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J Neuro > Nerve damage > Flashcards

Nerve damage Flashcards

1
Q

where is an UMN

what does it do

A

brain/brain stem/ventral cord of spinal cord

supplies input to LMN

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2
Q

where is an LMN

what does it do

A

outside spinal cord

commands muscle contraction, supplied by UMNs

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3
Q

aetiology of LMN lesion (3)

A

MND
nerve compression
diabetic neuropathy

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4
Q

aetiology of UMN lesion

A

stroke
brain tumour
spinal cord problem

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5
Q

do UMNs supply the face bilaterally or unilaterally

A

bilaterally

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6
Q

do LMNs supply the face bilaterally or unilaterally

A

unilaterally

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7
Q

how does UMN lesion present in face

A

bilaterally with forehead sparing (bc forehead has bilateral supply)

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8
Q

how does LMN lesion present in face

A

unilaterally (incl forehead)

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9
Q

what is the nerve supply to the forehead(where do the UMNs come from)

A

bilateral - has UMNs from both sides

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10
Q

tone in UMN lesion

A

increased

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11
Q

tone in LMN lesion

A

decreased

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12
Q

atrophy in LMN lesion

A

increased (presents as wasted muscles and weakness)

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13
Q

atrophy in UMN lesion

A

no

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14
Q

reflexes in UMn lesion

A

hyperreflexia eg babinskis sign

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15
Q

reflexes in LMN lesion

A

diminished (problem at the last part of reflex)

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16
Q

is ‘fingers feel like a bunch of bananas’ an UMn or LMN lesion sign

A

UMN - increased tone in fingers (LMN would have wasting)

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17
Q

what do the toes do in babinskis

what is the normal plantar response

A

fanning - up and down

usually curl down

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18
Q

is bells palsy UMn or LMN

hence how does it present in face

A

LMN

unilateral motor and sensory loss including forehead (drooping of face)

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19
Q

which nerve is damaged in bells palsy

A

CN VII (facial)

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20
Q

radiculopathy definition

A

damage to anterior and posterior rami of one spinal nerve

= probs sensory and motor dysfunction in that myotome/dermatome

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21
Q

cervical disc prolapse causes problems where

A

arms

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22
Q

lumbar disc prolapse causes problems where

A

legs

23
Q

what do you want to find out once you’ve figure out its a radiculopathy (nerve problem)

A

use dermatomes/myotomes to figure our which nerves

if several ?named nerve problem

24
Q

treatment of lateral disc prolapse

treatment of central disc prolapse

A

lateral - nothing, just symptomatic, more hassle than its worth
central - surgery bc irreversible, patients choice (risks of surgery)

25
Q

aetiology of brown sequard syndrome (2)

A

trauma - knife injury

demyelination

26
Q

how does brown sequard syndrome present

A

ipsilateral paralysis
ipsilateral loss of vibration and fine touch
contralateral loss of pain and temp

27
Q

why is paralysis and loss of vibration and fine touch ipsilateral in brownsequard syndrome

A

corticospinal tract and dorsal column cross fibres at the medulla (above the lesion)

28
Q

what part of the spine is affected in brown sequard syndrome

A

half of it (spinal cord hemisection) L or R

29
Q

why is pain and temp loss contralateral in brown sequards syndrome

A

spinothalamic tract crosses fibres below the lesion (as the enter the spinal cord)

30
Q

aetiology of central cord syndrome

A

syringomyelia

trauma - old person with fall and hit head

31
Q

pathophysiology of central cord syndrome

A

reduced blood supply to centre of spinal cord

32
Q

which spinal tract is completely fine in central cord syndrome

A

dorsal column

33
Q

how is the corticospinal tract affected in central cord syndrome

A 
lateral fibres (leg) are fine 
medial fibres (arm) are affected
34
Q

is fine touch normal or affected in central cord syndrome

A

normal

35
Q

what motor supply is affected in central cord syndrome

A

arms - bc they are more medial than legs

36
Q

how is the spinothalamic tract affected in central cord syndrome

A

it is lateral so not affected
BUT fibres that enter at that level cross over in the spinal cord here so they are affected

eg if central cord syndrome at C5-6 = loss of pain and temp sensation to badge patch and thumb

37
Q

what type of weakness occurs in central cord syndrome

A

upper limb weakness

38
Q

presentation of central cord syndrome (2)

A

upper limb weakness (from medial corticospinal tract)
pain and temp loss at nerves that enter spine at level of damage (cape like ST loss)

NO loss of fine touch (dorsal column fine)
lower limbs fine

39
Q

treatment of bone mets to spine

A

dexamethasone high dose

radiotherapy

40
Q

treatment of primary bone cancer

A

surgical excision

41
Q

where does osteomyelitis (infection) usually occur in the spin

A

epidural abscess

42
Q

what type of spine problem gets worse walking up hills

A

spinal claudication

43
Q

loss of bladder/bowel control
saddle anaesthesia
erectile dysfunction
loss of motor function in legs (paralysis)

A

cauda equina

SURGICAL EMERGENCY

44
Q

treatment of cauda equina

A

emergency surgical decompression

45
Q

plexopathy definition

A

nerve damage to a plexus

46
Q

peripheral neuropathy definition

A

damage to a peripheral nerve

47
Q

what is mononeuritis multiplex

A

damage to more than one peripheral nerve

48
Q

what is guillain barre syndrome

A

acutee motor demyelinating neuropathy

usually post infectious

49
Q

presentation of guillian barre syndrome

A

pain
progressive paraplegia (lower limbs)
diarrhea (from infectious cause)

50
Q

treatment of guillian barre syndrome

A

IVIg or plasma exchange

51
Q

what is a rare genetic neuropathy

A

hereditary sensory motor neuropathy - range of presentations

52
Q

is bells UMN or LMN

who does this present

A

LMN = unilateral face drooping INCLUDING forehead

53
Q

is hyperreflexia UMN or LMN

A

UMN

J Neuro (32 decks)

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