Limb Weakness Flashcards
if had midbrain damage?
Pons?
bulbar?
affects your eye movements (ptosis, diplopia)
face
speech and swallowing
what deficiency is related to dorsal column loss?
Vit B12
If patient had bilateral lower limb weakness with no cerebellar or brainstem dysfunction ?
– unlikely to be a brain problem and most likely somewhere in spinal cord: find out at which sensory level by testing dermatomes.
3 Motor tracts:
Pyramidal tract/corticospinal tract - controls what?
Extrapyramidal tract - controls what?
Cerebellar tract - controls what?
(moving, main tract for motor).
(moving smoothly, if affected: parkinson’s motor neurones)
(moving accurately
If it is a cerebellar problem then you can test cerebellar function:
D A N I S H
P
Dysdiakinoesis
Ataxia – they will have a wide stance as they can’t
Nystagmus
Intention tremor – look for this during past pointing as they will have a tremor as they try finger-nose co-ordination.
Slurred speech – ask them to say “baby hippopotamus”
Heel shin test
Past pointing – usually overshoot.
Leg weakness can either be:
- LMN
- UMN
- Proximal
- Fatiguable
- LMN: distal weakness (PNS)
- UMN: pyramidal weakness - if both limbs: spinal cord, if one limb: brain
- proximal - myopathy
- fatiguable - NMJ - myasthenia gravis
is babinski’s sign UMN or LMN?
UMN (hyperreflexia)
Parkinson’s Disease - Dopamine shortage:
- triad of ?
bradykinesia
resting tremor
rigidity (stiffness)
three types of tremor:
- resting tremor
- intention tremor
- postural tremor
how can you treat postural tremor?
- resting: goes away when moving (Parkinsonism)
- Intention tremor – when moving, cerebellar damage (MS, stroke).
- Postural tremor – neither at rest or moving but when held in a position,
give a beta blocker
which disease do you get chorea?
- Non-rhythmic, jerky, purposeless movements flitting from one place to another.
- Facial grimacing, raising shoulders.
- Cause: Huntington’s Disease
