Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
30 Cards in this Set
- Front
- Back
|
give the nerve roots and motor and sensory deficit associated
MSC |
C5,6,7
weak flexion ofthe elbow (biceps, brachialis) weak supination of the radioulnar joint (biceps) sensory: lateral forearm |
|
|
give the nerve roots, muscles innervated, major actions
Axillary |
C 5,6
|
|
|
give the nerve roots, muscles innervated, major actions
Radial |
C 5,6,7,8 T1
wrist drop (extensor caripi radialis longus & brevis, extensor carpi ulnaris) can't make a fist sensory: posterior lateral arm and forearm , hand dorsum sensory: radial portion of the palm + tips of 1st 3.5 digits |
|
|
give the nerve roots, muscles innervated, major actions
Median at elbow |
C5,6,7,8 T1
pronation of elbow: (pronator teres & quadratus) weak wrist flexion (flrexor carpi radialis) weak opposition of thumb (thenar muscles) ape hand deformity with extension papal hand (L sign with 1st 3 digits) with flexion -- flexor pollices longus, flexor digitorum superficialis, flexor digitorum profundus |
|
|
give the nerve roots, muscles innervated, major actions
Ulnar at elbow |
C8,T1
claw hand on extension of the fingers - 4th and 5th finger flex at the PIP and DIP (if on flexion, this would be a median nerve deficit) -- interossei and lumbricals loss f abduction and adduction of the M.P joints of finger s= interossei loss of flexion of the DIP of 4 and 5. flexor digitorum profundus - w/o this, it's ulnar compression at wrist ulnar and dorsal aspect of palm and 1.5 digits on ulnar side = sensory |
|
|
give the nerve roots, muscles innervated, major actions
Median at wrist |
C5,6,7,8, T1
weakened opposition of the thumb - thenar muscles ape hand (thumb hyperextended and adducted on extnesion - thenar muscles sensory: palmar surface and tips of the first 3.5 digits |
|
|
pt asked to extend fingers -- get pope's blessing (no extension of 4th and 5th digit) -- what's the deficit?
accompanied by what sx? |
ulnar nerve
accompanied by atrophy fo the first dorsal inerosseious muscle and cant spread out fingers |
|
|
pt asked to flex fingers fingers -- get pope's blessing (extension of 1, 2, 3 digit) -- what's the deficit?
accompanied by what sx? |
median nerve
accompanied byinability to oppose thumbs and wasting of thenar eminance |
|
|
ddx median compression at wrist vs elbow
|
at elbow: pt has lost pronation of elbow, wak wrist flexion (fl carpi radialis) and papl hand (on flexion, can't flex joints of first 3 digits)
wrist has none of this |
|
|
ddx ulnar compresison at wrist vs elbow
|
elbow has loss of flexxoin of the DIP 4 and 5 (fl dig profundus)
wrsit does not |
|
|
radiculopathy has
atrophy? fasciculations? weakness is complete? DTRS are depressed or absent early? what about peripheral neuropathy? |
radiculopathy -- atrophy and fasciculations are rare, weakness is incomplete. DTrs ARE depress/absent early
atrophy occurs early, weakness is complete and worse with use/better with rest, and fasciculations are common, rare reflex changes (depends on location) |
|
|
pain radiating down arm in a spinal nerve root distribution commonly with nect pain
this is more characterisitc of radiculopathy or neuropathy in the cervical area? |
radic
neurop = pain is more distal (near joint) |
|
|
NCS is radic is _____
EMG = abnl NSC is neuropathy = ____ EMG == ____ |
NCS radic=sensory nl, motor usually nl (may be abnl)
NCS neuropathy = conduduction delay at site of compression; EMG= normal |
|
|
DCML carry _____(asc/desc) fibers that relay what sensations?
1st neuron: (sacral, lumbar and lower thoracic neurons enter cord at the ______) upper thoracic and cervical roots enter via _____ carry info for ipsi body -- synapse with 2nd neruon in the _____ (cell body located in the _______ decussation = ____ as ____ fibers and ascend through brainstem as the ____ terminates at the ____ nuc of the thalamus and 3rd order neuron carries fibers to the ____ |
ascending fibers
proprioception(joint position/movement) dorsal rootss>>facsciculaus gracilus (medial = by grace i passed med school) fasciculus cuneatus medulla ipsi nucleus gracilis/cuneatus medulla as internal arcuate fibers; MEDIAL LEMNISCUS ventral posterior >>3rd order carries info to the somatosensory cortex=postcentral gyrus |
|
|
pain, temp, touch, pressure = relayed via ___
1st order enters cord and synapse on 2nd order neuron in the ____ pain/temp decussate w/in ___ segment of origin in the ____ touch/pressure decussate w/in ___ segments synapse w/ 3rd order neuron in the VPL and to the somatosensory cortex |
STT = ventral and lateral in cord
dorsal horn 1 segment - ventral white commissure several segments - ventral white commissure |
|
|
loss of proiprioception leads to ___ gait = sensory ataxi and is exacerbated with eyes closed = ____ sign
this + weakness/spasticity of limbs due to lateral corticospinal tract degen == _____ |
high steppage
romberg sign subacute combined degen resulting from def in B12 (pernicoius anemia) |
|
|
MS is an immune disease that dmages the _____ of the cervical spine leading to loss of proiprioception fo the hands/fingers, loss of dexteritiy, and asteriognosis (can't id shapes in hand)
|
fasciculus cuneatus
|
|
|
the ____ tracts are selectiviely damaged in syringomyelia 2/2 compression of the ___ order neurons in the ventral white commissure. causes selective loss of paint/temp in UE where touch/pressure remains nl = ____. complications = ____
|
STT
2nd order dissociated loss charcot's joints |
|
|
explain dissociate sensory loss
|
suggests focal lesion in brain or spinal cord
pain/temp/course touch/pressure = STT --- neurons enter cord -- ascend 2 levels -- then cross = tracts of lissauer; lesions here = loss of pain/temp 2 levels fine touch/proprioception = DCML cross the cord at the caudal medulla at the nucleus gracilis and cuneatus -- lesoin here results in loss below lesion=ipsi |
|
|
the spinocerebellar tracts relay information re ___
these tracts are ___ asc/desc dorsal tracts ascent ___ and enter the cerebellum via the ____ ventract tracts decussate and asscent on the opposite sideof the cord and enter into via the ____ degeneration of this tract leads to this dz ____ characterize dby incoordaination o f the arms (intention trmeor)_ and wide based gait (ataxia) |
posture control and coordination of movement
ascending ipsi -- inferior cerebellar peduncle superior cerebellar peducncle freiderich's ataxia |
|
|
decussion of the LCST occurs in the ___
|
pyramids of the caudal medulla
|
|
|
the rubrospinal tract aids in excitation of the _____ muscles and originates in the ____ and courses ____ and decussates ____ and descends in the spinal cord withthe LCST
|
limb flexors
red nucleus in the midbarin ventrolaterally ventral tegmental ducussation (midbrain) |
|
|
the tectospinal tract mediates ____
orginates:____ fibers run? decussate? finbers in the spinal run |
reflexive movements in response to visual stimuli
suprior colliculus of the midbrain (receives visual input) ventromedially dorsal tegmental decussation ventromedially |
|
|
describe light reflex
name the 2 nucleus involved what types of fibers? |
light to retina>>CN2>>bilateral projection to pretectal nucleus in the midbrain>>bilat projection to E-W nucleus in the midbrain>>ciliary ganglion>>pupillary sphincter>>miosis
all at the level of the superior colliculus fibers = parasympathetic E-W>>Ciliary=pregang parsymp of 3 Ciliary >>muscle = post gang parasymp of 3 |
|
|
describe path of accomodation
|
light>>visual cortex>>superior colliculus/pretectal area>>E-W and oculomotro
|
|
|
give cause:
down and out eye with ptosis and DILATED pupil |
transtentorial /uncal herniation + CN III compression from increased ICP
|
|
|
swinging flashlight test tests for _____ this is called ____
seen in this dz |
afferent pupillary reflex lim b (2)
relative afferent pupil (marcus gunn) -- pupils don't constrict fully with light >>to good eye then back to bad eye -- light causes dilation in both pupils seen in MS |
|
|
no direct or consensual light reflex with accomodation and convernence intact is ____ and seen in this dz
|
argyll-robertson pupil
light-near dissociation seen in neurosyph, DM |
|
|
facial nerve supplies motor to the face including which traits?
UMN lesion results in what type of lesion? LMN? |
wrinkle forehead, shut eye, flare nostril, smile
weakness of the contralateral lower face LOWER FACE=innervated by contralateral cortex UPPER FACE = innervated by upper facial nucleus which is innervated by bilateral cortex LMN: ipsi upper and lower face (bell palsy) |
|
|
facial nerve decussates in the ____ for motor
|
pons
|
