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Motor Weakness
Anatomy of Motor Weakness
| Question | Answer |
|---|---|
| The Descending Tracts of the Spinal Cord = ? | * Lateral corticospinal, Rubrospinal, Lateral Vestibulospinal |
| Lateral corticospinal ? | * projects to Lower Motor Neurons in ventral horn of spinal cord grey matter (willfully contract) |
| Rubrospinal ? | * projects primarily to LMNs innervating flexor muscle groups. |
| Lateral Vestibulospinal ? | * projects primarily to LMNs innervating extensor muscle groups, particularly in the lower limb |
| Where the Lateral Coticospinal tract decussates and what it means ? | * Crosses at the inferior Medualla... * If injured above that point = Have Motor Weakness on CONTRALAT. Side..... * If injured BELOW = Motor Weakness on IPS. Side |
| Artery of the brain that has the largest watershed area and has major deficits when it is blocked ? | * Middle Cerebral Artery |
| Artery Order from most inferior to superior on the Cerebellum ? | * Vertebral A's (PICA comes off of this)-> Basilar A (AICA comes off of this)-> Sup. Cerebellar A -> Posterior Cerebral A |
| If Ant. Cerebral A is blocked, what areas are lost ? | *lower limb areas |
| If middle cerebeal A is blocked ? | * face and upper limbs |
| Lower Motor Neuron basics ? | * Motor neurons in spinal cord’s anterior horn .....* They send axons along spinal nerves to reach skeletal muscle. |
| Signs of an Upper Motor Lesion ? | * Weakness with NO Atrophy.... * See INCREASED tone and reflexes |
| Signs of a Lower Motor Lesion ? | * Weakness WITH atrophy.... * See DECREASED tone and reflexes |
| rubrospinal tract basics ? | * do not see it really used in humans bc it is overpowered by the lateral corticospinal tract |
| Vestibulospinal Tracts = ? | * Medial vestibulospinal tract = control cervical movement to keep the head level during movement...... * Lateral vestibulospinal tract = inns. extensor muscles of the upper (little) and lower (lots) limbs. = balance w/o thinking |
| Loss of lateral corticospinal tract = ? | * lesion between thalamus and midbrain that extends the legs, clinches the fists, and flexes the arms = Decorticate Rigidity Flexor posturing |
| Loss of lateral corticospinal and rubrospinal tracts = ? | * extended hands, plantar flexed toes, everything is extended = Decerebrate Rigidity Extensor Posturing |
| 3 nerves that have their own nuclei ? | * Occulomotor, Trochlear, and Abducens |
| Muscles of Mastication and weakness issues ? | * Mandibular branch of trigeminal nerve (CN V3) ...* Weakness will be due to the loss of the Trigeninal Nucleus and the chin will point to the lesioned side (Ips.) |
| Mastication things to not confuse ? | * TMJ pain |
| Facial Musculature – Lesion of corticonuclear tract ? | * Paralysis of one side of face sparing forehead. Forehead muscles receive bilateral corticonuclear input. Lower face receives only contralateral input. ... * If lose Left, we see RIGHT lower face impairment, with RIGHT forehead being ok |
| Facial (Bell’s) Palsy = ? | * Peripheral nerve loss, effecting entire IPS. side of the face |
| Traps and SCM innervation = ? | * SCM = ips innervation by CN XI and Traps = Contralat inn. by CNXI |
| CN XII testing ? | * stick the tongue out... * If the tongue deviates, the side in which it is pointing, is the side that is lesioned |
| The tongue and lesions of the corticonuclear tract above the medualla results in ? | * the tongue pointing to the contralat. side |
| Brachial Plexus Roots ? | * C5 - T1 |
| Trunks ? | * Superior, Middle, Inferior |
| Cords ? | * Lateral, Posterior, Medial |
| Terminal Branches ? | * Musculocutaneous (C5,6,7).... *Axillary (C5-6) * Radial (all of them)... * Median (C6,7,8, T1).... * Ulnar (C8 - T1) |
| Musculo. sensory = ? | * Lateral FOREARM |
| Axillary = ? | * Lateral Shoulder |
| Radial Nerve = ? | * Innervates post. arm and forearm.... * Sensory from the posterior arm, posterior forearm, and posterior hand |
| Median Nerve = ? | * Inn the ant. forearm and some of the hand |
| Median nerves that does some of the hand and one that does some of the forearm ? | * Hand = Recurrent branch of Median Nerve ( Abductor pollicis brevis, opponens pollicis, flexor, and 1 and 2 lumbricals).... * Anterior interosseous nerve ( flexor pollicis longus) |
| Median Nerve Sensory = ? | * palmar aspect of digits 1-3 & the radial ½ of the 4th digit |
| Ulnar Nerve Inn. and Sensory = ? | * 2 muscles in the forearm ( 1/2 flex dig. profundus and flexor carpi ulnaris) and hand muscles via the deep branch of the ulnar nerve..... * Sensory = palmar and dorsal aspects of the 5th digit and the ulnar ½ of the 4th digit |
| Median Nerve Damage = ? | * inability to make a circle with thumb and 2nd digit and tingling/numbness along median sensory pathway... * If proximal lesion, have all the above plus "hand of benedict" (digits 1-3 in ext and 4-5 in flexion |
| Ulnar Nerve Damage = ? | * atrophy of hand muscles, except the thenar eminence, weak grip strength, weak abd and abb against resistance of the digits... * If proximal damge = all + weak wrist flexion |
| If signs of lesions involve Radial and Axillary nerves = ? | * Posterior Cord |
| Median and Musculocutaneous Nerves = ? | * Lateral Cord |
| Median and Ulnar Nerves = ? | * Medial Cord |
| Posterior Cord Damage things we see ? | * weakness in abduction of shoulder and in extension of arm/forearm |
| Damage to the Lateral Cord = ? | * weak forearm flexion at elbow, weak wrist flexors, palmar digit 1 -2 sensation loss and loss of sensory on lat. forearm |
| Damage to the Medial Cord = ? | * weakness of ALL muscles of the hand, digital flexor muscles, and sensation loos on medial arm/forearm and palmar aspect of the hand |
| Signs involving distal muscles (particularly those innervated by ulnar, distal radial, distal median nerves) = ? | * Inferior Trunk/C8 & T1 roots = Klumpke's Paralysis |
| Signs involving proximal muscles (particularly those innervated by axillary, musculocutaneous, suprascapular) = ? | * Superior Trunk/C5 & C6 roots = Erb-Duchenne Palsy (waiters tip sign) |
| See a winged scapula = ? | * long thoracic nerve lost (5,6,7) which loses serratus anterior muscle |
| Tennis Elbow = ? | * Lateral epicondylitis = Affects common extensor origin |
| Golfers Elbow = ? | * Medial epicondylitis = Affects common flexor origin |
| Femoral Nerve Basics = ? | * innervates muscles of the anterior compartment of the thigh.... * Sensory = anterior thigh, leg, and heel |
| lateral cutaneous nerve of the thigh = ? | * sensory only and palsy if common due to it passing through the ASIS |
| Obturator nerve = ? | * muscles of the medial compartment of the thigh (Inn and Sensory)... * abductors and adductors of the thigh |
| Superior gluteal nerve = ? | * gluteus medius, gluteus minimus, tensor fascia lata |
| Inferior gluteal nerve = ? | * gluteus maximus... * extends hip at thigh |
| Sciatic nerve = ? | * made up of the tibial and common fibular nerves and it innervates the muscles of the posterior compartment of the thigh |
| Tibial nerve = ? | * muscles of the leg’s posterior compartments (leg and foot) |
| Superficial fibular nerve = ? | * muscles of the leg’s lateral compartment which evert the foot at the ankle... * also innervates the muscles on the dorsum of the foot that assist in extending the toes. ... * sensation from the anterior-lateral leg and dorsum of the foot |
| What nerve is affected if you have a patient that was forcibly dorsiflexed ? | * Common Fibular |
| Deep fibular nerve = ? | * muscles in the anterior compartment of the leg.... * sensory input from a small patch of skin on the dorsum of the foot between the first and second digits |
| Weakness extending the leg against resistance is characteristic of ? | * Femoral Nerve Palsy |
| Obturator Nerve Damage = ? | * with weakness or inability to adduct the against resistance |
| Superior gluteal nerve palsy = ? | * inability to abduct hip on the affected limb side and see hip swing their torso towards the affected limb when walking |
| (Inversion) Ligament strain order in the ankle = ? | * anterior talofibular -> calcaneofibular -> posterior talofibular |
| Eversion sprain = ? | * Force from the medial side of the foot can stress the deltoid ligament of the medial ankle. The deltoid ligament often remains intact but avulses the medial malleolus... * further = fracture the distal fibula (Pott’s fracture) |
| Extending knee (seated with leg dangling) = ? | * quadriceps muscles --> femoral nerve |
| Ankle dorsiflexion = ? | * anterior muscles of leg --> deep fibular nerve |
| Ankle Eversion = ? | * fibularis muscles --> superficial fibular nerve |
| Ankle plantar flexion | * triceps surae (soleus & gastrocnemius muscles) --> tibial nerve |
| Knee flexion (laying prone) = ? | * hamstring muscles --> tibial division of sciatic (mostly) |
Created by:
thamrick800
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