Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FRACP clinicals > Neurology Shorts > Flashcards

Neurology Shorts Flashcards

1
Q

What nerve roots supply all the small muscles of the hand?

A

C8/T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the pathology in clawing of the ring and little finger?

A

Weakness in the lumbrical muscles; ulnar nerve lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Wasting of first dorsal interosseous and abductor digiti minimi - where is the lesion?

A

Ulnar nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Isolated wasting of the abductor pollicis brevis - where is the lesion?

A

Median nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hand of benediction - where is the lesion?

A

Proximal lesion of the median nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to test for weakness of the flexor pollicis longus and flexor digitorium profundus and where is the lesion that affects those nerves?

A
  • Ask the patient to form an “O” with the thumb and index finger. If there is weakness of the distal flexors, it will adapt this shape (see pic)
  • It is the weakness of the proximal median nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What muscles should be examined in hand wasting and what are some differentials?

A

abductor pollicus brevis

abductor digiti mini

1st dorsal interroseous

Ddx: nerve root/plexus lesion, Horner’s syndrome, avulsion of root, syringomyelia, tumour, trauma, MND, peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Nerve roots of reflexes:

  • Biceps
  • Brachioradialis
  • Triceps
A

Biceps: C5/6

Brachiradialis: C5/6

Triceps: C6/7 (mainly C7)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Musculocutaneous:

  1. Nerve roots
  2. Motor functions
  3. Sensory functions
A
  1. Nerve roots: C5, 6, 7
  2. Motor: brachialis, ciceps, coracobrachialis
  3. Sensory: lateral half of the anterior forearm, and a small lateral portion of the posterior forearm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Axillary nerve:

  1. Nerve roots
  2. Motor function
  3. Sensory function
A
  1. C5, 6
  2. Teres minor and deltoid muscle
  3. Inferior region of the deltoid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Median nerve:

  1. Nerve roots
  2. Motor function
  3. Sensory function
A
  1. C6 - T1
  2. Most flexors in the forearm, thenar muscles, 2 lateral lumbricals
  3. Lateral aspect of the palm, lateral 3 and half fingers on the angerior surface of the hand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Radial nerve:

  1. Nerve roots
  2. Motor function
  3. Sensory function
A
  • C5-T1
  • Triceps, muscles in the posterior compartment of the forearm
  • Posterior aspect of the arm and forearm and posterolateral aspect of the hand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ulnar nerve:

  • Nerve roots
  • Motor function
  • Sensory function
A
  1. C8/T1
  2. All muscles of the hand aside from the thenar muscles and 2 lateral lumbricals, flexor carpi ulnaris (flexion of the hand) and medial half of the flexor digitorum profundus (mass action muscle that flexes at the DIP)
    1. e.g. cannot abduct and adduct fingers
  3. Median palmar and dorsal hand area + 1.5 median fingers both sides

(note everything else in the anterior forearm is innervated by the median nerve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Difference in flexor digitorium profundus vs flexor digitorium superficialis:

  1. Innervation
  2. Clinical testing
A
  1. The median 2 digits of FDP are innervated by the ulnar nerve where as the rest of the anterior forearm muscles are innervated by the median nerve
  2. Test FDP by isolating the DIP for testing. Test the FDS by immobilising the other 3 digits so it stops the mass action of the FDP.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes wasting of one hand, loss of reflexes in the arm and a dissociated sensory loss (loss of pain with preserved fine touch) in a half cape distribution on the same side)?

A

Intrinsic lesion of the cervical and upper thoracic cord (e.g. syringomyelia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How to test for myotonia in the hands?

A

Ask the patient to make a tight fist and then open the fingers as rapidly as possible. If the fingers unfurll slowly, they have myotonia

17
Q

What is the most common cause of wasting of the small muscles of the hands?

A

Old age and arthritis (should have preserved muscle power in the muscles)

18
Q

What is the most common cause of the wrist drop?

A

Compression of the radial nerve in the spiral groove

19
Q

What muscles extend the wrist?

A

Extensor carpi radialis longus (C5/6 radial nerve)

Extensor carpi ulnaris (C7/8 posterior interosseous radial nerve)

20
Q

What wrist extensor does the posterior interosseous nerve innervate and what are the causes of lesions?

A

Extensor carpi ulnaris - weakness of finger extension w radial deviation on wrist extension

No sensory loss

Mononeuritis multiplex/simplex or any cause or nerve entrapment

21
Q

What nerve roots supply wrist extension?

A

C5/6 supplies extensor carpi radialis longus

C7/8 supplies extensor carpi ulnaris

22
Q

Investigatins of mononeuritis multiplex

A

NCS

EMG

CSF protein

Bloods tests for diabetes, hIV, HCV, ANCA, campylobacter, anti=GM1 and GQ1b antibodies, sarcoidosis

23
Q

How to separate radial nerve injury vs C7/8 nerve root injury?

A

Radial nerve would affect brachioradialis

24
Q

Deltoid innervation nerve roots

A

C5/6

25
Q

What is the action and nerve root innervation of the supraspinatus?

A

First 20 degrees of should abduction

C5/6

26
Q

What is the action of the infraspinatus and the innervation?

A

External rotation of the shoulder

Suprascapular nerve C5/6

27
Q

What is the innervation of the trapezius?

A

Spinal accessory nerve

C3/4

28
Q

What is the action of serratus anterior and its innervation?

A

Scapular fixation and rotation

Long thoracic nerve C5/6/7

29
Q

Most likely cause of unilateral proximal upper limb weakness?

A

Nerve roots/peripheral nerve/brachial plexus

30
Q

General inspection of proximal weakness

A
  • Skin for heliotrope rash around eyes, cheeks, fingers, elbows and knees for dermatomyositis
  • Joints for subluxation of the humerus
  • Wasting (deltoid and scapula)
  • Face - horner’s, ptosis, facial droop
  • Fasiculations
31
Q

Ddx for weakness of all proximal uscles of the arms and legs

A

Polymyositis, dermatoyositis, myasthenia gravis

32
Q

Selective weakness and wasting of proximal muscles of the arms and legs - differentials

A

Muscular dystrophy, spinal muscular atrophy, inclusion body myositis

Test facial movements and eye closure!

FRACP clinicals (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions