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Clinical Skills > Neurology > Flashcards

Neurology Flashcards

1
Q

What area will be affected in a CNS problem?

A

Hemiplegia, paraplegia or a whole limb

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2
Q

What area will be affected in a PNS problem?

A

May be peripheral or localised area or can be whole limb if a plexus is involved

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3
Q

What area will be affected in a NMJ problem?

A

Ocular (eyes) / bulbar (palsy of cranial nerves 7-12) / proximal limb

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4
Q

What area will be affected in a muscular problem?

A

Proximal muscles and will be symmetrical

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5
Q

Describe the description of a weakness due to problem in CNS?

A

Heaviness

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6
Q

Describe a description of a weakness due to problem in PNS?

A

Positional may get worse in sleep (e.g. carpal tunnel syndrome) or foot goes to sleep sitting in a certain position
ascending- starts in the feet and moves up

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7
Q

Describe a description of weakness due to a problem in NMJ?

A 
fatigue (worse after use of the muscles)
Diurnal variation (worse towards the end of the day)
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8
Q

Describe a description of weakness due to a problem in muscle?

A

May also have aching, maybe insidious in onset

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9
Q

Describe additional features in a CNS problem?

A

spasm or jerks

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10
Q

Describe additional features in a PNS problem?

A

cramp and twitching (aka fasciculation)

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11
Q

Describe additional features in an NMJ problem?

A

bulbar: issues with swallowing and speaking
ocular issues with diplopia and ptosis
respiratory: orthopnoea, sob on exertion

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12
Q

Describe additional features in a muscle problem?

A

Myalgia and Cramp

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13
Q

Are sensory symptoms possible in a CNS or PNS problem causing weakness?

A

Yes

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14
Q

Are sensory symptoms possible in an NMJ or muscle problem causing weakness?

A

No

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15
Q

In a CNS problem causing weakness what additional difficulties are possible?

A 
Cognitive
sphincter involvement (changes to urinary frequency)
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16
Q

In a PNS problem causing weakness what additional difficulties are possible?

A

Loss of grip
Tripping up
Unsteady with eyes closed

17
Q

In an NMJ problem causing weakness what additional difficulties are possible?

A

lots of chewing

Difficulties speaking or holding a prolonged gaze (may be apparent when trying to read or on prolonged drives)

18
Q

In a muscle problem causing weakness what additional difficulties are possible?

A

Getting up from low chairs
Hanging up washing
(things that involve big proximal muscles)

19
Q

Patterns of loss indicative of a UMN problem (6)

A 
. Affecting groups of muscles
. Extensors (ARMS) Flexors (LEGS)
. Spasticity in flexors (ARMS) extensors (LEGS) 
. Hyperreflexia
. +ve Babinski sign
. Loss of skilled fine finger movement
20
Q

Patterns of loss indicative of an LMN problem (4)

A

. affected muscles show wasting
. soft floppy limbs (flaccidity)
. reduced reflexes
. weakness corresponds to muscles supplied by LMN

21
Q

Which conditions show mixed LMN and UMN signs

A

. MND
. B12 deficiency
. Taboparesis

22
Q

Where is the lesion …

A

. UMN, LMN, NMJ or Muscle
. Vertebral level
. Motor or sensory (or both)
. Symmetrical or asymmetrical

23
Q

Specific HEADACHE questions

A 
. Onset 
. Duration
. Photophobia
. Stiff neck
. Conscious level
. Visual changes 
. Auditory changes 
. Pain worse on moving?
. Worse at any time of day? 
. SOCRATES
. (SITE) - . one sided . behind eye . scalp (GCA)
24
Q

Specific MIGRAINE questions

A 
. Unilateral
. Character- Throbbing
. behind eye
. Visual or Auditory aura 
. Nausea or Vomiting
25
Q

Specific VERTIGO or DIZZINESS questions

A 
. Establish what dizzy spells means
. rotational movement? 
. faintness 
. loss of consciousness
. falls?
. frequency 
. hearing loss?
26
Q

Specific WEAKNESS questions

A

. sudden or gradually worsening
. bowel and bladder control?
. saddle anaesthesia
. pain (cardiac, arthritic?)

27
Q

Specific LOSS OF CONSCIOUSNESS questions

A

. BEFORE

  • any warning (palpitations, discomfort)
  • particular circumstances
  • are attacks preventable

. DURING

  • loss of consciousness
  • loss of awareness
  • movement

. AFTER

  • how much do you remember
  • confusions
  • pain
  • confusion or sleepiness
28
Q

Neurology systemic enquiry for all history taking

A
  • Fevers
  • Night sweats
  • Weight change
  • Fatigue
•	Visual symptoms: 
•	Headache
•	Motor or sensory problems
•	Loss of consciousness including seizures
•	Confusion
. nausea or vomiting
. rashes or skin changes
. bone and joint pain
. abdo pain
. changes to toileting habits
. bretahlessness
. palpitations
. dizziness
. chest pain
29
Q

Neuro specific PAST MEDICAL HISTORY

A

. History of trauma to head or spine
. Heart disease
. Ever had a brain scan

30
Q

Neuro specific DRUG HISTORY

A 
. Initiation of any medications
. Think if peripheral neuropathy
. Narcotics?
. Over counter
. Allergies
31
Q

Neuro specific SOCIAL HISTORY

A

. how are they coping- screen for depression

. ARE THEY STILL DRIVING!!!!!!

Clinical Skills (1 decks)

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