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Flashcards in Pattern Recognition (revision) Deck (53):
1

Describe hyperkinetic movement disorders

Dystonia
Tics
Myoclonus
Chorea
Tremor

2

Describe hypokinetic movement disorders

Parkinsons; rigidity and bradykinesia

3

What is the pattern of weakness in MND?

UMN and LMN signs
Absence of sensory symptoms
+/- frontotemporal dementia

4

Inflammatory muscle disorders

Poly/deramatomyositis
Inclusion body myositis
Vasculitis
RA
Sjogren's

5

Endocrine muscle disorders

Hypothyroidism
Cushing's
Electrolyte disturbances
Hypophosphatemia
Hypocalcemia
Hypernatraemia/ hyponatraemia

6

Drugs/toxins causing muscle disorders

Illicit drugs; cocaine, heroin
Alcohol
Corticosteroids
Colchicine
Antimalarial drugs
Stains
Penicillamine

7

Infections causing muscle disorders

Viral; influenza, parainfluenza, coxsackie, HIB, CMG, echovirus, adenovirus, EBV
Bacteria
Fungal
Parasitis

8

Rhabdomyolysis causing muscle disorders

Crush trauma
Seizures
Alcohol absuse; hyperkinetic state with delirium tremens
Exertion
Vascular surgery
Malignant hyperthermia

9

Which muscle, nerve and nerve root are responsible for shoulder abduction?

M: deltoid
N: axillary
NR: C5

10

Which muscle, nerve and nerve root are responsible for elbow extension?

M: triceps
N: radial
NR: C7

11

Which muscle, nerve and nerve root are responsible for finger extension?

M: extensor digitorum
N: radial
NR: C7

12

Which muscle, nerve and nerve root are responsible for index finger abduction?

M: 1st dorsal interosseous
N: Ulnar
NR: T1

13

Which muscle, nerve and nerve root are responsible for hip flexion?

M: iliopsoas
N: femoral
NR: L1,2

14

Which muscle, nerve and nerve root are responsible for knee flexion?

M: hamstrings
N: sciatic
NR: S1

15

Which muscle, nerve and nerve root are responsible for ankle dorsiflexion?

M: tibialis anterior
N: common fibular and sciatic
NR: L4,5

16

Which muscle, nerve and nerve root are responsible for great toe dorsiflexion?

M: EHL
N: common fibular
NR: L5

17

Main deep tendon reflexes and oot innervation

Biceps/ supinator: C5,6
Triceps: C7,8
Knee: L3,4
Ankle: S1,2

18

What does a glove and stocking sensory loss indicate?

Length dependent neuropathy

19

What does a sensory level sensory loss indicate?

Spinal cord lesion

20

What does a hemianesthesia sensory loss indicate?

Contralateral cerebral lesion

21

What is a dissociated sensory loss indicate?

Loss of spinothalamic but preserved DCML; anterior spinal artery syndrome, brown sequard or syringomyelia

22

Extrapyramidal symptoms

Bradykinesia
Rigidity
Resting tremor
Shuffling gait
Stooped posture
Hypomimia
Hypophonia
Reduced arm swing
Impaired postural reflexes
Asymmetry in PD, symmetry in DI

23

Main function of frontal lobe

Executive function
Prefrontal cortex connects to the basal ganglia, limbic system, thalamus and hippocampus

24

Frontal lobe dysfunction

Personality disorder
Disinhibition
Paraparesis
Paratonia
Frontal gait dysfunction
Cortical hand
Seizures
Incontinence
Visual field defects - homonymous hemianopia
Expressive dysphagia - broca's area
Anosmia

25

Temporal lobe dysfunction

Episodic memory dysfunction
Agnosia
Receptive aphasia; wernicke's area
Superior quadrantanopia
Auditory dysfunction; as hearing is bilateral deafness is NOT a cerebral feature
Limbic dysfunction
Temporal lobe epilepsy

26

Parietal lobe dysfunction

Inferior homonymous quadrantanopia
Visuospatial dysfunction
Gerstmann's syndrome
Dyspraxia
Inattention
Denial

27

What is gerstmann's syndrome?

Dominant lobe; dysgraphia, left-right disorientation, finger agnosia, acalculia

28

Treatment protocol for PD

Symptomatic; levodopa or dopamine agonist
MDT including speech and language, OT, PT, exercise
Deep brain stimulation

29

Drugs used in PD

Levodopa; crosses BBB
Dopamine agonists; acts on D2 receptors
MAO-B inhibitors; improve symptoms in those with mild disease
Anticholinergics for tremor
Amantadine; blocks NMDA receptors

30

Imaging in stroke

MRI T1/T2 and FLAIR for old lesions and lesions of non-vascular origin
T2 to identify bleeds and microbleeds
CT: hyperintense; bleed. Ischaemic; loss of lentiform nucleus, poor grey white matter differentiation, loss of insular ribbon

31

Corticospinal tract origin and parts

Origin: primary motor cortex of precentral gyrus
Lateral (primary decussation) = voluntary motor control of limbs and digits
Anterior corticospinal (segmental decussation) = voluntary motor control of trunk and maintains posture

32

Corticobulbar tracts origin and function

Origin: primary motor cortex in precentral gyrus
Function: muscles of face, head and neck

33

Which CN do NOT have a bilateral innervation to their nuclei?

CN 12
Lower part of 7; if there is forehead sparing this is an UMN lesion of facial nerve

34

Rubrospinal tract origin and function

Origin: red nucleus of midbrain
Function: excites flexors and inhibits extensors of upper body

35

Reticulospinal tract origin and function

Origin: pons/medulla
Function: excites extensors

36

Which motor tract is in charge in decorticate rigidity?

Lesion above midbrain
Rubrospinal tract; flexion of upper limbs

37

Which motor tract is in charge in decerebrate rigidity?

Lesion below midbrain
Reticulospinal tract; extension

38

DCML function and route

Function; fine touch, pressure and vibration
Decussates in medulla to contralateral medial lemniscus to reach the primary somatosensory cortex in the postcentral gyrus of the parietal lobe

39

Difference between gracile fasciculus and cuneate fasiculus

Gracile; legs, below T6
Cuneatus; arms; above T6
Gracile medial to cuneate in spinal cord

40

Spinothalamic tract function and pathway

Function: pain and temp
Decussates segmentally in spinal cord to reach opposite primary somatosensory cortex

41

Extradural haemorrhage:
Location
Origin
Presentation
Symptoms
Ix
Imaging findings

L: skull and dura
O: middle meningeal artery
Px: injury to pterion
Sy: unconscious then lucid interval then unconscious
Ix: CT
Findings: hyperdense biconvex lens appearance

42

Chronic subdural haemorrhage
Location
Origin
Presentation
Symptoms
Ix
Imaging findings

L: dura and arachnoid
Origin: cerebral bridging veins
Px: older patients due to low impact trauma
Sy: progressive headache and confusion
Ix; CT
Findings: hypodense crescent shaped appearance

43

SAH
Location
Origin
Presentation
Symptoms
Ix
Imaging findings

L: arachnoid and pia
Origin: arterial; commonly berry aneurysm
Px: severe head injuries or ruptured berry
Sy: thunderclap headache, meningeal irritation (neck stiffness, photophobia), loss of consciousness
Ix: CT initially. Definitive diagnosis is CTA
Findings; hyperdense in SA space. Commonly star shaped

44

Symptoms of cerebral herniation

Extensor response
Cushing's triad; hypertx, brady, agonal breathing
Uncal herniation = blown pupil

45

Where can you find the dual venous sinuses?

Outer and inner dura

46

Expressive dysphasia

Brocas area

47

Receptive dysphasia

Wernicke's area

48

Nystagmus, intention tremor and dysarthria

Cerebellum

49

Temperature control

Hypothalamus

50

Oculomotor nucleus

Midbrain

51

Most common cause of hydrocephalus in children

Aqueduct stenosis - non-communicating hydrocephlus

52

Sy of aqueduct stenosis?

Growth in head circumference
Eyelids retracted; sunsetting eyes
Upward gaze impaired
Failure to thrive

53

What GCS indicates comatomse?

8 or less