NMS
5/26/99

Review handout—Neurological Disease or Dis-ease?
Dermatome = sensory; a piece of skin whose innervation comes from 1 IVF; anesthesia = loss of skin sensation (free nerve endings)—pain, spinothalamic—segmentally innervated
•	Tinel Sign—feel pain and paraesthesia in a dermatome due to the fact that the point of problem along the nerve  (in the cord) is irritated and sending messages up to the brain and the brain is sending the signal down even though there is no feeling in the dermatome
•	axnotmesis—cutting of the nerve axon
•	pathognmonic—name the exact problem
•	tinel sign/paresthesia—tells you exactly what is wrong and where
Myotome = motor; 

Cord lesion
•	could include a disc bulge
•	ex:  problem at C7 that wiped out the right half of the cord (hemisection of cord; Brown-Sequard Syndrome)
•	everything above the lesion is intake
•	would have problems in triceps in strength and tone
•	little finger is C7 dermatome
•	depressed triceps reflex
•	at the site of the problem will have LMN lesion problems
•	below C7
•	sensory
•	pain—from the left is gone; on the right it is okay
•	proprioception—is okay on the left b/c doesn't cross in cord; proprioception on the right is gone
•	motor
•	pyramidal from the left side of the brain to the right side of the body will be weak
•	pyramidal from the right side of the brain to the left side of the body will be fine
•	extrapyramidals will follow the same pattern
•	reflex
•	on the left they are normal
•	on the right DTR's are increased
•	decreased right superficial
•	(+) pathologic on the right

PNS
•	99% of all problems that come in the office are these
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