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Neurology > Localisation of pathology > Flashcards

Localisation of pathology Flashcards

1
Q

What area will a CNS pathology affect?

A

Hemiplegia/ paraplegia

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2
Q

What are will a PNS lesion affect?

A

Peripheral or localised area

Can be a whole limb if due to a plexus

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3
Q

What area will a NMJ lesion affect?

A

Ocular or bulbar

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4
Q

What are will a muscle lesion affect?

A

Proximal and symmetrical

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5
Q

What will the description of weakness be like in a CNS lesion?

A

Heaviness

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6
Q

What will the description of weakness be like in a PNS lesion?

A

Positional/ with sleep

Ascending

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7
Q

What will the description of weakness be like in a NMJ lesion?

A

Fatiguable; worse after use of the muscles

Diurnal variation; worse towards the end of the day

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8
Q

What will the description of weakness be like in a muscle lesion?

A

Aching

Insidious

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9
Q

What are the additional features of a CNS lesion?

A

Spasms

Jerks

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10
Q

What are the additional features of a PNS lesion?

A

Cramp

Twitching (fasiculations)

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11
Q

What are the additional features of a NMJ lesion?

A

Bulbar: swallowing, speaking
Ocular: diplopia, ptosis
Resp: orthopnoea, SOBOE

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12
Q

What are the additional features of a muscle lesion?

A

Myalgia

Cramp

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13
Q

Are sensory symptoms possible in a CNS lesion?

A

Yes

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14
Q

Are sensory symptoms possible in a PNS lesion?

A

Yes

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15
Q

Are sensory symptoms possible in a NMJ lesion?

A

No

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16
Q

Are sensory symptoms possible in a muscle lesion?

A

No

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17
Q

Are there any specific difficulties associated with a CNS lesion?

A

Cognitive involvement

Sphincter involvement

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18
Q

Are there any specific difficulties associated with a PNS lesion?

A

Loss of grip
Tripping up
Unsteady with eyes closed

19
Q

Are there any specific difficulties associated with a NMJ lesion?

A

Lots of chewing/ talking is difficult
Prolonged gaze hard (long drives/ reading)
Later in day

20
Q

Are there any specific difficulties associated with a muscle lesion?

A

Getting up from low chairs

Hanging up washing

21
Q

What will be seen specifical on inspection of a CNS lesion?

A

Limb posture

22
Q

What will be seen specifical on inspection of a PNS lesion?

A

Wasting/ fasciculations

Pes cavus

23
Q

What will be seen specifical on inspection of a NMJ lesion?

A

Additional ptosis/ opthalmoplegia

24
Q

What will be seen specifical on inspection of a muscle lesion?

A

Proximal wasting

25
Q

What will be seen specifically on tone of a CNS lesion?

A

Increased tone

Spasticity/ clonus

26
Q

What will be seen specifically on tone of a PNS lesion?

A

Decreased tone

27
Q

What will be seen specifically on tone of a NMJ and muscle lesion?

A

Neutral or decreased

28
Q

What is the pattern of weakness in a CNS lesion?

A 
Pyramidal: 
Arms; extensors weaker than flexors
Legs; flexors weaker than extensors
Brain; contralateral
Spine; ipsilateral
29
Q

What is the pattern of weakness in a PNS lesion?

A

Peripheral neuropathy; distal weakness

Root/ plexus/ mononeuropathy: dependent on innervated muscles

30
Q

What is the pattern of weakness in a NMJ lesion?

A

Fatigability

31
Q

What is the pattern of weakness in a muscle lesion?

A

Proximal weakness (symmetrical)

32
Q

What will the reflexes show in a CNS lesion?

A

Increased; brisk

33
Q

What will the reflexes show in a PNS lesion?

A

Decreased; hyporreflexic

34
Q

What will the reflexes show in a NMJ or muscle lesion?

A

Neutral or hyporreflexic

35
Q

What will the plantar response show in a CNS lesion?

A

Extensor response; positive babinski sign

36
Q

What will the plantar response show in a PNS, NMJ and muscle lesion?

A

Flexor response; negative babinski sign

37
Q

Are there any specific sensory symptoms associated with a CNS lesion?

A

Brain: hemisensory

Spinal cord: sensory level

38
Q

Are there any specific sensory symptoms associated with a PNS lesion?

A

Peripheral neuropathy; glove and stocking

Root etc; dependent on dermatome

39
Q

Are there any specific sensory symptoms associated with a NMJ or muscle lesion?

A

No

40
Q

What will a L3/4 root entrapment result in?

A

L4 root:
Pain down medial ankle
Loss of quads power
Reduced knee jerk

41
Q

What will a L4/5 root entrapment result in?

A

L5 root:
Pain down dorsum of foot
Reduced big toe dorsiflexion (extensor hallucis longus)

42
Q

What will a L5/S1 root entrapment result in?

A

S1 root:
Pain to sole of foot
Reduced plantar flexion power
Reduced ankle jerk

43
Q

What is erb’s palsy?

A

Injury to upper brachial plexus (C5/6)
Loss of motor innervation to deltoid, supraspinatus, infraspinatus, biceps and brachialis
Internal rotation; waiter’s tip posture

44
Q

What is klumpke’s palsy?

A

Lower brachial plexus (C8 and T1) injury
Paralysis of intrinsic hand muscles +/- finger and wrist flexors
Flexed fingers

Neurology (48 decks)

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