Anatomic Basis of Clinical Testing Pt. 2 (9/5c) Flashcards Preview

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Flashcards in Anatomic Basis of Clinical Testing Pt. 2 (9/5c) Deck (29)
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1

Reflex

Tests the afferent (spinal cord) and efferent (muscle) areas

2

CNS/PNS Neurons

CNS = upper motor neurons

PNS = lower motor neurons

3

Reflex - CNS Role

should normally put a slight inhibition on the reflex so the motion isn’t exaggerated

4

Reflex - PNS Role

innervates muscle by relaying sensation to the motor neuron

if not operating correctly, there would be reduced response

5

Pattern recognition - Dermatomes

peripheral nerve sensory distribution

6

Pattern recognition - Myotomes

peripheral nerve muscle innervations

7

Clinical testing of myotomes - Weakness

Looking for
1) weakness in muscles predominantly innervated by specific spinal nerves

2) pattern of weakness representative of a specific spinal nerve

8

Myotomes Chart - Shoulder Shrug

C2 , C3, C4

9

Myotomes Chart - Shoulder abduction

C5

10

Myotomes Chart - Elbow flexion

C6

11

Myotomes Chart - Wrist extension

C6

12

Myotomes Chart - Elbow extension

C7

13

Myotomes Chart - Thumb extension

C8

14

Myotomes Chart - Finger abduction

T1

15

Myotomes Chart - Hip flexion

L1 , L2

16

Myotomes Chart - Knee extension

L3 , L4

17

Myotomes Chart - Dorsiflexion

L4 , L5

18

Myotomes Chart - Great toe extension

L5

19

Myotomes Chart - Plantarflexion

S1

20

Muscle Impairment - Reasons

Peripheral nerve involvement → Spinal, Peripheral

CNS function → Motor control, Central inhibition

Disuse

Injury/mechanical stresses

Disease

Ischemia

21

Central inhibition

active nervous process arising in the CNS and leading to the suppression/prevention of excitation

22

Muscle Impairment - Clinical Signs

Weakness

Decreased control

Muscle atrophy

Pain/tenderness/cramping

23

Muscle Impairment - Clinical Assessment

Sensory Testing
Muscle Testing

24

Sensory testing (muscle impairment)

Looking for:

dermatomal distribution of symptoms

peripheral nerve cutaneous distribution of symptoms

other patterns (like stroke)

25

Muscle testing (muscle impairment)

Looking for:

myotomal pattern of weakness

weakness associated with a peripheral nerve

weakness NOT representative of a neurologic pattern

26

Symptoms of peripheral circulatory impairment

Changes in skin color quality

Pain (ischemic/general)

Swelling

Absent or decreased pulse

27

Digestive system

Alimentary canal/nutrition

Referred pain → often experience pain in other seemingly unrelated areas

(EX: pain down the arm, pain around scapula, etc)

28

2 Point Discrimination

the ability to discern that two nearby objects touching the skin are truly two distinct points, not one

usually used with a sharp item during a neuro exam

29

Barognosis

ability to evaluate the weight of objects by holding/lifting them