__Crash Course PNS

Question 1

Rigidity vs spasticity?

Answer 1

Rigidity (extra-pyramidial) is non-velocity dependant eg. Parkinsons

Spasticity (pyramidal) is velocity dependant (mainly UMN)

Question 2

Reflex arcs

Biceps, Triceps, brachial radialis

Answer 2

Biceps - C5/6
Triceps - C7/8
Brachial radialis - C5/6

Question 3

Most common cause of sensory loss in glove and stocking distribution

Answer 3

Diabetes, Alcohol, Drugs (e.g. isoniazid, chemo)

Question 4

Investigations for peripheral neuropathy

Answer 4

Nerve conduction studies

Differentiate between axonal and demyelination pathology

 Demyelinating causes are few but tend to be more treatable (AI causes or haem/blood dyscrasias)
Speed reduction

 Axonal – often can do nothing about (diabetes, drugs, etc)
Amplitude reduction

Question 5

Wide based gait - lesion localisation?

Answer 5

Cerebellar

causes: stroke, SOL, inflammation (MS), infection (HIV)

Question 6

Chorea - twitchy, restless movements

causes?

Answer 6

Huntington’s
Wilson’s
Sydenham’s chorea (rheumatic disease)
Lesion in basal ganglia (if unilateral)

Question 7

Causes of proximal myopathy?

Answer 7

Inflammatory myopathies
Endo - Cushing’s, hypothyroidism, Vit D def, diabetes
Drugs eg. steroids
Metabolic - renal failure

Question 8

Features of carpal tunnel syndrome

Answer 8

Pain at night
Relieved by shaking
Thenar wasting
Sensory loss over medial distribution
Tinel's sign (tap over flexor retinaculum)

Question 9

Causes of carpal tunnel syndrome (x4)

Answer 9

Rheumatoid, myxoedema, acromegaly, pregnancy