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Cranial Nerve 02
Cranial Nerve Testing Cont.
| Question | Answer |
|---|---|
| The area of skin innervated by a particular nerve root is referred as | Dermatome |
| Maps the precise areas of the body innervated by each nerve root | Dermatome |
| Testing the extremities focuses on the 2 main afferent pathways | Spinothalamic and Dorsal column |
| Spinothalamic nerves detect | Pain, temperature and crude touch |
| Dorsal column nerves detect | Position, vibratory sensation and light touch |
| Position is also known as | Proprioception |
| The patient's ability to perceive the touch of a sharp object is used to assess the ----- of the spinothalamics | Pain pathway |
| Refers to the body's ability to know where it is in space | Proprioception |
| As such, proprioception contributes to | Balance |
| Vibratory sensation travels to the brain via | Dorsal column |
| In testing the vibratory sensation, ----Hz tuning fork is used | 128 Hz |
| ----Patients should be able to distinguish simultaneous touch with 2 objects which are separated by at least ----- | Two point discrimination, 5mm |
| In two point discrimination, the stimuli are carried via the | Dorsal column |
| Two point discrimination is useful if a discrete ---- is suspected like in injury to ----- | Peripheral neuropathy Radial nerve |
| These are small nylons fibers that are designed such that a normal patient should be able to feel the ends when they are gently pressed against the soles of their feet | Disposable monofilaments |
| Other term for disposable monofilaments | Semmes-Weinstein Aethesiometer |
| If the examiner has to supply enough pressure such that monofilament bends prior to the patient being able to detect it, they likely suffer from | Sensory neuropathy |
| Most common in diffuse distal sensory loss | Diabetes |
| In diffuse distal sensory loss, what is the first part that is affected | Feet |
| Diffuse distal sensory loss is a systemic disease which occur simultaneously in | Both limbs |
| Impairment which is the area involved covers an entire distal region much as a sock or glove would cover a foot or hand | Stocking or glove distribution impairment |
| A continuous burning sensation affecting the distal extremity | Neuropathic pain |
| Example of cases where peripheral distribution impairment occurs | Infarction and trauma |
| It can occur if an intoxicated person falls asleep in a position that put pressure on the nerve as it travels around the humerus | Radial nerve palsy |
| Nerve root which can be compressed by herniated disc material in the lumbar spine | S1 |
| Sacral nerve roots serves what part of body | Anus and rectum |
| Testing this nerve roots are important if patients complain of incontinence, inability to defecate/urinate, etc | Sacral nerve roots |
| A condition where multiple sacral and lumbar roots become compressed bilaterally | Cauda equina syndrome |
| Common dysfunction seen in diabetic patients | Dorsal column dysfunction |
| Unit of action that causes movement | Muscle |
| Largest and most powerful groups of muscle | Quadriceps and hamstrings |
| While both legs have well developed musculature, what part has greater bulk | Left |
| A condition result in death of the lower motor neuron and subsequent denervation of the muscle | Amyotrophic lateral sclerosis |
| Amyotrophic lateral sclerosis causes twitching of the fibers known as | Fasciculations |
| A specific type of continuous, involuntary muscle activity that results in limb movement | Tremors |
| A condition that can cause a very characteristic resting tremor of the hand that diminishes when the patient voluntarily moves the affected limb | Parkinson's disease |
| A condition has persist thorough movement and is not associated with any other neurological findings, easily distinguishing it from parkinson's disease | Benign essential tumor |
| The major muscle group to be palpated are | Deltoid, triceps, biceps, hamstring and quadriceps |
| A rare condition characterized by idiopathic muscle inflammation | Myositis |
| In myositis, it causes the patient to experience ---- but not pain | Weakness |
| A case where that will cause upper extremity muscle bulk to be normal or even decreased which is just normal | Spinal cord transection at thoracic level |
| In assessing muscle tone, it is reasonable to limit assessment to only the major joints including | Wrist, elbow, shoulder, hip and knee |
| Increased muscle tone | Hypertonicity |
| It results when upper motor neuron no longer function | Spasticity |
| Complete absence of muscle tone | Flaccidness |
| It results when lower motor neuron is cut off from the muscles that it normally innervates | Flaccidness |
| Parkinson's disease is a disorder of | Extra pyramidal system |
| It normally contributes to initiation and smoothness of movement | Extra pyramidal system |
| Parkinson's disease generate increased tone producing ---- when the limbs are passively moved by the examiner | Ratchet like sensation |
| Other term for ratchet like sensation | Cog wheeling |
| Scale in muscle strength where there is no movement | 0/5 |
| Scale in muscle strength where there is barest flicker of movement in muscle though not enough to move the structure to which it's attached | 1/5 |
| Scale in muscle strength where there is voluntary movement which is not sufficient to overcome the force of gravity | 2/5 |
| Scale in muscle strength where there is voluntary movement capable of overcoming gravity but not any applied resistance | 3/5 |
| Scale in muscle strength where there is voluntary movement capable of overcoming some resistance | 4/5 |
| Scale in muscle strength where there is normal strength | 5/5 |
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