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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
discriminative sensation exam
test cortical sensory function
26
stereognosis
identify an object by touch and feel
27
2 point discrimination
cortical sensory function | -find minimal distance
28
number identification
identify shapes and numbers | -written on hand
29
extinction
touch bilaterally feel both side that doesn't feel - side of extinction
30
side of extinction
side that doesn't feel when testing for extinction
31
best way to test gastroc and soleus
raise up on toes when standing one leg at a time 5/5 if can do 10 times
32
muscle strength scale
``` 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
33
brainstem reflexes
corneal, gag, pupillary
34
superficial reflexes
abdominal plantar (babinski) anal
35
dermatomes to know
``` 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 ```
36
grading deep tendon reflexes
``` 0 no response 1 somewhat diminished 2 normal 3 brisker than average 4 hyperactive or clonus (oscillation) ``` document with drawing
37
reinforcement
way to increase reflex activity -isometric contraction blocks run away motor neuron signals going up to enhance reflex signal
38
biceps reflex
C5 C6
39
triceps reflex
C6 C7
40
brachioradialis reflex
C5 C6
41
knee reflex
L2, 3, 4
42
ankle reflex
S1 | strike achilles - see plantar flexion
43
babinski reflex
plantar L5- S1 toes should curl - normal
44
anal wink
S2-4 cauda equina stroke outward in four quadrants of anus should see reflex contraction
45
abdominal reflexes
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
CNS
usually have increased deep tendon reflex
47
PNS
usually have decreased deep tendon reflex
48
spasticity
hallmark of upper motor neuron lesion weakness without atrophy of muscle hyperreflex of DTR
49
ALS
has both upper and motor neuron involvement
50
UMN lesion disorders
stroke, MS, cerebral palsy, traumatic brain injury, ALS
51
LMN lesion disorders
guillan barre polio ALS
52
LMN lesion causes
flaccid paralysis muscle atrophy/wasting hyporeflexia
53
UMN vs. LMN
``` 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
PNS disorders
``` polio ALS herniated disc carpel tunnel bells palsy diabetes alcoholic neuropathy myesthenia gravis muscular dystrophy ```
55
anterior horn cell pathology
polio, ALS weak DTR fasciculations and weakness
56
spinal nerve root pathology
herniated disc sensory changes weakness - atrophy weak DTR pops posterior - catches sensory tract
57
peripheral mononeuropathy
carpal tunnel, bells palsy weak DTR weakness / sensory loss in nerve distribution
58
peripheral polyneuropathy
diabetes, alcoholic neuropathy distal weakness and stocking glove sensory loss weak DTR
59
neuromuscular junction pathology
myasthenia gravis muscle fatigability sensation intact DTR intact
60
muscular dystrophy pathology
weakness in proximal muscles sensation intact DTR intact or possible decreased
61
upper arm
brachial cutaneous nerve
62
lower arm
antebrachial cutaneous nerve
63
ulnar nerve
digit 4 and 5
64
median nerve
digit 1, 2, 3 | ventral hand
65
radial nerve
proximal digit 1, 2, 3 dorsum of hand
66
upper brachial plexus injury
falls and birth trauma damage to C5 C6
67
waiters tip
upper brachial plexus
68
lower brachial plexus injury
arm caught when fall less common thoracic outlet C8/T1 - motor palsy and weakness
69
thoracic outlet syndrome
``` 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
roos test
open and close when arm abducted
71
adsons test
abduct, rotate head opposite - feel radial pulse
72
long thoracic nerve injury
winging of scapula compression between clavicle and first rib damages C5-7 weak serratus anterior
73
median nerve injury
pronator syndrome carpal tunnel crush injury wrist slash palm-injury laceration
74
median nerve injury symptoms
injury to C6-T1 proximal or distal weak pronation, flexion atrophy of thenar muscles ape hand deformity
75
test for pronator syndrome
median nerve - resist pronation - tingling along arm and forearm - indicates positive for median nerve impingement
76
median nerve impingement
by pronator teres
77
anterior interosseous nerve injury
pinch ok test -pad to pad of finger is abnormal median nerve
78
phalens test
carpal tunnel syndrome | back of hands together
79
tinels sign
taps wrist
80
tests for carpal tunnel
tinels phalens reverse phalens (prayer)
81
reverse phalens test
prayer test
82
ulnar nerve injury
fracture of humerus cubital tunnel syndrome laceration near wrist entrapment at guyons canal
83
ulnar nerve injury levels?
C6-8
84
claw hand
ulnar nerve injury flexed digit 4 and 5
85
saturday night palsy
radial nerve injury wrist drop
86
tinels sign at elbow
tap funny bone | get tingly
87
sciatic nerve injury
L4-5
88
superior gluteal nerve injury
trendelenburg gait dropped hip
89
numbness over lateral thigh
lateral femoral cutaneous nerve injury
90
myasthenia gravis
antibodies against ACh receptors T cell

PCM III Exam 2 (8 decks)

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