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PCM III Exam 2 > PNS Exam > Flashcards

PNS Exam Flashcards

1
Q

CNS

A

mental status and cognition
coordination
cranial nerves (technically PNS)

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2
Q

PNS

A

motor - strength and motion
sensation
reflexes

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3
Q

screening neuro exam contains?

A 
mental status
cranial nerves
motor
sensory
reflexes
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4
Q

PNS defined

A

nerves outside brain and SC

carry impulses to and from cord

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5
Q

posterior root

A

sensory

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6
Q

anterior root

A

motor

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7
Q

peripheral nerve

A

merged posterior and anterior root

carry both motor and sensory

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8
Q

sensory pathway

A

pain, temp, crude touch - cross over ascend
-to thalamus

position, vibration, fine touch - same side ascend
-go to medulla - then cross over to thalamus

both types - exit thalamus to sensory cortex

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9
Q

dermatome

A

band of skin innervated by sensory root of single spinal nerve

less specific (multiple cutaneous nerves serve single dermatome)

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10
Q

cutaneous peripheral nerve

A

area of skin from specific peripheral nerve

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11
Q

sensory abnormalities

A

can be due to lesion at any level of CNS or PNS

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12
Q

motor pathway

A

begins in cortex (UMN)
travel to pyramids of medulla
cross occurs and move downward as corticospinal tract

synapse along way
-LMNs in anterior horn

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13
Q

dysesthesia

A

abnormal sensation

pain regardless of stimulus or not

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14
Q

paresthesia

A

tingling
pins and needles
without pain and without stimulus

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15
Q

hypesthesia

A

reduced sensation

aka hypothesia

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16
Q

hyperalgesia

A

severe pain response to mild stimulus

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17
Q

allodynia

A

non-painful stimulus perceived as painful

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18
Q

nerve compression

A

tingling, prickling

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19
Q

sensory neuropathy

A

burning

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20
Q

hyperventilation

A

tingling in hands and around mouth

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21
Q

5 types of sensation

A 
pain
temp
light touch
proprioception
vibration
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22
Q

sensation of spinothalamic

A

pain, temp, light touch

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23
Q

sensation of posterior column

A

proprioception

vibration

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24
Q

peripheral sensory exam

A

COMPARE SIDE TO SIDE

proximal and distal

close eyes - enhance sensitivity

map out abnormal area - find boudaries

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25
Q

discriminative sensation exam

A

test cortical sensory function

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26
Q

stereognosis

A

identify an object by touch and feel

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27
Q

2 point discrimination

A

cortical sensory function

-find minimal distance

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28
Q

number identification

A

identify shapes and numbers

-written on hand

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29
Q

extinction

A

touch bilaterally
feel both

side that doesn’t feel - side of extinction

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30
Q

side of extinction

A

side that doesn’t feel when testing for extinction

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31
Q

best way to test gastroc and soleus

A

raise up on toes when standing
one leg at a time

5/5 if can do 10 times

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32
Q

muscle strength scale

A 
0 no movement
1 muscle twitch without joint movement
2 movement with gravity eliminated
3 full strength against gravity
4 partial strength against resistance
5 full strength against resistance

COMPARE SIDE TO SIDE

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33
Q

brainstem reflexes

A

corneal, gag, pupillary

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34
Q

superficial reflexes

A

abdominal
plantar (babinski)
anal

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35
Q

dermatomes to know

A 
C2 - ear
C3 - front and back of neck
T4 - nipples
T10 - umbilicus
C6 - pointer and thumb and lateral forearm
C8 - ring and little finger
L1 - ingual region
L4 - kneen
L5 - anterior ankle and medial foot (toes 1 and 2)
S5 - perianal
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36
Q

grading deep tendon reflexes

A 
0 no response
1 somewhat diminished
2 normal
3 brisker than average
4 hyperactive or clonus (oscillation)

document with drawing

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37
Q

reinforcement

A

way to increase reflex activity
-isometric contraction

blocks run away motor neuron signals going up to enhance reflex signal

38
Q

biceps reflex

A

C5 C6

39
Q

triceps reflex

A

C6 C7

40
Q

brachioradialis reflex

A

C5 C6

41
Q

knee reflex

A

L2, 3, 4

42
Q

ankle reflex

A

S1

strike achilles - see plantar flexion

43
Q

babinski reflex

A

plantar
L5- S1
toes should curl - normal

44
Q

anal wink

A

S2-4
cauda equina

stroke outward in four quadrants of anus

should see reflex contraction

45
Q

abdominal reflexes

A

upper T8-T10
lower T10-T12

in relation to umbilicus
stroke each side of abdomen

contraction of muscles and deviation of umbilicus toward the stimulus

46
Q

CNS

A

usually have increased deep tendon reflex

47
Q

PNS

A

usually have decreased deep tendon reflex

48
Q

spasticity

A

hallmark of upper motor neuron lesion

weakness without atrophy of muscle

hyperreflex of DTR

49
Q

ALS

A

has both upper and motor neuron involvement

50
Q

UMN lesion disorders

A

stroke, MS, cerebral palsy, traumatic brain injury, ALS

51
Q

LMN lesion disorders

A

guillan barre
polio
ALS

52
Q

LMN lesion causes

A

flaccid paralysis
muscle atrophy/wasting
hyporeflexia

53
Q

UMN vs. LMN

A 
UMN - paralysis of movement
atrophy slight
spasticity**, hypertonic
DTR increase
babinski upgoing
LMN - paralysis from muscle atrophy
wasting pronounced
flaccid, hypotonic
DTR decreased
superficial reflexes fine
54
Q

PNS disorders

A 
polio
ALS
herniated disc
carpel tunnel
bells palsy
diabetes
alcoholic neuropathy
myesthenia gravis
muscular dystrophy
55
Q

anterior horn cell pathology

A

polio, ALS
weak DTR
fasciculations and weakness

56
Q

spinal nerve root pathology

A

herniated disc
sensory changes
weakness - atrophy
weak DTR

pops posterior - catches sensory tract

57
Q

peripheral mononeuropathy

A

carpal tunnel, bells palsy

weak DTR
weakness / sensory loss in nerve distribution

58
Q

peripheral polyneuropathy

A

diabetes, alcoholic neuropathy

distal weakness and stocking glove sensory loss
weak DTR

59
Q

neuromuscular junction pathology

A

myasthenia gravis
muscle fatigability
sensation intact
DTR intact

60
Q

muscular dystrophy pathology

A

weakness in proximal muscles
sensation intact

DTR intact or possible decreased

61
Q

upper arm

A

brachial cutaneous nerve

62
Q

lower arm

A

antebrachial cutaneous nerve

63
Q

ulnar nerve

A

digit 4 and 5

64
Q

median nerve

A

digit 1, 2, 3

ventral hand

65
Q

radial nerve

A

proximal digit 1, 2, 3

dorsum of hand

66
Q

upper brachial plexus injury

A

falls and birth trauma

damage to C5 C6

67
Q

waiters tip

A

upper brachial plexus

68
Q

lower brachial plexus injury

A

arm caught when fall

less common

thoracic outlet

C8/T1 - motor palsy and weakness

69
Q

thoracic outlet syndrome

A 
compression of brachial plexus
-3 locations:
anterio and middle scalenes
clavicle and 1st rib
ribs and pec minor

weakness and numbness of hands and arms

70
Q

roos test

A

open and close when arm abducted

71
Q

adsons test

A

abduct, rotate head opposite - feel radial pulse

72
Q

long thoracic nerve injury

A

winging of scapula

compression between clavicle and first rib

damages C5-7
weak serratus anterior

73
Q

median nerve injury

A

pronator syndrome

carpal tunnel
crush injury
wrist slash
palm-injury laceration

74
Q

median nerve injury symptoms

A

injury to C6-T1 proximal or distal

weak pronation, flexion

atrophy of thenar muscles

ape hand deformity

75
Q

test for pronator syndrome

A

median nerve

  • resist pronation
  • tingling along arm and forearm
  • indicates positive for median nerve impingement
76
Q

median nerve impingement

A

by pronator teres

77
Q

anterior interosseous nerve injury

A

pinch ok test
-pad to pad of finger is abnormal

median nerve

78
Q

phalens test

A

carpal tunnel syndrome

back of hands together

79
Q

tinels sign

A

taps wrist

80
Q

tests for carpal tunnel

A

tinels
phalens
reverse phalens (prayer)

81
Q

reverse phalens test

A

prayer test

82
Q

ulnar nerve injury

A

fracture of humerus
cubital tunnel syndrome
laceration near wrist
entrapment at guyons canal

83
Q

ulnar nerve injury levels?

A

C6-8

84
Q

claw hand

A

ulnar nerve injury

flexed digit 4 and 5

85
Q

saturday night palsy

A

radial nerve injury

wrist drop

86
Q

tinels sign at elbow

A

tap funny bone

get tingly

87
Q

sciatic nerve injury

A

L4-5

88
Q

superior gluteal nerve injury

A

trendelenburg gait

dropped hip

89
Q

numbness over lateral thigh

A

lateral femoral cutaneous nerve injury

90
Q

myasthenia gravis

A

antibodies against ACh receptors

T cell

PCM III Exam 2 (8 decks)

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