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Examinations > Neuro > Flashcards

Neuro Flashcards

1
Q

why is power tested in 2 movements per joint?

A

looking for pyramidal pattern of weakness (eg UMN)

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2
Q

causes of peripheral neuropathy

A 
Alcohol
B12
CKD
Diabetes + drugs
Every vasculitis

Charcot-Marie-Tooth, Cancer (para-neoplastic), Lyme’s

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3
Q

are cerebellar signs contralateral or ipsilateral?

A

ipsilateral

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4
Q

neuro exam - outstretched hands - potential findings?

A

wave around - cerebellar problem

pronator drift - UMN lesion

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5
Q

what are you feeling for on flexion + extension of elbow (neuro)?

A

clasp knife rigidity - more tone in initial movement:

leadpipe rigidity - uniform increase in tone

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6
Q

what are you feeling for on flexion of wrist (neuro)?

A

cogwheel rigidity - parkinson’s (tremor superimposed on this hypertonia results in intermittent increase in tone during the movement)

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7
Q

UMN posture

A

elbow + wrist flexed

foot flexed + circumductive gait

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8
Q

shoulder abduction - nerve root

A

C5

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9
Q

elbow flexion - nerve root

A

C6

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10
Q

wrist extension - nerve root

A

C7

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11
Q

finger extension - nerve root

A

C8

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12
Q

finger abduction - nerve root

A

T1

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13
Q

what can cause positive prayer sign?

A

RA
scleroderma
diabetic neuropathy
dupuytren’s

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14
Q

pincer grip test - why do you get the result you see in a positive test? what is a positive test?

A

froment’s sign - flexion of thumb due to ulnar nerve palsy
adductor pollicis is the one muscle in thenar eminence that’s ulnar innervated
long flexors are supplied by median nerve - act when adductor pollicis is weak

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15
Q

cerebellar signs - DANISH

A 
Dysdiadochokinesia
Ataxia
Nystagmus - at 20-30deg
Intention tremor
Slurred speech / scanning (staccato)
Hypotonia
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16
Q

carpal tunnel - presentation, cause, demographic, tests, sign OE

A

hand tingling + arm pain - oft worse at night
oft idiopathic in middle aged women
tinel’s + phalen’s
weakness + wasting of abductor pollicis brevis

17
Q

causes of carpal tunnel

A

RAPID TTT

RA
Acromegaly
Pregnancy
Idiopathic
Diabetes

Trauma
Tendons - tenosynovitis of flexor tendons
Thyroid (hypo)

18
Q

ulnar nerve palsy - 4 signs

A

sensory loss over little finger + ulnar half of 4th finger
weakness + wasting of 1st dorsal interosseous
weakness of pincer grip
partial claw hand - weakness of medial lumbricalis

19
Q

how does a lesion in front of the optic chiasm present?

A

central scotoma (optic nerve)

20
Q

what artery supplies the optic radiation in the temporal and parietal lobes? what does a stroke here cause?

A

MCA

contralateral hemiplegia + VFD

21
Q

what artery supplies the occipital lobe? how would an infarct here present?

A

PCA

isolated hemianopia ± macular sparing as tip of occipital lobe is supplied by a branch of the MCA

22
Q

causes of papilloedema

A

raised ICP due to tumour
essential intracranial HTN
malignant HTN
hypercapnia

23
Q

signs of optic neuropathy

A 
pale disc - optic atrophy 
loss of VA
loss of red colour vision (colour desaturation - may look green/blue)
central scotoma
RAPD
24
Q

optic neuropathy - causes

A 
demyelination - optic neuritis
ischaemic - DM, temporal arteritis
compression - pituitary tumour, meningioma
secondary to papilloedema (eg ICH)
trauma
toxic
25
Q

how can you differentiate UMN and LMN facial weakness?

A

UMN (stroke) - relative sparing of upper face

26
Q

causes of peripheral neuropathy

A 
Alcohol
B12
CKD + cancer (para-neoplastic)
Diabetes + drugs - nitro, metro, ethambutol, isoniazid
Every vasculitis/arthritis
27
Q

peripheral neuropathy - natural history

A

sensory loss before motor (except GBS + CMT)

loss of ankle jerks

28
Q

what is spasticity? what does it mean? how can it be assessed?

A

velocity-dependent hypertonia
indicates pyramidal/UMN lesion
supinator catch at wrist, clasp-knife at elbow

29
Q

what is rigidity? what does it indicate?

A

continuous hypertonia, non-velocity dependent

indicates extrapyramidal lesion eg parkinson’s

30
Q

what sign may you see with spasticity?

A

clonus

Examinations (15 decks)

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