Flashcards in Localisation of pathology Deck (44):
1
What area will a CNS pathology affect?
Hemiplegia/ paraplegia
2
What are will a PNS lesion affect?
Peripheral or localised area
Can be a whole limb if due to a plexus
3
What area will a NMJ lesion affect?
Ocular or bulbar
4
What are will a muscle lesion affect?
Proximal and symmetrical
5
What will the description of weakness be like in a CNS lesion?
Heaviness
6
What will the description of weakness be like in a PNS lesion?
Positional/ with sleep
Ascending
7
What will the description of weakness be like in a NMJ lesion?
Fatiguable; worse after use of the muscles
Diurnal variation; worse towards the end of the day
8
What will the description of weakness be like in a muscle lesion?
Aching
Insidious
9
What are the additional features of a CNS lesion?
Spasms
Jerks
10
What are the additional features of a PNS lesion?
Cramp
Twitching (fasiculations)
11
What are the additional features of a NMJ lesion?
Bulbar: swallowing, speaking
Ocular: diplopia, ptosis
Resp: orthopnoea, SOBOE
12
What are the additional features of a muscle lesion?
Myalgia
Cramp
13
Are sensory symptoms possible in a CNS lesion?
Yes
14
Are sensory symptoms possible in a PNS lesion?
Yes
15
Are sensory symptoms possible in a NMJ lesion?
No
16
Are sensory symptoms possible in a muscle lesion?
No
17
Are there any specific difficulties associated with a CNS lesion?
Cognitive involvement
Sphincter involvement
18
Are there any specific difficulties associated with a PNS lesion?
Loss of grip
Tripping up
Unsteady with eyes closed
19
Are there any specific difficulties associated with a NMJ lesion?
Lots of chewing/ talking is difficult
Prolonged gaze hard (long drives/ reading)
Later in day
20
Are there any specific difficulties associated with a muscle lesion?
Getting up from low chairs
Hanging up washing
21
What will be seen specifical on inspection of a CNS lesion?
Limb posture
22
What will be seen specifical on inspection of a PNS lesion?
Wasting/ fasciculations
Pes cavus
23
What will be seen specifical on inspection of a NMJ lesion?
Additional ptosis/ opthalmoplegia
24
What will be seen specifical on inspection of a muscle lesion?
Proximal wasting
25
What will be seen specifically on tone of a CNS lesion?
Increased tone
Spasticity/ clonus
26
What will be seen specifically on tone of a PNS lesion?
Decreased tone
27
What will be seen specifically on tone of a NMJ and muscle lesion?
Neutral or decreased
28
What is the pattern of weakness in a CNS lesion?
Pyramidal:
Arms; extensors weaker than flexors
Legs; flexors weaker than extensors
Brain; contralateral
Spine; ipsilateral
29
What is the pattern of weakness in a PNS lesion?
Peripheral neuropathy; distal weakness
Root/ plexus/ mononeuropathy: dependent on innervated muscles
30
What is the pattern of weakness in a NMJ lesion?
Fatigability
31
What is the pattern of weakness in a muscle lesion?
Proximal weakness (symmetrical)
32
What will the reflexes show in a CNS lesion?
Increased; brisk
33
What will the reflexes show in a PNS lesion?
Decreased; hyporreflexic
34
What will the reflexes show in a NMJ or muscle lesion?
Neutral or hyporreflexic
35
What will the plantar response show in a CNS lesion?
Extensor response; positive babinski sign
36
What will the plantar response show in a PNS, NMJ and muscle lesion?
Flexor response; negative babinski sign
37
Are there any specific sensory symptoms associated with a CNS lesion?
Brain: hemisensory
Spinal cord: sensory level
38
Are there any specific sensory symptoms associated with a PNS lesion?
Peripheral neuropathy; glove and stocking
Root etc; dependent on dermatome
39
Are there any specific sensory symptoms associated with a NMJ or muscle lesion?
No
40
What will a L3/4 root entrapment result in?
L4 root:
Pain down medial ankle
Loss of quads power
Reduced knee jerk
41
What will a L4/5 root entrapment result in?
L5 root:
Pain down dorsum of foot
Reduced big toe dorsiflexion (extensor hallucis longus)
42
What will a L5/S1 root entrapment result in?
S1 root:
Pain to sole of foot
Reduced plantar flexion power
Reduced ankle jerk
43
What is erb's palsy?
Injury to upper brachial plexus (C5/6)
Loss of motor innervation to deltoid, supraspinatus, infraspinatus, biceps and brachialis
Internal rotation; waiter's tip posture
44