Lec 14: Approach to Patients with Neuromuscular Disorders Flashcards
The following are features of UMN lesions EXCEPT: A. spasticity B. decreased muscle tone C. increased reflexes D. minimal atrophy E. absent fasciculations
B. muscle tone should be increased
The following are features of UMN lesions EXCEPT: A. normal/decreased reflexes B. decreased muscle tone C. flaccid muscle weakness D. profound muscle atrophy E. absent fasciculations
E. fasciculations are usually present
clinical hallmark of myasthenia gravis
fatiguable muscle weakness
muscle fibers are replaced by fat and connective tissue resulting in muscle weakness
calf-muscle pseudohypertrophy
deformity caused by peroneal muscle atrophy
stork leg deformity (characteristic finding in Charcot Marie Tooth disease)
patients with pelvic girdle weakness stand up from a sitting position by protruding their hips and straighten their legs
Gower’s sign
average grip strength in males
48-52kg
average grip strength in females
26-30kg
most important blood examination to determine a muscle lesion
CK test
autoantibody test for myasthenia gravis
Anti-AChR antibody
nerve conduction findings seen in axonal abnormalities
reduction in compund motor action potentials
nerve conduction findings in demyelinating injuries
prolonged latency, decreased nerve conduction velocities
a peripheral nerve is stimulated repetitively at rates of 2-5Hz
Repetitive nerve stimulation
EMG finding in myopathies
small motor unit action potentials with low amplitude
EMG finding in neuropathies
prolonged MUAP and increase in amplitude
EMG finding for myasthenia gravis
jitters on single fiber EMG
Most sensitive test for MG
single fiber EMG
CT scan finding for Distal Myopathy with Rimmed Vacuoles
marked hypodensity of tibialis anterior muscles
CT scan finding for Miyoshi Myopathy
affected gastrocnemius and soleus muscles
pharmacologic test used for the diagnosis of myasthenia gravis
edrophonium chloride/tensilon test
specimens for muscle biopsy are usually taken from where?
biceps beacuse they have equal ratio of type 1, 2A, 2B
histological features of segmental demyelination
onion bulb formation
histological feature of wallerian/axonal degeneration
myelin ovoids
