“elicitation of the movement opposite to that normally seen when the reflex is elicited”
2/
Mechanism
“a lesions simultaneously affecting the roots and spinal cord”
Damaged root
- interrupt local reflex
- absence of contraction
Damaged spinal cord
- interrupt corticospinal tract
- hyperactive response of the lower spinal segment
3/
Why is there a hyperactive response?
4/
Inverted radial (supinator) reflex
Level of pathology: C5/6
Positive response: Flexion of fingers and extension of elbow rather than elbow flexion when eliciting the supinator (brachioradialis) jerk.
Level of pathology: C5/6
Positive response: Extension of elbow rather than flexion when eliciting the biceps jerk.
11/
Inverted knee jerk
Level of pathology: L2/3/4
Positive response: Flexion of knee (hamstring contraction) rather than knee extension when eliciting the knee or quadriceps jerk.
12/
Special
Absent quadriceps reflex with distant toe flexor response
Level of pathology: L3/4
The cavity of the diencephalon is ----- the 3rd ventricle
All of the structures of the diencephalon are around the 3rd ventricle, so the cavity of the diencephalon is the 3rd ventricle.
2/
Parts
a. level of consciousness
b. vital signs (BP & breathing pattern)
c. cranial nerves (fundoscopy + vision + brainstem)
d. motor & sensory
e. reflex
f. meningeal signs
2/
Level of consciousness
Normal
Clouding of consciousness
Confusion/delirium
Lethargy
Obtundation
Stupor
Coma
Meningitis
-inflammation of leptomeninges & underlying subarachnoid CSF
Meningismus
-morbid state characterized by meningitic syndrome (triad: headache, photophobia, nuchal rigidity)
Meningism
-synonymous of meningismus
-neck stiffness w/o meningeal inflammation
2/
Mechanism
“maneuvers used to elicit meningeal signs produce tension on inflamed and hypersensitive spinal nerve roots, and the resulting signs are postures, protective muscle contractions, or other movements that minimize the stretch and distortion of the meninges and roots”
3/