Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro > Clinical Neuro - Beary > Flashcards

Clinical Neuro - Beary Flashcards

1
Q

In a case that appears to be a myopathy, what initial lab value will I use in my work up?

A

CPK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CPK will be markedly increased in…

A

Muscle dystrophies Inflammatory myopathies Hyperthyroid myopathy Rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CPK will be normal or decreased in…

A

Dermatomyositis Hypothyroidism Steroid Induced Myopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Steroid induced myopathy will show what type of muscle fiber atrophy?

A

type II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A big risk factor for statin myopathy would be…

A

combo statins with fibrates or CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Taking antipsychotics could cause what form of myopathy?

A

neuroleptic malignant syndrome - rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What mutation causes increased Ca release from the SR and can cause malignant hyperthermia?

A

Autosomal dominant ryanodine receptor mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you tx malignant hyperthermia?

A

dantroline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Critical illness myopathy might appear in ICU pt exposed to prolonged disuse and neuromuscular blocking agents. A biopsy would show…

A

type I fiber atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

With dermatomyositis I am going to first check for …. and I am also going to look for… if there are anti-Jo-1 abs present,

A

malignancies interstitial lung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A biopsy showing perifascicular atrophy and vasculatic changes will make consider the diagnosis of…

A

dermatomyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A muscle biopsy showing CD8+ mononuclear inflammation/MHC-1 antigen + between muscle fibers will make me consider dx of …

A

polymyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A chronic, progressive, asymmetric weakness of finger/wrist extensors, knee extensors, and ankle dorsiflexors along with a biopsy showing ringed vacuoles will make me want to dx…

A

inclusion body myositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The MC muscle dystrophy is… with what pattern of inheritence?

A

Duchenne (DMD) X linked recessive (Xp21)- dystrophin error

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If a pt who was initially thought to have DMD is still ambulatory by 16 yo, he will be dx’d with …

A

Becker MD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What drug should be offered to all pts dx’d with DMD?

A

corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a main sign of Becker MD?

A

calf hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If a pt has adult onset idiopathic dilated cardiomyopathy, what else needs to be in my ddx?

A

Becker MD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Chromosome 4 D4Z4 tandem repeat truncated to 10 or less causing DUX4 gene transcript is found in what disease?

A

Fasicoscapulohumeral MD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In fascioscapulohumeral MD, what will be one of the first ssx? What muscle does this MD spare? What is this called?

A

eye or lip weakness spares deltoids - ‘pop eye arms’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the MC muscular dystrophy in adults?

A

myotonic dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is associated with Type 1, autosomal dominant myotonic dystrophy?

A

Chrom 19, CTG repeat (anticipation) distal weakness - facial, pharyngeal, finger flexor, foot flexor Hatchet face, cataracts, myotonia death by other organ involvement in their 50s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is associated with Type 2, autosomal dominant myotonic dystrophy?

A

Chrom 3, CCTG repeat (no anticipation) proximal weakness in leg an hand live a normal life span

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does anticipation (increased length of trinucleotide repeat sequence) mean for clinical appearance?

A

earlier onset with each generation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Pompe disease (GSD Type II) is considered static, and is a mutation in… What are ssx in infants? What are ssx in adults?

A

acid maltase on chromosome 17 infants - hypotonia, enlarged tongue, cardiomegaly, hepatomegaly (death 1-2 yo) adults - pelvic weakness> shoulder weakness, abdominal and diaphragm weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which glycogen storage disease will have a normal forearm exercise test?

A

Pompe disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is a normal forearm exercise test?

A

>2 fold increase in lactate with normal or increased ammonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

McArdle Disease (GSD Type V) is considered dynamic and is a deficiency in… what does this mean for the pt?

A

myophosphorylase on chromosome 11 they cannot break down glycogen in muscles - with high intensity exercise there will be cramps, myalgias with second wind phenomenon, myoglobinuria and muscle contracture, CK elevated to 1k for about 1-2 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which GSD has an abnormal forearm exercise test?

A

McArdle Disease (GSD Type V)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

In carnitine palmitoyltransferase II deficiency, the defect causes …

A

impaired beta oxidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the MCC of recurrent myoglobinuria in adults?

A

CPT II deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are features of CPT II deficiency that directly contrast McArdle GSD?

A

no second wind phenomenon normal CK between bouts of exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What should CPT II deficient people avoid?

A

valproic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

If a pt presents as a child with multiple organs apparently involved in an issue, I should be thinking about…

A

mitochondrial myopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Hypokalemic periodic paralysis uses what ion channels?

A

Cav or ligand gated Na channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are triggers for hyopkalemic periodic paralysis?

A

cold, rest after exercise, high carb intake, etoh, stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are triggers for hyperkalemic peirodic paralysis?

A

cold, fasting, rest after exercise, K+ rich foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What channel is used in hyperkalemic periodic paralysis?

A

Nav SCN4A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Should someone with hyperkalemic periodic paralysis eat carbs?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

In which periodic paralysis syndrome does paralysis last longer?

A

hypokalemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Which periodic paralysis syndrome has an EMG that shows increased CMAP amplitude with electrical myotonia?

A

hyperkalemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

AD Myotonia Congenita, aka Thomsen’s Dz is mostly in male infants and is a mutation in… causing…

A

calcium channels painless muscle stiffness without periodic paralysis inability to re-open eyes after face is washed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Myotonia is worse in what climate?

A

cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

It is not uncommon to find what kind of disorders associated with periodic paralysis?

A

thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

In a normal pt, with repeated nerve stimulation, n (quanta (ACh) ready for release), m (number of quanta released), and EPP all go (up/down). What is still generated and why?

A

down MFAP - muscle fiber action potential

still generated because EPP is always above threshold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Describe Myasthenia Gravis features and ssx

A

Post-synaptic autoimmune disease abs to ACh receptors,

causes inhibition of excitatory effects of nACh receptors

ocular type involves muscles only, rare pupils involved

fatiguable weakness, good in the morning and worse as the day goes on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the MC presenting symptom of Myasthenia Gravis? What tumor is a common association?

A

diplopia and ptosis thymoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are some tests you could do to dx MG? Which is the most sensitive test?

A

Tensilon test with Edrophonium - prolongs ACh life in cleft and relieves ssx briefly

ice pack test - 2 min of ice to eyes causes at least a 2 mm improvement

Single fiber EMG is most sensitive test -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What happens with repetitive nerve stimulation to someone with MG?

A

decremental response will be present

m (# quanta released) will be normal

EPP is initially low and decreases because less ACh R available

EPP decreases threshold, MFAP is not generated, CMAP is decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

All pts dx’d with MG and < 60 yo should get a … What is another reason not to get one?

A

thymectomy anti-MuSK abs present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

How do you tx MG with rx?

A

steroids/prednisone to decrease ocular version conversion to general

thymectomy

AChE inhibitor/pyridostigmine for ssx releif (not modifying)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What medications might trigger a Myasthenia Crisis?

A

aminoglycosides, beta blockers, CCB, Mg Sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How do you tx Myasthenia Crisis?

A

IVIG or plasma exchange

avoid NM blockers, use etomidate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Compare and Contrast Myasthenia Crisis with Cholinergic Crisis

A
  • Myasthenia Crisis
    • under rx’d
    • resp depression
    • can’t count to 10
    • pupils nl or mydriasis
    • improvement w/ Tensilon test
    • tx IVIG or plasma exchange
  • Cholinergic Crisis
    • over rx’d
    • N/V/D
    • generalized muscle weakness
    • pupils have miosis
    • Tensilon test worsens paralysis
    • tx with Atropine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What malignancy is associated with Lambert Eaton Syndrome?

A

small cell lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the pathophys behind Lambert Eaton Disease?

A

abs to P/Q type voltage gated Ca channels on

  1. presynaptic motor nerve terminals
  2. autonomic nerve terminals
  3. cerebellar purkinje cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are the ssx of Lambert Eaton and how would you diagnose it?

A
  • proximal weakness that improves throughout the day (increased d/t increased Ca entering nerve terminals)
  • dx probs with repeated nerve stimulation
    • initial EPP generally is normal for m (#quanta released), but initial n (quanta) is decreased bc presynaptic Ca concentration is low
    • initial EPP is below threshold
    • no MFAP generated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

In lambert eaton, what is the ‘ramping up effect’ a/w 50 hz Repeated Stimulation?

A

incremental increased response in CMAP because rate stimulation is greater than that of calcium clearing from the presynaptic nerve terminus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

How do you tx Lambert Eaton?

A

3,4 DAP

inhibits presynaptic Kv channel, increasing Cav channel opening, increasing ACh release

removing cancer in lung also improves ssx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Compare and Contrast Myasthenia Gravis with Lamber Eaton

A
  • MG
    • normal reflexes
    • no ANS involved
    • worse with use
    • abs to AChR
    • responds to edrophonium
    • 10% have thymoma
  • LE
    • decreased or no reflexes
    • ANS ssx
    • repair phenomenon, throughout day
    • abs to P/Q Cav channel
    • no response to edrophonium
    • a/w small cell lung cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Within 3 days of a MG mom giving birth, the child is having transient feeding difficulties, weak cry, breathing difficulties, and floppiness. What are we suspecting and what can we do about it?

A

Transient Neonatal MG

transplacental passage of AChR abs

Tx - vent support, neostigmine, recovery is usually within 3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What ssx of botulism is found in all forms of botulism?

A

dilated, poorly reactive pupils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What are the 5 cognitive domains within mental status?

A
  1. social function/behavior
  2. executive function
  3. memory
  4. language
  5. visual/perceptual/spatial - attention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Where do executive function and social cognition and behavior reside in the brain?

A

frontal, temporal, subcortical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

The center for language is usually found in what area of the brain, description wise?

A

dominant side (L usually) frontotemporoparietal area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Visuospatial function comes from what area of the brain?

A

non-dominant parietal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

The L hemisphere usually dominates praxis which is… What else does the L brain do?

A

mechanical language expression/reception as well as complex motor programming (praxis) and sequential analysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

R side of the brain is usually thought of as artistic, what does it do?

A

dominant for visual-spatial orientation, appreciation for art/musical color, and expression/reception of language tone (prosody)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

If I have dyspohonia or dysarthria, what area of the CNS would have damage, most likely?

A

brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

If I am unable to express or comprehend the emotional part of speech (melody, emphasis, inflection, gestures) I may have a lesion where?

A

non-dominant hemisphere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are some possible deficits that I could find if there was damage to the R side of the brain?

A

extinction, inattention, spatial neglect, emotional indifference, euphoria

72
Q

The frontal lobe has a few different functions depending on area..

What is each responsible for and what would be deficits if there was a lesion in that area?

dorsolateral

medial frontal

orbital frontal

A
  • dorsolateral
    • judgement, abstract, problem solving
    • deficits of impaired planning, perseveration, retrival
  • medial frontal
    • motivation, initiation
    • deficit with mutism, emotional/cognitive motor apathy, urinary incontinence
  • orbital frontal
    • emotional/social/sexual restraint
    • deficit shows disinhibition, witzelsucht emotional lability, echopraxia, impulsiveness
73
Q

hypermetabolism in what area would cause OCD?

A

orbital frontal area of frontal lobe

74
Q

When I am clinically assessing the frontal lobe, I might check for frontal release signs. What is an example of this?

A

Glabellar tap - continue tapping forehead and a positive test is the person will continue to be surprised every time

75
Q

What is the circuit of Papez?

A
  • hippocampus
    • mammillary bodies
      • antero/dorsomedial thalamus
        • cingulate gyrus
          • enterorhinal cortex
76
Q

What kind of memory is circuit of papez involved with? What does this kind of memory do?

A

long term memory - declarative

conscious aquisition, retention and retrieval of knowledge; it can be episodic or semantic

77
Q

What is an example of non-declarative long term memory?

A

procedural memory - skills or habits relatively impervious to decay

78
Q

What is in charge of encoding episodic information?

What is essential for episodic recollection?

A

hippocampus encodes

frontal lobes recollect

79
Q

What is it called when old memories are more strongly consolidated than recent ones and can therefore be more easily recalled?

A

Ribot’s rule

80
Q

Where is semantic information stored in the brain?

A

lateral temporal lobe (L>R)

81
Q

Where is Wernicke’s area located?

A

posterior superior temporal gyrus

82
Q

What happens in Wernicke’s area?

A

where sounds are married with meaning

holds all the memory of what the sounds of words mean

83
Q

A lesion in Wernicke’s area might produce…

A

sensory aphasia - fluent speech but meaningless

84
Q

Damage to what area might cause dyslexia?

A

angular gyrus

85
Q

What is the pathway of sound being interpreted and speech created?

A
  1. primary auditory cortex
  2. Wernicke’s area interprets
  3. goes via arcuate fasciculus to
  4. Broca’s area
86
Q

Where is Broca’s area? What does this area do? Damage here would cause what?

A

inferior frontal gyrus

word programming needed for production

damage here - motor aphasia - can’t get words out

87
Q

A pt’s speech is sparse and agrammatic, they are not able to repeat you. Where is the lesion?

A

Broca’s

88
Q

A pt’s speech is paraphasic and a little bit of a word salad, but they have fully formed words. Where is this lesion? Are they able to comprehend you?

A

Wernicke’s

no comprehension

89
Q

What lobe of the brain is responsible for spatial attention and awareness?

A

parietal lobe (R>L)

90
Q

A deficit in the R parietal lobe might cause…

What are some tests that can be administered to test this?

A

neglect of sensory or motor intention

tests: draw clock face, bisect line, test for sensory extinction

91
Q

If a pt has a conduction apraxia, what are they unable to do?

A

cannot imitate gestures

92
Q

a pt with ideomotor apraxia cannot…

A

perform a task when cued

93
Q

Gerstman Syndrome occurs in the L inferior parietal lobe and consists of 4 main elements…

A
  1. agraphia
  2. acalculia
  3. L-R distortion
  4. Finger agnosia (can’t distinguish)
94
Q

What are some tests you might use to see the function of the primary somatonsensory cortex?

A

2 point discrimination

stereogenesis

graphesthesia

touch

vibration

proprioception

95
Q

The secondary somatosensory cortex will be very good with a sense of what two things?

A

pain and temp

96
Q

What pathway does the “where” analysis of motion and space?

A

occipital/parietal dorsal pathway

97
Q

What pathway does the “what” analysis of form/color/face/letters?

A

occipital/temporal ventral pathway

98
Q

Bilateral lesions in the occipital/parietal dorsal pathway would cause what syndrome? What kind of lesion is this usually from?

A

Balint syndrome

optic ataxia, oculomotor apraxia, simultanagnosia (Navon figure)

usually from MCA-PCA watershed stroke

99
Q

If someone has a lesion in the occipital/temporal ventral pathway, and cannot recognize people by face, but can recognize them by their voice, they have…

A

prosopagnosia

100
Q

Alice in Wonderland Syndrome is caused by a lesion where?

A

occipital/temporal ventral pathway

101
Q

Alexia without agraphia is caused by a lesion where? What kind of visual field defect might go with this?

A

L PCA stroke

R homonymous hemianopia

102
Q

A pt is having parosmias. What is going on?

A

perversion of smell

103
Q

What area of the cortical brain has an area for smell? What happens if there are lesions here?

A

uncus of temporal lobe

olfactory hallucinations

deja vu

104
Q

If a pt says they are having deja vu with olfactory hallucinations, what should be done and why?

A

get MRI

medial temporal lobe lesion is probably

105
Q

What syndrome is associated with an orbital frontal tumor that compresses the olfactory nerve causing ipsilateral anosmia and optic atrophy?

What else could be happening?

A

Foster Kennedy Syndrome

CL papilledema due to increased ICP from tumor - atrophic disc cannot swell

106
Q

What is seen in pre-chiasmal disease, classicly due to retinal ischemia?

A

altitudinal scotoma

107
Q

What might occur if there is a temporal lobe lesion compressing the optic nerve?

Would this be pre or post chiasmal?

A

“pie in the sky” - CL homonymous superior quadratopia

post-chiasm

108
Q

What might occur if there is a parietal lobe lesion involving the optic nerve?

A

“pie on the floor” - CL inferior homonymous quadranatopia

post-chiasmal

109
Q

If a pituitary tumor is influencing the optic nerve, what might the pt be seeing? Where would this lesion be?

A

bitemporal hemianopia

binocular chiasmal

110
Q

If the doc doing a funduscopic exam sees a swollen disc, but the pt claims to be seeing normally, this would be…

caused by…

A

papilledema

increased ICP, impedes retinal venous return

111
Q

75 yo female with sudden painful vision loss, HA, jaw claudication, anorexia. PMHx of temporal arteritis and polymyalgia rheumatica.

What will I see on PE?

Dx? Tx?

A

fundus is always abnormal

Arteritic Ischemic Optic Neuropathy

tx with emergent steroids

112
Q

Pt describes a ‘shade curtain’ falling over eye and has transient, painless blindness for <10 minutes.

Dx? Sign of? Concerns?

PE?

A

Amaurosis Fugax

sign of retinal vascular insufficiency, consider retinal TIA

most often from Internal carotid artery

funduscopic pallor causing cherry red spot inside fovea

113
Q

If I pinch my pt’s neck and activate the sympathetic chain, resulting in pupillary dilation, this would be called..

A

ciliospinal reflex

114
Q

In optic neuritis, a common presentation of MS, the fundus exam will be… and the pt will feel…

A

normal

pain with EOM

115
Q

Near Light Dissociation is what?

A

pupils constrict more to accommodation than they do to light

116
Q

This pt appears to have hypertropia, the visual axis in one eye is higher than the other. This could be due to..

A

compression of the trochler nerve

117
Q

A bilateral palsy of the abducens nerve must mean there is…

A

increased ICP

118
Q

What does a complete palsy of CN VI appear as?

A

eye adducted and cannot move laterally beyond midline

119
Q

With an abducens palsy, a pt might have diplopia. Based on diplopia, how do you know which eye is affected?

A

Diplopia is always worse looking toward the side with paralyzed muscle

120
Q

Cavernous Sinus Syndrome impacts what nerves?

A

III, IV, VI, V1

121
Q

In cavernous carotid aneurysm/fistuals, what nerve is often involved first, and why?

A

CN VI due to its close proximity to ICA

122
Q

Orbital Apex Syndrome includes which CN?

A

II, III, IV, V1, V2

123
Q

in poliomyelitis, inflammation is confined to…

A

grey matter

124
Q

in pachymeningitis, inflammatory process is limited to…

A

spinal dura

125
Q

cervicomedullary lesion presents in what symptomatic fashion?

A

‘around the clock’ pattern of weakness

possible neck pain

CSF +/- obstruction (ICP)

downbeat nystagmus, papilledema

126
Q

At what cervical level will you start to see ‘onion skin’ pattern of facial numbness if there is a lesion there?

A

C4

127
Q

With a spinal cord lesion, what happens to reflexes at, above, and below the lesion?

A

at the lesion is decreased

below the lesion is increased

above the lesion is normal

128
Q

conus medullaris will present with what?

A

bilateral saddle sensory loss

129
Q

cauda equina will present with what?

A

radicular pain, asymmetric sensory loss

130
Q

Complete cord transection injury will have spinal sensory loss where?

A

1-2 levels below the lesion

131
Q

How do you know if you have spinal shock or neurogenic shock?

A
  • spinal shock
    • acute onset
    • decreased or no reflexes
    • no sensation
    • flaccid paralysis
    • is less than 48 hours
  • neurogenic shock
    • injury to T6 or above
    • delayed onset
    • hypotension, bradycardia, hypothermia
    • lasts 1-3 weeks
132
Q

A person with autonomic dysreflexia is at risk for…

A

malignant HTN

133
Q

Hemicord severed/ Brown Sequard syndrome presents with what ssx?

A
  • ipsilateral vibration and position loss below the lesion
  • ipsilateral UMN weakness below the lesion
  • CL loss of pain and temp 1-2 segments below the lesion
134
Q

a small central cord syndrome would cause what?

A

disruption of bilateral crossing of spinothalamic tract fibers - loss of pain and temp bilaterally, typically suspended cape or vest

135
Q

What causes ascending CL sensory loss? GBS would be in the ddx.

A

Extramedullary compression

spondyltic myelopathy is MCC of myelopathy in older pts

136
Q

Most intradural, intramedullary tumors are what?

A

ependymomas

137
Q

Intradural, extramedullary lesions are most likely…

A

meningiomas, schwannomas, neurofibromas

138
Q

sensory ataxia and stomping gate will be seen in what spinal cord lesion?

A

Posterior Cord Syndrome

139
Q

What are Argyll Robertson pupils?

A

Pupils that accommodate but do not react. Are found in neurosyphilis often

140
Q

How could a B12 or Copper deficiency present in a spinal cord lesion?

A

Posterolateral syndrome - decreased vibration and proprioception, UMN is weak, temp and pain is spared

ataxic gait, increased or decreased reflexes

141
Q

What spinal cord lesion will present with split hand (atrophy medial to thumb), no ptosis or EOM issues, and painless distal asymmetric weakness of hand or limb?

A

combo anterior horn and corticospinal tract

142
Q

Anterior cord syndrome often happens as secondary to a spinal cord stroke in what regions?

A

anterior spinal artery around sensory level T10

great radicular artery of Adamkiewicz

143
Q

burning pain caused by nerve trauma

A

causalgia

144
Q

Large myelinated fibers in charge of muscle control are what type?

A

A alpha fibers

145
Q

Fairly large nerve fibers for touch, vibration, position, perception are what kind of fibers? Are they myelinated?

A

A alpha beta

myelinated

146
Q

both cold perception and warm perception and pain are on smaller neurons that are what fibers?

A

A delta for cold

C fibers for warm

147
Q

Autonomic neurons use what fibers?

A

C fibers

148
Q

carpal tunnel syndrome can have a ddx of what spinal level radiculopathy?

A

C6

149
Q

Proximal median nerve weakness will include what muscles?

A

flexor pollicis Longus

flexor digitorum I and II

pronator teres

150
Q

extension of MCP and flexion of IP joints of digits 2 and 3 would fall under what neuropathy?

A

proximal median neuropathy

151
Q

distal to pronator teres is the largest motor branch of the median nerve. an issue here is called what? What are its ssx?

A

anterior interosseous nerve syndrome

cutaneous sensation intact

weak FPL and FDP in digits 2 and 3 (flat finger in OKsign)

152
Q

finger abduction with 4 and 5 claw is seen in what posture and neuropathy?

A

benediction posture

ulnar neuropathy at elbow

153
Q

What is froment sign?

A

cannot adduct thumb

154
Q

weak 3rd palmar interossei is …

A

Wartenberg sign

155
Q

triceps and anconeus are innervated above or below the spiral groove?

A

above

156
Q

deltoid and latissimus weakness would suggest

A

posterior cord brachial plexus injury

157
Q

if inferior and superior gluteal nerves are involved in a ‘sciatic’ issue, consider…

A

higher lumbosacral plexus issue

158
Q

deep peroneal will have weak

A

dorsiflexion

159
Q

common peroneal n will have weak

A

dorsiflexion and eversion

160
Q

sciatic nerve will have normal…

A

glutes

161
Q

iliacus weakness/flexion of thigh is weak

A

femoral neuropathy

162
Q

posterior tibial nerve entrapment and pain worse with weight bearing will be…

A

tarsal tunnel syndrome

163
Q

hereditary sensory and motor neuropathy with spectrum of disorders; may have pes cavus and hammer toes a/w high arched foot, atrophy of distal leg in a champagne bottle sign

A

charcot-marie-tooth disease

164
Q

ascending weakness out of proportion to sensory deficit

A

Guillian barre syndrome

165
Q

Erbs palsy (waiters tip) is an upper trunk plexopathy that will cause weakness in what muscles?

A

deltoid, biceps, infraspinatus, teres minor

166
Q

hyperabduction of the arm at birth might cause…

A

Klumpke’s palsy

167
Q

immune mediated brachial plexus neuropathy is also known as…

a/w acute onset nocturnal shoulder pain to progressive weakness

A

parsonage-turner syndrome

168
Q

What are the 3 main mechanisms for degenerative nerve root disease?

A

disc herniation

uncovertebral joint degeneration

facet joint degeneration

169
Q

weakness in 2 muscles in 1 extremity supplied by different peripheral nerves I am thinking…

A

nerve root disorder

170
Q

deltoid and biceps weakness might suggest

A

C5 nerve root disease

171
Q

What is the MC herniated cervical level? What would this affect?

A

C7 - affects triceps and pronator teres

172
Q

C8 nerve root disorder could affect..

A

entire hand weakness

173
Q

spinal or radicular shocklike paresthesia with neck flexion is called…

A

Lhermitte Phenomenon

174
Q

decreased patellar reflex, quad weakness, and decreased medial sensation on foot suggests

A

T4 radiculopathy

175
Q

L5 radiculopathy would have…

A

gluteal involvement and patellar reflex would be normal, decreased sensation to the top of the foot

176
Q

decreased achilles reflex makes you think..

A

S1 radiculopathy

177
Q

If a pt has a radiculopathy and is getting sensory nerve conduction studies, what will the result be?

A

normal sensory studies in radiculopathies bc nerver root is proximal to DRG

Neuro (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions