Neuro Flashcards
why is power tested in 2 movements per joint?
looking for pyramidal pattern of weakness (eg UMN)
causes of peripheral neuropathy
Alcohol B12 CKD Diabetes + drugs Every vasculitis
Charcot-Marie-Tooth, Cancer (para-neoplastic), Lyme’s
are cerebellar signs contralateral or ipsilateral?
ipsilateral
neuro exam - outstretched hands - potential findings?
wave around - cerebellar problem
pronator drift - UMN lesion
what are you feeling for on flexion + extension of elbow (neuro)?
clasp knife rigidity - more tone in initial movement:
leadpipe rigidity - uniform increase in tone
what are you feeling for on flexion of wrist (neuro)?
cogwheel rigidity - parkinson’s (tremor superimposed on this hypertonia results in intermittent increase in tone during the movement)
UMN posture
elbow + wrist flexed
foot flexed + circumductive gait
shoulder abduction - nerve root
C5
elbow flexion - nerve root
C6
wrist extension - nerve root
C7
finger extension - nerve root
C8
finger abduction - nerve root
T1
what can cause positive prayer sign?
RA
scleroderma
diabetic neuropathy
dupuytren’s
pincer grip test - why do you get the result you see in a positive test? what is a positive test?
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
cerebellar signs - DANISH
Dysdiadochokinesia Ataxia Nystagmus - at 20-30deg Intention tremor Slurred speech / scanning (staccato) Hypotonia
carpal tunnel - presentation, cause, demographic, tests, sign OE
hand tingling + arm pain - oft worse at night
oft idiopathic in middle aged women
tinel’s + phalen’s
weakness + wasting of abductor pollicis brevis
causes of carpal tunnel
RAPID TTT
RA Acromegaly Pregnancy Idiopathic Diabetes
Trauma
Tendons - tenosynovitis of flexor tendons
Thyroid (hypo)
ulnar nerve palsy - 4 signs
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
how does a lesion in front of the optic chiasm present?
central scotoma (optic nerve)
what artery supplies the optic radiation in the temporal and parietal lobes? what does a stroke here cause?
MCA
contralateral hemiplegia + VFD
what artery supplies the occipital lobe? how would an infarct here present?
PCA
isolated hemianopia ± macular sparing as tip of occipital lobe is supplied by a branch of the MCA
causes of papilloedema
raised ICP due to tumour
essential intracranial HTN
malignant HTN
hypercapnia
signs of optic neuropathy
pale disc - optic atrophy loss of VA loss of red colour vision (colour desaturation - may look green/blue) central scotoma RAPD
optic neuropathy - causes
demyelination - optic neuritis ischaemic - DM, temporal arteritis compression - pituitary tumour, meningioma secondary to papilloedema (eg ICH) trauma toxic
