Nervous & Musculoskeletal Exam Review

Overview

• Set of 136 flashcards covering nervous, musculoskeletal, and assessment vocabulary.
• Focuses on anatomy, pathologies, tests, risk factors, and clinical assessment methods.
• Useful for exam review: definitions, signs, prevention, and basic management.

Central Nervous System And Related Terms

• Central Nervous System (CNS): brain and spinal cord.
• Peripheral Nervous System (PNS): cranial and spinal nerves outside CNS.
• Somatic System: PNS part for voluntary control.
• Autonomic System: PNS part for involuntary control.
• Brainstem: controls vital functions (heart rate, blood pressure, respiration).

Cerebral Lobes And Stroke Effects

• Frontal Lobe: personality, behavior, emotions, intellectual functions.
• Parietal Lobe: sensation, calculation, tactile sensation.
• Occipital Lobe: vision.
• Temporal Lobe: hearing and memory.
• Left Brain Stroke: right-side weakness; language and writing problems.
• Right Brain Stroke: left-side weakness; memory and visual problems; possible personality changes.

Language Disorders (Aphasia)

• Expressive Aphasia: cannot express words but can understand.
• Receptive Aphasia: cannot understand spoken words.
• Global Aphasia: both expressive and receptive deficits.

Postures Indicating Brain Injury

• Decorticate Posture: flexed arms; damage above brainstem.
• Decerebrate Posture: extended arms; damage at/below brainstem; worse prognosis.

Meningeal Signs And Balance Tests

• Meningitis: inflammation of CNS protective membranes.
• Positive Kernig’s and Brudzinski’s Signs: indicate meningeal irritation.
• Romberg Test: assesses balance with eyes closed.
• Proprioception: recognizing body position/movement with eyes closed.

Cranial Nerves

• Cranial Nerves: nerves that emerge directly from the brain.

Bone And Joint Basics

• Bone marrow: spongy layer for hematopoiesis; surrounded by compact bone.
• Osseous Tissue: bone tissue.
• Osteoclasts: cells that break down old bone.
• Osteoblasts: cells that build new bone.
• Bone Shapes: short, long, flat, irregular.
• Red Marrow: produces red blood cells.
• Yellow Marrow: adipose tissue.
• Joint: articulation where two bones meet.
• Ligaments: connect bone to bone.
• Tendons: connect muscle to bone.

Joint Types And Features

• Fibrous Joints: immovable (e.g., skull sutures).
• Cartilaginous Joints: slightly movable (sternum-rib joints).
• Synovial Joints: freely movable; contain bursa for cushioning.

Muscle Types

• Skeletal Muscle: voluntary (e.g., biceps).
• Smooth Muscle: involuntary (e.g., arteries).
• Cardiac Muscle: myocardium of heart.

Movement Terms

• Abduction: move away from body.
• Adduction: move toward body.
• Circumduction: circular motion.
• Inversion: turn foot inward.
• Eversion: turn foot outward.
• Hyperextension: extend beyond normal range.
• Dorsiflexion: top of foot toward ankle.
• Plantar Flexion: foot points downward.
• Pronation: palm/forearm turned down.
• Supination: palm/forearm turned up.
• Protraction: move part forward (jaw forward).
• Retraction: move part backward (jaw back).
• Rotation: internal/external turning.
• Flexion: bending a joint.
• Extension: straightening a joint.

Common Musculoskeletal Conditions

• Osteoarthritis: wear-and-tear arthritis in older adults.
• Rheumatoid Arthritis: autoimmune arthritis.
• Osteoporosis: decreased bone density; higher fracture risk; common in older women.
• Sciatica: nerve pain from lumbar spine.
• Kyphosis: upper back curvature affecting breathing.
• Scoliosis: lateral spine curvature; assessed by forward bend.

Risk Factors For Bone Loss / Fracture

• Non-Modifiable: age, gender, family history, genetics, ethnicity, prior fractures.
• Modifiable: alcohol, smoking, low BMI, eating disorders, vitamin D deficiency, low calcium intake, sedentary lifestyle, frequent falls, secondhand smoke.

Prevention And Management For Bone Health

• Adequate calcium intake: dairy and green leafy vegetables.
• Vitamin D: obtained from sunlight; essential for bone health.
• Weight-bearing exercises: at least three times weekly.
• Avoid protein malnutrition and corticosteroid overuse.
• Fall-prevention strategies and assistive devices (canes, walkers).
• Bone density/DEXA scans: screening tool; women may lose 20% bone mass in first 5–7 years post-menopause.
• Parathyroid glands regulate blood calcium.
• Hypercalcemia: high blood calcium with health consequences.

Assessment Tools And Concepts

• OLDCARTS: Onset, Location, Duration, Character, Aggravating, Relieving, Timing, Severity.
• Activities of Daily Living (ADLs): assess mobility limitations and assistive device need.
• Pain Assessment: scale, location, character, functional impact.
• Musculoskeletal Injury Assessment Priorities: musculoskeletal, cardiovascular, neurological.
• Circulatory Assessment: check pulses and capillary refill promptly.
• Neurological Assessment: evaluate motor and sensory function.
• Muscle Strength Grading Scale: 0/5 (no contraction) to 5/5 (full strength against gravity).

Specific Joint/Region Notes And Tests

• Falls: leading cause of death in elderly.
• Orthostatic Hypotension: dizziness on standing; prevent by rising slowly.
• Scoliosis Screening: common in adolescents and older adults.
• Temporomandibular Joint (TMJ): inspect symmetry, palpate for ROM and strength.
• Sternoclavicular Joint: inspect for tenderness and abnormalities.
• Palpation: check by touch for tenderness, masses, lumps.
• Crepitus: grinding/clicking felt during joint movement.
• Cervical Spine: seven vertebrae; C7 is prominent at base of neck.
• Cervical ROM: flexion, hyperextension, lateral flexion, rotation.
• Thoracic/Lumbar Spine: normal subtle S curvature; lumbar lordosis is excessive inward curve.
• Shoulders: inspect symmetry, muscle atrophy, skin changes, swelling.
• Olecranon Process: bony elbow prominence.
• Olecranon Bursitis: elbow swelling, often not painful.
• Carpal Tunnel Syndrome: median nerve compression causing numbness, burning, tingling in specific fingers.
• Phalen Test: backs of hands pressed together for 60 seconds; pain suggests carpal tunnel.
• Tinel Test: percuss median nerve; reproduction of symptoms indicates carpal tunnel.
• Hips: inspect standing to observe deformity, sway, symmetry.
• Range Of Motion After Hip Replacement: avoid certain ROM exercises to prevent dislocation.

Key Terms And Definitions

• CNS, PNS, somatic, autonomic
• Aphasia types: expressive, receptive, global
• Osteoblasts/osteoclasts, red/yellow marrow
• Synovial/fibrous/cartilaginous joints
• Crepitus, proprioception, DEXA scan, OLDCARTS

Action Items / Exam Study Tips

• Memorize lobe functions and stroke lateralization effects.
• Practice distinguishing aphasia types with sample cases.
• Learn movement terms with joint examples and demonstrations.
• Review bone health prevention: calcium, vitamin D, exercise guidelines.
• Practice common bedside tests: Romberg, Phalen, Tinel, Kernig’s, Brudzinski’s.
• Know muscle strength grading scale and key assessment priorities for injuries.

Summary Table — Selected Structured Facts

| Topic | Definition / Key Point | | CNS | Brain and spinal cord | | PNS | Cranial and spinal nerves outside CNS | | Frontal Lobe | Personality, behavior, emotions, intellect | | Parietal Lobe | Sensation, calculation, tactile function | | Temporal Lobe | Hearing and memory | | Occipital Lobe | Vision | | Left Brain Stroke | Right weakness; language and writing issues | | Right Brain Stroke | Left weakness; memory, visual, personality changes | | Expressive Aphasia | Can understand, cannot express words | | Receptive Aphasia | Cannot understand spoken language | | Osteoporosis | Low bone density; increased fracture risk | | DEXA Scan | Bone density screening; monitor post-menopausal loss | | Phalen Test | Hands back-to-back 60s; positive suggests carpal tunnel | | Tinel Test | Percuss median nerve; positive if tingling reproduces | | Romberg Test | Balance test with eyes closed | | OLDCARTS | Symptom assessment mnemonic |