Neurological Seminology Flashcards

1
Q

Bell’s Palsy

A

Idiopathic disorder of facial nerve 7 - unilateral facial weakness and inability to close the eye

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2
Q

Bilaterla ptsosi

A

Unusual finding that signals NM weakness…consider MG, Miller fisher variant of G-B syndrome and botulism

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3
Q

Corneal reflex

A

Use cotton wisp and approach lateral aspect…predominantyl tests opthalmic division of trigeminal but facial nerve involved in efferent

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4
Q

Deep tendon reflexes

A

2/4 normal

Hyper reflex - hyeradrenergic and focal with UMN dz as you lose inhibitory effect of LMN

Hyporeflexia - neuropathy, acute spinal dz, LMN damage, NMJ dz like MG

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5
Q

CLonus and hypothyroidism

A

Clonus - repeated contractiojn after elicitation of deep tendon reflex…indicating extreme hyper reflexia

Hypothyroidism - slow relaxation phase of deep tendon reflex

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6
Q

Diff cortical and lacunar stroke

A

Hemiplegia/paresis usually indicats vascular etiology

Cortical - 80% by ischemia produce weakenss in predictable patter based on cortical motor strip

Hand and face have large rep due to complication actions with sparing of lower…also may involve sensroy cortex and involve speech problems

Lacunar - pure motor or sensory defects…large infarcts of small penetrating arterioles that effect radiation of the cortical neurons and as such, small lesion can effect a large dist without sensory def or other indicaiton of cortical event

Motor units of cranial nerves receive cortical input so pt does not develop deviated tonuge unless hypoglossal nucleus or nerve is inovlved…upper face involvement diff cortical stroke from bells palsay

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7
Q

TIA mechs

A

1) low flow state due to large art occlusion
2) small emboli from large artery or heart
3) lacunar TIA from stenosis of small penetrating vessel…may involve anterior (carotid) or posterior (vertebral and basilar arteries)…resolves in 24 hours but IDs pt at high risk of stroke

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8
Q

Dolls eyes

A

Tests CN 8 and semicricular canal function…performed in comatose ony

Manually raise both eyelids and move head side to side….if they don’t move in tandem, damage to one or more

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9
Q

Frontal release signs

A

Palmomental relfex (stroke thnar area of hand and cause contraction ipsi or orbicularis oris and mentalis)

Suck reflux - sucking movements of lips when stroked or touched

Snout - puckering or protrusion of lips with percussion

Grasp - examiner hand is placed softly into pts palm during distraction - stroking produces grasps that persists with movement

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10
Q

Cerebellar ataxia

A

Wide-based, unsteady, lateral veering…MS or tumor or cerebellum

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11
Q

Sensory ataxia

A

Loss of propioception so pt subs visual and nociceptive glues

Stamp and stick gait with pt looking at ground

B12 def, tabes dorsalis, and other post column dz

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12
Q

Festinating gait

A

Shuffling steps with rigitdity…lowwrr body chassing upper…Parkinsons

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13
Q

Steppage or equine gait

A

Cannot dorsiflex foot - trauma to peroneal nerve, Charcot-Marie-Tooth

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14
Q

Plantar relfex

A

Firmly strok the plantar surface from post to ant

rResponse normally flexin

Ext normal in newborn but otherwide pathologic - UMN

Common etiologies - cortical stroke, spinal cord dz from B12 def, and occasisonaly drug-induced

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15
Q

Triple flexion

A

Ultimate babinski reflex with exten and fanning of toes, dorsiflexion at ankle and flexion of knee and hip

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16
Q

Pronator drift

A

Test of subtle UMN (cortical stroke with borderline weakness)

Hold arms out with palms upward and then close eyes

Unilatera lweakness will have limb fdrop with simultaneous prontation

Malingering - arm drops without pronation

Post column dz - involved limb searches for other limb

17
Q

Romberg test

A

Post column fxn and test for tabes dorsalis (tertiary syphilis)

Stand with feet together and close eyes,…normal ppl can stand for 60 sec

18
Q

Postural tremor

A

Becomes evindent with action or hyperandrenirgic, physiologic, alcohol withdrawl, and essential tremor

19
Q

Resting trewmor

A

Occurs in posture and suppressed with activity

Pill rolloing of Parks disappears with activity and ocmplete relaxation

20
Q

Intention trmemor

A

Appears with action and worse as goal reach….cause relates to cerebrellar