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| Characteristics of cerebellar ds | Dysmetria, diadochokinesia, bal/coord impaired, intention tremor, ataxic gait, strength unaffected
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| Common ds that affect cerebellar | MS, alcoholism
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| Tests for Cerebellar Dysfunction | (blank)
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| Tests for Cerebellar Dysfunction | rapid alt of pron/supin.; finger to nose; heel to shin; Romberg
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| Finger to nose sign | intention tremor will be evident
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| heel to shin sign | pt overshoots knee (dysmetria)
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| Romberg sign | Pt is equally unsteady with eyes open or closed
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| damaged area with eyes open unsteadiness in Rombergs | cerebellar
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| area damaged with eyes closed in Rombergs | post. column
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| Charac of posterior column ds | two pt discrim., vibration, position sense, deep touch and pressure all affected
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| Ds affecting post col | MS, Tabes Dorsalis, Leprosy
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| Tests for post col | Tuning fork, alt 2 pt touch with 1 pt touch, push great toe into dorsiflexion then plantar, Romberg Test
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| Tuning fork sign for post col | dec vibratory sense
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| Alt 2 pt touch with 1 pt for post col | can't discriminate betw the two
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| Great toe test for post col | unable to perceive the difference
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| Romberg test for post col | min sway with eyes open, exaggerated with them closed (ddx from cerebellar ds)
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| Wexler Scale 0 | no reflex
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| Wexler Scale 1 | hyporeflexic
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| Wexler scale 2 | normal
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| Wexler scale 3 | hyperreflexic w/o clonus
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| Wexler scale 4 | hyperreflexic w/ transient clonus
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| Wexler scale 5 | hyperreflexic w/ sustained clonus
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| muscle grade 0 | no evidence of contraction
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| muscle grade 1 | evidence of contraction but no mvmt
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| muscle grade 2 | mvmt w/o gravity
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| muscle grade 3 | mvmt w/ gravity
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| muscle grade 4 | slight resistance
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| muscle grade 5 | full resistance
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| Main ascending pathways | spinothalamic
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| spinothalamic fibers | c, a delta, pain & temp
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| where do spinothalamic fibers decussate | w/in 1-2 levels of entry into spinal cord
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| px/temp ipsi or contralateral in spino | contralateral
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| Dorsal col function | proprioception, fine touch, 2 pt, vibration, graphesthesia
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| LMN location | n. to muscle-ventral horn/ant horn
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| lmn type | alpha motor neuron
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| lmn pathway location | final common pathway
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| UMN location | corticospinal tract
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| corticospinal tract decussates in | pyramidal tract (90%)
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| umn mvmt type | voluntary
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| what is the effect of most descending pathways | primitive-reflexive
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| effect of umn lesion | inhibitory effect from corticospinal path will be dampened by inc in dtr
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| signs of umn lesion | inc dtr, spastic paralysis, inc mm. tone, pathological reflexes, absent superficial reflexes
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| signs of lmn lesion | dec dtr, flaccid paralysis, dec mm tone, no pathological reflexes, diminished superficial reflexes
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| ds with waddling gait | MD, polio, dislocated hip
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| steppage gait | toe/foot drop (paralysis of foot dorsiflexors) as in damage to peroneal n.
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| ds with steppage gait | Charcot Marie Tooth syndrome-weak tib ant mm.
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| Scissors gait | spastic paraplegia, knees scrape together
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| type of lesion with scissors gait | umn-seen w/ cerebral palsy
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| stroke affects which side in circumduction gait | same side-hemiparesis
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| Trendelenburg gait | lift leg weak contralateral glut medius-weight shifts over weak G-med, acetabulum and femur support weight
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| Festinating or propulsion gait | forward leaning posture, small shuffling steps seen with Parkinson's, mask like facies
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| Ataxic/tabetic gait | wide, watches feet, slap foot on ground to help fire proprioceptors-dorsal col ds seen with tabes dorsalis
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| Motor ataxia gait | cerebellar dysfunction-irreg. unsteady reeling vertigo wide based steps
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| Brown sequard syndrome | hemisection of spinal cord with neuro changes
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| neuro changes with brown sequard | corticospinal ipsi below lesion-spastic paralysis; spinothalamic-contra w/in 1-2 leves below site-dec in px/temp; dorsal col-ataxia, proprio, 2pt, vib discrim ipsi below lesion
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| Amyotrophic lateral sclerosis | motor neuron ds causing LMN signs in upper ext and umn sign in lower ext
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| Myasthenia gravis | sporadic muscular weakness d/t defect at myoneural junction, dec acetylcholine
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| are cranial nn. involved w/myasthenia gravis | yes
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| Tabes dorsalis | ataxia d/t loss of proprioceptive paths
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| Wallenberg | thormbosis of post inf cerebellar artery causing vertigo, nausea, contra hemiparesis, hemianesthesia, loss of hearing, tinnitus & ataxia
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| Barre Lieou | vertigo, tinnitus, nausea assoc w/ vertebral a. disturbance
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| Guillian Barre | acute polyneuropathy w/ muscular weakness and some sensory loss, preceded by nonspecific febrile (usually viral) illness 1-3 wks prior
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| Syringomyelia | chronic progressive ds of the spinal cord, loss of px & temp. Touch and pressure ok; loss of sensation with shawl like distrib.
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| Rotator Cuff muscles | SITS-supraspinatus, infraspinatus, teres minor, subscapularis
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| TFL | pt. externally rotates and abducts leg
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| Perthes test | checks competence of the venous valves of 2 extremities
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| L4/L5 facet syndrome | flank, groin and medial knee px
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| milwaukee brace | scoliosis brace, use indicated if curve is 20 degrees w/rot.
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| what can cause upper teeth px | maxillary sinus
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| what n. is involved in post. compartment | tibial
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| syndromes involving br. of common peroneal n. | superficial peroneal n. lateral compartment-foot eversion; deep peroneal n. ant. compartment-foot dorsiflexion (dermatome betw. 1st/2nd toes); peroneal n. palsy-aka charcot marie tooth syndrome
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| what does shoulder depression test | dural sleeve adhesions
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| what is closed pack | in full ext
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| what is open pack | in full flexion
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| m. involved in tennis elbow | carpi radialis brevis-aka lat. epicondylitis
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| klippel feil syndrome | short web neck, low hairline, dec # of c/s vert with fusion, cns affected
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| signs of cervical rib | symptoms at 4th and 5th metacarpal and medial forearm
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| osteoid osteoma | rare benign bone tumor composed of sheets of osteoid tissue, px relieved by aspirin
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| what n. involves adduction of thumb | ulnar (froment's paper sign)
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| Scheuerman's ds | kyphotic curve unilateral rib curve, schmorl's nodes
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| Acetabula protrusio | femur heads protruding into the pelvic bowl, complication of RA, fracture, Pagets
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| Diabetes mellitus | hip jt changes-most common seen is avascular necrosis
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| Myasthenia gravis | eyelid ptosis, severe facial weakness, recurring ocular fatigue, sx dec with rest
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| Multiple sclerosis | charcot's triad=SIN (scanning speech, intention tremor, nystagmus). Shock like sensation throughout spine (Lhermitte's). Transient blindness with optic disc neuritis
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| Olecranon bursitis | MC associated with gout
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| ['0 | (blank)
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| sx of tarsal tunnel syndrome | numbness in toes
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| cause of ankle pronation | plantar fascitis
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| most common dyscrasia in elderly | multiple myeloma
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| is retinitis pigmentosis assoc w/ sudden vision loss | no
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| amaurosis fugax | sudden transient loss of vision in one eye secondary to optic artery compression
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| subarachnoid hemorrhage | sudden onset like a blow to the head with fevar and nuchal rigidity
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| rhabdomyosarcoma | malignant tumor of skeletal muscle
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| myelopathy | cord problem
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| greatest tension in cervical spine | flexion-soto hall, lindner's, lhermitte's sign
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| sjorgren's disease | xeropthalmia, xerostomia and RA
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| MC location for lower ext bruit | popliteal a.
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| thromboangitis obliterans | young males, increased w/ smokers
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| patellar tendonitis aka | jumper's knee
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| athetoid motion | slow, writhing, worm like motion
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| choreiform motion | jerky dance like mvmt (Huntington's-congenital, Syndeham's-strep acquired)
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| MC cause of avascular necrosis of the femoral head | Sickle cell anemia
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| pes planus | flat feet, normal posture in one year old
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| Strabismus | Optic axes can not be directed to the same object
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| what n. serves brachioradialis m. | radial n., C6
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| what n. goes to nucleus ambiguous | vagus n.
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| subluxation location causing cardiac problems | upper c/s, can influence vagus n. flow to the heart
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| Cervical spine tests | Valsalvas, Dejarines, Milgrams, Naffzigers
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| Test for meningitis | Brudzinski's-leg flexion=meningitis
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| Sheppleman's ipsi vs. contra | ipsi=intercostal neuritis, contra=pleurisy
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| Chest expansion measure | males=2" females=1.5"
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| When is chest exp dec | with AS
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| Beevors indicator | deviation of umbilicus, indicates side and general level of lesion
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| Lhermites finding | shooting px into extremities=MS
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| Where does rib fx px go | lateralizes to side of fx
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| Forrestiere bowstring indicates | ipsi mm. contracts with AS
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| aka for SLR | Leseagues
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| SLR findings | 0-30=hip, 30-60=SI, 60>=n. root; indicates lateral disc bulge
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| WLR aka | Fazjerstsan's
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| WLR findings | indicates medial disc bulge
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| Kemp's findings | Ipsi facet, contra is n. root
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| Ely's finding | lateral fem n. irritation
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| Thomas finding | iliopsoas tension
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| Hibbs finding | SI or hip, depending on site of px
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| Nachlas finding | SI lesion, tight quads, ant thigh px
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| Yeoman finding | ant SI lesion
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| Gaenslen's finding | SI or hip involvement
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| Neri bowing finding | hamstring thightness, not n. root traction
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| Calloway's finding | disloc of humerus
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| Dugas finding | disloc of humerus
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| Apprehension finding | disloc of humerus
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| Codman's finding | rotator cuff tear usually supraspinatus
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| Yergason's finding | bicipital tendonitis or transverse humeral ligament
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| Describe Weber's test | 512 hz tuning fork placed on vertex of skull
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| Weber's test findings | Lateralization indicates air conduction loss on same side or sensorneural loss on side opposite lateralization
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| Describe Rinne's test | 512 hz tuning fork placed on mastoid process, held until pt no longer hears then fork held in air beside ear.
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| Rinne's test findings | neg if air conduction 2x longer than bone; pos if bone conduction longer than air conduction
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| Describe Schwabach's test | after pt can no longer hear air conduction with Rinne's Dr listens to tuning fork for comparison
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| Barany test | labyrinthine test, whirling or calorimetric test
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| Muscle tension HA sx | unvarying dull HA, band like pattern
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| Classic migraine HA sx | aura, throbbing phase, mood change
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| Brain tumor sx | can present as weak lateral rectus m., HA and elevated optic disc
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| Posterolateral sclerosis aka | combined systems ds
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| Posterolateral sclerosis sx | stocking glove distrib, B12 down, complication secondary to pernicious anemia
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| Duchenne's MD sx | 50-100X inc in CPK, mm. wasting, waddling gait
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| Sudeck's atrophy sx | RSDS w/ osteoporosis
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| Hegar's sign | softening of the cervix
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| Best test for polymyositis | tissue biopsy
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| Osteochondritis dessicans sx | jt. mice lateral aspect of the medial compartment of the knee MC site
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| Pelligrini Stieda sx | partial avulsion of the MCL with resultant calcification
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| Order of shoulder dysfunction | tendonitis to bursitis to capsulitis
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| Neurotrophic jt sx | hx, jt effusion, inc sensitivity, inc with DM, not a shooting type px
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| Where is hematogenous osteomyelitis most often located | metaphyseal bone
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