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PCM Final > PNS- 10 ?s > Flashcards

PNS- 10 ?s Flashcards

1
Q

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

A

28%

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2
Q

What is the most important part of neurologic pathology

A

knowing the LOCATION

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3
Q

Where could lesions be in the CNS

A

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

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4
Q

where could lesions be in the PNS

A

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

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5
Q

What are the overall exams for CNS

A

mental status and cognition, coordination, CN

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6
Q

what are the overall exams for PNS

A

motor: strength and motion
sensation
reflexes

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7
Q

What are the components of a neuro exam

A

mental status, CN, motor, sensory, reflexes

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8
Q

The posterior root of spinal cord carry what type infor

anterior?

A

posterior- sensory

anterior- motor

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9
Q

what type of info is in a peripheral nerve

A

both sensory and motor

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10
Q

What are the 2 nervous system distribution

A

dermatomes

cutaneous peripheral

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11
Q

What are the most common complains of peripheral nerve disorder

A

pain weakness and paresthesias

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12
Q

what are associated symptoms of peripheral nerve disorders

A

swelling, rash, spasm deformities, mental status

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13
Q

what is important in PMH for peripheral nerve disorder

A

autoimmune, dystrophies, diabetes, DJD

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14
Q

What are the most common causes of peripheral nerve disorder

A

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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15
Q

what are findings on the sensory exam for peripheral nervous problems

A

hypesthesia or hypoesthesia
hyperesthesia
hyperalgesia
allodynia

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16
Q

what is allodynia

A

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

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17
Q

how do patients with peripheral nervous disorders describe their sensations

A

dysesthesia

paresthesia

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18
Q

What are examples of proximal weakness

A

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

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19
Q

what are examples of distal weakness

A

open a jar, writing, tripping

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20
Q

What are the 5 types sensation

A

pain, temp, light touch, proprioception, vibration

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21
Q

What is stereognosis

A

identifying object by feel

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22
Q

What is the scale for mm strength

A 
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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23
Q

What are the brainstem reflexes

A

corneal, gag, pupillary

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24
Q

what are the superficial reflexes

A

abdominal, plantar, anal

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25
Q

When is clonus seen in reflexes

A

UMN lesions

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26
Q

The abdominal wink reflexes involve what nn

A

T8-T10

T10-12

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27
Q

what are levels involved in anal wink

A

S2-4

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28
Q

what are the levels involved in plantar(babinski)

A

L5-S1

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29
Q

what is a normal babinski response

A

downgoing, the toes curl

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30
Q

describe lesion signs for DTR CNS vs PNS

A

CNS- increased DTR

PNS- decreased DTR

31
Q

What are the levels in brachioradialis DTR

A

C56

32
Q

what are the levels in biceps DTR

A

C56

33
Q

what are the levels in triceps DTR

A

C67

34
Q

what are the levels in patellar DTR

A

L2-4

35
Q

what are the levels in achilles DTR

A

S1

36
Q

What is the scale for DTR

A 
0-absent
1- diminished
2- normal average
3- mildly over-active
4- highly over-active
37
Q

what is the max amount of strikes for DTR

A

3

38
Q

What can cause UMN lesions

A

MS
cerebral palsy
traumatic brain injury
ALS

39
Q

What are causes of LMN lesions

A

Polio
Guillain-Barre
ALS

40
Q

What do you see in LMN lesions

A 
paralysis from muscle atrophy
wasting pronounced
falccid, hypotonic
DTR low or absent
superficial reflexes fine
41
Q

What are the most common causes of peripheral nervous disorders

A

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

42
Q

Where does ALS, polio affect nervous system

A

in the ventral horn

43
Q

where does herniated discs hurt nervous system

A

along spinal nerve

44
Q

where does bells palsy and diabetes and ETOH affect nervous system

A

distal peripheral nerve

45
Q

where does myasthenia gravis affect nervous system

A

motor component of nerve in muscle

46
Q

What is peripheral mononeuropathy

A

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

47
Q

what is peripheral polyneuropathy

A

distal weakness and stocking-glove distribution sensory loss

caused by DM, alcoholic neuropathy

48
Q

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

A

muscular dystrophy

49
Q

What are common ways to cause upper brachial plexus injury

A

birth trauma- pulling head

falling on shoulder

50
Q

the waiters tip is seen in what type injury

A

upper brachial plexus- radial

51
Q

What are the tests for thoracic outlet syndrome

A

Roos and Adsons

52
Q

What nn levels are involved in thoracic nerve injury

A

C5-7

53
Q

What is pronator syndrome

A

injury to median n- compression

54
Q

Ape hand deformity is seen in what

A

median n injury

also thenar eminence atrophy

55
Q

how do you test for pronator syndrome

A

resist pronation

56
Q

What are causes of anterior interosseus neuropathy

A

pronator teres impingement of anterior interosseus N

trauma caused by tennis elbow strap too tight

57
Q

what is the test for anterior interosseus neuropathy

A

pinch grip “ok”

58
Q

What are the tests for carpal tunnel syndrome

A

tinels, phalens, reverse phalens

59
Q

What can cause ulnar n injruy

A

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

60
Q

What are signs or ulnar n injury

A

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

61
Q

what are causes of radial n injury

A

fracture of humerus near radial groove

satruday night palsy

62
Q

what are signs of radial n injury

A

sensory loss back of hand

wrist drop- weak brachioradialis, supinator, wrist and digit extensors

63
Q

What is a steppage gait and what causes it

A

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

64
Q

What n injury causes trendelenburg gait

A

superior gluteal n injury

65
Q

What causes lateral femoral cutaneous nerve injury

A

compression at iliac crests

numbness over lateral thigh

66
Q

What are signs of peroneal n injury

A

paralysis dorsiflexors, evertes

loss sensation anterolateral leg and dorsum foot, foot drop

67
Q

What are signs of superficial fibular n injury

A

paralysis foot everters, no foot drop

loss sensation anterolateral leg and dorsum foot

68
Q

What are signs of deep fibular n injury

A

weak dorsiflexors

foot drop

69
Q

what cause medial plantar n injury

A

cause entrapment longitudinal arch, joggers foot

70
Q

what are signs of medial plantar n injury

A

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

71
Q

the most common polyneuropathy

A

DM

72
Q

What sensation goes away first in DM

A

vibration

73
Q

What are signs of myasthenia gravis

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

PCM Final (8 decks)

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