Localisation of pathology Flashcards Preview

Neurology > Localisation of pathology > Flashcards

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

What is klumpke's palsy?

Lower brachial plexus (C8 and T1) injury
Paralysis of intrinsic hand muscles +/- finger and wrist flexors
Flexed fingers