Clinical neurology

Question 1

what does pyramidal weakness mean?

Answer 1

extensors are stronger than flexors

Question 2

what does encephalopathy mean?

Answer 2

pathology of the brain

Question 3

what does myelopathy mean?

Answer 3

pathology of the spinal cord
- weakness of legs and associated with bowel and bladder disturbances

Question 4

what does radiculopathy mean?

Answer 4

pathology of nerve root eg. sciatica

Question 5

what does neuropathy mean?

Answer 5

pathology of nerve

Question 6

what does myopathy mean?

Answer 6

pathology of the muscle

Question 7

what is hemiparesis?

Answer 7

weakness of one side of the body (typically seen with stroke)
- pathology of cerebral hemisphere

Question 8

what can arise from pathology of the brainstem?

Answer 8

hemiparesis or quadriparesis

Question 9

what can arise from pathology of the cervical cord?

Answer 9

quadriparesis

Question 10

whats the name of pathology below the arms eg. thoracic/lumbar cord pathology?

Answer 10

paraparesis (weakness of both legs)

Question 11

what pattern of weakness does pathology of the peripheral nerves cause?

Answer 11

distal pattern (weakness of ankles before knees)

Question 12

what pattern of weakness is caused by pathology of neuromuscular junctions?

Answer 12

• fatigable weakness (gets worse throughout the day or after repetitive action)
• seen in myasthenia gravis

Question 13

what pattern of weakness is seen in myopathys?

Answer 13

proximal weakness (typically affects deltoids and flexors)

Question 14

what are UMN classed as?

Answer 14

• form the hemisphere of the brain to the anterior horn cell in the spinal cord

Question 15

How does tone differ in UMN and LMN problems?

Answer 15

UMN: increase tone/spasticity
LMN: flaccidity, wasting and fasciculations (small twitching movements in muscle)

Question 16

How does power differ in UMN and LMN problems?

Answer 16

UMN: pyramidal pattern of weakness (flexors stornger than extenosrs in upper limbs but weaker in lower limbs)
LMN: distal weakness

Question 17

How do reflexes differ in UMN and LMN problems?

Answer 17

UMN: brisk reflexes with clonus and extensor plantar reponse (big toe flexes upwards)
LMN: absent relfexes, plantars flexor goes down or mute

Question 18

what sensation does the spinothalamic tract carry?

Answer 18

pain and temperature

Question 19

where does decussation occur in spinothalamic tract?

Answer 19

shortly after entering spinal cord and ascend in opposite tract

Question 20

what sensation do the dorsal columns carry and where do they decussate?

Answer 20

vibration and joint position
- decussate in brain stem

Question 21

what is ‘glove and stocking’ loss?

Answer 21

loss starts in the feet and ascends, reaching hands after legs etc.

Question 22

what are the two types of pathology that do not involve sensory loss?

Answer 22

NMJ and muscle pathology

Question 23

what is Brown-sequard (hemi-cord) syndrome?

Answer 23

• half of spinal cord is damaged at cervical level
• loss of motor function, vibration and joint position on same side as damage (as these cross in brain stem)
• pain and temperature loss form opposite side of body (cross over shortly after entering spinal cord)

Question 24

what is wernickes dysphasia?

Answer 24

• speech comprehension
• ‘word salad’, fluent speech that does not make sense

Question 25

what is brocas dysphasia?

Answer 25

• speech production (cannot produce sentences)
• makes sense but only short words

Question 26

what is conduction aphasia?

Answer 26

• unable to repeat words or phrases
• damage to arcuate fasciculus (connects Brocas and Wernickes)

Question 27

difference between aphasia and dysphasia?

Answer 27

aphasia is medical term for full loss of language
- dysphasia is partial loss of language

Question 28

what is dysarthria?

Answer 28

• ## slurred speech/ articulation problems

Question 29

what is dysarthria?

Answer 29

• slurred speech/ articulation problems
• damage to cerebellar bullbar

Question 30

whats dysphonia?

Answer 30

• disorder of the voice
• laryngeal pathology or respiratory muscle weakness

Question 31

what is dysphagia?

Answer 31

• problems swallowing
• can be neurological or mechanical
• in neurological both solids and liquids will be present early but in mechanical, will usually be solids first then liquids

Question 32

Clinical signs of disorders of UMN?

Answer 32

• increased tone
• increased reflexes
• extensor plantar response
• wading gait

Question 33

Clincial signs of disorders of LMN?

Answer 33

• evidence of muscle wasting and fasciculation
• reflexes absent and flaccid weakness

Question 34

what is ataxia?

Answer 34

combination of symptoms and signs which indicate coordination loss eg. balance, speech, eye movement

Question 35

what causes ataxia?

Answer 35

• cerebellum malfunction

Question 36

what can the different types of nystagmus show?

Answer 36

• vertical nystagmus tends to be damage to cerebellum
• horizontal nystagums tends to be damage to one hemisphere

Question 37

what does microvascular disease mean?

Answer 37

disease to blood supply to a specific nerve

Question 38

what indicates cerebral hemisphere damage?

Answer 38

unilateral problems

Question 39

what indicates spinal cord damage?

Answer 39

dermatome/myotome

Question 40

what indicates cerebellum damage?

Answer 40

discoordination

Question 41

what indicates brain stem damage?

Answer 41

cranial nerve palsies/ crossed modalities