NMS DX Flashcards Preview

NBCE Part II/III > NMS DX > Flashcards

Flashcards in NMS DX Deck (147):
1

Pneumonic for Cranial Nerves - sensory or motor:

Some
Say
Marry
Money
But
My
Brother
Says
Big
Boobs
Matter
Most

2

R Corneal Reflex

A: 5 (trig)
Int: Pons
E: 7 (fac)

3

R Pharyngeal (Gag)

A: 9 (glos)
Int: Medulla
E: 10 (vag)

4

R Palateal (Uvular)

A: 9 (glos)
Int: Medulla
E: 10 (vag)

5

R Interscapular

A: T2-T7 spinal n
Int: T2-T7 spinal cord
E: Dorsal scapular n

6

R Abdominal

A: Up: T7-10, Lo: T11-12
Int: SC T7-T12
E: T7-10, Lo: T11-12

** NORMAL: umbilicus moves toward side stroked

7

R Plantar

A: Tibial n.
Int: SC S1-2
E: Tibial n.

8

R Direct Light

A: 2 (optic) ips
Int: midbrain
E: 3 (occu) ips

9

R Indirect Light

A: 2 (optic) ips
Int: midbrain
E: 3 (occu) contra

10

R Accomodation

A: 2
Int: occipital cortex
E: 3

11

R Carotid Sinus

A: 9 (glos)
Int: medulla
E: 10 (vag)

12

R Occulocardiac

A: 5 (trig)
Int: Medulla
E: 10 (vag)

13

R Ciliospinal

A: cervical symp chain
Int: T1-T2 spinal cord
E: cervical symp chain

14

Trigeminal Neuraliga

aka Tic Douloureaux
Burning on the face in multiple episodes on jaw or cheek, unilateral

15

Cardinal Fields of Gaze

S0-4 LR-6 / 3

Superior Oblique = down and in

16

Parasympathetic of Occulomoter N

Ciliary muscles (lens shape)
Constrictor papillae

17

Bells Palsy

CN 7 (Facial)
Ipsilateral facial paralysis - impermanent
Can NOT raise eyebrows

**DDX from Stroke (bilateral, forehead wrinkles)

18

Cervical Dystonia

AKAs: Torticollis, Wry Neck
- spasm of SCM
- CN 11 lesion
- ipsilateral = lateral flexion, contralateral = rotation

19

Westphal Sign

DTR absence

-- Jendrassik Man = distractor to help

20

Wexler Scale

0 = absent with reinforcement
1+ Hypoactive with no reinforcement or normal with reinforcement -- LMNL
2+ normal
3+ hyperactive -- UMNL
4+ hyperactive w/ transient clonus
5* hyperactive w/ sustained clonus

21

Jaw Jerk DTR

Trigeminal (CN 5)

22

Patellar DTR

Femoral L4

23

Medial Hamstring DTR

Sciatic L5

24

Achilles

Tibial S1

25

Cremasteric

Male
A: Femoral N.
E: Genitofemoral N.

26

Geigel's

Female
A: Femoral N.
E: Genitofemoral N.

27

Beevors

A: Up: T7-10, Lo: T11-12
Int: SC T7-T12
E: T7-10, Lo: T11-12

**Normal: Umbilicus stays midline; Pathological: Umbilicus moves away from lesion

28

UMNL

spastic paralysis
hyperactive DTR
pathological reflexes
clonus
hypertonic
no superficial reflexes

29

LMNL

** CN or Nerve Root **
flaccid paralysis
hypoactive / absent DTR
hypotonic
degeneration / atrophy
fasiculations
no superficial reflexes

30

PR Gordon's

Squeeze calf below knee

31

PR Schaefer

Squeeze achilles

32

PR Rossolimo

Tap ball of foot

33

PR Gordon's finger

strokes pisiform

34

PR Chaddocks wrist

strokes distal ulnar side of forearm near wrist

35

Muscle Grading

5 = Normal: ROM against gravity w/ resistance
4 = Good: ROM against gravity w/ SOME resistance
3 = Fair: ROM against gravity
2 = Poor: ROM no gravity
1 = Trace: no motion, slight contractility
0 = Zero: none

36

Erb's Palsy

C5,C6 -- radial n entrapment, too
Waiter's Tip Deformity: ADDUCTION + INTERNAL ROTATION + WRIST FLEXION

37

Wrist Drop

C7 -- radial n entrapment, too

38

Klumpke's Paralysis

C8-T1 -- lower brachial plexus palsy from childbirth

clas hand deformity with wrist flexion

39

Meralgia Paresthetica

L1-L3

40

Foot Drop

L4-5

41

Cauda Equina

S2-4

42

NR L1-L3

M: Hip flexion
Muscle: Psoas
S: Inguinal Lig, Oblique, Oblique Across

43

NR L2-L4

M: Hip flexion
Muscle: quads + add

44

NR T5-12

M: Trunk flexion
Muscle: REctus Abdominus
S: T5-T12

45

Axillary N.

M: Arm ABduc
Muscle: Deltoid + Teres Minor
S: Lateral arm
Disorder: GH dislocation

46

Radial N.

M: Wrist/Finger Extension + Thumb Abd
Muscle: Wrist/Finger extensors + Triceps
S: dorsal web b/w thumb and index
Disorder: Wrist Drop, Crutch Palsy, Erbs Palsy

47

Musculocutaneous N.

M: elbow flexion
Muscle: biceps, brachialis, coracobrachialis
S: lateral forearm
Disorder: impingement

48

Median N.

M: pincher grip, thumb opposition
Muscle: wrist/thumb flexors, thenar, thumb abd
S: distal radial hand, 2nd digit
Disorder: carpal tunnel, pronator teres, ape hand

49

Ulnar N.

M: pinky + thumb adduction
Muscle: finger ab/add + thumb add
S: distal ulnar hand, 5th digit
Disorder: Claw hand

50

Dorsal Scapular N.

M: elevate + retract scap
Muscle: rhomboids + lev scap
S:
Disorder: Flaring of Scap

51

Lateral Femoral Cutaneous N.

Lateral Thigh --> Meralgia Paresthetica

52

Saphenous N.

Anteromedial knee + Medial Leg

53

Obturator N.

M: Hip Adduction
Muscle: Hip Adductor muscles
S: Medial thigh
Disorder: Impingement

54

Femoral N.

M: Hip flexion, Knee extension
Muscle: Psoas + Quads
S: Anteromedial thigh + leg
Disorder: Impingement

55

Sciatic N.

M: Knee Flexion
Muscle: Hamstrings
S:Ant/Post Leg, Sole/Dorsum of foot
Disorder: Piriformis Syndrome

56

Peroneal N.

M: Foot Dorsiflexion / Inv / Ev
Muscle: Tib Ant, Toe extens, peroneals
S: Anterior Leg + Dorsum of Foot
Disorder: Fib Head Fx

57

Medial Plantar N.

M: Toe flexion
Muscle: Toe flexor muscles
S:
Disorder: Tarsal Tunnel Syndrome

58

Peripheral Nerve Entrapments:

DR CUMA

Drop Wrist
Radial N.
Claw Hand (aka pope hand)
Ulnar N.
Median N.
Ape Hand (thenar atrophy)

59

Dermatogenous

Sensory distribution of a Nerve Root

60

Myotogenous

Muscle

61

Scleratogenous

Facet / Joints --- embryological sclerotomes

62

Radicular

Dermatome of a nerve root

63

Referred

Along scleroderm origination...share a pathway

64

Types of pain for:
Muscle
Nerve
Circulation
Bone Cx
Scleratogenous
Myofascial

Muscle - cramping / spasm / ache / dull
Nerve - shooting / radiating / burning
Circulation - THROBBING / PULSATING
Bone Cx - CONSTANT / DEEP / BORING / NOCTURNAL
Scleratogenous - poorly localized / dull ache
Myofascial - trigger points

65

Referred Pain Sites:
Gallbladder
Pancreas
Heart
Intestines
Appendix
Kidney
Ureter
Bladder

Gallbladder: RT shoulder + Inf Scap
Pancreas - T10 epigastric
Heart - LF shoulder + med LF arm
Intestines - periumbilical
Appendix - early = epigastric; late = RLQ
Kidney - flank
Ureter - groin
Bladder - suprapubic area

66

3 Night Pains

C's
- Cancer
- Carpal Tunnel
- Cluster Headache

67

Carpal Tunnel Syndrome

Median N (1st 3 digits)
Flexor Retinaculum
Cause: fluid retention due to pregnancy
Thenar atrophy + Ape Hand (weak opp poll)
Nocturnal Pain
Adjust Lunate
Grip strength (ONLY med n)

68

Pronator Teres Syndrome

Median N (1st 3 digits)
--> Ant Inteross N.
Heads of pronator teres
MOI: carpenter / mechanic (MALE)
Grip strength (ONLY med n)

69

Ulnar N Entrapment

1) Tunnel of Guyon (Pisi + H.Hamate)
2) Cubital Tunnel
Cyclist
Claw Hand deformity
Weak add poll + hypothenar atrophy
Weak wrist flexion on ulnar side

70

Radial N Entrapment

Wrist drop + Erb's Palsy + Saturday Night Palsy + Crutch Palsy
Location = spiral groove
LEAD TOXICITY
no triceps reflex

71

Long Thoracic N. Entrapment

Scapula Winging
Serateous Anterior
"SALT your Wings"

72

Dorsal Scapular N. Entrapment

Scapular Flaring
Rhomboid mm paralysis

73

Lateral Femoral Cutaneous N. Entrapment

Meralgia Paresthetica
Site: PELVIC BRIM UNDER INGUINAL LIGAMENT
Burning on antero-lateral thigh (ddx nerve root)
Obese + tight jenes + cop

74

Sciatic N. Entrapment

Site: pelvis, hip, popliteal fossa
pain in - post butt, thigh, leg down to floor
Weak knee flexion
Achilles reflex is weak

75

Tibial N. Entrapment

Tarsal Tunnel Syndrome (Medial Plantar N)
Unilateral BURNING PARESTHESIA on bottom of feet
MOI: inversion ankle sprain jamming medial side

76

Morton's Neuroma

3rd and 4th MTs
Narrow toes shoes
Mortons Squeeze

77

Common Peroneal N. Entrapment

Site: Fib Head
Lateral leg pain + weak peroneal mm
FOOT DROP

78

Deep Peroneal N.

Anterior Compartment Syndrome = FOOT DROP
Can affect any of the 4 compartments:
1 Tib Ant
2 Ext Hall Long
3 Ext Dig Long
4 Per Tertius

79

Mallet Finger

Fingertip curled from injury

80

Swan Neck Deformity

PIP: hyperEXT
DIP: hyperFLEX
RA!!!

81

Boutonniere Deformity

PIP:hyperFLEX
DIP: hyperEXT
RA!!!

82

Dupuytren's Contracture

ABNORMAL THICKENING underneath palm and fingers (not there = ulnar n. lesion)
last 2 fingers curl into palm

83

Trigger Finger

finger locked in flexed position

84

De Queervains Disease

Inflammation of EXTENSOR POLLICIS BREVIS + ABDUCTOR POLLICIS LONGUS
Finklesteins

85

Syringomyyelia

loss of pain and temp on shoulders and back in CAPE LIKE DISTRIBUTION (SHAW LIKE)

86

MS (multiple sclerosis)

Female 30s
Demyelination of CNS
Gets better, than worse, better, than worse
optic neuritis causing transient blindness
Leg UPMNL --> distal weakness
(+) LHERMITTE'S TEST
Heat = contra-indicated
CHARCOT'S TRIAD = ITs a SIN to have MS!!
- S = scanning speech
- I = intention tremors
- N = nystagmus

87

Myasthenia Gravis

Female 30s
Autoimmune - antibodies against ACh receptors = myoneural junction dysfunction
Muscle weakness at END OF DAY or post exercise

88

ALS

Aka Lou Gehrigs Disease
Male 60s
LMNL in arms + UMNL in legs
MOTOR ONLY!!!!!!
Usually begins in hands and feet, life expectancy short
Corticospinal tract + anterior horn

89

PLS

Combined Systems Disease
Glove + Stocking Paresthesia
(+) SCHILLING TEST!!
Symptoms irreversible
Cause: B12 Deficiency (pernicious anemia)

90

Brown Sequard

Same side MOTOR FUNCTION loss
Opp side PAIN/TEMP loss

91

Cerebral Palsy

Anoxia to brain
SCISSOR GAIT -- legs cross midline
Athetoid = MC

92

Paralysis Agitans

Parkinsons Disease
1) Fenestrating Gait 2) Shuffling Gait 3) Propulsive Gait
RESTING TREMORS
FORWARD STOOPED POSTURE
MASKED FACE

93

Guillian-Barre Syndrome

PNS inflammatory polyneuropathy!!
Linked to recent IMMUNIZATIONS or POST FLU INFECTION
Ascending Paralysis -- can be dangerous if reaches diaphragm

94

Tabes Dorsalis

Teritiary Syphillis
SLAPPAGE GAIT
Pupil irregularities

95

Muscular Dystrophy

Erb Duchenne
BOYS 3-7
WADDLING GAIT
PSEUDO-HYPERTROPHY OF CALVES/DELTOIDS
GOWERS SIGN
Increase in CPK, Decrease creatinine

96

Charcot Marie Tooth Disease

Hereditary affecting motor and sensory
Foot drop + High-stepped gait
Hammer toes

97

Hungingtons Chorea

MC age of onset 35-44
Neurodegenerative Genetic Disorder

98

Gait Cycle

STANCE = 60%
- Heel Strike
- Foot Strike
- Toe Off

SWING = 40%

99

Acceleration of Gait

Psoas + Rectus Femoris

100

Deceleration of Gait

Hamstrings ECCENTRICALLY contracting

101

Heel Strike of Gait

Dorsiflexors ECCENTRICALLY contrct
Quadriceps ECCENTRICALLY contract

102

Foot Strike of Gait

Abductors hold body up
Plantar Flexors (gastroc, soleus, plantaris = triceps surae) contract to push body ahead

103

Toe Off of Gait

Quadriceps CONCENTRICALLY contract to help plantar flexors push body forward

104

Waddling Gait

Muscular Dystrophy

105

Propulsion Gait

Parkinsons

106

Festinating Gait

Parkinsons

107

Shuffling Gait

Parkinsons

108

Steppage Gait

Anterior Compartment Syndrome = Foot Drop

109

Trendelenburg

Weak glut med

110

Slappage Gait

Posterior Column Disease = TABES DORSALIS

111

Circumduction Gait

Stroke

112

Spastic Gait

UMNL

113

Antalgic Gait

avoidance of pain

114

Drunken / MOtor Gait

Cerebellum problem -- wide based gait

115

Rotator Cuff Tear

MC = supraspinatus MC
DX = MRI

116

Rotator Cuff Muscles

Supraspinatus
Infraspinatus
Teres Minor
Subscapularis

117

Rotator MM: Supraspinatus

ABduction
Suprascapular N
GT insertion

118

Rotator MM: Infraspinatus

EX ROT
Suprascapular N
GT insertion

119

Rotator MM: Teres Minor

EX ROT
Axillary N.
GT insertion

120

Rotator MM: Subscapularis

IN ROT
Subscapular N.
LESSER TUBERCLE INSERTION!!

121

Scapular Motion

Elevation: Trap + Lev Scap
Retraction: Rhomboids (Maj + Min)
Protraction: Serratus Anterior

122

Test for Subclavian Artery + Scalenus Medius Syndrome

Modified Adsons

123

Test for Cervical Rib

Adsons (Scalenus Anticus)
Halsteads

124

Test for compression of 1st rib + clavicle

Edens or Costoclavicular

125

Test for pec minor syndrome or Axillary A compression

Wrights or Hyperabduction Maneuver

126

Test for TOS

Roos
Bikele's

127

Ortolanis

baby legs ABducted + Externally rotated
CHD

128

Barlows

baby legs ADDucted

129

Ligament Tear

Immediate swelling = Intra Articular

130

Meniscus Tear

Swelling 12-24 hours; unable to lock out
Joint Line

131

Chondromalacia Patella

Runners Kne
Walking downstairs = PAIN
Tests: Clark + Fouchets

132

Jumpers Knee

Patellar tendonitis

133

Housemaids Knee

Prepatellar Bursitis

134

TFL Syndrome

shortened TFL
running, up/down stairs/hills = PAIN

135

Pes Planus

Flat foot

136

Talipes Equinovarus

MC birth defect
clubfoot
heel elevated, foot inward

137

Pes Cavus

high arch
March fx = common

138

Metatarsal Stress FX

March FX

139

Sprain / Strain grading

1 no tear..slight swelling and loss of motion
2 partial tear...swelling + brusing...no motion
3 complete tear

140

Burn Bench Test

Malingering Test

141

Lasegue's Sitting

Malingering Test
..negative yet + with normal SLR

142

Magnussons

Malingering Test
different points

143

Mannkopfs Sign

If patient's pulse increases when applying pressure to painful spot, they are NOT malingering

144

AS tests

Chest Expansion Test
Forrestier Bowstring Sign
Lewin Supine Test
Amoss Sign

145

Libman

test for patient's pain threshold

146

Rust Sign

graps head upon sitting from recumbent position
--> cervical instability, RA

147

Dejerine's Triad

Space occupying lesion
(coughing, sneezing, straining)