction to degeneration
absent vs present
51
UMNL VS LMNL * Atrophy
absent vs present
52
UMNL VS LMNL * fasciculation
absent vs present
53
UMNL VS LMNL * superficial reflex
absent vs absent
54
Visceral organic reflex * def * lesion * how many?
* brainstem integrates these reflex * absent in both * 3
55
Ciliospinal * perform : * afferent : * efferent :
* perform : pinch neck while noting dilation of eyes * afferent : sensory of neck * efferent : cervical sympathetics
56
oculocardiac * perform : * afferent : * efferent :
* perform : put pressure on eye slow heart by 10 bmp * afferent : V * efferent : X
57
Carotid sinus * perform : * afferent : * efferent :
* perform : press on caritod sinus slow of heart and decrease pressure * afferent : IX * efferent : X
58
Pathological reflex * def * what are they? 8
* UMNL * babinski, chaddock,oppenheim, gordon calf, schaefer,rossolimo, hoffman, trommer
59
Muscle grading
* 5 = normal = complete ROM, against gravity w/ FULL resis * 4 = good = complete ROM, against gravity w/ SOME resis * 3 = fair = complete ROM against gravity w/ NO resis * 2 = poor = complete ROM w/o gravity w/o resis * 1 = trace = slight contractility with no join motion * 0 = zero = no contractility
60
C5 * muscle : * motor : * sensory : * Disorder :
* muscle : middle delt * motor : arm abduction, forare flexion * sensory : lateral arm * Disorder : Erb's palsy = muscle weakness of arm/shoulder d/t birth trauma
61
C6 * muscle : * motor : * sensory : * Disorder :
* muscle : extensor carpi ulnaris, extensor carpi radialis, brachialis * motor : wrist extension * sensory : lateral forearm, thumb and index * Disorder : Erb's palsy, wrist drop
62
C7 * muscle : * motor : * sensory : * Disorder :
* muscle : flexor carpi radialis, flexor carpi ulnaris, triceps * motor : wrist flexion, finger extension * sensory : middle finger * Disorder : klumpke's
63
C8 * muscle : * motor : * sensory : * Disorder :
* muscle : flexor digitorum superficialis, flexor digitorm profundus, lumbricals * motor : finger flexion * sensory : medial forearm, pinky , ring finger * Disorder : = klumpke's poaralysis
64
T1 * muscle : * motor : * sensory :
* muscle : dorsal interossei, palmar interossei * motor : finger abduction , finger adduction * sensory : medial elbow
65
L1-L3 * muscle : * motor : * sensory : * Disorder :
* muscle : iliopsoas * motor : hip flexion * sensory : [inguinal lig L1] [oblique L2] [oblique across knee L3] * Disorder : = meralgie peresthesia ( numbness anterior lateral thigh )
66
L2 - L4 * muscle : * motor :
* muscle : quadriceps, adductors * motor : hip flexion, adduction, knee extension
67
L4 * muscle : * motor : * sensory : * Disorder :
* muscle : tibialis anterior * motor : inversion, dorsiflexion * sensory : medial aspect of foot and leg * Disorder : foot drop
68
L5 * muscle : * motor : * sensory : * Disorder :
* muscle : extensor digitorum, extensor hallucis longus, gluteus medius and gluteus minimus * motor : toe extension, heel walk, hip abduction * sensory : lateral aspect of leg across dorsum of foot to big toe * Disorder : foot drop
69
S1 * muscle : * motor : * sensory :
* muscle : peroneous longus, peroneous brevis, gluteus maximus, * motor : eversion, plantar flexion, hip extension * sensory : lateral aspect of foot and plantar surface of foot
70
S2-S4 * muscle : * motor : * sensory : * Disorder :
* muscle : levator ani, cocygeus * motor : anal wink * sensory : perianal * Disorder : cauda equana
71
Axillary * muscle : * motor : * sensory : * Disorder :
* muscle : deltoid , teres minor * motor : arm abduction * sensory : lateral arm * Disorder : glenohumeral dislocation
72
radial * muscle : * motor : * sensory : * Disorder :
* muscle : wrist extensor, finger extensor, triceps * motor : wrist extension, finger extension, triceps * sensory : dorsal web between thumb and index * Disorder : wrist drop, crutch palsy, erb's palsy
73
musculocutaneous * muscle : * motor : * sensory : * Disorder :
* muscle : biceps, brachialis, coracobrachialis * motor : elbow flexion * sensory : lateral forearm * Disorder : impingement
74
median * muscle : * motor : * sensory : * Disorder :
* muscle : wrist flexors, thumb flexor, thumb abductor, thenar * motor : thumb pinch, opposition thumb * sensory : distal radial hand, 2nd digit * Disorder : ape hand, carpal tunner, pronator teres
75
Ulnar * muscle : * motor : * sensory : * Disorder :
* muscle : finger abduction, finger adductor, thumb adductors * motor : abduction of 5th digit, adduction of thumb * sensory : distal ulnar , 5th digit * Disorder : Claw hand, tunnel of guyin, cubital tunnel
76
Dorsal scapular * muscle : * motor : * Disorder :
* muscle : rhomboid , levator scap * motor : elevation and retraction of scapula * Disorder : flaring of scapula * FORDS = flaring of rhomboid dorsal scapula
77
Long thoracic * muscle : * motor : * Disorder : * cause :
* muscle : Seratus anterior (SALT) * motor : protraction of scapula * Disorder : wing of scapula * cause : traumatic, idiopathic, iatrogenic process.
78
Lateral femoral cutaneous * sensory : * Disorder :
* sensory : Lateral thigh L1 2 3 * Disorder : meralgia, paresthesia
79
Femoral * muscle : * motor : * sensory : * Disorder :
* muscle : iliopsoas, quadriceps * motor : hip flexion, knee extension * sensory : anterior medial thigh and leg * Disorder : impingement
80
Sciatic * muscle : * motor : * sensory : * Disorder :
* muscle : hamstrings * motor : flexion of knee * sensory : anterior leg, posterior leg, sole of foot , dorsom of foot * Disorder : piriformis syndrome
81
Peroneal * muscle : * motor : * sensory : * Disorder :
* muscle : tib anterior, toe extensors, peroneals * motor : foot dorsiflexion, inversion, eversion * sensory : anterior leg, dorsom of foot * Disorder : fibular head fx
82
Medial plantar * muscle : * motor : * Disorder :
* muscle : toe flexor musclke * motor : toe flexion * Disorder : tarsal tunnel syndrome
83
DR CUMA
Drop wrist radial claw hand ulnar median ape hand
84
dermatomes
pain along the sensory distribution of nerve root
85
myotogenous
pain from muscle
86
scleratogenous
* pain from embryological sclerotomes * facet, tmj, si
87
radicular
same as dermatogenous
88
referred
* muscle : pain along scleroderm shared pathway
89
Type of pain : muscle
* cramping, spasm, aching, dull
90
Type of pain : nerve
* shooting, radiating, burning,
91
Type of pain : Circulation
throbbing, pulsating
92
Type of pain : bone cancer
constant, deep, boring, nocturnal , progressive, unremitting
93
Type of pain : scleratogenous
poorly localized, dull ,ache
94
Type of pain : myofascial
trigger point,
95
Referred pain : gall bladder
right shoulder inferior scapular
96
Referred pain : pancreas
Spine @ T10
97
Referred pain : heart
Left shoulder/ medial arm
98
Referred pain : intestine
periumbilical
99
Referred pain : appendix
epigastic early rlq late
100
Referred pain : kidney
flant
101
Referred pain : ureter
groin
102
Referred pain : bladder
suprapubic area
103
Carpal tunner syndrome * nerve : * site : * cause : * symptom : * test : * management :
* nerve : median nerve * site : under the flexor retinaculum * cause : trauma, obesity, fluid retention during pregenancy hypothroidism * symptom : thenar atrophy, nocturnal pain, weak opponens policies, ape hand appearance * test : tinels, phalens, grip strength w/ dynamometer, thumb test * management : adjust, cock up splint, natural dieuretic vit b6, ergonomics
104
Pronator teres syndrome * AKA : * nerve : * site : * cause : * symptom : * test : * management :
* AKA anterior interosseous syndrome * nerve : median nerve * site : between heads of pronator teres at elbow * cause : hypertonicity of muscle by occupation ( carpenter,mechanics ) * symptom : pain, paresthesia on anterior aspect of forearm, lateral palm and lateral digits. * test : pinch grip test * management : trigger point therapy, spray, stretch
105
Tunnel of guyon * nerve : * site : * cause : * symptom : * test : * management :
* nerve : median nerve * site : tunnel of guyon, under hook of hamate * cause : direct trauma or repetitive microtrauma * symptom : pain, tingling, numbness in last 2 digits weakness of adductor pollicis, CLAW hand deformity, hypothenar athrophy : weak wrist flexion on the ulnar side * test : * management :
106
Cubital tunnel (elbow) * nerve : * site : * cause : * symptom : * test : * management :
* nerve : ulnar * site : elbow (cubital tunnel) * cause : stretch of ulnar nerve, using phone too much * symptom : weakness of wrist flexors is not seen in tunnel of guyon verson * test : same * management :same
107
klumpke's paralysis * cause : * symptom :
* nerve : lower brachial plexus C8-T1 * symptom : palsy of lower brachial plexus from childbirth, presents w/ claw hand deformity and flexion of the wrist
108
radial nerve * nerve : * site : * cause : * symptom : * test : * management :
* nerve : radiel nerve * detail : wrist drop (unable to extend elbow and wrist) erb's palsy ( water tip deformity,adduction, internal rotation , flexion of wrist ) saturday night pulsy, crutch palsy, * site : spiral groove * cause : trauma, lead poisoning, pressure from crutches * symptom : loss of tricep reflex, decrease sensation to posterior arm ,forearm, and posterolateral 3.5 finger * test : * management :
109
Sciatica * nerve : * site : * cause : * symptom : * management :
* nerve : sciatic * site : pelvis, hip, popliteal fossa * cause : trauma, traction, wallet pressure, piriformis, muscle spasm * symptom : sensory pain in buttocks, thigh, lefn down to floor. weak muscles of foot , aggrevated by walking or standing.
110
Tarsal tunnel syndrome * nerve : * site : * cause : * symptom : * test : * management :
* nerve : tibial nerve * symptom : burning paresthesi &decreased sensation on soles of feet and weak muscles of foot, aggrevated by walking or standing * management :adjust, orthotic support, keep foot in slight inversion
111
Morton Neuroma * AKA: * site : * cause : * symptom : * test : * management :
* AKA: intermetatarsal neuroma * site : between 3rd and 4th metatarsal * cause : repetitive microtrauma, narrow toed shoes, RA , foot deformity. * symptom : pain in does and dorsum of foot * test : morton squeeze * management : surgery may be neccessary
112
common peroneal nerve * Site : * presents : * cause :
site : fibular head presents : pain in lateral of leg, weak peroneal muscle or foot drop caused by trauma
113
Deep peroneal nerve * AKA : * symptom * similar to what?
* Anterior compartment syndrome * affect all 4 muscles : tibilias anterior, extensor hallucis longus, extensor digitorum longus, peroneus tertius * charcot marie tooth
114
Mallet finger
* finger is curled in , cannot str8 by itself * d/t injury that damage tendon or tears tendon off bone
115
Swan neck deformity
* common w/ lupus , RA * hyperflexion of DIP * hyperextension of PIP,
116
boutonniere
* Hyper flexion of PIP * hyper extension of DIP * RA & trauma
117
dupuytren's contracture * detail * cause *
* thickening underneat the skin of palm and finger * last 2 finger curls *
118
Trigger finger * detail *
* finger gets locked in flexed position * d/t swollen , inflamed *
119
de quervain's tenosynovitis
* inflammation of extensor pollicis brevis * abductor pollicis longus * test : finklestein test+ bracing the thumb + wrist
120
Cerebrum
* sensory and motor interpretation * language * stroke * cerebral palsy * alcoholism * alzheimer * tumor
121
Cerebellum
* balance * coordination * dsmetria ( past pointing) * dyssynergie ( lack of coordination) * diadochokinesia ( rapidly alternating movements ) * tandem gait * multple sclerosis * alcoholism
122
Posterior column
* 2 point discrimiation - 2 needle poking your skin * vibration * joint position sense - your joint position when you move * MS * tabes dorsalis * syphillis
123
corticospinal
* Voluntary motor * flxeor of hands and feet * umnl
124
Lateral spinothalamic
* pain * temp * syringomyelia * umnl
125
Anterior spinothalamic
Crude light touch = something touch skin but no other info
126
vestibulospinal
* balance reflex * postural muscles * benign positonal vertigo * labyrinthitis
127
Rubrospinal
* muscle tone * synergy to proximal flexors of extremities
128
Reticulospinal
* muscle tone * synergy to voluntary muscles extensors
129
Lateral corticospinal
* crosses at medullary pyramids and travels to the flexors of the extremities
130
Ventral corticospinal
* crosses at the segmental level and then to flexors of the trunk * umnl
131
Syringomyelia * detail : * sensory: * location : * symptom : * management :
* detail : longitudinal cyst of the central canal of the spinal cord : fluid filling cavities expand in adult years * sensory : sensory * track : CST , LSTT * location : congenital weakening , c5-c6 area * symptom : loss of sense of pain and temperature over shoulders in a cape like distribution * cause : flexion, whiplash issue, or congenital issue * management : refer to neurologist, MRI
132
Multiple sclerosis * detail : * sensory: * age : * location : * symptom : * test : * labs : * management :
* detail : demyelination of CNS : Oligodendrocytes : spinal cord & brain : Charcot's triad ( SIN )= scanning speach, intention tremors, nystagmus * sensory: sensory + motor * age : 20-40 * location : * symptom : worse when moving from cold to warm climate : diplopia, scotomas, transient blindness, optic neuritis, pain, vertigo, UMNL on legs causing distal weakness * test : Lhermitte's test ( pt touch chin to chest will cause symptom ), MRI * Labs : protein in CSF * management : adjust, co-manage neurologist, away from heat, reduce fall rist, ADL
133
Myastenia gravis * detail : * sensory: * age : * symptom : * test : * management :
* detail : autoimmune disease : body makes antibodies against the Acetylcoline receptors : myoneural dysfunction * sensory: motor * age : 20-40 female * symptom : weakness in cranial nerves then proximal muslce affected : ptosis, diplopia, fatigue of muscles ( especially after exercise : Muslce weakness worse at end of day * test : tensilon test * management : cholinesterase inhibiting drugs, adjust, co - manage neuro, reduce fall risk, adl
134
Amyotrophic lateral sclerosis * AKA: * detail : * sensory: * track : * age : * symptom : * management :
* AKA : lou gehrig's disease * detail : begins in hands and feet. : life expectancy is short : ddx = lateral canal stenosis * sensory: motor findings * track : corticospinal tract, anterior horn * age : over 40 yo * symptom : fasciculation = lmnl = arms : spasticity + increased DTR = umnl = legs * management : adjust, mri, co manage neuro
135
Posterolateral sclerosis * AKA: * detail : * track : * symptom : * test :
* AKA : combined system disease * detail : symptoms are irreversible * track : degeneration of Posterior column & corticospinal tract d/t b12 deficiency * symptom : pernecious anemia, glove and stocking paresthesia, : start on tip of hand & feet then to spine : taking B12 will not reverse but stop progress * test : + schilling test
136
Brown sequard * detail : * sensory: * symptom : * management :
* detail : hemisection of spinal cord d/t injury * sensory: sensory + motor * symptom : ipsilateral loss of motor function and dorsal column ( proprioception : contralateral loss of pain and temp * management : refer neuro
137
cerebral palsy * detail : * sensory: * symptom : * management :
* detail : non progressive motor disorder of cerebral cortex d/t anoxia to the brain prenatally or during birth trauma * sensory: motor * symptom : scissor gate, spatic paralysis, athetoid worm like movement on upper ext, normal intelligence * management : adj, co- neuro,
138
Parkinson's dx * AKA : * detail : * track : * age : * symptom : * management :
* AKA: paralysis agitans * detail : chronic progression condition associated w/ loss of dopamine in substantia nigra causing basal ganglionic dysfunction * track : extrapyrimidal tract ( reticulspinal, vestibulospinal., rubrospinal, tectospinal) * age : over 50 * symptom : resting tremors, mask like face, festinating gait, cogwheel, lead pipe regidity, forward stoop posture, bradykinesia * management : adjust, co-neuro, l-dopa +anticholinergics, reduce fall rist, adl, deep brain stimulator
139
guillain - barre syndrome * detail : * sensory: * symptom : * management :
* detail : linked to recent immunization or after flu infection : can be medical emergency if reaches diaphram * sensory: sensory + motor * symptom : ascending paralysis and sensory symtpom : begin in legs * management : ER
140
Tabes dorsalis * detail : * symptom :
* detail : tertiary syphiliis : wasting away of posterior column * symptom : Argyll robertson's pupil = accomodate but does not respond to direct light : coordination and balance is disturbed : slappage gait : worse when eyes closed , difficult walking @ night
141
Mascular dystrophy * AKA: * detail : * age : * symptom : * test : * labs :
* AKA: erb duchenne * detail : sex lixed disorder * age : boys 3-7 * symptom : proximal muscle weakness : waddling gait : toe walking : hyperlordosis : psudohypertrophy of calves * test : Gower sign * labs : Large increase in CPK ( CK-MM) , decrease creatinine
142
Charcot marie tooth disease * detail : * sensory * age : * symptom :
* detail : heredetary condition * sensory: sensory + motor * age : Over 30 yo * symptom : weakness of foot and lower leg : foot drop : high step gait : frequent tripping or falls : lower leg atrophy
143
Alzheimers
* mental deterioration( cortical degeneration) , amnesia, most definity dx = autopsy
144
Huntington's chorea
* 35-44 * neurodegenerative genetive disorder * muscle coordination * cognitive decline * dementia
145
Fibromyalgia * detail : * symptom : * management :
* detail : chronic widespread of pain * symptom : heigtened pain to pressure, debilitating fatigue, sleep disturbance, joint stiffness, depression. : pain points ( musct have 11 out of 18) * management : adj, exercise, neuro,
146
Gait's : stance phase
* 60%
147
Gait's : heel strike
* when heels hit the ground
148
Gait's : foot stike
* when heel of foot is on ground
149
Gait's : toe off
* when up on toe and about to kick off
150
Gait's : swing phase
* 40% * when one leg is swinging
151
acceleration * muscles :
* muscles : iliopsoas : rectus femoris = imporant muscle , can come off easily from AIIS d/t cartilaginous apophysis attachment
152
Deceleration * muscles
* muscles : hamstring = contract eccentrically ( elongating ) * pulled off by kicking or decelerate quickly
153
heel strike * muscles
* muscles : dorsiflexors (anterior tibial group = tib anterior, deep fibular n) : Quadrieps
154
Foot strike Muscles
* muscles : abductors * plantar flexors ( gastrocnemous , soleus, plantaris )
155
Toe off * muscles
* muscles : quadriceps * plantar flexors
156
Gait : propulsion * AKA : * detail : * disease :
* AKA : festinating, shuffling * detail : forward leaning posture with small shuffle step * disease :
157
scissors * detail : * disease :
* detail : knee cross midline while walking * disease : cerebral palsy, adductor stronger then abductor,
158
waddling * detail : * disease :
* detail : weak glute + psoas , like a preg mom * disease : muscular dystrophy
159
steppage * detail : * disease :
* detail : High step, cannot dorsiflex * disease : anterior compartment syndrome, foot drop , L4 lesion, paresis of Tibialis anterior
160
Trendelenberg * detail : * disease :
* detail : weak gluteus medius causing lurching and drastic pelvic tilting on affceted side * disease :
161
Slappage * AkA: * detail : * disease :
* AKA: sensory ataxia * detail : difficulty walking in dark, stomping on ground because cannot feel the foot. * disease : posterior column disease
162
Cicumduction * AKA: * detail : * disease :
* AKA: hemiphlegic * detail : swining, unilateral , * disease : stroke, spastic hemiplegia
163
Spastic
* scissor gait * UMNL
164
Antalgic
* gait is utilized to avoid provoking pain.
165
Drunken / motor ataxic
* wide base gait ( cerebellum )

part 2 / 3 boards (7 decks)

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