Neurologic Causes of Weakness and Paralysis Flashcards
a reduction in the power exerted by muscle
weakness
inability to sustain performance of an activity that should be normal for a person of same age, sex, and size
fatigability
prevents adequate feedback information
proprioceptive sensory loss
increased time for full power to be exerted
bradykinesia
disorder of planning and initiating a skilled/learned mov’t
apraxia
weakness so severe that muscle can’t be contracted at all
paralysis
less severe weakness
paresis
refers to one half of body
“hemi-“
both legs
“para-“
four limbs
“quadri-“
myopathic weakness is marked in
proximal muscles
no specific pattern
neuromuscular junction weakness
resistance of a muscle to passive stretch
tone
increase in tone associated with disease of UMN
spasticity
velocity-dependent, sudden release after reaching maximum “clasp-knife”
spasticity
hypertonia that is present throughout the range of motion
lead-pipe or plastic stiffness
affects flexors and extensors equally
rigidity
has a cogwheel quality that is enhanced by voluntary mov’t of contralateral limb
seen in extrapyramidal symptoms
rigidity
increased tone that varies irregularly; from disease of frontal lobes
paratonia or gegenhalten
decreased tone
flaccidity
weakness with decreased tone or normal tone occurs with disorders of what
motor units
refers to a single lower motor neuron and all the muscle fibers it innervates
motor unit
muscle bulk is generally not affected by
UMN lesions
atrophy is conspicuous in what lesion
LMN lesions
muscle stretch reflexes are increased when?
UMN
hyperreflexia in UMN lesions is usually accompanied by
loss of cutaneous reflexees
tendon reflexes are ____ in myopathic weakness except in advances stages
preserved
in this neuromuscular junction disorder, reflex responses are enhanced by previous voluntary activity (low to high)
Lambert-Eaton myasthenic syndrome
in this neuromuscular junction disorder, reflex responses are depressed by previous voluntary activity (high to low)
myasthenia gravis
neuropathic (LMN) vs myopathic
distal weakness
neuropathic (LMN)
neuropathic (LMN) vs myopathic
symmetric proximal weakness
myopathic
visible or palpable twitch and early atrophy indicates what lesion
neuropathic (LMN)
hemiparesis
brain CT or MRI
paraparesis
UMN - cerebral signs?
yes, CT scan (if none, spinal MRI)
no, spinal MRI (if none, myelogram/brain MRI)
LMN - EMG and NCS
quadriparesis
if alert, UMN (spinal MRI) or LMN (EMG and NCS)
if not, CT scan or MRI
monoparesis
UMN (brain CT or MRI)
LMN (EMG and NCS)
distal, proximal, rectricted weakness
EMG and NCS
electromyography (EMG) and nerve conduction studies (NCS)
UMN pattern -> spinal MRI
LMN pattern -> anterior horn, root, or peripheral nerve disease
myopathic -> muscle or neuromuscular disease
