neurological weakness

Question 1

which part of the brain is involved in functional neuroanatomy

Answer 1

prefrontal cortex (motor cortex)

Question 2

name large areas of motor homunclus

Answer 2

hands, mouth

Question 3

6 disorders of neurological weakness

Answer 3

• tumour
• stroke
• MS
• bell’s palsy
• motor neurone disease
• myaesthesia gravis

Question 4

4 characterisations of upper motor neurone weakness

Answer 4

weakness
no wasting
increased muscle tone
no fasciculations

Question 5

4 characterisations of lower motor neurone weakness

Answer 5

weakness
wasting
reduced muscle tone
fasciculations (visible spontaneous contractions)

Question 6

pathology of disease that progresses to symptoms over

a. minutes-hours
b. days-weeks
c. weeks-months
d. months-years

Answer 6

a. minutes-hours: vascular
b. days-weeks:inflammation/ infection
c. weeks-months:tumour
d. months-years: degeneration

Question 7

what are the four sets of muscles that should be tested for neurological weakness

Answer 7

• face/mouth: VII (facial)
• jaw/ chewing: V (trigeminal)
• tongue: XII (hypoglossal)
• swallowing: X(vagus) and IX (glossopharyngeal)

Question 8

how to test each of these muscles

Answer 8

• face/mouth: VII (facial): smile
• jaw/ chewing: V (trigeminal): open your mouth
• tongue: XII (hypoglossal)
• swallowing: X(vagus) and IX (glossopharyngeal)

Question 9

what is seen in neurological weakness of facial muscle 6

Answer 9

unilateral:

• brow droop
• upper lid retraction
• paralytic ectropion
• ptotic palpebral malar sulcus and nasojugal sulcus
• loss of nasolabial fold

Question 10

difference in features of VII weakness in upper and lower motor neurone weakness

Answer 10

upper: pt can elevate both sides of forehead (stroke, tumour)
lower: cannot smile, close, eye fully, wrinkle ipsilateral forehead (bell’s palsy)

Question 11

sign of neurological weakness of CNV on testing (open your mouth)

Answer 11

jaw points towards weak side

Question 12

sign of neurological weakness of CNXII on testing (stick out your tongue)

Answer 12

tongue points towards weak side

Question 13

sign of neurological weakness of CNX on testing (swallow)

Answer 13

uvula points AWAY FROM weak side

Question 14

what is bulbar palsy

Answer 14

Bulbar is Below
bilateral impairment of function of cranial nerve V, VII, X and XI (5,7,10,11) due to lower motor neurone lesion in medulla (or bilateral lesions of lower cranial nerves outside brainstem)

Question 15

what is psuedobulbar palsy

Answer 15

bilateral impairment of function of cranial nerves 5,7,10,11 due to UPPER motor neuone lesions affecting cortical pathways to medulla

Question 16

signs/ symptoms of

a. bulbar palsy
b. pseudobulbar palsy

Answer 16

a. bulbar palsy: dysphagia, difficulty chewing, nasal regurgitation, dysarthria, choking on liquid, nasal speech, dribbling, tongue atrophy/ fasciculations, weak soft palate)
b. pseudobulbar palsy: dysphagia, dysarthria, difficulty chewing, choking, uncontrollable laughing/crying, slow thick speech, small stiff tongue

Question 17

sign of neurological weakness of CNXI on testing (say ahh)

Answer 17

cant say ahh (weak soft palate)

Question 18

4 neurological weakness affecting upper motor neurone

Answer 18

stroke
multiple sclerosis
tumour
pseudobulbar palsy

Question 19

3 neurological weaknesses affecting lower motor neurone

Answer 19

• peripheral neuropathy (eg diabetes, B12)
• bells palsy (CNVII)
• bulbar palsy (CN5,7,10,11)

Question 20

name a neurological disease affecting NMJ

Answer 20

myasthenia gravis

Question 21

diagnose:
no tongue wasting
no fasciculations
eye muscle weakness

Answer 21

myasthenia gravis (NMJ)