Movements

Question 1

Hypokinetic

Answer 1

Parkinsonism
PSP
Drug induced

Question 1

Hyperkinetic movement conditions

Answer 1

Huntingtons
Drug induced

Question 2

Causes of abnormal gait

Answer 2

• Global or focal weakness
• Loss of sensory input → propriocecption (sensory ataxia)
• Loss of coordination (cerebellar atxia)
• Movement paucity or excess (extrapyrramidal)

Question 3

Neuromucular vs constitutional weakness

Answer 3

NM = less than expected force generated from movement
Consitutional weakness - generalised fatigue, inability to carry out tasks

Question 4

UMN signs

Answer 4

Spasticity/rigidity
Hyperreflexia
positive/upgoing plantar reflex
Pronator drift
Clasp knife response

Question 5

LMN signs

Answer 5

Flaccid tone
Decreased/absent reflexes
Negative babinsis #
Muscle wasting
Fasciculations

Question 6

Hoffmans sign

Answer 6

UMN sign - jump when flick finger or hand

Question 7

Pyramidal weakness

Answer 7

Damage above decussation at medulla - Arm flexors > extensors
- Leg extensors>flexors

Question 8

Proximal weakness

Answer 8

Weakness of shoulder abduction>distal

Weakness of hip abduction>feet
Gowers sign
Trendelenburg gait

Question 9

Gowers sign

Answer 9

Difficulty rising from floor - climbing up legs using hands
Shows proximal weakness

Question 10

What screen for in proximal weakness

Answer 10

Muscle disease
Metabolic causes
Inflammatory muscle disease eg myosistis - C
INherited eg duchennes MD
SACD
AI
Chronic steroids/drugs
Vit D deficiencu

Question 11

Painless distal weakness differentials

Answer 11

MS, MND

Question 12

Causes of foot drop

Answer 12

• MND
• MS
• Peripheral neuropathy
• Focal compression (common peronneal nerve) - crossing legs too much
• Vasculitic multifocak neuropathy

Question 13

Hemiplegic weakness causes

Answer 13

Cerbral palsy
Stroke/cerebral injury

Question 14

Hemiplegic weakness features

Answer 14

Anti gravity position -
Arm flexion, leg extension
Increased tone and releces - spasticity

Question 15

What sign suggestst functional weakenss

Answer 15

Hoover ssign - extend leg press into bed is weak but flex with other leg is strong at the same time

Question 16

NMJ problems features

Answer 16

Weakness on repetition
Ptosis, double vision, spitting and swallowing difficult
Fatiguability

Question 17

What would UMN + LMN weakness with no sensory signs suggest

Answer 17

MND

Question 18

What does lesion/inflammation in drosal columns in neck cause

Answer 18

Clumsy/oppenheimers hands

Question 19

Sensory vs cerebellar ataxia

Answer 19

Sensory - lack of proprioception - balance loss. Broad based gait. Marked when cant see legs
Cerbellar - imbalance, alcohol gait, DANISH

Question 20

Where is affeted in huntingations and parkinsons

Answer 20

Basal gnglia