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Year 3 - Exams > Neuro Limb Extras > Flashcards

Neuro Limb Extras Flashcards

1
Q

UMN lesion; tone, power, reflexes, plantars, coordination, other features

A
  • Tone: spastic
  • Power: reduced
  • Reflexes: brisk
  • Plantars: up
  • Coordination: reduced
  • Other features: clonus
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2
Q

Extrapyramidal lesion; tone, power, reflexes, plantars, coordination, other features

A
  • Tone: rigid
  • Power: normal
  • Reflexes: normal
  • Plantars: down
  • Coordination: reduced
  • Other features: TRAP
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3
Q

Cerebellar lesion; tone, power, reflexes, plantars, coordination, other features

A
  • Tone: reduced
  • Power: normal
  • Reflexes: normal
  • Plantars: down
  • Coordination: very reduced
  • Other features: VANISHED
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4
Q

Pain and temperature pathway and pathology Ddx

A

Pathway: spinothalamic

Ddx: syringomyelia

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5
Q

Vibration, proprioception and fine touch pathway and pathology Ddx

A

Pathway: dorsal column

Ddx: tabes dorsalis, b12/folate deficiency (subacute combined degeneration of the cord - SCDC)

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6
Q

Syringomyelia - pathophysiology, signs

A

Pathophysiology: expansion of central canal due to CSF blockage

Signs:

  1. Loss of pain and temperature sensation (arms, shoulder and upper body - ‘Cape like’)
  2. LMN signs in upper limbs
  3. Spastic paraparesis in lower limbs
  4. Dorsal column sensation affected if severe
  5. Syringobulbia if syrinx extends into brainstem
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7
Q

Erb’s palsy signs

A

Injury to C5-7 - shoulder dystocia during birth

  1. Sensory loss down lateral arm
  2. ‘Waiter’s tip’ position (shoulder adducted, arm internally rotated, forearm pronated)
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8
Q

Klumpke’s palsy

A

Injury to C8-T1 - excessive arm traction during birth

  1. Sensory loss in medial forearm and hand
  2. Complete claw hand
  3. Wasting of small muscles in hand
  4. Horner’s syndrome may coexist
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9
Q
  1. Sensory loss down lateral arm
  2. ‘Waiter’s tip’ position (shoulder adducted, arm internally rotated, forearm pronated)
A

Erb’s palsy

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10
Q
  1. Sensory loss in medial forearm and hand
  2. Complete claw hand
  3. Wasting of small muscles in hand
A

Klumpke’s palsy

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11
Q

Tone: reduced

Power: reduced

Reflexes: reduced

Plantars: down

Coordination: normal

Other features: wasting, fasiculations

A

LMN lesion

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12
Q

Tone: spastic

Power: reduced

Reflexes: brisk

Plantars: up

Coordination: reduced

Other features: clonus

A

UMN lesion

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13
Q

Tone: rigid

Power: normal

Reflexes: normal

Plantars: down

Coordination: reduced

Other features: TRAP

A

Extrapyramidal lesion

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14
Q

Tone: reduced

Power: normal

Reflexes: normal

Plantars: down

Coordination: very reduced

Other features: VANISHED

A

Cerebellar lesion

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15
Q

LMN lesion; tone, power, reflexes, plantars, coordination, other features

A

Tone: reduced

Power: reduced

Reflexes: reduced

Plantars: down

Coordination: normal

Other features: wasting fasiculations

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16
Q

Unilateral leg weakness Ddx - UMN

A
  1. Stroke
  2. Tumour
  3. MS
17
Q

Unilateral leg weakness Ddx - LMN

A
  1. Root lesion
  2. Nerve lesion
18
Q

B12/folate deficiency - subacute combined degeneration of the cord (SCDC) signs

A
  1. Spastic paraparesis
  2. Up going plantar
  3. Reduced lower limb reflexes
  4. Dorsal column loss including Romberg
19
Q

Amyotrophic lateral sclerosis (ALS) signs

A

Type of MND

  1. Weakness
  2. Wasting
  3. Fasiculation
  4. Spasticity
  5. Brisk reflexes
20
Q

Foot drop Ddx

A
  1. Common peroneal nerve palsy
  2. Stroke
  3. L4/5 root lesion
  4. MND
  5. Charcot-Marie-Tooth syndrome
21
Q

Bilateral leg weakness Ddx - acute/progressive (unlikely in OSCE)

A
  1. Acute spinal cord compression (UMN)
  2. Cauda equina syndrome (LMN)
  3. Guillain Barre syndrome (LMN)
22
Q

Bilateral leg weakness Ddx - UMN

A
  1. Sagittal sinus lesion (exclusively motor signs)
  2. Bilateral strokes
  3. Syringomyelia (with upper limb signs)
  4. Cord trauma
  5. Cord compression (extramural tumour, disc prolapse, spondylosis)
  6. Intrinsic cord disease (tumour, vascular myelopathy, MS) Check sensory level for 4-6 LMN at level of 5
23
Q

Bilateral leg weakness Ddx - LMN

A
  1. Polio
  2. Mostly motor peripheral neuropathy (GB, lead poisoning, Charcot Marie tooth)
  3. Mixed peripheral neuropathy (diabetic, uraemic, vitamin def., paraneoplastic, alcoholic)
24
Q

Peripheral sensory neuropathy Ddx

A
  1. Mononeuropathies - I.e. Compression neuropathy e.g carpel tunnel
  2. Diabetic peripheral neuropathy
  3. Demyelinating neuropathy
  4. Neuritis - B12 deficiency, shingles
25
Q

Guillain barre - cause, observation

A

Cause - cross reactivity (anti-ganglioside antibodies)

Observation - progressive, idiopathic, symmetrical weakness, and loss of deep tendon reflexes. Maximal intensity at 4 weeks

26
Q

Charcot Marie Tooth - cause, observation

A

Cause: Genetic disease

Observation: gradual loss of muscle bulk and sensation.

  1. Foot drop
  2. Loss of sensation
  3. Neuropathic pain
27
Q

Charcot Marie Tooth - Ix

A
  1. Nerve conduction studies
  2. Nerve biopsy
  3. Genetic testing

Year 3 - Exams (25 decks)

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