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Upper/lower Limb Flashcards

1
Q

What is the effect on tone after an upper motor neurone lesion?

A

Hypertonia

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2
Q

What is the effect on tone after a lower motor neurone lesion?

A

Hypotonia

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3
Q

For shoulder abduction, what myotomes and muscles are involved?

A

C5 and deltoid muscles

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4
Q

For shoulder adduction, what myotomes and muscles are involved?

A

C6/C7 and teres major/ latissimus dorsi/ pectoralis major

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5
Q

For elbow flexion, what myotomes and muscles are involved?

A

C5/C6 and biceps brachii

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6
Q

For elbow extension, what myotomes and muscles are involved?

A

C7 and triceps brachii

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7
Q

For wrist flexion, what myotomes and muscles are involved?

A

C6/C7 and flexors of wrist

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8
Q

How is power scored?

A

MRC Muscle Power Scale

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9
Q

What myotomes are involved in the biceps reflex?

A

C5, C6

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10
Q

What myotomes are involved in the triceps reflex?

A

C7,C8

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11
Q

What myotomes are involved in the supinator reflex?

A

C6

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12
Q

Where is the biceps tendon found?

A

Medial aspect of antecubital fossa

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13
Q

Where is the triceps tendon found?

A

Superior to Olecranon process of ulna

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14
Q

Where is brachioradialis tendon found ( for supinator reflex) ?

A

Posterolateral aspect of wrist - 4 inches from base of thumb

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15
Q

What is the effect on reflexes after a lower motor neurone lesion?

A

Areflexia

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16
Q

What is the effect on reflexes after a upper motor neurone lesion?

A

Hyperreflexia

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17
Q

Where is the C5 dermatome found?

A

Lateral aspect of lower edge of deltoid muscle ( regimental patch)

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18
Q

Where is the C6 dermatome found?

A

Palmar side of thumb

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19
Q

Where is the C7 dermatome found?

A

Palmar side of middle finger

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20
Q

Where is C8 dermatome found?

A

Palmar side of little finger

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21
Q

Where is T1 dermatome found?

A

Medial aspect of antecubital fossa proximal to medial epicondyle

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22
Q

Where is T2 dermatome found?

A

Axilla

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23
Q

What spinal nerve roots are involved in the patellar reflex?

A

L2-L4

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24
Q

What spinal nerve roots are involved in the Achilles reflex?

A

S1-S2

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25
Q

Where is the L2 dermatome found?

A

Lateral aspect of thigh

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26
Q

Where is the L3 dermatome found?

A

Lower medial aspect of thigh

27
Q

Where is the L4 dermatome found?

A

Medial aspect of leg, medial foot and great toe ( REMEMBER- L3 to the knee, L4 to the floor!)

28
Q

Where is L5 dermatome found?

A

Lateral aspect of leg , mid dorsum of foot, middle three toes

29
Q

Where is the S1 dermatome found?

A

Little toe, lateral foot and sole of foot

30
Q

Where is the S2 dermatome found?

A

Back of upper leg and thigh

31
Q

What action at the hip joint does the psoas major and iliacus allow? What nerve is involved?

A

Flexion, femoral nerve

32
Q

At the hip joint, what action does the gluteus maximus allow? What nerve is involved?

A

Extension, inferior gluteal nerve

33
Q

At the hip joint, what action does the gluteus medius and minimus allow? What nerve is involved?

A

Abduction , superior gluteal nerve

34
Q

At the hip joint, what action do the muscles adductor longus/ brevis/ Magnus allow? What nerve is involved?

A

Adduction, obturator nerve

35
Q

What action does the obturator externus muscles allow?

A

Internal rotation

36
Q

What action does the obturator internus, Piriformis, gemellus muscles and quadratus femoris allow?

A

External rotation

37
Q

What Test is used to assess the hip abductors?

A

Trendelenburg Test

38
Q

What would a positive trendelenburg test show?

A

If there’s weakness in hip abductors, will be unable to stabilise hip on that side.
Pelvis will sag towards unsupported side.

39
Q

What movement at the ankle joint do the muscles tibialis anterior, EHL, EDL allow? What nerve is involved?

A

Dorsiflexion, deep peroneal nerve

40
Q

What nerve is involved in plantarflexion?

A

Tibial nerve

41
Q

At what joint does inversion of the ankle take place?

A

Subtalar joint

42
Q

What manoeuvre can patients do to elicit a stronger patellar reflex?

A

Jendrassik manoeuvre ( clench teeth + flex both sets of fingers in hook form)

43
Q

Describe the motor and sensory loss after a femoral nerve lesion.

A

Motor loss- quadriceps paralysis - weakness of knee , difficulties climbing up and down stairs

Sensory loss- anterior and medial thigh, medial leg, medial foot

44
Q

Describe the motor and sensory loss after an obturator nerve lesion?

A

Motor loss- paralysis of adductors , cross legging affected

Sensory loss- pelvis diseases, ovarian tumours can cause medial thigh pain

45
Q

Describe the motor and sensory loss after a common peroneal nerve lesion?

A

Motor loss- Foot drop ( extensors and Evertors paralysed )

Sensory loss- anterior and lateral leg, dorsum of foot

46
Q

Describe the motor and sensory loss after a tibial nerve lesion?

A

Motor loss- Hamstring muscles , posterior leg muscles and sole of foot

Sensory loss- sole of foot

47
Q

What injuries could affect the whole sciatic nerve?

A

Pelvic fracture, hip joint dislocation, penetrating injuries

48
Q

What is the motor effect after a whole sciatic nerve injury?

A

Paralysis of Hamstrings + muscles below knee
Knee flexion affected

49
Q

What happens to the foot after a whole sciatic nerve injury?

50
Q

What is the sensory loss after a whole sciatic nerve injury?

A

Loss below knee except narrow area on medial leg and foot ( saphenous nerve area)

51
Q

What is sciatica and what causes it?

A

Pain radiating from posterior back into buttock , posterior/lateral thigh and into leg

Caused by herniated lumbar intervertebral disc which compresses on L5-S1 part of sciatic nerve

52
Q

Name the borders of the femoral triangle?

A

Superior- inguinal ligament
Medial- Adductor longus
Lateral- Sartorius

53
Q

What is the dermatome region for L1?

A

Area of inguinal ligament

54
Q

What is the dermatome region for S3?

A

Gluteal fold area

55
Q

What is compartment syndrome?

A

Pressure in muscle compartment becomes very high —> venous drainage gets blocked —>muscle ischaemia and death can arise

56
Q

Give some causes of compartment syndrome?

A

Fractures, burns, infections, prolonged limb compression

57
Q

What are the 6 symptoms associated with compartment syndrome?

A

The 6 Ps

  • Pallor
  • Pain
  • Paraesthesia
  • Pulselessness
  • Paralysis
  • Perishingly cold
58
Q

On examination, what would you see for compartment syndrome?

A

Swollen limb, passive movement painful

59
Q

How would you treat compartment syndrome?

A

Relieve pressure by

1) removing all dressings/casts/splints

2) Open fasciotomy- surgically open skin and deep fascia along length of muscle compartment

60
Q

At what vertebral level is an epidural injection given in an adult?

61
Q

When would you deliver a lumbar epidural injection?

A
  • child birth
  • back pain/ sciatica
62
Q

Give 3 abnormalities of tone you can assess at each joint.

A
  • Spasticity
  • Rigidity
  • Cogwheeling hypotonia
63
Q

What spinal level is lumbar puncture performed at?

64
Q

What is lumbar puncture used to diagnose?

A

Meningitis, bleed

cpa (6 decks)

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