Written exam 4 Study Guide Flashcards
If a patient is dragging or circumducting a weak or spastic leg, what is this called?
Hemiplegia
usually accompanied by a spastic arm flexed at elbow that crosses abdomen
Which type of walk is typically seen in a patient with parkinson’s?
Shuffle- short, hurried steps, head is bowed.
If a patient shuffles into the ER with short, hurried steps, hunched over, which disease might they have?
Parkinson’s
If a patient is walking with a wide-based gait, and they stagger side to side, what could be occuring?
Cerebellar ataxia (poor muscle control/lack of muscle control)
If a patient is slapping their foot on the floor what is this due to in their gait?
Called footdrop-
Due to weakness of dorsiflexers of ankle
If a patient is high-stepping with their gait and their feet slap down firmly, what is this called?
Sensory ataxia
Footdrop vs sensory ataxia
Footdrop- slapping results from weakness of dorsiflexors
Sensory ataxia- pt doesn’t know where thier feet are so they slap down intentionally
Sensory ataxia vs cerebellar ataxia
Sensory- slapping foot down, high steps, pt doesn’t know where their feet are.
Cerebellar ataxia- Pt has wide-based feet that are far apart, staggering from side to side.
What are the 8 dermatomes with their locations?
C6- thumb
C7- Middle finger
C8- Little finger
T4- Nipples
T10-Umbilicus
L4-Medial calves
L5-Big toe
S1-little toe
What does babinski sign indicate
UMN or LMN lesion in CST
Drag object across foot from heel to ball of foot, present sign is dorsiflexion of big toe and fanning of other toes.
What does a positive kernig sign indicate
meningeal infection
Pt lies supine, flex knee and hip to 90 degrees. Fully extend knee. Pain indicates positive
What does a positive brudizinski’s test indicate
Supine pt, flex patient’s neck. If causes flexion of patient’s hips and knees, suggests meningeal irritation
What does Hoffman’s sign indicate
Cervical spinal lesion
Positive hoffman sign is abduction and flexion of thumb/fingers when you pull on distal middle finger during hand pronation
What is romberg test and what does it indicate
- Have patient stand and extend arms with palms facing up, close eyes, see ability to maintain upright
Indicates cerebellar dysfunction and ataxia
What is Pronator drift and what does it indicate
Patient stands with both arms forward, eyes closed, palms up, abnormal is that arm drifts down
indicates ataxia or stroke
If you have a tremor that has an oscillation of 10-12 cycles per second, what kind of tremor is this?
Physiologic
If you have a tremor present at rest but decreased during activity, what kind of tremor is present?
Pathologic- slower like parkinson’s disease, 3-6 times a second.
A tremor that is slow, 2-4 times a second, that increases with movement, what type of tremor does your patient have
Intentional tremor
Involuntary jerky movements of hands and limbs are called what and are signs of which disease
Chorea- Huntington’s disease presents with this.
Where do the cranial nerves attach?
1 and 2 to the forebrain, rest to brainstem
Which cranial nerve extends to the abdomen?
Vagus nerve
Huntington’s disease presents with which type of a tremor?
Chorea- involuntary, jerky movements
Which cranial nerves havve parasympathetic control
3 (oculomotor), 7 (facial), 9 (Glosopharyngeal), 10 (vagus).
If you have a patient who comes to a clinic with anosmia, which cranial nerve is implicated?
CN 1- olfactory
If you have a patient whose pupils do not respond to light, which nerve is likely implicated?
3- oculomotor- parasympathetic response
Which Cranial nerves control eye movements
SO4 LR6, All rest 3
If your patient has trouble with mastication, which nerve is implicated?
Trigeminal- mandibular branch
If your patient is unable to distinguish light and sharp touches on their face, which cranial nerve is likely implicated?
Trigeminal- no sensation
If your patient does not have a corneal reflex, which nerve is likely implicated?
Trigeminal- no eye blink reflex= trigeminal not working to blink eyelid/muscle innervation dysfunctioning
Which nerve controls the sensory function for anterior 2/3 of the tongue?
7- facial
Which nerve controls the sensory function for posterior 1/3 of the tongue
9- glosopharyngeal
If your patient comes in and is not able to make distinct facial expressions, which nerve is likely harmed?
Facial- responsible for raising eyebrows, closing eyes, frowning, smiling, etc
If your patient has dry eyes or dry mouth (xerostomia), which nerve could be implicated?
Dry eyes= Facial
Dry mouth= Facial or Glosopharyngeal
If your patient has a negative shoulder shrug test, which nerve is dysfunctioning?
11- accessory- Innervates Trapezius and SCM
If your patient’s tongue is deviating to the right, which nerve is dysfunctional and on which side of the body?
Right hypoglossal nerve
(same side of the body problem and dysfunction)
If a patient’s uvula is pulled to the left side, which nerve is likely dysfunctioning and on which side of the body?
Likely glosopharyngeal nerve dysfunction on the Right side of the body
(opposite side dysfunction and sign)
What is the inability to perform a voluntary movement in the absece of deficits?
Apraxia
What is the decreased ability to perform a movement?
dyspraxia
What is the inability to construct or draw a simple shape or design
constructional apraxia
If your patient is weak on the right half of their body, how do you describe this?
Right sided hemiperesis
If a patient is paralyzed on the right side of their body, how do you describe this?
Hemiplegia
If a patient is paralyzed on their lower extremities, how do you describe this?
Paraplegia
What is the corticospinal tract responsible for
Voluntary movement, very skilled, discrete, purposful movements
What is the spinothalamic tract responsible for
Pain, temperature, and crude touch transmission
Ascending sensory pathway
What is the DCML tract responsible for
Transmission of vibrations, proprioception, fine touch
Ascending sensory pathway
When is the Jendrassik meneuver helpful
during testing of lower extremity reflexes- distract them
What is the main function of peripheral nerves
Send messages to and from the brain, carry motor output to glands or muscles from brain or send sensory input to the brain.
If a patient says they are feeling like the room is moving, how would you classify this feeling?
as vertigo- a spinning sensation
If a patient says that they feel like they just stood up too fast and will fall over, how do you classify this feeling?
Light-headedness, dizziness
What are the different types of spine deformities
Kyphosis, lordosis, scoliosis
Kyphosis= hunchback
Lordosis= stomach sticks out, lumbar pushed anteriorly
Scoliosis= spine is not straight line, curves laterally