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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
Q

Jendrassik’s maneuver
*AKA
* test

A

Reinforcement test
bring out reflex bt cortical distraction

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26
Q

What is the test for DTR

A

Wexler scale

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27
Q

Tell the DTR scale and its Lesion and disease

A
  • 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
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28
Q

DTR : jaw jerk
* nerve
* nerve root

A

Nerve : trigeminal
Nerve root : CN 5

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29
Q

DTR : bicep
* nerve
* nerve root

A

musculocutaneous
C5

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30
Q

DTR : brachioradialis
* nerve
* nerve root

A

radial
c6

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31
Q

DTR : triceps
* nerve
* nerve root

A

radial c7

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32
Q

DTR : patellar
* nerve
* nerve root

A

femoral L4

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33
Q

DTR : medial hamstring
* nerve
* nerve root

A

sciatic
l5

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34
Q

DTR : ankle jerk / achilles
* nerve
* nerve root

A

tibial S1

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35
Q

Superficial reflex
* Definition
* what are they? 7
* where is the lesion

A
  • withdrawal reflex to noxious stimuli
  • corneal, pharyngeal, cremasteric, geigel’s, plantar, abdominal, beevor’s
  • Both UMNL & LMNL
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36
Q

Corneal reflex
* how to do :
* Afferent :
* efferent :

A
  • how to do : touch w/ cotton, blink or tear
  • Afferent : V
  • efferent : VII
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37
Q

Pharyngeal / gag
* how to do :
* Afferent :
* efferent :

A
  • how to do : touch back of tongue with tongue blade =
    produce gagging
  • Afferent : IX
  • efferent : X
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38
Q

Cremasteric
* how to do :
* Afferent :
* efferent :

A
  • how to do : stroke inner thigh of male , ipsilateral rise in
    testes
  • Afferent : Femoral
  • efferent : genitofemoral
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39
Q

Geigel’s
* how to do :
* Afferent :
* efferent :

A
  • how to do : stroke up in the inner thighm poupart’s ligament contracts.
  • Afferent : femoral
  • efferent : genitofemoral nerve
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40
Q

Plantar
* how to do :
* Afferent :
* efferent :

A
  • how to do : stroke up sole of foot, curling of toes and pulling away is normal
  • Afferent : tibial
  • efferent : tibial
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41
Q

Abdominal
* how to do :
* Afferent :
* efferent :

A
  • 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
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42
Q

Beevor’s
* how to do :
* Afferent :
* efferent :

A
  • how to do : observe patient do sit up normal ubilicus stay midline
  • Afferent : Upper = T7 to T9 Lower = T10 to T12
  • efferent : same
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43
Q

UMNL
* definition

A

brain, spinal cord

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44
Q

LMNL

A

Anterior horn cells of to the myoneural junction

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45
Q

UMNL VS LMNL
* paralysis

A

Spastic vs flaccid

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46
Q

UMNL VS LMNL
* DTR

A
  • hyperactive ( 3 4 5 ) vs hypoactive/basent ( 0 1 )
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47
Q

UMNL VS LMNL
* Pathological reflex

A

Present vs absent

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48
Q

UMNL VS LMNL
* clonus

A

present vs absent

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49
Q

UMNL VS LMNL
* Tone

A

hypertonic vs hypotonic ( soft /squishy)

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50
Q

UMNL VS LMNL
* Reaction to degeneration

A

absent vs present

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51
Q

UMNL VS LMNL
* Atrophy

A

absent vs present

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52
Q

UMNL VS LMNL
* fasciculation

A

absent vs present

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53
Q

UMNL VS LMNL
* superficial reflex

A

absent vs absent

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54
Q

Visceral organic reflex
* def
* lesion
* how many?

A
  • brainstem integrates these reflex
  • absent in both
  • 3
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55
Q

Ciliospinal
* perform :
* afferent :
* efferent :

A
  • perform : pinch neck while noting dilation of eyes
  • afferent : sensory of neck
  • efferent : cervical sympathetics
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56
Q

oculocardiac
* perform :
* afferent :
* efferent :

A
  • perform : put pressure on eye slow heart by 10 bmp
  • afferent : V
  • efferent : X
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57
Q

Carotid sinus
* perform :
* afferent :
* efferent :

A
  • perform : press on caritod sinus slow of heart and decrease pressure
  • afferent : IX
  • efferent : X
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58
Q

Pathological reflex
* def
* what are they? 8

A
  • UMNL
  • babinski, chaddock,oppenheim, gordon calf, schaefer,rossolimo, hoffman, trommer
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59
Q

Muscle grading

A
  • 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
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60
Q

C5
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : middle delt
  • motor : arm abduction, forare flexion
  • sensory : lateral arm
  • Disorder : Erb’s palsy = muscle weakness of arm/shoulder d/t birth trauma
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61
Q

C6
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : extensor carpi ulnaris, extensor carpi radialis, brachialis
  • motor : wrist extension
  • sensory : lateral forearm, thumb and index
  • Disorder : Erb’s palsy, wrist drop
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62
Q

C7
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : flexor carpi radialis, flexor carpi ulnaris, triceps
  • motor : wrist flexion, finger extension
  • sensory : middle finger
  • Disorder : klumpke’s
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63
Q

C8
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : flexor digitorum superficialis, flexor digitorm profundus, lumbricals
  • motor : finger flexion
  • sensory : medial forearm, pinky , ring finger
  • Disorder : = klumpke’s poaralysis
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64
Q

T1
* muscle :
* motor :
* sensory :

A
  • muscle : dorsal interossei, palmar interossei
  • motor : finger abduction , finger adduction
  • sensory : medial elbow
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65
Q

L1-L3
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : iliopsoas
  • motor : hip flexion
  • sensory : [inguinal lig L1] [oblique L2] [oblique across knee L3]
  • Disorder : = meralgie peresthesia ( numbness anterior lateral thigh )
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66
Q

L2 - L4
* muscle :
* motor :

A
  • muscle : quadriceps, adductors
  • motor : hip flexion, adduction, knee extension
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67
Q

L4
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : tibialis anterior
  • motor : inversion, dorsiflexion
  • sensory : medial aspect of foot and leg
  • Disorder : foot drop
68
Q

L5
* muscle :
* motor :
* sensory :
* Disorder :

A
  • 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
Q

S1
* muscle :
* motor :
* sensory :

A
  • muscle : peroneous longus, peroneous brevis, gluteus maximus,
  • motor : eversion, plantar flexion, hip extension
  • sensory : lateral aspect of foot and plantar surface of foot
70
Q

S2-S4
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : levator ani, cocygeus
  • motor : anal wink
  • sensory : perianal
  • Disorder : cauda equana
71
Q

Axillary
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : deltoid , teres minor
  • motor : arm abduction
  • sensory : lateral arm
  • Disorder : glenohumeral dislocation
72
Q

radial
* muscle :
* motor :
* sensory :
* Disorder :

A
  • 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
Q

musculocutaneous
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : biceps, brachialis, coracobrachialis
  • motor : elbow flexion
  • sensory : lateral forearm
  • Disorder : impingement
74
Q

median
* muscle :
* motor :
* sensory :
* Disorder :

A
  • 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
Q

Ulnar
* muscle :
* motor :
* sensory :
* Disorder :

A
  • 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
Q

Dorsal scapular
* muscle :
* motor :
* Disorder :

A
  • muscle : rhomboid , levator scap
  • motor : elevation and retraction of scapula
  • Disorder : flaring of scapula
  • FORDS = flaring of rhomboid dorsal scapula
77
Q

Long thoracic
* muscle :
* motor :
* Disorder :
* cause :

A
  • muscle : Seratus anterior (SALT)
  • motor : protraction of scapula
  • Disorder : wing of scapula
  • cause : traumatic, idiopathic, iatrogenic process.
78
Q

Lateral femoral cutaneous
* sensory :
* Disorder :

A
  • sensory : Lateral thigh L1 2 3
  • Disorder : meralgia, paresthesia
79
Q

Femoral
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : iliopsoas, quadriceps
  • motor : hip flexion, knee extension
  • sensory : anterior medial thigh and leg
  • Disorder : impingement
80
Q

Sciatic
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : hamstrings
  • motor : flexion of knee
  • sensory : anterior leg, posterior leg, sole of foot , dorsom of foot
  • Disorder : piriformis syndrome
81
Q

Peroneal
* muscle :
* motor :
* sensory :
* Disorder :

A
  • muscle : tib anterior, toe extensors, peroneals
  • motor : foot dorsiflexion, inversion, eversion
  • sensory : anterior leg, dorsom of foot
  • Disorder : fibular head fx
82
Q

Medial plantar
* muscle :
* motor :
* Disorder :

A
  • muscle : toe flexor musclke
  • motor : toe flexion
  • Disorder : tarsal tunnel syndrome
83
Q

DR CUMA

A

Drop wrist
radial
claw hand
ulnar
median
ape hand

84
Q

dermatomes

A

pain along the sensory distribution of nerve root

85
Q

myotogenous

A

pain from muscle

86
Q

scleratogenous

A
  • pain from embryological sclerotomes
  • facet, tmj, si
87
Q

radicular

A

same as dermatogenous

88
Q

referred

A
  • muscle : pain along scleroderm shared pathway
89
Q

Type of pain : muscle

A
  • cramping, spasm, aching, dull
90
Q

Type of pain : nerve

A
  • shooting, radiating, burning,
91
Q

Type of pain : Circulation

A

throbbing, pulsating

92
Q

Type of pain : bone cancer

A

constant, deep, boring, nocturnal , progressive, unremitting

93
Q

Type of pain : scleratogenous

A

poorly localized, dull ,ache

94
Q

Type of pain : myofascial

A

trigger point,

95
Q

Referred pain : gall bladder

A

right shoulder inferior scapular

96
Q

Referred pain : pancreas

A

Spine @ T10

97
Q

Referred pain : heart

A

Left shoulder/ medial arm

98
Q

Referred pain : intestine

A

periumbilical

99
Q

Referred pain : appendix

A

epigastic early
rlq late

100
Q

Referred pain : kidney

A

flant

101
Q

Referred pain : ureter

A

groin

102
Q

Referred pain : bladder

A

suprapubic area

103
Q

Carpal tunner syndrome
* nerve :
* site :
* cause :
* symptom :
* test :
* management :

A
  • 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
Q

Pronator teres syndrome
* AKA :
* nerve :
* site :
* cause :
* symptom :
* test :
* management :

A
  • 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
Q

Tunnel of guyon
* nerve :
* site :
* cause :
* symptom :
* test :
* management :

A
  • 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
Q

Cubital tunnel (elbow)
* nerve :
* site :
* cause :
* symptom :
* test :
* management :

A
  • 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
Q

klumpke’s paralysis
* cause :
* symptom :

A
  • 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
Q

radial nerve
* nerve :
* site :
* cause :
* symptom :
* test :
* management :

A
  • 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
Q

Sciatica
* nerve :
* site :
* cause :
* symptom :
* management :

A
  • 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
Q

Tarsal tunnel syndrome
* nerve :
* site :
* cause :
* symptom :
* test :
* management :

A
  • 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
Q

Morton Neuroma
* AKA:
* site :
* cause :
* symptom :
* test :
* management :

A
  • 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
Q

common peroneal nerve
* Site :
* presents :
* cause :

A

site : fibular head
presents : pain in lateral of leg, weak peroneal muscle or foot drop
caused by trauma

113
Q

Deep peroneal nerve
* AKA :
* symptom
* similar to what?

A
  • Anterior compartment syndrome
  • affect all 4 muscles : tibilias anterior, extensor hallucis longus, extensor digitorum longus, peroneus tertius
  • charcot marie tooth
114
Q

Mallet finger

A
  • finger is curled in , cannot str8 by itself
  • d/t injury that damage tendon or tears tendon off bone
115
Q

Swan neck deformity

A
  • common w/ lupus , RA
  • hyperflexion of DIP
  • hyperextension of PIP,
116
Q

boutonniere

A
  • Hyper flexion of PIP
  • hyper extension of DIP
  • RA & trauma
117
Q

dupuytren’s contracture
* detail
* cause
*

A
  • thickening underneat the skin of palm and finger
  • last 2 finger curls
    *
118
Q

Trigger finger
* detail
*

A
  • finger gets locked in flexed position
  • d/t swollen , inflamed
    *
119
Q

de quervain’s tenosynovitis

A
  • inflammation of extensor pollicis brevis
  • abductor pollicis longus
  • test : finklestein test+ bracing the thumb + wrist
120
Q

Cerebrum

A
  • sensory and motor interpretation
  • language
  • stroke
  • cerebral palsy
  • alcoholism
  • alzheimer
  • tumor
121
Q

Cerebellum

A
  • balance
  • coordination
  • dsmetria ( past pointing)
  • dyssynergie ( lack of coordination)
  • diadochokinesia ( rapidly alternating movements )
  • tandem gait
  • multple sclerosis
  • alcoholism
122
Q

Posterior column

A
  • 2 point discrimiation - 2 needle poking your skin
  • vibration
  • joint position sense - your joint position when you move
  • MS
  • tabes dorsalis
  • syphillis
123
Q

corticospinal

A
  • Voluntary motor
  • flxeor of hands and feet
  • umnl
124
Q

Lateral spinothalamic

A
  • pain
  • temp
  • syringomyelia
  • umnl
125
Q

Anterior spinothalamic

A

Crude light touch = something touch skin but no other info

126
Q

vestibulospinal

A
  • balance reflex
  • postural muscles
  • benign positonal vertigo
  • labyrinthitis
127
Q

Rubrospinal

A
  • muscle tone
  • synergy to proximal flexors of extremities
128
Q

Reticulospinal

A
  • muscle tone
  • synergy to voluntary muscles extensors
129
Q

Lateral corticospinal

A
  • crosses at medullary pyramids and travels to the flexors of the extremities
130
Q

Ventral corticospinal

A
  • crosses at the segmental level and then to flexors of the trunk
  • umnl
131
Q

Syringomyelia
* detail :
* sensory:
* location :
* symptom :
* management :

A
  • 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
Q

Multiple sclerosis
* detail :
* sensory:
* age :
* location :
* symptom :
* test :
* labs :
* management :

A
  • 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
Q

Myastenia gravis
* detail :
* sensory:
* age :
* symptom :
* test :
* management :

A
  • 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
Q

Amyotrophic lateral sclerosis
* AKA:
* detail :
* sensory:
* track :
* age :
* symptom :
* management :

A
  • 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
Q

Posterolateral sclerosis
* AKA:
* detail :
* track :
* symptom :
* test :

A
  • 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
Q

Brown sequard
* detail :
* sensory:
* symptom :
* management :

A
  • 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
Q

cerebral palsy
* detail :
* sensory:
* symptom :
* management :

A
  • 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
Q

Parkinson’s dx
* AKA :
* detail :
* track :
* age :
* symptom :
* management :

A
  • 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
Q

guillain - barre syndrome
* detail :
* sensory:
* symptom :
* management :

A
  • 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
Q

Tabes dorsalis
* detail :
* symptom :

A
  • 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
Q

Mascular dystrophy
* AKA:
* detail :
* age :
* symptom :
* test :
* labs :

A
  • 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
Q

Charcot marie tooth disease
* detail :
* sensory
* age :
* symptom :

A
  • 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
Q

Alzheimers

A
  • mental deterioration( cortical degeneration) , amnesia, most definity dx = autopsy
144
Q

Huntington’s chorea

A
  • 35-44
  • neurodegenerative genetive disorder
  • muscle coordination
  • cognitive decline
  • dementia
145
Q

Fibromyalgia
* detail :
* symptom :
* management :

A
  • 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
Q

Gait’s : stance phase

A
  • 60%
147
Q

Gait’s : heel strike

A
  • when heels hit the ground
148
Q

Gait’s : foot stike

A
  • when heel of foot is on ground
149
Q

Gait’s : toe off

A
  • when up on toe and about to kick off
150
Q

Gait’s : swing phase

A
  • 40%
  • when one leg is swinging
151
Q

acceleration
* muscles :

A
  • muscles : iliopsoas
    : rectus femoris = imporant muscle , can come off
    easily from AIIS d/t cartilaginous apophysis
    attachment
152
Q

Deceleration
* muscles

A
  • muscles : hamstring = contract eccentrically ( elongating )
  • pulled off by kicking or decelerate quickly
153
Q

heel strike
* muscles

A
  • muscles : dorsiflexors (anterior tibial group = tib anterior,
    deep fibular n)
    : Quadrieps
154
Q

Foot strike
Muscles

A
  • muscles : abductors
  • plantar flexors ( gastrocnemous , soleus, plantaris )
155
Q

Toe off
* muscles

A
  • muscles : quadriceps
  • plantar flexors
156
Q

Gait : propulsion
* AKA :
* detail :
* disease :

A
  • AKA : festinating, shuffling
  • detail : forward leaning posture with small shuffle step
  • disease :
157
Q

scissors

  • detail :
  • disease :
A
  • detail : knee cross midline while walking
  • disease : cerebral palsy, adductor stronger then abductor,
158
Q

waddling
* detail :
* disease :

A
  • detail : weak glute + psoas , like a preg mom
  • disease : muscular dystrophy
159
Q

steppage
* detail :
* disease :

A
  • detail : High step, cannot dorsiflex
  • disease : anterior compartment syndrome, foot drop , L4 lesion, paresis of Tibialis anterior
160
Q

Trendelenberg
* detail :
* disease :

A
  • detail : weak gluteus medius causing lurching and drastic pelvic tilting on affceted side
  • disease :
161
Q

Slappage
* AkA:
* detail :
* disease :

A
  • AKA: sensory ataxia
  • detail : difficulty walking in dark, stomping on ground because cannot feel the foot.
  • disease : posterior column disease
162
Q

Cicumduction
* AKA:
* detail :
* disease :

A
  • AKA: hemiphlegic
  • detail : swining, unilateral ,
  • disease : stroke, spastic hemiplegia
163
Q

Spastic

A
  • scissor gait
  • UMNL
164
Q

Antalgic

A
  • gait is utilized to avoid provoking pain.
165
Q

Drunken / motor ataxic

A
  • wide base gait ( cerebellum )

part 2 / 3 boards (7 decks)

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