PNS Exam Flashcards
What is parasthesia?
Tingling like pins and needles. This presents without pain and without apparent stimulus.
What are hypoesthesia and hyperesthesia?
Reduced sensation in response to stimulus and increased sensation in response to stimulus, respectively.
What is hyperalgesia?
Increased pain in response to a mildly painful stimulus
What is allodynia?
Pain perceived in response to a non-painful stimulus
What is stereognosis?
Ability to identify an object through tactile sensation
How is motor strength graded and what does each grade mean?
Graded on a scale of 0 to 5. 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
What are the superficial reflexes and what do they assess?
Abdominal reflex assesses T8-10 or T10-12
Babinski sign assess UMNs - toe curling is normal
Anal wink will assess S2-4 (Cauda equina)
Where are all the DTRs performed and what spinal levels do they assess?
Brachioradialis - C5,6 Biceps Brachii - C5,6 Triceps Brachii - C6,7 Patellar - L2,3,4 Achilles - S1
How are reflexes graded and what does each grade mean?
Graded on a scale of 0 to 4. 0 = absent reflex 1 = diminished 2 = normal 3 = mildly over-active 4 = highly over-active
What are hallmark signs of UMN damage?
Spasticity, loss of dexterity, loss of superficial reflexes, hyperreflexia of DTR, up going babinski, and weakness without atrophy
What are hallmark signs of LMN lesions?
flaccid paralysis, atrophy, and hyporeflexia
How can upper brachial plexus injuries occur and how do they present?
This injury is common with falling or birthing trauma. Commonly effects the motor and sensory components of C5 and C6 roots. Patient will present in the waiter’s tip position.
How can thoracic outlet syndrome occur and what are the manifestations?
Compression of the brachial plexus or neurovascular structures of the axillary sheath between the anterior and middle scalenes, clavicle and 1st rib, or ribs and pectoralis minor. Manifestations include weakness and numbness in the hand and arm.
How can thoracic outlet syndrome be assessed?
Roo’s or Adson’s test
How does median nerve injury present?
Weak forearm pronation, atrophy of thenar muscles, and parasthesias in the lateral palm, thumb, index finger, and middle finger.