Localize Me! Flashcards
Ulnar neuropathy
Traumatized as arm is stretched- pian in fourth and fifth fingers, interosseus weakness, normal reflexes.
Transposition of nerve can be done
Lumbar spinal stenosis
Neurogenic claudication from disc disease adn hyperrophy
relief by bending forward increases diameter of canal
Going uphill/upstairs is easier
Straight leg raising positive at 45 degrees, weak hip flexors, no reflexes in lower extremities
S1 radiculopathy
Heel pain and difficult standing on toes, plantar flexion weakness, missing ankle reflex
Sciatic nerve lesion
Damage to common fib and tib w/ paralysis of all foot muscles and impaired knee flexion, no standing on heel or toie
Syringomyelia
Cyst in the SC. Devpt anomaly w/ arnold-chiari (type I cerebellar tonsils lie low, II w/ meningomyelocele)
Can have preserved posterior columns b/c it enlarges with time
Median neuropathy
Numbness of thumb through half of ring finger, positive tinel’s sign, electrical dysethesias, do a wrist splint at night, then divid carpal ligament
Axillary nerve sydnrome
Shoulder abduction impairment, if clavicular or shoulder injury
Anterior interosseous nerve entrapment
Can’t make a pinch w/ thumb and index, but normal sensation
Myasthenia gravis
Autoimmune disease, diplopia w/ fatigue, orbicularis oculi weakeness after repeated lid closure, diplopia after sustained lateral gaze
Post synaptic Ach receptor antibodies block ach!
dx w/ edrophonium or tensilon test
Tx w/ cholinesterase inhib lkke pyridostigmine
Eaton Lambert
Presynaptic paraneoplastic, abs to calcium channels. Weakness IMPROVES w/ exertion!
Peroneal Neuropathy
Common peroneal = L4-S2 fusion, innervates biceps femoris, then divies to sup/deep peroneal, vulnerable to injury where winds around neck of fibula
Foot cannot be everted or dorsiflexed
Deep peroneal gets tibilis anterior + extensor hallicus longus, Foot drop! flip flop spot
If sup peroneal involved then dorsum of foot sensory change, but lat/med borders spared, up anterlat leg
L5 Radiculopathy
Radic = more slective/restricted
Leg pain, pain in buttock, toe extension less, less pinprick
Normal reflex b/c patellar = l4, ankle = s1
Lesion between 4 and , nick l5
Pain in lateral thigh/anterolat leg, sensory loss dorsal foot, and inversion affected
ALS
No sensory signs, but UMN and LM. UMN signs above the LMN (so it can’t be in the cervical spine)
tripping, brisk reflexes, babinkski, but also fasiculations in diff places :(
Tet of fallot w/ one sided weakness?
Hemisphere w/ a seizure, maybe from brain abscess
Foramen magnum sx?
Lower cranial nerve sx, cerebellar sx, umn signs! (weak limbs + brrisk reflexes, fasiculations in R tongue)
