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Stuff at top Flashcards

1
Q

What causes LMN signs

A

Damage from anterior horn cells including nerve roots, plexus and peripheral

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2
Q

What are LMN signs

A 
Ipsilateral FLACCID muscle paralysis
Muscle wasting / atrophy 
Fasiculation 
Hypotonia
Hyporeflexia
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3
Q

What is top differential of a LMN lesion and how do you differentiate

A

Primary muscle disease

  • Usually more symmetrical
  • Proximal muscles more affected
  • Reflexes normal
  • No sensory signs
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4
Q

What causes fasciculation

A

Increased receptor concentration to compensate for lack of innervation

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5
Q

What causes UMN signs

A

Damage anywhere along corticospinal tracts (pyramidal) -> pre central gyrus of frontal cortex

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6
Q

How does UMN present

A 
Ipsilateral SPASTIC paralysis 
Muscle weakness 
Hypertonia
Hyper-reflexia
Extensor plantar 'Babinski' 
Sustained clonus
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7
Q

What pattern of muscle weakness

A

Pyramidal
Extensors weaker in arms
Flexors weaker in legs

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8
Q

If lesion above decussation what type of paralysis

A

Contralateral

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9
Q

If below

A

Ipsilateral

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10
Q

What types of hypertonia do you get

A

Spastic

Rigid

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11
Q

What is spastic

A

Increased tone that reaches a point then break
Velocity dependent
The faster you move the more resistance until it gives way

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12
Q

What is rigid

A

Increased tone through whole range

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13
Q

What is important to remember

A

UMN lesion can mimic LMN. due to spinal shock before spasticity and hyperreflexia kick in

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14
Q

Biceps reflex

A

C5/6

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15
Q

Supinator reflex

A

C6

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16
Q

Triceps reflex

A

C7

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17
Q

Hip flexors reflex

A

L2

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18
Q

Knee extensor

A

L3/4

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19
Q

Ankle plantar flexor

A

S1

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20
Q

What are sensory modalities

A 
Pain
Temp
Touch
Vibration
Joint position
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21
Q

What tract do pain and temp go up

A

Lateral Spinothalamic

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22
Q

What tract do joint position and vibration go up

A

Large dorsal column

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23
Q

If lesion in spinothalamic tract where is loss

A

Contralateral as cross as soon as enters

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24
Q

If lesion in dorsal

A

If above decussation = contralateral

If below = ipsilateral

25
What is brachial plexus divided into
Roots Trunk Division Cords
26
What supplies the brain
Circle of Willis
27
What makes up circle of Willis
ICA (anterior) Basillar artery (posterior) - formed by 2 vertebral Vertebral
28
What does vertebral supply
Brain stem
29
What does ICA supply
Anterior 2/3 of cerebral hemisphere + basal ganglia
30
What does ICA split up into
Anterior cerebral Middle cerebral Posterior cerebral
31
What does anterior cerebral suppy
Frontal and medial part of cerebrum
32
If occlusion
Weak, numb contralateral leg or arm | Face is spared
33
What does middle cerebral supply
Lateral hemisphere | Basal ganglia
34
If occlusion
Contralateral homonymous hemianopia Cognitive change if dominant hemisphere Visuo-spational disturbance if non-dominant
35
What does posterior supply
Occipital lobe
36
If occlusion
Contralateral homonymous hemianopia
37
What does vertebrobasillar supply
Cerebellu, brain stem and occipital lobe
38
What can occlusion cause
``` Hemianopia Cortical blidness Diplopia Vertigo Nystagmus Ataxia Dysarthria Dysphasia Hemi or quadraplegia Can be uni or bilateral Hiccups Coma ```
39
What syndromes arise due to infarctions of brains stem
Lateral medullary | Locked in
40
Important
Differentiate lesion | e.g. UMN vs LMN etc.
41
Spastic paraparesis DDX
MS Cord compression Stroke
42
Spastic hemiparesis DDx
Stroke Tumour MS
43
Parkinsonism DDX
PD Vascular Drug
44
Cerebellar DDX
Alcohl Stroke MS
45
3rd nerve palsy medica
DM HTN Stroke
46
3rd nerve palsy surgical
Aneurysm Tumour ICH
47
4th nerve palsy
Trauma
48
Bulbar palsy
Stroke - affect LMN as leave brainstem MND MG
49
Pseudobulbar
Stroke MND MS
50
Mixed
MND Cervical spondylosis SACD
51
Acute bilateral leg weakness
Cord compression | Cauda equina
52
Acute unilateral food drop
``` DM Common perineal palsy Prolapse MS Stroke ```
53
Chronic spastic paraparesis (UMN)
``` MS MND Malignancy of cord Syringomyelia B12 Infection ```
54
Chronic flaccid
Peripheral neuropathy | Myopathy
55
What does sensory loss suggest
Spinal cord issue
56
What does loss of bladder / bowel suggest
Cauda eeqina
57
If acute / sudden
Cord compressio
58
If raised inflammatory
Infectious
59
dDx of spinal issue
Infarct - Hyperacute + vascular RF Discitis - IVDU / immunosuppressed / fever Cord compression - Back pain - Red flag Sx / Hx malignancy

Neuro (19 decks)

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