Neurology - Clinical examinations interpretations Flashcards
What does the presence of a pronator drift inidcate in an Upper limb exam
UMN pathology - Contralateral pyrimidal tract lesion
What is spasticity
Condition in which muscles stiffen (increased tone) preveting fluid movement - UMN lesion
- Velocity dependent
- Pyramidal tract lesions
What is rigidity
Muscles inability to relax normally
- High muscle tone throughout the movement
- Velocity independent
- Extrapyrimidal tract lesions
Upper limb exam -
Name the myotomes for these movements:
- Shoulder abduction
- shoulder adduction
- C5
- C6/7
Explain clasp knife reflex
Increased tone that suddenly reduces past a certain point
Upper limb exam -
Name the myotomes for these movements:
- Elbow flexion
- Elbow Extension
- C5/6
- C7
Upper limb exam -
Name the myotomes for these movements:
- Wrist extension
- Wrist flexion
- C6
- C6/7
Myotomes
- biceps reflex
- triceps reflex
- supinator reflex
- C5/6
- C7
- C5/6
What does the presence of dysdiadochokinesia suggest
Ipsilateral cerebellar pathology
What is tardive dyskinesia and what is it caused by
Involuntary body movements
- Lip smaking
- Protrusion of the tongue
- Grimacing
- Neuroleptic medications
- Antipsychotics
- Anti emetics
Waht does a broad based ataxic gait indicate
Midline cerbellar pathology
- Lesion in MS
- Degeneration of cerebella r vermis secondary to alcohol excess
What is a waddling gait and what causes it
- Shoulders sway from side to side
- Legs lifted off the ground by tilting the trunk
- Myopathy
Proximal lower limb muscle weakness
What is a spastic paraparesis gait
Bilateral hemiparetic gait
- Scissor knee
- Both legs stiff and circumducting
What myotome for:
- Knee jerk refelx
- Ankle jerk reflex
- Plantar reflex
- L3/4
- S1
- L5/S1
What is dysmetria a sign of
Incoordination
Ipsilateral cerebellar pathology
What would you see in CN3 palsy
- Down and out
- Ptosis
- Myadrisis
- Hard to open eyes in the morning
Waht would you see in CN4 palsy
Vetrical diplopia
- Head tucked in and tilted fowards
Torsional diplopia
- Head tilt
What is Rinne’s positive
Air > bone conduction
What is sensorineural deafness - Rhinnes
Air> bone
Equal reduction in conduction
What is Rhinne’s negative
Bone > Air conduction
Sensorineural deafness - Webers
Sound heard louder on intact ear
Conductive deafness - Webers
Sound heard louder on affected ear
UMN + LMN lesion differences
UMN
- No fasciculations
- No wasting
LMN
- Fasciuclations
- wasting
UMN + LMN differences - power
UMN -
Pyramidal pattern of weakness
LMN - Varies
