Principles Of Neurological Examinations Flashcards
What are the different type of tremors? (6)
Physiologic tremor
Essential tremor
Cerebellar or intention tremor
Parkinsonian tremor
Dystonic tremor
Orthodontic tremor (shaky leg syndrome)
What is a physiologic tremor?
A tremor of no clinical significants. The sort of tremor that is normal like when you’re scared ect
What is an essential tremor?
This mostly affects the hands, voice, tongue, legs, and trunk.
They may be accompanied by mild gait disturbances
What is a cerebellar tremor?
A slow, broad tremor of the extremities that occur at the end of a purposeful movement.
Caused by lesions in or damage of the cerebellum, MS or chronic alcoholism.
What is a parkinsonian tremor?
A tremor classic of pill-rolling action in the hands
What is a dystonic tremor?
This is a sustained involuntary muscle contraction cause twisting and repetitive motions and or painful / armorial postures
What is orthostatic tremor ?
Fast rhythmic muscle contrations that occur in the legs and trunk immediately after standing.
The shaking stops then the patient sits down
What is a cause of symmetry muscle wasting ?
Duchenne muscual dystrophy
What is a cause for muscle wasting asymmetrical?
Polio
What can cause proximal muscle wastage?
LGMD (Limb girdle muscular dystrophy)
What can cause general muscle wastage ?
Motor neurone disease
What are the 4 main characteristics of symptomatic muscle tone ?
Paratonia
Hypotonia (LMD)
Spasticity (UMN)
Rigidity
Muscle strength is graded 0-5. Is 0 high or low in this case?
0 is low mean no muscle detection. 5 is active movement against full resistance (normal strength).
Muscle strength is graded 0-5. Is 0 high or low in this case?
0 is low mean no muscle detection. 5 is active movement against full resistance (normal strength).
What does myotonia mean?
Slow muscle relaxation after a voluntary contraction
Where are the deep tendon reflexes ? (5)
Bicept
Brachioradials
Triceps
Patella
Ankle
What is a overflowing of a reflex?
When a reflex is hyperactive, nearby muscles respond
What scale are reflexes graded by? What is normal?
0 - +4
Normal is +1- +3. 0 is no response and +4 is an elicit a reacting reflex
Define hyporeflexes
An absent or diminished response to tapping and a sign of lower motor neuron
Define hyperreflexia
A hyperactive or repeating reflexes.
A sign of upper motor neuron.
What is clonus?
A series of involuntary muscular contractions due to a sudden stretching of the muscle.
Particularly associated with UMN lesions.
> 5 beats is considered abnormal
Grading muscle strength - what does a 3 mean?
Active movement against gravity
Grading muscle strength - what does a 2 mean
Active movement of the body with gravity eliminated
Grading muscle strength - what does a 5 mean
Active movement against full resistance without evidence of fatigue
Grading muscle strength - what does a 4 mean?
Active movement against gravity and some resistance
Grading muscle strength - what does a 0 mean
No muscle contraction
Grading muscle strength (power) - what does a 1 mean
A barletta detectable flicker of contraction
