Neurology - Clinical examinations interpretations Flashcards

1
Q

What does the presence of a pronator drift inidcate in an Upper limb exam

A

UMN pathology - Contralateral pyrimidal tract lesion

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2
Q

What is spasticity

A

Condition in which muscles stiffen (increased tone) preveting fluid movement - UMN lesion

  • Velocity dependent
  • Pyramidal tract lesions
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3
Q

What is rigidity

A

Muscles inability to relax normally

  • High muscle tone throughout the movement
  • Velocity independent
  • Extrapyrimidal tract lesions
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4
Q

Upper limb exam -
Name the myotomes for these movements:
- Shoulder abduction
- shoulder adduction

A
  • C5

- C6/7

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5
Q

Explain clasp knife reflex

A

Increased tone that suddenly reduces past a certain point

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6
Q

Upper limb exam -
Name the myotomes for these movements:
- Elbow flexion
- Elbow Extension

A
  • C5/6

- C7

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7
Q

Upper limb exam -
Name the myotomes for these movements:
- Wrist extension
- Wrist flexion

A
  • C6

- C6/7

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8
Q

Myotomes

  • biceps reflex
  • triceps reflex
  • supinator reflex
A
  • C5/6
  • C7
  • C5/6
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9
Q

What does the presence of dysdiadochokinesia suggest

A

Ipsilateral cerebellar pathology

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10
Q

What is tardive dyskinesia and what is it caused by

A

Involuntary body movements

  • Lip smaking
  • Protrusion of the tongue
  • Grimacing
  • Neuroleptic medications
  • Antipsychotics
  • Anti emetics
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11
Q

Waht does a broad based ataxic gait indicate

A

Midline cerbellar pathology

  • Lesion in MS
  • Degeneration of cerebella r vermis secondary to alcohol excess
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12
Q

What is a waddling gait and what causes it

A
  • Shoulders sway from side to side
  • Legs lifted off the ground by tilting the trunk
  • Myopathy
    Proximal lower limb muscle weakness
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13
Q

What is a spastic paraparesis gait

A

Bilateral hemiparetic gait

  • Scissor knee
  • Both legs stiff and circumducting
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14
Q

What myotome for:

  • Knee jerk refelx
  • Ankle jerk reflex
  • Plantar reflex
A
  • L3/4
  • S1
  • L5/S1
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15
Q

What is dysmetria a sign of

A

Incoordination

Ipsilateral cerebellar pathology

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16
Q

What would you see in CN3 palsy

A
  • Down and out
  • Ptosis
  • Myadrisis
  • Hard to open eyes in the morning
17
Q

Waht would you see in CN4 palsy

A

Vetrical diplopia
- Head tucked in and tilted fowards

Torsional diplopia
- Head tilt

18
Q

What is Rinne’s positive

A

Air > bone conduction

19
Q

What is sensorineural deafness - Rhinnes

A

Air> bone

Equal reduction in conduction

20
Q

What is Rhinne’s negative

A

Bone > Air conduction

21
Q

Sensorineural deafness - Webers

A

Sound heard louder on intact ear

22
Q

Conductive deafness - Webers

A

Sound heard louder on affected ear

23
Q

UMN + LMN lesion differences

A

UMN

  • No fasciculations
  • No wasting

LMN

  • Fasciuclations
  • wasting
24
Q

UMN + LMN differences - power

A

UMN -
Pyramidal pattern of weakness

LMN - Varies

25
Q

UMN + LMN differences - Reflexes

A

UMN - Babinski sign +ve

LMN - No movement

26
Q

Ataxic gait

  • Description
  • Causes
A

Unsteady broad based gait
Stomping gait
Loss of heel to turn
Unbalanced

Cerebellar pathology
- Sensory ataxia

27
Q

Test for sensory ataxia

A

Romberg test

  • Propioceptive
  • Vestibualr
28
Q

Causes of sensory ataxia

A

B12 deficiency

Ageing

29
Q

Parkinsonian gait

  • Description
  • Causes
A

Reduced arm swing
Small shuffling steps
Increased steps to turn
Stooped posture

30
Q

Causes of bilateral high steppage gait

A

Generalised polyneuropathy

31
Q

Hemiparetic gait

  • Description
  • Causes
A

Stiff leg movements
Leg circumdunction
Flexion - upper limb
Extension - lower limb

32
Q

Causes of hemiparetic gait

A

Stroke

Cerebellar he,isphere tumour

33
Q

Spastic gait

  • Description
  • Causes
A

Legs move slowly + stiffly
Hips adducted
Feet plantarflexed
Scissor gait

SC compression
Cerebral palsy
Multiple sclerosis
MND