Test 2 Flashcards
Pain, temperature, and light touch are known as?
Superficial sensations
Superficial sensations are also classified as what?
Exteroceptive
Or
Cutaneous sensations
What receptors lie in the skin and mucous membrane?
Exteroceptive sensations
Pain, touch, and proprioception are what type of sensation?
Deep pain
What is the highest level of sensation?
Multimodal or association cortex
Who used the observation of herpetic lesions and traumatic involvement of the spinal cord to study dermatomal distribution?
Head, he came first… Then Sherrington and foerster
Which researchers performed isolated posterior root sections and noted the remaining, or unaltered, sensibility after certain roots were cut?
Sherrington and foerster
Which researcher studied a large series of cases involving herniated intervertebral discs with the blocking of a single nerve root?
Keegan
What did Keegan discover that contradicted head and foerster?
Found little to no overlap of dermatomes and was able to delineate strips of hypalgesia which extend to the most distal portions of the extremities.
Which specialized receptors are found in skin, mucous membranes, and peritrichal endings around the hair follicles?
Tactile disc of merkel
Light tough or non-discriminating touch is known as?
Thigmesthesia
The neuro-pathway of light touch is basically the same one used for?
Pain using slightly myelinated fibers that ascend in the anterior lateral column to the thalamus
Deep touch,or discriminating (well localized) touch is known as?
Topesthesia
What specialized receptors are found in the hairless portion of skin?
Corpuscles of meissner, responsible for Topesthesia
What sensation is primarily carried by large diameter, heavily myelinated fibers through the posterior spinal cord district?
Topesthesia (well localized) touch
During what examination should you prevent putting any pressure on the subcutaneous tissues?
Light touch examination
When a dual head instrument moves away from the involved side this indicates what?
Nerve irritation
A decrease in sympathetic function resulting in vasodilation indicates what type of nerve issue?
Nerve compression
Dual head towards involved side
Which nerve issue would sensory, motor, and deep tendon reflex exam exhibit normal findings?
Nerve irritation
In nerve compression, what is the order of functional loss?
1) Light touch
2) sharp pain and temperature
3) position and vibratory sensation
Returns in reverse order
What syndrome causes loss of abduction of the shoulder and loss of Flexion at the elbow?
Erb-Duchenne (avulsion of C5 and C6 roots)
What paralysis is due to avulsion of C8 and T1 nerve roots, causing loses in use of intrinsic muscles of the hand in the long flexor a and extensors of the fingers?
Klumpke paralysis
What must be done before you can mark muscle stretch reflex as absent?
Try with reinforcement (gritting teeth)
What tissues are devoid of nociceptors?
Synovial membranes
Articulate cartilage
The inner annulus and nucleus of an intervertebral disc
Noxious stimuli maybe caused by what three general categories?
Thermal
Mechanical
Chemical
The subluxation syndrome could be considered what type obnoxious stimulant?
Mechanical stimulant (No pain equals a normal joint)
Upon correction of nerve compression I what order will senses return?
1) position and vibratory sense
2) pain and temperature
3) light touch
Because of the presence of of nociceptive nerve endings within the annulus fibrosis of the disc, annular tears can cause pain where?
Lower back, buttocks, S-I region, and lower extremity
Bilateral leg pain, bowel and bladder incontinence, sensory exam of S3-S5 is absent for either light touch or sharp indicates what?
Cauda equine syndrome
Between Cauda equine and sacral sparing syndrome, which one would bowel and blade function be normal or maybe some leakage?
Sacral sparing
you are concerned that your patient has Cauda equina sydrome, so you perform a sensory exam of S3-S5 and it is equal bilaterally. Do you call an ambulance or not?
No they have sacral sparing
Evaluate, monitor and treat accordingly
Awkwardness of movement as opposed to weakness is characteristic of?
Both cerebellar and basal ganglia lesion
What are some of the many substances shown to excite nociceptors?
PROstaglandins
POTassium
SUBstance P
SEROtonin
HISTAmine
PLASMA kinins
What impulses travel along the slightly myelinated A-Delta fibers AND along the UNmyelinated C fibers?
Nociceptive impulses
The clinical examination for pain should be done using only what stimulus?
Sharp with dull being used occasionally as a reliability check
What are the terms indicating an area insensitive to pain?
Alganesthestia and analgesia
What term indicates an area with decreased sensitivity to pain?
Hypalgesia
When a primary sensory modality is not in working order, then the deficit is referred to as?
Anesthesia or analgesia
Loss of vibratory sensation is termed?
Pallanesthesia
What are the three areas to evaluate during a motor exam?
Strength
Tone
Volume
The force exerted in changing position is known as?
Kinetic
The force exerted in resisting movement is known as?
Static
True or false. In most diseases kinetic and static power are equally affected?
True
However in the extrapyramidal (UMNL) syndromes, kinetic power may be diminished while static power remains normal
Which is stronger, Wrist flexors or wrist extensors?
Wrist flexors
Which is stronger, biceps or triceps?
Triceps
Increased muscle tone can be noted as what two types?
Spasticity
Rigidity
This indicates an upper motor neuron lesion
An active spasticity where an increased muscular resistance is felt by the examiner during the joint motion then the resistance quickly fades away is known as what syndrome?
Clasped knife syndrome
A passive involuntary muscular resistance felt when moving a resting joint throughout its entire range of motion is known as?
Rigidity
Gooseneck rigidity is when it feels like bending a microphone while in its holder
Hypotonicity suggests what type of motor neuron lesion?
Lower motor neuron lesion
What is an acute, severe upper motor neuron lesion damage in either the brain and/or spinal cord?
Neural shock
Initial neural shock shows only what type of findings?
Peripheral type neurological findings
disease of what part of the brain may cause diffuse hypotonia?
Cerebellum
Loss of normal neurological function, such as; reductions in muscle tone, muscle stretch reflexes, muscle strength and volume. This is known as?
Deficit phenomenon AKA lower motor neuron lesion
Exaggerations or perversions of normal neurological function are due to a loss of cortical inhibition. This is known as?
Release phenomena AKA upper motor neuron lesion
Hyper-reflexia, hypertonia, and pathological reflexes would indicate which phenomena?
Release phenomena
Named due to the release from descending cortical inhibition
Upon assessing a DTR you must look at?
Speed of reaction
Vigor of response
Length of contraction
How do you test for pathological clonus in the upper extremity?
Passively apply resistance into the wrist while held in extension
How do you test for pathological clonus in the lower extremity?
Passively dorsiflex the ankle and or traction the patella from superior to inferior
