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Neuro > Stuff at top > Flashcards

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
Q

What is brachial plexus divided into

A

Roots
Trunk
Division
Cords

26
Q

What supplies the brain

A

Circle of Willis

27
Q

What makes up circle of Willis

A

ICA (anterior)
Basillar artery (posterior) - formed by 2 vertebral
Vertebral

28
Q

What does vertebral supply

A

Brain stem

29
Q

What does ICA supply

A

Anterior 2/3 of cerebral hemisphere + basal ganglia

30
Q

What does ICA split up into

A

Anterior cerebral
Middle cerebral
Posterior cerebral

31
Q

What does anterior cerebral suppy

A

Frontal and medial part of cerebrum

32
Q

If occlusion

A

Weak, numb contralateral leg or arm

Face is spared

33
Q

What does middle cerebral supply

A

Lateral hemisphere

Basal ganglia

34
Q

If occlusion

A

Contralateral homonymous hemianopia
Cognitive change if dominant hemisphere
Visuo-spational disturbance if non-dominant

35
Q

What does posterior supply

A

Occipital lobe

36
Q

If occlusion

A

Contralateral homonymous hemianopia

37
Q

What does vertebrobasillar supply

A

Cerebellu, brain stem and occipital lobe

38
Q

What can occlusion cause

A 
Hemianopia
Cortical blidness
Diplopia
Vertigo
Nystagmus
Ataxia 
Dysarthria
Dysphasia
Hemi or quadraplegia
Can be uni or bilateral
Hiccups
Coma
39
Q

What syndromes arise due to infarctions of brains stem

A

Lateral medullary

Locked in

40
Q

Important

A

Differentiate lesion

e.g. UMN vs LMN etc.

41
Q

Spastic paraparesis DDX

A

MS
Cord compression
Stroke

42
Q

Spastic hemiparesis DDx

A

Stroke
Tumour
MS

43
Q

Parkinsonism DDX

A

PD
Vascular
Drug

44
Q

Cerebellar DDX

A

Alcohl
Stroke
MS

45
Q

3rd nerve palsy medica

A

DM
HTN
Stroke

46
Q

3rd nerve palsy surgical

A

Aneurysm
Tumour
ICH

47
Q

4th nerve palsy

A

Trauma

48
Q

Bulbar palsy

A

Stroke
- affect LMN as leave brainstem
MND
MG

49
Q

Pseudobulbar

A

Stroke
MND
MS

50
Q

Mixed

A

MND
Cervical spondylosis
SACD

51
Q

Acute bilateral leg weakness

A

Cord compression

Cauda equina

52
Q

Acute unilateral food drop

A 
DM
Common perineal palsy
Prolapse
MS
Stroke
53
Q

Chronic spastic paraparesis (UMN)

A 
MS
MND
Malignancy of cord
Syringomyelia
B12 
Infection
54
Q

Chronic flaccid

A

Peripheral neuropathy

Myopathy

55
Q

What does sensory loss suggest

A

Spinal cord issue

56
Q

What does loss of bladder / bowel suggest

A

Cauda eeqina

57
Q

If acute / sudden

A

Cord compressio

58
Q

If raised inflammatory

A

Infectious

59
Q

dDx of spinal issue

A

Infarct
- Hyperacute + vascular RF

Discitis
- IVDU / immunosuppressed / fever

Cord compression

  • Back pain
  • Red flag Sx / Hx malignancy

Neuro (19 decks)

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