x. Dermatomes, Edema, Pulses, Reflexes, Strength Flashcards
edema: absent
0/4
edema: barely detectable, slight pitting (2mm) disappears rapidly
1+/4
edema: slight indentation (4mm); 10-15 sec
2+/4
edema: deeper indentation (6mm); > 1 min
3+/4
edema: very marked indentation (8mm); 2- 5min
4+/4
areas to assess for edema
- dorsum of foot
- anterior tibia
- behind medial malleolus
pulses: bounding
4+/4
pulses: strong, full, increased
3+/4
pulses: average intensity, expected, normal
2+/4
pulses: diminished, barely palpable
1+/4
pulses: absent, not palpable
0/4
strength: no muscular contraction
0/5
strength: barely detectable flicker/trace of contraction
1+/5
strength: active movement with gravity eliminated
2+/5
strength: active movement against gravity
3+/5
strength: active movement against gravity and some resistance
4+/5
strength: active movement against full resistance without evidence of fatigue (normal muscle strength)
5+/5
reflexes: no response
0/4
reflexes: somewhat diminished, low normal
1/4
reflexes: average, normal
2/4
reflexes: brisker than average, possibly but not necessarily indicative of disease
3/4
reflexes: very brisk, hyperactive, with clonus (rhythmic oscillation b/w flexion and extension)
4/4
evaluation of motor system
- body position & gait
- involuntary movement (tremors, tics, fasciculations)
- muscle bulk (wasting, atrophy)
- muscle tone (resistance to stretch)
muscle/muscle group: shoulder shrug
trapezius (CN XI)
muscle group: flexion at the elbow
C5-C6
muscle group: extension at the elbow
C6-C8
muscle group: flexion and extension at the wrist
C6-C7
muscle group: hand grip
C7, C8, T1
muscle group: finger abduction
C8-T1
muscle group: opposition of thumb
C8-T1
muscle group: hip flexion
L2-L4 (psoas and iliacus)
muscle group: hip extension
S1 (gluteus maximus)
muscle group: hip adduction
L2-L4
muscle group: hip abduction
L4, L5, S1
muscle group: knee flexion
L4, L5, S1, S2 (hamstrings)
muscle group: knee extension
L2-L4 (quads)
muscle group: ankle plantarflexion
S1 (gastrocnemius)
muscle group: dorsiflexion
L4-L5 (tibialis anterior m)
dermatomes: auricle
C2
dermatomes: earlobe, anterior/posterior neck
C3
dermatomes: shoulder top
C4
dermatomes: radial aspect forearm
C6
dermatomes: long finger
C7
dermatomes: clavicles
C5
dermatomes: little finger
C8
dermatomes: nipple
T4
dermatomes: umbilicus
T10
dermatomes: inguinal
L1
dermatomes: patella, medial calf
L4
dermatomes: anterolateral calf, great toe
L5
dermatomes: posterolateral calf/little toe
S1
abdominal reflexes
T10-T12 - stroke peripheral to the umbilicus in each quadant = contraction
anal reflex
S2-S4: scratch anus bilaterally = contraction of anal muscles
plantar response
L5-S1: stroke plantar aspect of foot from heel to ball = dorsiflexion (normal response)
DTR: biceps
C5-C6
DTR: triceps
C6-C7
DTR: brachioradialis
C5-C6
DTR: patellar
L2-L4
DTR: Achilles
S1
DTR: hyperactive DTRs indicate _____.
CNS lesion
DTR: hypoactive DTRs indicate _____.
PNS lesion