PDF - PE Flashcards
Supratentorial CNs?
I &2
Afferent and efferent pupillary CNs?
Afferent: 2
Efferent: 3
What is miosis?
Smaller pupil on one side
How to test obliques and rectus?
Obliques: ADduction
Rectii: ABduction
Where are CN III - IV?
Midbrain
Where are CN V - VIII?
Pons
Where are CN IX - XII?
Medulla
CN III Pupillary palsies?
Pupil constricted: likely metabolic with something inside nerve
If dilated: A mass outside is pressing on the nerve
Vascular problem causing 3rd nerve palsy?
PCA aneurysm
What does the trochlear nerve do?
Superior oblique: CNIV
Only CN within wall of cavernous sinus?
CN VI: Abducens (lateral rectus)
Binocular diplopia or monocular leurologic?
Binocular
What innervates angle of mandible?
C3, no V3
When is asymmetric nasolabial fold seen?
CN VII lesion
Lower face innervation? Upper?
Lower: by bilateral hemisphere
Upper: bilateral
What is stereognosis?
Recognition of an object by touch with eyes closed
Where would a lesion present stereognosis?
Parietal sensory cortex
Failure in double simultaneous stimulation is what lesion?
Contralateral parietal lobe
Senses first lost in large and small fibers?
Large: Proprioception (posterior dorsal column)
Small: Pain / temp
Which dermatome is C5?
Lateral Shoulder
Which dermatome is C6?
Thumb
Which dermatome is C7?
Index/middle fingers
Which dermatome is C8/T1?
Ring/little finger
- Medial arm and forearm
Which dermatome is T4?
Nipple
Which dermatome is T10?
Umbillicis
Which dermatome is L3/4?
Anterior Thigh
Which dermatome is L5?
Dorsal foot
Which dermatome is S1?
Lateral foot / sole
What is the Jendrassik maneuver?
Patient hooks together flexed fingers to distract with DTRs are tested
Nerves responsible for the bicecps reflex?
C5/6
Nerves responsible for the Brachioradialis reflex?
C5/6
Nerves responsible for the Triceps reflex?
C7/8
Nerves responsible for the Finger flexors reflex?
C8/T1
Nerves responsible for the Knee jerk reflex?
L2-4
Nerves responsible for the ankle jerk reflex?
S1-2
What is clonus?
Repetitive muscle contractions when tendon is stretched
Nerve in the pupillary reflex?
Afferent: CN II
Efferent: CN III
Nerve in the corneal reflex?
Afferent: CN V
Efferent: CN VII
Nerve in the palpebral reflex?
Afferent: CN V
Efferent: CN VII
Nerve in the gag (pharyngeal) reflex?
Afferent: CN IX
Efferent: CN X
Strength Grading?
0 - No movement 1 - Flicker of movement 2 - Only with no gravity 3 - Only AGAINST gravity 4 - Against light resistance 5- Normal
Lesion if bilateral lower limb weakness?
Bilateral thoracic cord
Lesion in all weakness?
Bilateral cervical
Bilateral UMN
Type of lesion in spasticity?
UMN
When is atrophy present?
LMN lesion
When are fasciculations present?
LMN lesion
Only place fibrillations visible?
Tongue - this is an individual muscle fiber and the tongue is a naked muscle
What happens in spinal shock?
- Expected UMN signs initially absent
- Emerge days to weeks later
- Paralysis will be initially present with hypotonia
