An orthopaedic overview. Higher function Gait Cranial nerves Motor ◦ UMN and LMN ◦ Reflexes ...
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Transcript of An orthopaedic overview. Higher function Gait Cranial nerves Motor ◦ UMN and LMN ◦ Reflexes ...
Higher function Gait Cranial nerves Motor
◦ UMN and LMN◦ Reflexes
Sensory (vibration, proprioception, light touch, pinprick, TPD, temperature)
Autonomic (pupils, pulse, BP, bladder)
Spastic/scissors: CP or MS
Propulsive: Parkinsons
Steppage: foot drop
Waddling gait or Trendelenberg: weak proximal muscles
Twelve cranial nerves Deficits can be motor, sensory or autonomic Pupillary response part of examination of a
unconscious patient
Five patterns of muscular weakness:◦ UMN – tone, reflexes, pyramidal◦ LMN – tone, absent reflexes, wasting,
fasciculations◦ Muscle disease – wasting, impaired reflexes◦ NMJ – fatiguable weakness◦ Functional – erratic power
Root Movements Reflex
C5 Shoulder abd, elbow flex Biceps
C6 Elbow flex (semi-pronated) Supinator
C7 Finger ext, elbow ext Triceps
C8 Finger flexors Finger
T1 Intrinsic hand None
Long thoracic◦ Stabilization of scapula in pushup
Rhomboid◦ Hands on hips, resisted rearward movement of
elbow Suprascapular
◦ ?
Root Movements Reflex
L1, 2 Hip flex None
L3,4 Knee ext, dorsiflex Patellar
L5 Ext great toe None
S1 Hip ext, knee flex, plantarflex Ankle
Movement Muscle Nerve Root
Hip flex Iliopsoas Sacral plexus L1,2
Hip ext Glut max Inf glut nerve L5, S1
Knee ext Quad Femoral nerve L3,4
Knee flex Hamstrings Sciatic nerve L5, S1
Dorsiflex Tib ant Deep peroneal nerve L4,5
Plantarflex Gastroc Post tib nerve S1
Hip abd Glut med/min Sup glut nerve L4,5
Hip add Adductors Obturator nerve L2,3
Eversion Peroneus long Superf peroneal n L5, S1