Upper Neuro Limb Exam 2 Flashcards
How do mononeuropathies present?
localised sensory disturbance in area supplied by the damaged nerve
How does peripheral neuropathy present?
symmetrical sensory deficits in a ‘glove and stocking’ distribution in the peripheral limbs
When is peripheral neuropathy more common?
- DM
- Chronic alcohol excess
When does radiculopathy occur and how does it present?
- due to nerve root damage (e.g. compression by a herniated intervertebral disc)
- sensory disturbances in the associated dermatomes
How does spinal cord damage present?
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
How do thalamic lesions present e.g. stroke?
contralateral sensory loss
How does myopathies present?
symmetrical proximal muscle weakness
How would a patient with cerebella pathology perform coordination?
- dysmetria
- intention tremor
What is dysmetria?
- lack of coordination of movement
- results in the patient missing the target by over/undershooting
What is an intention tremor?
broad, coarse, low-frequency tremor that develops as a limb reaches the endpoint of a deliberate movement
How does an intention tremor show clinically?
results in a tremor that becomes apparent as the patient’s finger approaches yours
What would the presence of dysmetria and intention tremor suggest?
ipsilateral cerebellar pathology
What is dysdiadochokinesia?
inability to perform rapid, alternating movements
What is dysdiadochokinesia a feature of?
ipsilateral cerebellar pathology
What does the presence of dysdiadochokinesia suggest?
s ipsilateral cerebellar pathology
How would a patient with cerebellar ataxia carry out the task?
slow and irregular movements
What are UMN signs in the inspection?
No fasciculation or significant wasting (there may however be some disuse atrophy or contractures)
What are UMN signs in pronator drift?
may be present
What are UMN signs for tone?
Increased (spasticity or rigidity)
What are UMN signs for power?
Classically a “pyramidal” pattern of weakness (extensors weaker than flexors in arms, and vice versa in legs)
What are UMN signs for reflexes?
Exaggerated or brisk (hyperreflexia)
What are LMN signs on inspection?
Wasting and fasciculation of muscles
What would LMN signs in pronator drift?
may be some drift/movement of the arm(s) if weak or deafferented, but not pronator drift
What are LMN signs for tone?
decreased (hypotonia) or normal
What are LMN signs for power?
different patterns of weakness, depending on the cause (e.g. classically a proximal weakness in muscle disease, a distal weakness in peripheral neuropathy)
What are LMN signs for reflexes?
reduced or absent (hyporeflexia or areflexia)
