Upper Neuro Limb Exam 2 Flashcards

1
Q

How do mononeuropathies present?

A

localised sensory disturbance in area supplied by the damaged nerve

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2
Q

How does peripheral neuropathy present?

A

symmetrical sensory deficits in a ‘glove and stocking’ distribution in the peripheral limbs

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3
Q

When is peripheral neuropathy more common?

A
  • DM

- Chronic alcohol excess

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4
Q

When does radiculopathy occur and how does it present?

A
  • due to nerve root damage (e.g. compression by a herniated intervertebral disc)
  • sensory disturbances in the associated dermatomes
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5
Q

How does spinal cord damage present?

A

sensory loss both at and below the level of involvement in a dermatomal pattern due to its impact on the sensory tracts running through the cord

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6
Q

How do thalamic lesions present e.g. stroke?

A

contralateral sensory loss

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7
Q

How does myopathies present?

A

symmetrical proximal muscle weakness

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8
Q

How would a patient with cerebella pathology perform coordination?

A
  • dysmetria

- intention tremor

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9
Q

What is dysmetria?

A
  • lack of coordination of movement

- results in the patient missing the target by over/undershooting

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10
Q

What is an intention tremor?

A

broad, coarse, low-frequency tremor that develops as a limb reaches the endpoint of a deliberate movement

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11
Q

How does an intention tremor show clinically?

A

results in a tremor that becomes apparent as the patient’s finger approaches yours

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12
Q

What would the presence of dysmetria and intention tremor suggest?

A

ipsilateral cerebellar pathology

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13
Q

What is dysdiadochokinesia?

A

inability to perform rapid, alternating movements

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14
Q

What is dysdiadochokinesia a feature of?

A

ipsilateral cerebellar pathology

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15
Q

What does the presence of dysdiadochokinesia suggest?

A

s ipsilateral cerebellar pathology

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16
Q

How would a patient with cerebellar ataxia carry out the task?

A

slow and irregular movements

17
Q

What are UMN signs in the inspection?

A

No fasciculation or significant wasting (there may however be some disuse atrophy or contractures)

18
Q

What are UMN signs in pronator drift?

A

may be present

19
Q

What are UMN signs for tone?

A

Increased (spasticity or rigidity)

20
Q

What are UMN signs for power?

A

Classically a “pyramidal” pattern of weakness (extensors weaker than flexors in arms, and vice versa in legs)

21
Q

What are UMN signs for reflexes?

A

Exaggerated or brisk (hyperreflexia)

22
Q

What are LMN signs on inspection?

A

Wasting and fasciculation of muscles

23
Q

What would LMN signs in pronator drift?

A

may be some drift/movement of the arm(s) if weak or deafferented, but not pronator drift

24
Q

What are LMN signs for tone?

A

decreased (hypotonia) or normal

25
Q

What are LMN signs for power?

A

different patterns of weakness, depending on the cause (e.g. classically a proximal weakness in muscle disease, a distal weakness in peripheral neuropathy)

26
Q

What are LMN signs for reflexes?

A

reduced or absent (hyporeflexia or areflexia)