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NPTE > PTFE NM > Flashcards

PTFE NM Flashcards

1
Q

in the cervical spine, nerves exit _ same number vertebrae

A
  • above
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2
Q

in thoracic and lumbar spine, nerves exit _ same number vertebrae

A
  • below
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3
Q

UE myotomes

A
  • C1/C2: neck flexion, extension
  • C3: neck lateral flexion
  • C4: shoulder elevation
  • C5: shoulder abduction
  • C6: elbow flexion and wrist extension
  • C7: elbow extension and wrist flexion
  • C8: thumb extension
  • T1: abduction/adduction of hand intrinsics
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4
Q

LE myotomes

A
  • L1/L2: hip flexion
  • L3: knee extension
  • L4: ankle df
  • L5: great toe extension
  • S1: ankle PF and EV
  • S2: knee flexion
  • S3: anal wink
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5
Q

dermatomes

A
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6
Q

axillary nerve

A
  • C5-6
  • deltoid, teres minor
  • sensory for proximal lateral arm
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7
Q

musculocutaneous nerve

A
  • C5-7
  • coracobrachialis, brachialis, biceps
  • sensory for lateral forearm
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8
Q

long thoracic nerve

A
  • C5-7
  • serratus anterior
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9
Q

dorsal scapular nerve

A
  • C5
  • rhomboids, levator scapulae
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10
Q

suprascapular nerve

A
  • C5-C6
  • supraspinatus, infraspinatus
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11
Q

neuropraxia

A
  • “it’s coming backsia”
  • transient block from stretch/pressure
  • pain, weakness, numbness, no muscle wasting
  • recovery: minutes to days
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12
Q

axonotmesis

A
  • nerve preserved but axons damaged
  • Wallerian degeneration
  • pain, complete sensory/motor/symp loss w/ muscle wasting
  • recovery: 1 inch/month or 1 mm/day
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13
Q

neurotmesis

A
  • total cut, scarred, severe/prolonged compression
  • no pain w/ muscle wasting -> complete loss
  • recovery: months, only with surgery
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14
Q

medial scapular winging due to

A
  • serratus anterior weakness
  • strengthen w/ push up plus
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15
Q

lateral scapular winging

A
  • due to damage to traps or rhomboids
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16
Q

radial nerve

A
  • C6-T1
  • A: abductor policis longus
  • B: brachioradialis
  • E: extensors
  • A: anconeus
  • S: supinator
  • T: triceps
  • posterior interosseous nerve - muscular branch for ext, sup, APL
  • sensory over dorsal arm and forarm, dorsal hand, 1st web space for thumb
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17
Q

damage to what nerve causes wrist drop

A
  • radial nerve
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18
Q

crutch use can cause injury to what nerve

A
  • radial n
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19
Q

midshaft humeral fx most likely to damage what nerve

A
  • radial nerve
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20
Q

PIN syndrome

A
  • purely motor loss of finger extension
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21
Q

median nerve

A
  • C5-T1
  • 1/2 L: lumbricals
  • O: opponens pollicis
  • A: abductor pollicis brevis
  • F: flexors - radial side
  • P/P: pronators - quadratus and teres
  • sensory for lateral hand (1st 3 digits and half of 4th)
  • anterior interosseous nerve - flexor pollcisi longus, tip to tip pinch grip
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22
Q

ape hand

A
  • thenar wasting
  • d/t median nerve damage
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23
Q

anterior interosseous nerve syndrome

A
  • inability to make OK sign - median nerve
  • tip to tip pinch grip w/ FPL and FDP
  • compensate w/ adductor pollicis (ulnar n)
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24
Q

hand of benediction

A
  • median nerve lesion
  • attempting to make a fist, fingers 1-3 do not flex
  • d/t weakness of flexor digitorum superficialis and flexor digitorum profundus on radial side - innervated by median n
  • NOT to be confused w/ ulnar claw - similar presentation but stuck d/t ulnar nerve palsy
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25
Q

ulnar nerve

A
  • C8-T1
  • M: medial 2 lumbricals (3&4)
  • A: adductor pollicis
  • F: flexors - ulnar side
  • I: interossei - dorsal
  • A: abductor digiti minimi
  • sensory for little finger and medial half of 4th digit
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26
Q

froment’s sign

A
  • ulnar nerve
  • testing adductor pollicis (ulnar n) ability to key grip
  • froment’s (+) - compensating w/ FPL (median n)
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27
Q

ulnar lesion hand

A
  • ulnar claw
  • loss of lumbricals 3-4 that should flex MCP
  • hand at rest in MCP hyperextension and DIP and PIP flexion
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28
Q

erb’s palsy

A
  • upper brachial blexus injury (C5-6)
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29
Q

klumpke’s palsy

A
  • lower brachial plexus injury
  • C7-T1
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30
Q

humeral condylar fractures result in _ n damage

A
  • lateral condylar - radial n
  • medial condylar - median n
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31
Q

no tip to tip pinch of 1st-2nd fingers is

A

anterior interosseous syndrome (median nerve)

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32
Q

a disc herniation is L4-L5 creates what symptoms

A
  • L5 symptoms
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33
Q

femoral nerve

A
  • L2-4
  • Qu: quads
  • I: iliopsoas
  • P: pectineus
  • S: sartorius
  • sensory to anterior and medial thigh, medial knee, proximal leg
  • saphenous nerve - branch of femoral, sensory
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34
Q

obturator nerve

A
  • L2-4
  • “Hello obturator”
  • medial compartment - adductor longus/brevis, gracilis, adductor magnus, obturator externus
  • sensory to small area on medial thigh/groin
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35
Q

gluteal nerve

A
  • superior gluteal nerve (L4-S1): glute med, glute min, tensor fascia lata - deeper
  • inferior gluteal nerve (L5-S2): glute max - superficial
36
Q

sciatic nerve divisions

A
  • tibial nerve (L4-S3): PF, posterior compartment - gastroc, soleus, popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus
  • sural nerve - sensory of tibial, posterolateral lower leg and lateral foot
  • common peroneal (L4-S2):
  • superficial peroneal - EV, fibularis longus/brevus, sensory over lower leg and dorsum of foot
  • deep peroneal - DF, tibialis ant, extensory digitorum longus, extensor hallucis longus, sensory of 1st webspace of foot
37
Q

tibialis posterior does

A
  • PF and inversion
  • TP is the issue if there is excessive pronation
38
Q

fibularis longus does

A
  • PF and eversion
39
Q

tarsal tunnel syndrome

A
  • at deltoid ligament at med ankle
  • pain: medial heel, medial arch, worse w/ standing and walking - medial plantar nerve
  • motor: weak foot intrinsics
  • ROM: full AROM, may have pain w/ pronation
40
Q

weak DF and sensory loss over 1st webspace of foot

A
  • deep peroneal n issue
41
Q

weak ankle eversion d/t

A
  • superficial peroneal n
42
Q

ankle actions and corresponding nerves

A
  • PF - tibial nerve
  • EV - superficial peroneal
  • DF - deep peroneal
43
Q

CN VII (facial) and X (vagus) injuries

A
  • deviation away from lesion
44
Q

CN V (trigeminal) and XII (hypoglossal) injuries

A
  • toward side of lesion
45
Q

cranial nerve origins

A
  • ce(rebrum): 1, 2
  • mi(dbrain): 3, 4
  • pons: 5, 6, 7, 8
  • medu(lla): 9, 10, 11, 12
46
Q

CN eye movements

A
  • CN 3: elevate, depress, adduct - medial rectus
  • CN 4: eyes down and out
  • CN 6: abduct eye - lateral rectus
47
Q

gag reflex

A
  • CN 9: sensory component
  • CN 10: motor component
48
Q

corneal reflex

A
  • CN 5: sensory
  • CN 7: motor
  • if introduce stimulus to L eye and no reaction - sensory issue
  • if intoduce stimulus to L eye and R eye closes - motor issue
49
Q

optic nerve vs chiasm injury

A
  • optic nerve: blindness in ipsilateral eye
  • optic chiasm lesion: loss of both lateral fields
  • optic tract lesion: homonymous hemianopsia
50
Q

spinal tracts that decussate in medulla

A
  • corticospinal tract (motor)
  • dorsal columns (deep touch, proprioception, vibration)
51
Q

spinal tracts that decussate at spinal level

A
  • spinothalamic tracts (pain, temperature, light touch)
52
Q

key dermatomes & myotomes

A
  • T4: nipple
  • T10: belly button
  • L3: med knee
  • L4: to the floor
53
Q

LE myotomes

A
  • L1-L2: hip flexion
  • L3: knee extension
  • L4: ankle dorsiflexion
  • L5: great toe extension
  • S1: plantarflexion
54
Q

central cord syndrome

A
  • Motor > sensory
  • Upper extremity
  • Distal
  • Extension injury
55
Q

anterior cord syndrome

A
  • flexion injury
  • loss of motor and pain/temp
  • greater loss in UE than LE
56
Q

brown sequard

A
  • stab or GSW
  • ipsilat loss of motor, vibration, proprioception
  • contralateral loss of pain and temperature
57
Q

posterior cord syndrome

A
  • rare
  • loss of proprioception, 2 pt discrimination, stereognosis
  • motor function preserved
58
Q

C1-C4 injuries

A
  • tetraplegia or quadriplegia
  • require complete assistance w/ ADLs
  • use special controls on WC
  • cannot drive
  • 24 hr personal care
59
Q

C5 injury

A
  • can likely raise arms and bend elbows
  • some or total paralysis of wrists, hands, trunk, legs
  • can speak and use diaphragm but breathing weakened
  • need assistance w/ most ADLs but can move from one place to another independently in power WC
60
Q

C6 injury

A
  • paralysis in hands, trunk, legs
  • important to preserve tenodesis
  • weakened breathing
  • can move in/out of WC and bed with assistive equipment
  • may also be able to drive adapted vehicle
  • little/no voluntar B/B control but may manage w/ special equipment
61
Q

C7 injury

A
  • most can straighten arm and have normal shoulder movement
  • can do most ADLs alone but may need assistance for more difficult tasks
  • may be able to drive adapted vehicle
  • little/no voluntary control of B/B but can manage on their own
62
Q

C8 injury

A
  • nerves control some hand movement
  • should be able to grasp and release objects
  • can do most ADLs alone but may need assistance
  • may drive adapted vehicle
  • little/no control B/B but can manage w/ equipment
63
Q

T1-T5 injuries

A
  • arm and hand function normal
  • paraplegia - affects trunk and legs
  • usually in a manual WC
  • can drive modified car
  • can stand in frame or walk w/ braces (KAFO)
64
Q

T6-T12 injury

A
  • usually paraplegia
  • normal upper-body movement
  • fair-good ability to control balance of trunk while seated
  • should be able to cough productively
  • little/no control of B/B but manage on own w/ equipment
  • manual WC
  • modified car
  • standing frame or braces
65
Q

L1-L5 injury

A
  • some loss of function of hips and legs
  • little/no voluntary control of bowel/bladder, can manage w/ equipment
  • may need WC and braces (AFOs)
66
Q

S1-S5 injury

A
  • some loss of function of hips and legs
  • little/no voluntary control B/B but can manage w/ equipment
  • most likely able to walk - can DF, maybe not PF
67
Q

autonomic dysreflexia

A
  • SCI at T6 or above
  • strong noxious sensory input carried to SC via peripheral nerves - impulse cannot reach brain
  • s/s: high BP, pounding HA, flushed/red face, sweating, pale, cool skin, bradycardia
  • response
  • SIT, stop exercise, sit up from supine
  • check indwelling catheter - kinks, full or overflowing bag
68
Q

brunnstrom stages

A
  1. flaccidity
  2. dealing with spasticity apearance
  3. increased spasticity
  4. decreased spasticity
  5. complex movement combinations
  6. spasticity disappears
  7. normal function returns
    - flaccidity sucks, then you are dealing with spasticity. first it increases, then it decreases. it’s complex but spasticity will disappear, and you will return to normal function
69
Q

MCA stroke

A
  • Most common
  • Contralateral hemiplegia
  • Arm (mostly UE worse than LE)
  • s/s: homonymous hemianopsia, aphasia, apraxia
70
Q

broca’s aphase

A
  • Brocas
  • Frontal
  • Non-fluent - expressive

like boca - mouth issue

71
Q

wernicke’s aphasia

A
  • Wernicke’s
  • Temporal
  • Fluent

WTF

72
Q

ACA stroke

A
  • altered mental status
  • impaired judement
  • contralateral weakness (legs&raquo_space; arms)
  • contralateral cortical sensory deficits
  • gait apraxia w/ initiation
  • urinary incontinence
73
Q

PCA stroke

A
  • acute vision loss
  • confusion
  • posterior cranium HA
  • paresthesias
  • limb weakness
  • dizziness
  • nausea
  • memory loss
74
Q

ranchos los amigos levels of cognitive functioning

75
Q

contract relax

A
  • mobility
  • reach limit, contract antagonist
76
Q

hold relax

A
  • mobility
  • stretch, then isometrically contract all muscle groups at limiting point in ROM
  • for patients w/ a lot of pain
77
Q

rhythmic initiation

A
  • mobility
  • let me move you
  • help me move you
  • move against resistance
  • slow and rhythmic movements w/ correct hand placement
78
Q

slow reversals

A
  • stability, controlled mobility and skill
  • strengthen and build endurance of weaker muscles and develop co-ordination and establish normal reversal of antagonist muscles
79
Q

joint distraction

A
  • mobility
  • proprioceptive component used to increase ROM around a joint
80
Q

2 month milestones

A
  • hold head up
  • push up when on tummy
  • smoother arm/leg movements
81
Q

4 month milestones

A
  • head steady, unsupported
  • pushes down on legs when feet are on hard surface - feet and knees locked
  • may roll tummy to back - head momentum
  • hold toy
  • hands to mouth
  • pushes up to elbow on stomach
82
Q

6 months milestones

A
  • rolls over in both direction
  • sit w/o support
  • bounces when standing on legs and feet
  • rocks back and forth, sometimes crawl backward before moving forward (army crawl)
83
Q

9 months milestones

A
  • stands, holds on
  • can get into sitting
  • sits without support
  • pulls to stand
  • creeps
84
Q

1 year milestone

A
  • into sitting w/o helps
  • pulls to stand
  • walks w/ furniture
  • few steps w/o holding on
  • may stand alone
85
Q

18 months

A
  • walks alone
  • may walk up steps and run
  • pulls toys while walking
  • can undress
  • drinks w/ cup, eats w/ spoon
86
Q

2 years milestones

A
  • stands on tiptoe
  • kicks ball
  • begins to run
  • climbs onto and down from furniture w/o help
  • walks up and down stairs holding on

NPTE (32 decks)

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