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NMS 1 > Unit 2 Info > Flashcards

Unit 2 Info Flashcards

0
Q

Dermatome: posterior aspect of the shoulders

A

C4

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1
Q

Primary sensory modality is not in working order deficit referred to as

A

Analgesia

Anesthesia

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2
Q

Dermatome: lateral aspect of the upper arms

A

C5

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3
Q

Dermatome: medial aspect of the lower arms

A

T1

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4
Q

Dermatome: tip of the thumb

A

C6

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5
Q

Dermatome: tip of the middle finger

A

C7

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6
Q

Dermatome: tip of the pinky finger

A

C8

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7
Q

Sensory distribution: AXILLARY NERVE

A

LATERAL DELTOID

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8
Q

Sensory distribution: MUSCULOCUTANEOUS

A

LATERAL FOREARM

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9
Q

Sensory distribution: RADIAL NERVE

A

WEB SPACE, THUMB AND INDEX FINGER

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10
Q

Sensory distribution: ULNAR NERVE

A

DISTAL ULNAR ASPECT OF 5TH DIGIT

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11
Q

Sensory distribution: MEDIAN NERVE

A

DISTAL RADIAL ASPECT OF PALM AND DIGITS 1-3

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12
Q

Superficial sensory exams test for which modalities and what is used to test each modality?

A

Pain (sharp, pin prick)
Temperature (test tubes with hot or cold water)
Light touch (cotton swab, small brush)

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13
Q

Neuro-pathway for light touch would be thru the __________ of the cord to the thalamus.

A

anteriorlateral columns (anterior spinothalamic tract)

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14
Q

Deficits to light touch in dermatomal pattern may indicate __________ or ____________.

A

Nerve Root compression

Peripheral nerve lesions

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15
Q

Pain examination finds problems in the _________ tract.

A

lateral spinothalamic

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16
Q

Deficits to pain in dermatomal pattern may indicate _____________ or ___________.

A

Nerve Root compression

Peripheral nerve lesions

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17
Q

Alganesthesia/analgesia:
Hypalgesia:
Hyperalgesia:

A

areas insensitive to pain
decreased sensation
increased sensitivity

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18
Q

Pallanathesia

A

Loss of vibratory sense

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19
Q

Tractus ________ for upper extremity

Tractus ________ for lower extremity

A

Cuneatus

Gracilis

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20
Q

Temperature examination:
Cold: ________ degrees F
Hot: ________ degrees F

A

41-50

104-113

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21
Q

Compression of dorsal nerve root signs/symptoms

A

Numbness and tingling are most common
Loss of vibration or position sense
Hyporeflexia with no muscle atrophy- No sensory input of stretch, but muscle can shorten and work normally

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22
Q

Compression of the anterior nerve root (motor) signs/symptoms

A

Muscle weakness
Loss of DTR – Muscle not responding, could have atrophy
No pathologic reflexes are present
Vasomotor changes due to autonomic nervous system being affected

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23
Q

Causes of nerve root compression

A 
Disc herniation 
Degenerative joint disease
Recent trauma 
Inflammatory changes 
Tumors
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24
Q

Strength testing 0/5

A

Complete paralysis, 0% of normal movement

No evidence of contraction

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25
Q

Strength testing 1/5

A

A twitch of the muscle, trace, 0-10% of movement

Dr. can feel muscle action but no movement seen

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26
Q

Strength testing 2/5

A

Moderate to severe paresis, active movement is available when gravity eliminated
11-25% of normal movement
Patient lay on side and move joint through full range without gravity

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27
Q

Strength testing 3/5

A

Moderate paresis, active movement against gravity
26-50% of normal movement
Complete range of motion against gravity

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28
Q

Strength testing 4/5

A

Mild paresis, active movement against gravity andmild resistance
51-74% of normal movement
Usually resistance of two fingers

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29
Q

Strength testing 5/5

A

Normal strength

76-100% of normal movement

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30
Q

Muscle tests for C5

A

DELTOID, BICEPS

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31
Q

Muscle tests for C6

A

BICEPS, WRIST EXTENSORS

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32
Q

Muscle tests for C7

A

WRIST FLEXORS, FINGER EXT

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33
Q

Decreased muscle tone indicates what kind of lesion?

A

LMNL

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34
Q

Increased muscle tone indicates what kind of lesion?

A

UMNL

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35
Q

Spasticity

A

increased muscular resistance felt by the examiner during quick joint movement which quickly fades away aka “clasped knife”

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36
Q

Spasticity is associated with ______ or _______ lesions (_MNL).

A

cortical
pyramidal
(UMNL)

37
Q

Rigidity

A

involuntary muscular resitance felt when moving a resting joint and persists as the joint is moved through its entire range of motion. Aka
“gooseneck” rigidity, like bending a microphone holder

38
Q

Rigidity is consistent with _________ pathways related to muscle spindle mechanism interference from diseased __________ structures (_MNL)

A

extrapyramidal
extrapyramidal
UMNL

39
Q

Hypotonia is usually indicative of neurologic issues at the level of the ___________ (_MNL).

A

reflex arc

LMNL

40
Q

Neural shock may occur following acute severe ________ motor neuron damage in the brain or spinal cord. Unique because suddenly occurring _______ first causes only _______ type symptoms

A

upper
UMNL
peripheral

41
Q

Deficit Phenomenon

A

Loss of normal neurological function.Reduced muscle tone, muscle stretch reflexes, muscle strength, volume, (LMNL).

42
Q

Release Phenomena

A

Exaggerations or perversions of normal neurological function due to a loss of cortical inhibition. Hyper-reflexia, hypertonia, and pathologic reflexes.

43
Q

Biceps Reflex nerve supply

A

C5

Musculocutaneous

44
Q

Nerves tested in the Brachioradialis Reflex

A

C6

Radial

45
Q

Nerves tested in the Triceps Reflex

A

C7

Radial

46
Q

Nerves tested in the Finger flexion reflex

A

C8

Median/ulnar

47
Q

C5 Reflex

A

Biceps Reflex, Musculocutaneous

48
Q

C6 Reflex

A

Brachioradialis Reflex, Radial

49
Q

C7 Reflex

A

Triceps Reflex, Radial

50
Q

C8 Reflex

A

Finger Flexion Reflex, Median/ulnar

51
Q

Musculocutaneous Reflex

A

Biceps Reflex, C5

52
Q

Median/ulnar Reflex

A

Finger flexion Reflex, C8

53
Q

Radial Reflex

A

Brachioradialis Reflex, C6

Triceps Reflex, C7

54
Q 
Reflex Grading System
0=  
1= 
2= 
3= 
4=
A 
0 = Absent  
1 = hypoactive 
2 = normal 
3 = hyperactive 
4 = hyperactive with sustained or transient clonus-specify
55
Q

Superficial reflexes are graded as ________.

A

Either present or absent

56
Q

Gag Reflex
Segmental/peripheral innervation:
Method:
Normal:

A

Segmental/peripheral innervation: CN IX, X
Method: Touch posterior tongue or back of throat
Normal: Gag and elevation of soft palate, constriction ofpharyngeal muscles

57
Q

Corneal blink reflex
Segmental/peripheral innervation
Method:
Normal finding:

A

Segmental/peripheral innervation CN V, VII
Method: Touch cornea with cotton wisp
Normal finding: Blinking of eyes

58
Q 
Epigastric reflex 
Segmental innervation
Peripheral nerve
Method
Normal finding
A

Segmental innervation (T5-T7)
Peripheral nerve (intercostal)
Method: Stimulate from sternum to umbilicus
Normal finding: Contraction of upper ab muscles, move umbilicus upward

59
Q 
Upper Abdominal Reflex 
Segmental innervation
Peripheral innervation
Method
Normal finding
A 
Segmental innervation (T7-T9) 
Peripheral innervation (intercostal) 
Method: Stimulate upper abs down and out, out to in 
Normal finding: Contraction of the upper abs, moves umbilicus upand out
60
Q 
Middle Abdominal reflex 
Segmental innervation
Peripheral innervation
Method
Normal finding
A

Segmental innervation (T9-T11)
Peripheral innervation (intercostal)
Method: Stimulate skin from level of umbilicus out to in and vertical
Normal finding: Contraction of middle abs moving umbilicus laterally

61
Q 
Lower Abdominal Reflex 
Segmental innervation
Peripheral innervation
Method 
Normal findings
A 
Segmental innervation (T11-T12) 
Peripheral innervation (intercostal, iliohypogastric, ilioinguinal) 
Method Stimulate the skin of lower abs from out to in and up to down 
Normal findings Contraction of lower abs moving umbilicus down and out
62
Q 
Cremasteric reflex 
Segmental innervation
Peripheral innervation
Method
Normal findings
May not be seen in
A

Segmental innervation (L1-L2)
Peripheral innervation (ilioinguinal, genitofemoral)
Method: Stroke inner thigh from superior to inferior direction
Normal findings: Ipsilateral elevation of the testicle
May not be seen in: elderly or hydrocele and varicocele

63
Q 
Gluteal Reflex 
Segmental innervation
Peripheral innervation
Method
Normal finding
A

Segmental innervation (L4-S2)
Peripheral innervation (inferior gluteal)
Method: Stroke skin over glute max
Normal finding: contraction of gluteal muscles

64
Q 
Plantar Reflex   
Segmental innervation
Peripheral innervation
Method
Normal
Abnormal
A

Segmental innervation (L4-S2)
Peripheral innervation (tibial)
Method: Stroke plantar foot from heel to metatarsals to big toe
Normal: plantar flexion of toes and foot
Abnormal: dorsiflexion of great toe and flairing of the other toes

65
Q 
Anal Reflex (wink) 
Segmental innervation
Peripheral innervation
Method 
Normal finding
A 
Segmental innervation (S2-S5) 
Peripheral innervation (hemorrhoidal) 
Method: Stroke skin of perianal area 
Normal finding: Contraction of external sphincter
66
Q

CN IX, X Reflex

A

Gag reflex

67
Q

CN V, VII reflex

A

Corneal blink reflex

68
Q

T5-T7 intercostal nerve reflex

A

Epigastric reflex

69
Q

T7-T9 intercostal nerve reflex

A

Upper abdominal reflex

70
Q

T9-T11 intercostal nerve reflex

A

Middle abdominal reflex

71
Q

T11-T12 intercostal/iliohypogastric/ilioinguinal reflex

A

Lower abdominal reflex

72
Q

L1-L2 or ilioinguinal/genitofemoral reflex

A

Cremasteric reflex

73
Q

L4-S2 or inferior gluteal reflex

A

Gluteal reflex

74
Q

L4-S2 or tibial reflex

A

Plantar reflex

75
Q

S2-S5or hemorrhoidal reflex

A

Anal reflex (wink)

76
Q

The primitive responses seen with reflexes are pathological if
found in _______, but may be normal in _______ up to about _________ of age (or even up to _______ for certain reflexes, such as Babinski’s sign).

A

Adults
Infants up to 6 months of age
2 years

77
Q

Hoffman Sign
Method
Positive sign
Lesion location

A

Method: Sharp forcible flick of thumb against patient’s middle finger
Positive sign: Flexion of fingers and adduction of thumb
Lesion location: Segmental (above C5 in corticospinal tract)

78
Q

Tromner Sign
Method
Positive sign
Lesion location

A

Method: Tap the volmar surface of the middle finger
Positive sign: Flexion of fingers and adduction of the thumb
Lesion location: above C5 corticospinal tract

79
Q

Rossolimo Sign
Method
Positive sign
Lesion Location

A

Method: Tap the ball of the foot or tap the tips of the toes
Positive sign: Plantar flexion of the toes
Lesion Location: Corticospinal tract

80
Q 
Babinski Sign
Method
Normal
Abnormal
Lesion location
A

Method: Stroke plantar foot from heel to metarsals to big toe
Normal: plantar flexion of toes and foot
Abnormal: dorsiflexion of great toe and flaring of other toes
Lesion location: Corticospinal tract; UMNL

81
Q 
Chaddock Sign
Method
Normal
Abnormal
Lesion location
A

Method: Stroke from lateral malleolus on heel to toe
Normal: no motion of toes and foot
Abnormal: dorsiflexion of great toe and flaring ofthe other toes
Lesion location: Corticospinal tract, UMNL

82
Q 
Oppenheim Sign 
Method 
Normal
Abnormal 
Lesion location
A

Method: Stroke anterior tibial surface from superior to inferior
Normal: no motion of toes and foot
Abnormal: dorsiflexion of great toe and flaring of the other toes
Lesion location: Corticospinal tract UMNL

83
Q 
Gordon Sign 
Method
Normal
Abnormal 
Lesion location
A

Method: Squeeze the calf
Normal: no motion of the toes and foot
Abnormal: dorsiflexion of great toe and flaring ofthe other toes
Lesion location: UMNL, Corticospinal tract

84
Q 
Schaefer Sign
Method
Normal 
Abnormal
Lesion location
A

Method: Squeeze the achilles
Normal: no motion of thetoes and foot
Abnormal: dorsiflexion of great toe and flaring of other toes
Lesion location: UMNL, Corticospinal tract

85
Q

Pupillary Light Reflex
Segmental innervation
Method
Normal finding

A

Segmental: Afferent CN II/Efferent CN III
Method: Shine light into one eye watch for constriction in both
Normal: bilateral pupil constriction

86
Q

Accomodation Reflex
Segmental innervation
Method
Normal findings

A

Segmental: CN III
Method: Patient look at finger about 2 ft away then follow it in to about 6” away from the nose and then back at an object further away
Normal: Convergence of eyes and constriction of the pupils with lens thickening

87
Q 
Ciliospinal Reflex
Afferent
Efferent 
Method
Normal finding 
May signify
A

Afferent: cervicals and CN V
Efferent: cervical sympathetics
Method: Painful stimulus to side of the neck, pinching the skin
Normal finding: Dilation of the pupil on the painful side
May signify: cervical sympathetic problem

88
Q 
Oculocardiac Reflex 
Afferent
Efferent
Method
Normal finding
A

Afferent: CN V
Efferent: CN X
Method: Press thumb pressure on eyeball
Normal finding: Decrease in heart rate

89
Q 
Carotid Sinus Reflex 
Afferent
Efferent
Method
Normal finding
A

Afferent: CN IX
Efferent: CN X
Method: Pressure on carotid sinus
Normal finding: Decrease in heart rate and a fall in the blood pressure

90
Q

Bulbocavernosus Reflex
Segmental Innervation
Method
Normal finding

A

Segmental Innervation: S3-S4
Method: Stroke, pinch, prick the dorsum of the glans of penis
Normal finding: Contraction of the bulbocavernosus muscle, urethral constriction and contraction of anal sphincter

NMS 1 (4 decks)

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