1 Flashcards
Set pattern
UMN vs LMN
Cognition
Face
Symmetrical vs asymmetrical
Hemiparesis vs focal
Proximal vs distal
Sensation - pure motor (anterior horn, motor nerve, NMJ, muscle fibres)
Care in radiculopathy - overlapping dermatome with less sensation impairment
Stroke with hemiparesis
Aphasia/neglect - higher cortical signs
Asymmetry (arm flexion, leg extension)
Facial asymmetry
Motor pattern - hemi vs tetraparesis
Hemi - ACA (LL > UL), MCA
Tetra - basilar, cervical, polyneuropathy, muscle disorder
UMN signs - hypertonia, hyperreflexia, Babinski, UMN pattern weakness
Spinal pathology
Paraparesis vs tetraparesis
Sensory level
Spinal scars
Incontinence - catheter
Spasticity
UMN
Neuropathy
Mononeuropathy
Mononeuropathy multiplex
Piexopathy
Polyneuropathy
Polyneuropathy
LMN - hyporeflexia, hypotonia, atrophy
Length dependent - LL first before UL, distal first before proximal
Focality
Sensorimotor
Gloves and stocking
Dermopathy
Focal neuropathy
Median neuropathy - Hand of Benediction
Unable to flex lateral 2-3 digits (first 3)
Vs ulnar claw
hyper extended little and ring finger
Affects the whole hand - adductor policis weakness (Froman sign)
Wartenberg sign (unable to adduct little finger)
Foot drop
Commonest: L5 vs peroneal
Deep peroneal - eversion
Common peroneal
Sciatic
Lumbosacral plexopathy
Lumbar radiculopathy - inversion
MND
Parasagittal cortical or subcortical cerebral lesion
Myopathy
No sensory loss
Scars
Muscle bulk
Tone normal or reduced
Reflex normal or reduced
Weakness proximal and symmetrical
Gait
Causes of myopathy
PEACH PODS
Polymyositis
Endocrine
Alcohol
Carcinoma
HIV
Periodic hypokalaemic paralysis
Osteomalacia
Drugs steroids, statij
Sarcoidosis
Rarely NMJ
MND
Muscle atrophy (man in barrel appearance)
Asymmetry
Fasciculations
Spastic or wasted tongue with fasciculations
Reflexes - mixed
No involvement of sensation
