NBS Neurology Flashcards
Charcot’s triad
Associated with cerebellum
Speech, intention tremor, nystagmus
Test for cerebellum
Heel to shin
Diadochokinesia (dyssinergia)
Finger to nose (dysmetria)
Cerebellum disease
MS
Alcoholism
Motor ataxia
Cerebellum responsibility
Motor
Coordination
Speech
Gait
Posterior column responsibility
Vibration (primary)
Sensory
2 point discrimination
Position
Posterior column test
Rhomberg
2 point
Posterior column disease
PLS
MS
Syphilis
Diabetes Melitus
Charcot’s joint (Neurogenic Neurotrophic Joint) associated with which part of the brain and MC location
Post. Column
Ankle
Extra pyramidal responsibility, test, disease
Resp: Postural
Test: Gait
Disease: Parkinson’s
Lateral spinal thalamic - Pseudo charcot joint
Responsibility, test, disease
Resp: Sensory, pain temp
Test: Hot cold test tube
Dx: Syringomyelia
Corticospinal/ Pyramidal Responsibility and test
Resp: Motor, voluntary
Test: Muscle test, DTR, mensuration
Corticospinal/ Pyramidal dx
UMNL - myelopathy - before anterior cell
LMNL - ant. cell to periphery - radiculopathy and neuropathy
Fasciculation in UMNL and LMNL
UMNL: Absent
LMNL: Present
Superficial reflex in UMNL and LMNL
Absent in both
LMNL characteristic
PNS, Unilateral (localized), Primary care
UMNL characteristic (Pyramidal lesion)
CNS, Bilateral, Co-care
In what pattern/ distribution is the loss of pain and temperature in lateral spinothalamic lesion?
Shawl distribution
Young boys, muscle destruction, pseudohypertrophy, waddling gait, albuminuria, creatinuria, GOWER’S SIGN
Muscular dystrophy
ALS involves…
UMNL
LMNL
Bulbar Palsy (breathing swallowing)
ALS starts in
hands
Autoimmune, myoneural junction, Intermittent (rest, nap helps), Tensilon test
Myasthenia Gravis
Myasthenia gravis symptoms include
Diplopia, swallowing, fatigue, shoulders, head
Non-progressive, motor disorder at birth due to anoxia, scissors gait,
Cerebral palsy
Parkinsons AKA
Paralysis agitans
No arm swing when walking, blank stare, oily –> associated with
Parkinson’s
Parkinson’s tremor and gait
Resting tremor (pill rolling), Festinating gait - difficulty initiating gait
5 Motor only neurological disease
Muscular dystrophy ALS Myasthenia Gravis Cerebral Palsy Parkinsons
Rapidly ascending paralysis (post viral polyneuropathy), starts at the feet and deadly when it gets to the lungs, lethargic
Guillian Barre (Note Myasthenia gravis is top down affecting only the cranial muscles)
Hemisectional of the spinal cord
Brown Sequard’s
Brown sequards cause loss of motor and paresthesia ipsi/contra and pain&temp ipsi/contra?
Motor&Paresthesia - Ipsi
Pain temp - Contra
Calf weakness and sensory loss, steppage gait
Charcot Marie Tooth (peroneal disease)
Foot drop due to loss of dorsiflexion, toes point down an scrape down while walking
Steppage gait
Cord compression causes neurological symptoms in … is it UMNL/LMNL
upper and lower extremity
Myelopathy
UMNL
Cauda Equina is UMNL or LMNL and which level?
S2-S4
LMNL
Bowel and Bladder control
CVA (Hemiplegia) includes or spares forehead
Spares
Fluid filled cavitation that expands and puts pressure on lateral spinothalamic tract. Cervical spine, pain and temp loss in shawl and capelike distribution
Syringomyelia
Burning sensation on hands associated with
Syringomyelia
Gastritis - pernicious anemia, paresthesia, weakness, pain and temperature loss, progressive neurological deficit, reticulocytosis (lots of big RBC)
PLS / Cobined system disease
PLS test
Schilling’s test
Demyelination of the cord from plaque formation
MS
Symptoms of MS
Diplopia, incontinence, exacerbation and remission, heat and humidity irritates it
Note: MS associated with charcot’s triad
MS ortho test
Lhermitte
MS tremor
Intention tremor
MS tests
MRI
CSF evaluation
Eye exam
TIA “refersal of blood flow”, stenosis of subclavian. Overhead reaching cause dizziness
Subclavian steal
Subclavian steal ddx
TOS
Post trauma TIA
Wallenburg syndrome
Rotate head quickly cause dizziness, post trauma, mimics meniere’s
Barre Lieou
Post trauma, fatiguable diziness, unpredictable
BPV (Benign Paroxysmal Positional Vertigo)
Meniere’s AKA
Endo-lyphatic-hydrops
Meniere’s symptoms
Tinnitus
Vertigo
Transient deafness
Interruption of sympathetic to the face cause anhydrosis, ptosis, miosis
Horners
Cause of Horner’s
TOS
Pancoast Syndrome
Whiplash
Birth
Pancoast Syndrome
Bronchogenic Carcinoma
Metastasis
TOS (neuropathy)
Horner’s
Gait AKA shuffling, mincing, propulsion. Associated with Parkinsons
Festination
Aka Staggering. Associated with Cerebellum
Motor Ataxia
Aka Slappage. Posterior column
Sensory ataxia
Foot drop, toe drag, foot slap, tibialis anterior
Steppage - Charcot Marie tooth(L4)
Lateral sway over the weight bearing leg
Gluteus medius lurch L5
A-P Sway (leans back during mid stance)
Gluteus maximus lurch S1
CVA, weak quads (unilateral)
Circumduction
Muscular dystrophy, clumsy and weak
Waddling
Cerebral palsy, adductor spasm
Scissors