NBCE Cards Flashcards
What type of Lesion?
- LMNL
- Dermatogenous pain
- Lateral Flexion & Rotation
- IVF
Radiculopathy
What type of Lesion?
- LMNL
- PNE (peripheral nerve entrapment)
- Extremity
- Causalgia (burning nerve pain)
Neuropathy
What type of Lesion?
- UMNL
- Neck Flexion
- Bilateral symptoms
Myelopathy
What part of the spine has the most myelopathy?
Why?
Cervical spine
RA - Upper C1/C2 - targets synovium b/t dens and transverse ligament.
OA - Lower C5/C6 - exacerbated by cervical flexion
What CNS tract provides speech & gait MOTOR responsibility?
Cerebellum
What are the 3 items present in Charcot’s Triad associated with motor.
“SIN”
- Speech
- Int. Tremors
- Nystagmus
What are some tests to check for speech/gait motor inhibition?
- Heel to shin
- Diadochokinesia (alternating movements)
- Finger to Nose
What are some diseases that cause speech/gait motor inhibition?
- Alcoholism
- Multiple Sclerosis (MS)
- Ataxia (wandering gait)
What CNS tract provides SENSORY responsibility?
Posterior Columns
What is a “Charcot’s Joint”?
Weight bearing joint
What responsibilities does sensory have?
- 2pt discrimination
- Vibration
- Position sense
What is the first sensory receptor that geriatrics lose?
Vibration
What are some tests to check sensory inhibition?
- Rombergs (stand eyes open, then close them)
- 2 Pins
- 128 tuning fork (vibration)
- Toe placement
What are some diseases associated with sensory inhibition?
- Syphilis
- MS
- PLS (stocking & glove paresthesia)
- DM
- Ataxia (sensory)
What CNS tract provides voluntary motor responsibility?
Corticospinal Pyramidal Tracts
What are some tests to check voluntary motor?
- Muscle test
- Mensuration
- DTR
What are some diseases that might inhibit voluntary motor or the corticospinal tract?
UMNL - before anterior cell
LMNL - anterior cell to periphery
What CNS tract provides responsibility for Pain & Temp Sensory information?
Lateral Spinothalamic
What test checks for pain & temp sensory inhibition?
Hot & Cold test tubes
What disease affects pain & temp sensory or lateral spinothalamic tract?
Syringomyelia
UMNL or LMNL?
- Spastic paralysis
UMNL
UMNL or LMNL?
- Flaccid paralysis
LMNL
UMNL or LMNL?
- Increase in DTR’s
UMNL
UMNL or LMNL?
- Decrease in DTR’s
LMNL
UMNL or LMNL?
- Pathologic Reflex present
UMNL
UMNL or LMNL?
- Pathologic Reflex absent
LMNL
UMNL or LMNL?
- Clonus present
UMNL
UMNL or LMNL?
- Clonus absent
LMNL
UMNL or LMNL?
- Muscle Hypertrophy
UMNL
UMNL or LMNL?
- Muscle Atrophy
LMNL
UMNL or LMNL?
- Fasciculations Absent
UMNL
UMNL or LMNL?
- Fasciculations Present
LMNL
UMNL or LMNL?
- Superficial reflex absent
Both - UMNL & LMNL
Describe CNS Motor Lesion
- Myelopathy
- Bilateral
- Pyramidal lesion
- CVA, Tumor
Describe PNS Motor Lesion
- Radiculopathy, Neuropathy
- Unilateral
- Disc, PNE, IVF
What 2 diseases are associated with both UMNL & LMNL?
MS & ALS
What are the 5 Motor Only neurological diseases?
- Muscular Dystrophy (MD)
- Myasthenia Gravis
- ALS
- Cerebral Palsy
- Parkinsonism (Paralysis Agitans)
Motor Neurological disease:
- Young boys (sex linked)
- Albuminuria
- CPK-MM
- Creatinuria
- Weak Muscles
- Difficulty walking (waddling)
- Gowers sign
- Fatal by 20yo
Muscular Dystrophy (MD)
More deadly form of MD?
Erb Duchenne’s
Motor Neurological disease:
- Myoneural junction (CN muscles)
- Descending paralysis (face & shoulders)
- Diplopia (double vision)***
- Trouble swallowing, fatigue, masked facies
- Intermittent! (feels good after rest)***
Myasthenia Gravis
Most neurological conditions start where?
Eyes
Motor Neurological disease:
- Older males
- 5yrs terminal
- Starts in Intrinsic Hand muscles***
- UMNL & LMNL
- Bulbar Palsy frequently (CN IX-XII)
ALS
Motor Neurological disease:
- Non-progressive motor disorder that occurs at birth due to anoxia
- Athetoid and choreiform movement
- Scissors gait
Cerebral Palsy
Motor Neurological disease:
- Basal ganglia / Substantia Nigra lesion (dopamine)
- Extrapyramidal tract = Resting Tremor (pin rolling)
- Blank Stare (masked facies), oily, dependent arms, festinating gait
- Trouble initiating motion & then trouble stopping motion
Parkinsonism (Paralysis Agitans)