Reminders! Flashcards
sciatic nerve levels
L4-S3
femoral nerve levels
L2-L4
common peroneal nerve levels
L4-S1
deep peroneal nerve levesl
L4-L5
superficial peroneal nerve levels
L5-S1
tibial nerve levels
S1-S2
normal reflex #
2+
AA joint (cervical spine) is what motion
rotation (50%)
OA joint cervical spine motion
flexion/extension
describe hoffman’s sign
UMN lesion - flick distal phalanx of middle finger. positive if IP of thumb moves
ribs 1-6 what motion
pump handle
7-10 ribs what motion
bucket handle
8-12 ribs motion
calipers
sternal notch is at what level
T3
positive babinksi’s = what
big toe extension and splaying of other toes
convex on concave =
roll and glide opposite
concave on convex =
roll and glide same
type 1 lumbar dysfunction: in neural, rotation and SB
are opposite
type 2 lumbar in flexion or extension, rotation and SB are
in the same direction
disc herniation in the cervical spine is most common at what level
C6
which two structures pass between the anterior and middle scalenes?
brachial plexus and subclavian artery
Myotome: C1-C2
occipital flex/ext
Myotome: c2-c3
cervical LF/ext
Myotome: c3-c4
shoulder shrug
Myotome: c5
shoulder abduction, ER
Myotome: c5-c6
elbow flexion, shoulder IR
Myotome: C6
elbow flexion, wrist extension
Myotome: c7
elbow extension, wrist flexion
Myotome:c8
extensor pollicics longus of distal phalanx
Myotome: t1
first dorsal interossei
sharp-purser test (which ligament and how to perform)
transverse ligament, stabilize SP of C2 and glide head/C1 posteriorly.
deltoid is innervated by what nerve
axillary n C5-6
supraspinatus innervation
suprascapular n c5-6
infraspinatus innervation
suprascapular nerve
teres minor innervation
axillary n
teres major innervation
lower subscapular nerve
attachment to greater tubercle of humerus (2)
pec major and teres minor
attachment to lesser tublercle of humerus 2
teres major and subscapularis
lat dorsi innervation
thoracodorsal nerve
rhomboid innervation
dorsal scapular nerve
trapezius innervation
spinal accessory nerve
innervation of serratus anterior
long thoracic nerve C5,6,7
ober test postition
knee flexed!!!
modified ober test
knee extended!
obers/modified obers tests for what
ITB and TFL tightness.
Modified ober’s knee extended takes out the rectus if it is tight
tibialis anterior innervation
deep peroneal nerve
peroneus longus attachmnet
base of the first MT and of the medial cuneiform
peroneus longus functions
plantar flexion and eversion
innervation of soleus and gastroc
tibial nerve
innervation of psoas major
lumbar plexus
iliacus innervation
femoral nerve
TFL innervation
superior gluteal nerve L4-S1
IR of hip 3
glut med, glut min, TFL
glut med = anterior fibers IR, while posterior fibers ER
piriformis innervation
sacral plexus
ER of the hip (6)
piriformis, quadratus femoris, obturator internus, obteratur externus, gemelii
glut min MMT
sidelying, abduction, no rotation. pressure is into adduction and slight extnesion
glut med MMT
position: sidelying, abduction with slight extension and slight ER. pressure is into adduction and slight flexion
central cord syndrome
UE more invovled than LE
more motor deficits with central cord than sensory defictis
mechanism of injury of central cord syndrome
cervical hyperextension
anterior cord syndrome
due to hyperflexion
loss of motor, pain, temp below the lesion due to damage to coritcospinal and spinothalamaic tracts
ASIA B - sensory incomplete what is intact
sensory is intact below the level of the lesion and extends through sacral segments S4-5. motor funtionbelow the lesion is not preserved
ASIA C
motor incomplete. motor function is preserved below the level of the lesion but muscle grades are <3
ASIA D
motor incomplete where motor function is preserved below the neuro level and mm grades are > or ewual to 3
ASIA E
normal
ASIA A
complete
first thing you do with SCI
mobilize the C spine!
determining motor level for ASIA scale
motor level for the asia scale is determined by the most caudal key muscles that have a strength of at least 3/5 with the superior segment having a normal strength or 5/5
determining sensory level for asia scale
the most caudal dermatome with a normal scle of 2/2 for pinprick and light touch
autonomic dysreflexia symptoms
- high blood pressure
- vasodilation above the level of the injury
- sweating
- headache
- blurred vision
- stuffy nose
- goose bumps below the lesion
autonomic dysreflexia do not put them in what position
do not lay them down because that will further elevate their BP!!! sit them up! common with T6 and above
tetraplegia/quadriplegia what segment of spinal cord
C1-C8
paraplegia what segments of SC
thoracic lumbar or sacral segments
cauda equina is damage to what nerves
damage to lumbosacral nerve roots
conus medullaris is damage to what
the sacral cord. often an L2 lesion
T/F cauda equina is a medical emergency
true!
what is neurogenic shock
severe autonomic dysfunction. interruption of the SNS
nuerogenic shock usually does not occur with lesions below what level
T6
s/s of neurogenic shock (remember the SNS is disrupted)
hpotension, bradycardia, peripheral vasodilation
if a patient with a SCI below T6 is hypotensive, consider it what until proven otherwise?
consider hemorrhagic until proven otherwise! probably not from neurogenci shock if their lesion is below T6
patients with injuries above T6 what happens with their baseline bp and HR
decreased!
define retrograde amnesia
the inability toe remember events before the injury
anterograde memory
the inability to create new memories
4 components of clubfoot
cavus (high arch)
forefoot adductus
hindfoot varus
equinus
erb-duchenne palsy is a lesion of what nerve roots
C5-6. Waiters tip. adducted, IR, wrist flexed, forearm pronated
klumpke paralysis is a lesion of which nerve roots
C8-T1. lose innervation of intrinsic hand mm’s. claw hand. horner syndrome.
median nerve levels
C6-T1
ulnar nerve levels
C8 t1
radial nerve levels
C5-8
normal angle of inclination (hip) - through neck of femur and down shank of femur
normal = 125 degrees
coxa vara
< 125 degrees. more shear force in neck of femur, increased fracture risk, decreased abd rom
coxa valga
> 125 degrees
normal angle of anteversion in adults
12-14 degrees. infants = 40 degrees
retroversion = angle and what do the feet do
<12 degrees, toe out
anteversion (large) = angle and what do feet do
toe in >15 degrees
