Lesion localization

Question 1

what happens to tone, atrophy, fasiculations, weakness, reflexed and plantar un UMN lesion

Answer 1

tone - spacticity
atrophy - none
fasiculations - none
weakness - pyramidal
reflexes - increased
plantar - extensor

Question 2

what happens to tone, atrophy, fasiculations, weakness, reflexed and plantar un LMN lesion

Answer 2

tone - loss
atrophy - yes
fasiculations - yes
weakness - peripheral nerve
reflexes - decreased
plantar - flexor

Question 3

what does both sense and motor loss rule out

Answer 3

1. muscle
2. NMJ
3. ant. horn cell

Question 4

what is central lesion that can cause foot drop

Answer 4

foot area of motor cortex

Question 5

what is 4 peripheral lesions that can cause foot drop

Answer 5

1. peroneal nerve
2. sciatic nerve
3. lumbosacral nerve root
4. L5 nerve root

Question 6

what nerve supplies dorsiflexion

Answer 6

deep peroneal

Question 7

what nerve suppies ankle eversion

Answer 7

superficial peroneal

Question 8

what are 4 common causes of common peroneal neuropathy

Answer 8

1. leg crossing
2. prolonged kneeing or squatting
3. prolonged immobility
4. weight loss

Question 9

4 muscles supplied by median nerve distal to carpal tunnel

Answer 9

1. abductor pollicis
2. opponens pollicis
3. flexor pollicis brevis
4. lumbricles 1 and 2

Question 10

what does involvement of muscle proximal to tunnel tell us

Answer 10

lesion not due to tunnel

Question 11

what is main symptom of CTS

Answer 11

tingling in hand - pain can be present, but tingleing is main

Question 12

what hand is CTS most common in

Answer 12

dominant, but 55% are bilateral

Question 13

what are diagnostic tests

Answer 13

1. history

2. whalens or tinel test, but poor sensitivity

Question 14

what would one find in a radiculopathy, but not CTS

Answer 14

1. neck pain with radiation
2. Sx due to neck movements
3. C6-7 muscle weakness
4. reduced or absent bicep, brachioradialis reflexes

Question 15

3 blood tests to do in CTS

Answer 15

1. glucose - diabetes
2. TSH - hypothyroid
3. rheummatoid factor

Question 16

3 causes of acute CTS

Answer 16

1. exacerbation of Rhem A
2. wrist fracture
3. unaccustomed manual labor

Question 17

3 main treatments

Answer 17

1. splint - try for 6-8 weeks
2. local corticosteroid injection - long term bandaid
3. carpal tunnel release