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Neurology > Weakness, Numbness, Gait Disturbance, Neuropathy, Vertigo > Flashcards

Weakness, Numbness, Gait Disturbance, Neuropathy, Vertigo Flashcards

1
Q

Paresis

A

Slight or incomplete paralysis, weakness

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2
Q

Paralysis

A

Loss of motor function

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3
Q

-plegia

A

A word termination meaning paralysis or stroke

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4
Q

Hemiplegia

A

right or left half paralysis or stroke

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5
Q

Monoplegia

A

One limb paralysis or stroke

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6
Q

Paraplegia

A

Lower half paralysis or stroke

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7
Q

Diplegia

A

Two limbs paralysis or stroke

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8
Q

Quadriplegia

A

All four limbs paralysis or stroke

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9
Q

Palsy

A

Paralysis (complete or partial)

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10
Q

Hypertonic

A

increased muscle tone

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11
Q

Hypotonic

A

decreased muscle tone

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12
Q

Spasticity

A

stiff muscles with increased muscle tone

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13
Q

Atrophy

A

loss of muscle mass

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14
Q

Rigidity

A

inability to passively flex or extend a joint due to neurological or muscle disease

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15
Q

UMN

A

upper motor neuron lesion: weakness and spasticity

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16
Q

LMN

A

lower motor neuron lesion: weakness with flaccidity and atrophy

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17
Q

Clonus

A

alternate muscle contractions and relaxation in rapid succession

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18
Q

Apraxia

A

loss of ability to carry out familiar, purposeful movements in the absence of paralysis or other motor or sensory impairment

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19
Q

Akinetic

A

loss of ability to carry out spontaneous movement

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20
Q

Amnestic

A

inability to carry out a command due to inability to remember the command

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21
Q

Diplopia

A

double vision

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22
Q

Dysarthria

A

imperfect articulation of speech due to distrubance of muscle control (UMN or LMN lesion)

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23
Q

myopathy

A

any disease of muscle

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24
Q

Examples of myopathy

A

alcoholism

metabolic disease

thyrotoxic

steroid (catabolic)

25
Q

Weakness

A
  • Lack of muscle power due to neurologic or muscle impairment
  • Unable to perform the first repetition of a task
  • Decrease in muscle power
26
Q

Weakness Emergencies

A
  • Respiratory weakness
  • Tachypnea - mechanical ventilation
  • Myesthinia gravis (MG)
  • Guillan Barre Syndrome (GBS)
  • Pharyngeal muscle weakness
  • Dysphagia, dysarthria - intubation
  • MG, dermatomyositis, polymyositis, West Nile Virus
  • Vascular accidents
  • Spinal cord compression
27
Q

Fatigue

A

Inability/difficulty to continue performing a task after multiple repetitions

28
Q

Asthenia

A

Sense of weariness or exhaustion; vague, more general term

29
Q

Upper Motor Neuron

A

originate in the primary motor cortex of the cerebrum; long axons which comprise the corticospinal and corticobulbar tracts

30
Q

UMN Lesion Findings

A

spastic paralysis, hyperreflexia, babinski reflexes, clonus

31
Q

Causes of UMN Lesion

A

Central Nervous System: stroke, tumor

Spinal Cord: trauma, infection, tumor, demyelinating disease

32
Q

Lower Motor Neuron

A

originate in the brainstem (cranial nerve motor nuclei) and spinal cord (anterior horn cells); directly innervate skeletal muscles

33
Q

LMN Lesion Findings

A

Flaccid paralysis, significant atrophy, fasciculations and fibrillations, hyporeflexia

34
Q

Causes of LMN Lesion

A

Lead poisoning, poliomyelitis, West Nile Virus, ALS, spinal muscular atrophy, Charcot-Marie-Tooth disease, progressive muscular atrophy

35
Q

Peripheral Nerve Lesion Findings

A

muscle weakness, may also have sensory symptoms

36
Q

Causes of Peripheral Nerve Lesions

A

DM, alcoholism, nerve compression

37
Q

Neuromuscular Junction Lesion Findings

A

progressive muscular weakness

38
Q

Causes of Neuromuscluar Junction Lesions

A
  • Myasthenia Gravis: anti-acetylcholine receptor antibodies
  • Organophosphate Poisoning: inhibition of acetylcholinesterase
  • Lambert-Eaton Syndrome: interference with presynaptic calcium channel function inhibitng the release of acetylcholine
39
Q

Myopathy Lesion Findings

A

weakness, may have associated extramuscular symptoms

40
Q

Causes of myopathy

A

muscular dystrophy, polymyositis, dermatomyositis (heliotrope rash), influenza, rhabdomyolysis

41
Q

Muscular Dystrophy

A
  • Inherited disorders
  • Multiple types with different inheritance patterns
  • Progressive muscle weakness and atrophy in predictable patterns
  • Involvement of other systems is common
    • CV (cardiomyopathy, heart failure, arrhythmia), lung (infections, scoliosis), mental impairment, fractures from falling
42
Q

Duchenne Muscular Dystrophy

A
  • x-linked recessive
  • defective dystrophin
  • weakness: trunk then legs, then arms
  • other systems: dilated CM, scoliosis (lung), falling/fractures, mental impairment
43
Q

Myasthenia Gravis

A
  • Autoimmune disorder
  • Affects neuromuscular junction - autoantibodies to acetylcholine receptor
  • Weakness and fatigue
  • Fluctuation and variable combination
  • Ocular, bulbar, limb and respiratory muscles
44
Q

Guillan Barre Syndrome

A
  • Rapidly progressive polyneuropathy with weakness and/or paralysis
  • Symmetric, proximal LE
  • Then respiratory muscles, facial, oropharyngeal
  • Decreased or absent reflexes
  • Paresthesia hand/feet
  • Immune response to myelin or axon
  • Usually trigger event (GI or respiratory infection, immunization)
45
Q

Amyotrophic Lateral Sclerosis (ALS)

A
  • Lou Gehrigs Disease
  • UMN and LMN signs and symptoms
  • Motor neuron degeneration
46
Q

-myositis

A
  • idiopathic imflammatory myopathy
  • muscle fiber necrosis, degeneration, regeneration, inflammatory cell infiltrate
  • Weakness - symmetric, proximal, may involve oropharyngeal
  • Increase creatine kinase, lactate dehydrogenase, aldolase
  • EMG, muscle biopsy
  • Polymyositis - T-cell mediated muscle injury
  • Dermatomyositis - vasculopathy, skin signs (heliotrope rash); weakness
47
Q

Neuropathy

A
  • a neuropathy may cause a loss of sensation, change in sensation and/or motor weakenss
  • Sensory change: most common cause is disorder of peripheral nerves, but there may also be a central cause
  • Common feature of many systemic diseases
  • Common causes: diabetes and alcoholism
  • Worldwide: mycobacterium leprae, HIV
48
Q

Diabetes Mellitus

A
  • due to axonal degeneration
  • symmetric polyneuropathy - most common
    • progressive loss of distal sensation, “stocking-glove”
  • Autonomic neuropathy - postural hypotension, gastroparesis, enteropathy
  • Radiculopathy - nerve root damage at thoracic or lumbar levels
  • Mononeuropathy - peripheral or cranial
49
Q

HIV

A
  • develops as a result of HIV infection, drug therapy or other complications (diabetes)
  • polyneuropathy - symmetric and distal “stocking-glove”
  • radiculopathies - subacute lumbosacral polyradiculopathy
  • autonomic dysfunction - orthostatic hypotension, bladder dysfunction, impotence, syncope, cardiac arrhythmias
50
Q

Ataxia

A
  • disorganized movement
    • defective muscular coordination
51
Q

Antalgic Gait

A
  • limp
  • stance phase duration shortens to compensate for pain in the affected limb
52
Q

Vertigo

A
  • Sensation that patient or environment is spinning
  • Deficit within the vestibular system (unilateral, bilateral lesions generally do not produce vertigo)
  • Challenging symptom
53
Q

Approach to Vertigo

A
  • rule out other causes of dizziness through history
  • differentiate peripheral from central vertigo
  • differentiate benign from life threatening
  • correct identification for treatment purposes
54
Q

Dizziness

A
  • Vertigo - illusion of movement within environment
  • Lightheadedness/Presyncope - impending faint
  • Imbalance (dysequilibrium) - unsteadiness of gait
  • Nonspecific dizziness - ill defined
55
Q

Central Vertigo

A
  • central pathways and nuclei within brain
  • Cerebellar infarct
  • Brainstem ischemia
  • Multiple Sclerosis
56
Q

Peripheral Vertigo

A
  • Labyrinths/inner ear
  • peripheral cranial nerve VIII, vestibular nerve
  • Benign Positional Vertigo
  • Meniere’s Disease
  • Vestibular Neuritis - Labyrinthitis
  • Acoustic Neuritis
57
Q

Central Vertigo Findings

A
  • nystagmus - purely vertical, horizontal or torsional
  • Severe Imbalance
  • Nonauditory neurological symptoms common
  • Symptoms of longer duration and gradual onset
58
Q

Peripheral Vertigo Findings

A
  • Nystagmus - combined horizontal and torsional
  • Imbalance - mild to moderate
  • Nausea and vomiting
  • Hearing loss and tinnitus
  • Nonauditory neuro symptoms rare
  • Aggravated by change in position
  • Fatigue of symptoms

Neurology (5 decks)

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