PNS- 10 ?s Flashcards by Amanda Beach

NS disorders are responsible for what percent of years lived with disability

28%

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What is the most important part of neurologic pathology

knowing the LOCATION

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Where could lesions be in the CNS

Cx, basal ganglion, brain stem, cerebellum, spinal cord

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where could lesions be in the PNS

CN, motor efferents, sensory afferents, NMJ, muscle itself

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What are the overall exams for CNS

mental status and cognition, coordination, CN

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what are the overall exams for PNS

motor: strength and motion
sensation
reflexes

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What are the components of a neuro exam

mental status, CN, motor, sensory, reflexes

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The posterior root of spinal cord carry what type infor

anterior?

posterior- sensory

anterior- motor

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what type of info is in a peripheral nerve

both sensory and motor

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What are the 2 nervous system distribution

dermatomes

cutaneous peripheral

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What are the most common complains of peripheral nerve disorder

pain weakness and paresthesias

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what are associated symptoms of peripheral nerve disorders

swelling, rash, spasm deformities, mental status

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what is important in PMH for peripheral nerve disorder

autoimmune, dystrophies, diabetes, DJD

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What are the most common causes of peripheral nerve disorder

ischemia (arterial stenosis)
bleeding (TIA, CVA)
masses (impingement)
peripheral nervous disorders (MS, Guillian Barre)
Neuromuscular disorders (Myasthenia gravis)
muscular disorders (dystrophies)

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what are findings on the sensory exam for peripheral nervous problems

hypesthesia or hypoesthesia
hyperesthesia
hyperalgesia
allodynia

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what is allodynia

non-painful stimulus perceived as painful on the skin, sometimes severe

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how do patients with peripheral nervous disorders describe their sensations

dysesthesia

paresthesia

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What are examples of proximal weakness

combing hair
getting out of chair
worse with repeated effort (myasthenia gravis)

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what are examples of distal weakness

open a jar, writing, tripping

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What are the 5 types sensation

pain, temp, light touch, proprioception, vibration

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What is stereognosis

identifying object by feel

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What is the scale for mm strength

0- no mvmnt
1- m twitch no joint
2- mvmnt w/o gravity
3- full strength against gravity
4- partial strength against resistance
5- full strength against R

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What are the brainstem reflexes

corneal, gag, pupillary

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what are the superficial reflexes

abdominal, plantar, anal

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When is clonus seen in reflexes

UMN lesions

The abdominal wink reflexes involve what nn

T8-T10 | T10-12

what are levels involved in anal wink

S2-4

what are the levels involved in plantar(babinski)

L5-S1

what is a normal babinski response

downgoing, the toes curl

describe lesion signs for DTR CNS vs PNS

CNS- increased DTR | PNS- decreased DTR

What are the levels in brachioradialis DTR

C56

what are the levels in biceps DTR

C56

what are the levels in triceps DTR

C67

what are the levels in patellar DTR

L2-4

what are the levels in achilles DTR

What is the scale for DTR

``` 0-absent 1- diminished 2- normal average 3- mildly over-active 4- highly over-active ```

what is the max amount of strikes for DTR

What can cause UMN lesions

MS cerebral palsy traumatic brain injury ALS

What are causes of LMN lesions

Polio Guillain-Barre ALS

What do you see in LMN lesions

``` paralysis from muscle atrophy wasting pronounced falccid, hypotonic DTR low or absent superficial reflexes fine ```

What are the most common causes of peripheral nervous disorders

polio, ALS, herniated disc, carpel tunnel syndrome, bell's palsy, diabetes, alcoholic neuropathy, myesthenia gravis, muscular dystrophy

Where does ALS, polio affect nervous system

in the ventral horn

where does herniated discs hurt nervous system

along spinal nerve

where does bells palsy and diabetes and ETOH affect nervous system

distal peripheral nerve

where does myasthenia gravis affect nervous system

motor component of nerve in muscle

What is peripheral mononeuropathy

weakness, sensory loss in peripheral n distribution- carpal tunnel and bells palsy

what is peripheral polyneuropathy

distal weakness and stocking-glove distribution sensory loss | caused by DM, alcoholic neuropathy

Weakness in proximal mm, intact sensation and slight decreased DTR might be what

muscular dystrophy

What are common ways to cause upper brachial plexus injury

birth trauma- pulling head | falling on shoulder

the waiters tip is seen in what type injury

upper brachial plexus- radial

What are the tests for thoracic outlet syndrome

Roos and Adsons

What nn levels are involved in thoracic nerve injury

C5-7

What is pronator syndrome

injury to median n- compression

Ape hand deformity is seen in what

median n injury | also thenar eminence atrophy

how do you test for pronator syndrome

resist pronation

What are causes of anterior interosseus neuropathy

pronator teres impingement of anterior interosseus N | trauma caused by tennis elbow strap too tight

what is the test for anterior interosseus neuropathy

pinch grip "ok"

What are the tests for carpal tunnel syndrome

tinels, phalens, reverse phalens

What can cause ulnar n injruy

fracture humerus near medial epicondyle cubital tunnel syndrome laceration near wrist entrapment at Guyon's canal

What are signs or ulnar n injury

weak wrist flexion, ADduction, weak finger ABduction, ADduction loss tumb Adduction loss MCP flexion 4th5th digits claw hand

what are causes of radial n injury

fracture of humerus near radial groove | satruday night palsy

what are signs of radial n injury

sensory loss back of hand | wrist drop- weak brachioradialis, supinator, wrist and digit extensors

What is a steppage gait and what causes it

weakness or paralysis of hamstring mm and thigh extensors and mm below knee from sciatica

What n injury causes trendelenburg gait

superior gluteal n injury

What causes lateral femoral cutaneous nerve injury

compression at iliac crests | numbness over lateral thigh

What are signs of peroneal n injury

paralysis dorsiflexors, evertes | loss sensation anterolateral leg and dorsum foot, foot drop

What are signs of superficial fibular n injury

paralysis foot everters, no foot drop | loss sensation anterolateral leg and dorsum foot

What are signs of deep fibular n injury

weak dorsiflexors | foot drop

what cause medial plantar n injury

cause entrapment longitudinal arch, joggers foot

what are signs of medial plantar n injury

aching pain in arch and burring/paresthesia in medial plantar surface

the most common polyneuropathy

What sensation goes away first in DM

vibration

What are signs of myasthenia gravis

``` fatigue, proximal m weakness droopy eyelids double vision trouble swallowing trouble speaking dyspnea, respiratory m weakness no sensory loss or altered reflexes ```

PNS- 10 ?s Flashcards

(73 cards)