Note: C1 doesn’t have a sensory branch For the purpose of making learning easier, we divide the remaining dermatomal segments into 4 groups which will be accompanied by analogies and mnemonics. C2-C4 These supply the “hooded cape” region. C2: hood region abutting the trigeminal distribution C3: upper neck C4: lower…
Tag: Nervous system
PGMEE, MRCS, USMLE, MBBS, MD/MS
Nerve Conduction Study (NCS) and Electromyography (EMG) : Mnemonic Approach
Nerve Conduction Study (NCS) In the Nerve conduction study, assessment must be done for ABCDEFGH. Action potential Amplitude Measures the height of response in millivolts (mV) for motor nerve and microvolts (μV) for sensory nerve Indicates quantity of axons contributing to action potential Block of conduction CMAP on proximal stimulation…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Diagnosis of Spinal Instability (White & Panjabi) : Mnemonic
Mnemonic: Remember 4 D common to all + 3 D for C-spine and 1 D for L-spine Diagnosis requires: Score >4 Denis column disruption: Anterior column destroyed or unable to function (2 points) Posterior column destroyed or unable to function (2 points) Deformity: Will have a maximum score of 4…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Paraplegia in Extension and Flexion
Paraplegia in extension and paraplegia in flexion occur only after the spinal shock has ceased. Paraplegia in extension indicates an increase in the extensor muscle tone owing to the overactivity of gamma efferent nerve fibers to muscle spindles as the result of the release of these neurons from the higher…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Tinel Sign
Synonyms: Hoffman-Tinel test, Tinel’s sign, Nerve percussion test Definition: “pins and needle feeling” elicited by tapping on a nerve proximally, with resulting paresthesia experienced in the corresponding distal cutaneous distribution of an injured peripheral nerve. Eliciting tinel sign: With gentle percussion by a finger or percussion hammer along the course of…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Nerve fibers – Classification
Nerve fibers can be classified as A, B and C and A type fibers can be further classified into alpha, beta, gamma and delta. The size and myelination (thus conduction) progressively decreases in the descending order. A alpha: Efferent (Somatic motor) – To extrafusal fibers (muscle spindle) Afferent (Proprioception): Ia…
Clinical Skills and Approaches
CNS examination long case: How to prepare
Central nervous system (CNS) examination is the most difficult thing to complete within a time limit during final exam and the dilemma is that, most of time the CNS is what is kept as a long case. Examiners love judging you on the basis of CNS case because: 1. CNS…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Complex Regional Pain Syndrome (CRPS)
Synonyms: CRPS, Sudeck’s atrophy, Reflex sympathetic dystrophy, RSD, Causalgia Chronic regional pain syndrome (CRPS) is a persistent neuropathic pain syndrome of an inappropriate intensity due to sustained sympathetic activity with the absence of impending or ongoing tissue damage. There are 2 types of CRPS: Type 1 (Sudeck’s atrophy or Reflex…