Neurological Examation of Limbs Flashcards
What did Brown-Séquard give his name to?
The syndrome of cord hemisection
What may a patient with a stroke affecting the right middle cerebral artery have? (4)
left sided hemi-paresis
left sided numbness
left sensory neglect
left hemianopia
When you are examining the power of left elbow flexion, what are you testing (apart from motor planning and the right motor cortex)? (2)
What tract? What nerve roots?
Consciousness
Language reception
Right corticospinal tract
C5&6 roots
Is descending control negative or positive overall?
Negative
Upper motor neuron lesions cause weakness due to loss of descending control of what type of neurons?
α-motor neurons
Lower motor neuron weakness is due to loss of…?
Alpha motor neurons, motor axons or muscles
What are you looking for on inspection? (4)
Fasciculation
Muscle wasting
Spontaneous movement
Scars
What are fasciculations a sign of?
Ongoing damage to LMNs
What is ‘tone’?
Is it increased in UMN or LMN lesions?
The global muscle activity at rest, or resistance to passive movement
UMN lesions
In UMN lesions, which two actions are relatively spared?
Upper limb flexion and lower limb extension
What is quadraparesis?
Weakness below the level of the cervical cord
What is paraparesis?
Weakness below the level of the thoracic cord
What spinal levels control the diaphragm?
C3, C4, C5
What spinal levels control the bladder and anal sphincters?
S2, S3, S4
How is power graded? What does a score of __ mean?
5?
3?
0?
MRC grading
5 Normal
3 Able to overcome gravity
0 No movement
What type of reflexes are tendon reflexes?
In UMN lesions are they exaggerated or diminished?
Monosynaptic
Exaggerated
What levels control the following reflexes? Biceps Supinator Triceps Patellar Ankle
C5/6 C6 C7/8 L3/4 S1
When testing for coordination, what are you trying to reveal?
An ipsilateral cerebellar hemispheric lesion
What does dysdiadochokinesia mean?
Impairment of the ability to perform rapidly alternating movements
What pattern of sensory deficit is seen in peripheral neuropathy?
Glove and stocking
What pattern of sensory deficit is seen in spinal cord lesions?
Loss below a sensory level
Dorsal column is for… (3)
Proprioception
Vibration
Light touch
Spinothalamic tract is for… (2)
Pain
Temperature
Carpal tunnel syndrome causes numbness in which digits?
edian nerve lesion at the wrist
Radial 3½ digits
Carpal tunnel syndrome causes weakness in…?
Abductor pollicis brevis
Which nerve lesion causes carpal tunnel syndrome?
Median nerve (at the wrist)
Which nerve lesion causes cubital tunnel syndrome?
Ulnar nerve (at the elbow)
Cubital tunnel syndrome causes numbness in which digits?
Ulnar 1½ digits
Which muscles are weak in cubital tunnel syndrome?
Interossei (notably 1st dorsal) and hypothenar muscles
