Movements Flashcards
Hypokinetic
Parkinsonism
PSP
Drug induced
Hyperkinetic movement conditions
Huntingtons
Drug induced
Causes of abnormal gait
- Global or focal weakness
- Loss of sensory input → propriocecption (sensory ataxia)
- Loss of coordination (cerebellar atxia)
- Movement paucity or excess (extrapyrramidal)
Neuromucular vs constitutional weakness
NM = less than expected force generated from movement
Consitutional weakness - generalised fatigue, inability to carry out tasks
UMN signs
Spasticity/rigidity
Hyperreflexia
positive/upgoing plantar reflex
Pronator drift
Clasp knife response
LMN signs
Flaccid tone
Decreased/absent reflexes
Negative babinsis #
Muscle wasting
Fasciculations
Hoffmans sign
UMN sign - jump when flick finger or hand
Pyramidal weakness
Damage above decussation at medulla - Arm flexors > extensors
- Leg extensors>flexors
Proximal weakness
Weakness of shoulder abduction>distal
Weakness of hip abduction>feet
Gowers sign
Trendelenburg gait
Gowers sign
Difficulty rising from floor - climbing up legs using hands
Shows proximal weakness
What screen for in proximal weakness
Muscle disease
Metabolic causes
Inflammatory muscle disease eg myosistis - C
INherited eg duchennes MD
SACD
AI
Chronic steroids/drugs
Vit D deficiencu
Painless distal weakness differentials
MS, MND
Causes of foot drop
- MND
- MS
- Peripheral neuropathy
- Focal compression (common peronneal nerve) - crossing legs too much
- Vasculitic multifocak neuropathy
Hemiplegic weakness causes
Cerbral palsy
Stroke/cerebral injury
Hemiplegic weakness features
Anti gravity position -
Arm flexion, leg extension
Increased tone and releces - spasticity
What sign suggestst functional weakenss
Hoover ssign - extend leg press into bed is weak but flex with other leg is strong at the same time
NMJ problems features
Weakness on repetition
Ptosis, double vision, spitting and swallowing difficult
Fatiguability
What would UMN + LMN weakness with no sensory signs suggest
MND
What does lesion/inflammation in drosal columns in neck cause
Clumsy/oppenheimers hands
Sensory vs cerebellar ataxia
Sensory - lack of proprioception - balance loss. Broad based gait. Marked when cant see legs
Cerbellar - imbalance, alcohol gait, DANISH
Where is affeted in huntingations and parkinsons
Basal gnglia
