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Stage 3: FOCP > Neuro week: Hx & Ex > Flashcards

Neuro week: Hx & Ex Flashcards

1
Q

Neuro cardinal symptoms

A
  1. memory, cognition
  2. loss of consciousness
  3. headache
  4. vision
  5. hearing
  6. speech, swallowing
  7. limb weakness
  8. limb numbness
  9. bladder/bowel disturbance
  10. gait, balance
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2
Q

Describe degree of atrophy, fasiculations, tone, reflexes in an UMN lesion

A

Minimal atrophy

No fasciculations

Spastic tone

Brisk reflexes (hyperreflexia)

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3
Q

Describe degree of atrophy, fasiculations, tone, reflexes in a LMN lesion

A

Atrophy present

Fasciculations present

Reduced tone

Diminished reflexes

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4
Q

If the cerebrum is affected, are symptoms unilateral or bilateral

A

Usually bilateral

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5
Q

If there is lower limb weakness but no upper limb weakness, where must lesion be?

A

Below level of T1

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6
Q

Where would urinary incontinence/ urgency/ frequency indicate the lesion is?

A

Spinal cord

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7
Q

Describe Guillain Barre syndrome

A
  • Rapid onset muscle weakness
  • Immune system damages peripheral nervous system
  • tends to start in feet and hands, before spreading to arms and legs
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8
Q

Define syncope

A

Transient loss of consciousness due to brain hypoperfusion

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9
Q

What to ask in a syncope history

A
  • trigger
  • warning symptoms
  • predisposing factors
  • witness account
  • situation
  • aftermath
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10
Q

What might cause cardiac syncope

A

LV outflow obstruction

  • aortic stenosis
  • hypertrophic cardiomyopathy

Arrhythmia

  • complete heart block
  • VT
  • VF

Tends to occur during exercise

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11
Q

What might cause neurogenic syncope

A
  • Vasovagal
  • Cough syncope
  • Micturition syncope
  • Carotid sinus sensitivity

Occurs in any situation resulting in increased pressure

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12
Q

What might cause generalised seizure

A
  • Alcohol excess
  • Sleep deprivation
  • Photosensitivity
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13
Q

The witness account is as follows. What type of syncope might have happened?

  • Patient turned ashen grey
  • Patient was had floppy limbs and minor intermittent jerking
A

Neurogenic or cardiac syncope

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14
Q

The witness account is as follows. What type of syncope might have happened?

  • Patient had floppy limbs
  • Continuous rhythmical convulsions
  • Central cyanosis
  • Abnormal noisy breathing
A

Generalised seizure

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15
Q

In a generalised seizure, where is the tongue normally bitten during the tonic movement?

A

Laterally

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16
Q

In which types of syncope does the patient recover quickly, which types does thee patient wake up confused?

A

Quick recovery:
Neurogenic, cardiac

Waking up confused:
Generalised seizure

17
Q

Name some causes of L sided Horner’s syndrome

A
  1. L carotid artery dissection
  2. L apex bronchial carcinoma
  3. Syringomyelia of cervical spinal cord
18
Q

Where in neck does CN 10 run

A

Carotid sheath

19
Q

Bell’s palsy is caused by UMN or LMN lesion

A

LMN

20
Q

List 0-5 on the MRC scale

A

0: complete paralysis
1: minimal contraction
2: active movement if no gravity
3: weak movement against gravity
4: active movement against gravity and resistance
5: normal strength

21
Q

What nerve roots do the follow reflexes test:

  • biceps
  • supinator
  • triceps
  • knee
  • ankle
  • Babinski
A 
Biceps: C5
Supinator: C6
Triceps: C7
Knee: L3/4
Ankle: S1
Babinski: L5/S1
22
Q

Why do LMN lesions result in increased fasciculations

A

Ach receptors are upregulated

23
Q

Where does spinal cord end

A

L1

24
Q

Would symptoms in cerebrum be unilateral or bilateral

A

Unilateral

25
Q

Describe degree of atrophy, fasiculations, tone, reflexes in Parkinson’s

A
  • muscle atrophy present
  • fasiculations present
  • increased tone
  • normal reflexes

Parkinsons is UMN disease (basal ganglia). Basal ganglia does not have direct connections to LMN so reflexes not affected

26
Q

Where does sensory inattention indicate the problem is

A

Problem in higher cortical areas

27
Q

3 types of tremor

A

action tremor
resting tremor
intention tremor

28
Q

What type of tremor do Parkinsons patients have

A

Resting tremor

29
Q

What is a normal Babinski reflex

A

Plantar reflex (foot goes down)

30
Q

What is chorea

A

Involuntary movement disorder (type of dyskinesia)

Looks like dancing

31
Q

What is dystonia

A

Sustained/ repetitive contractions resulting in twisting/ abnormal fixed postures

May look like tremor

32
Q

Where does a positive Babinski reflex indicate damage to

A

UMN

corticospinal tract

33
Q

What is transverse myelitis

A

Inflammation of the spinal cord at 1 level

34
Q

What does a crossed abductor reflex indicate

A

UMN disease (pyramidal problem)

Pyramidal tracts = corticospinal + corticobulbar

35
Q

What causes paraplegia

A

Spine injury at level of thoracic/lumbar vertebra

Stage 3: FOCP (47 decks)

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