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Is it acute or gradual onset? If it is acute onset, Bell's palsy, diabetic neuropathy, and cerebral vascular accident must be considered. If it is gradual onset, one must consider an acoustic neuroma, advancing petrositis, or a ... DIAGNOSTIC WORKUP
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Is the extremity pain of acute or gradual onset? Acute onset would suggest arterial embolism, deep vein thrombophlebitis, and cellulitis. If there is a history of trauma, it would suggest a fracture, sprain, or torn ligament. ... DIAGNOSTIC WORKUP
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Are the pulses diminished? The presence of diminished pulses should suggest peripheral arteriosclerosis or Leriche's syndrome.
Is there associated pain in the involved extremity? The presence of pain in the involved extremity should suggest ... DIAGNOSTIC WORKUP
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Paralysis is the total loss of voluntary motor function of an affected area and most frequently indicates a serious neurologic problem in the site of distribution of the affected area. The key to correct diagnosis of paralytic syndromes is knowledge of the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Differentiate supranuclear facial palsy from peripheral (nuclear) facial palsy. Supranuclear palsy involves predominantly the lower part of the face. Emotional responses may be intact (e.g., the patient may not be able to show you his teeth but will... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Although Bell palsy is the most frequent etiology, it is a diagnosis of exclusion; one must thoroughly rule out infections, congenital, developmental, and other causes. Serial electrical testing provides objective monitoring of nerve function and may provide some prognostic information... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... A facial palsy is usually considered to be Bell palsy and it frequently is. Nevertheless, the clinician who begins treatment without ruling out other possibilities will eventually get burned. Anatomy is the key to recalling these possibilities before the
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... This symptom, as opposed to generalized weakness and fatigue (see page 541), is almost invariably due to a neurologic disorder. Consequently, a comprehensive list of causes is developed using neuroanatomy. Muscle weakness or paralysis may be due to disease of the muscle,
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... When the clinician tries to recall the causes of a mass in the extremities, he or she should consider the anatomy. As the clinician dissects downward from the skin, he or she encounters the subcutaneous tissue, veins, muscles, ligaments, bursae, arteries, lymph
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... Analgesia, the absence of sensitivity to pain, is an important sign of central nervous system disease, commonly indicating a specific type and location of spinal cord lesion. It always occurs with loss of temperature sensation ... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Paralysis, the total loss of voluntary motor function, results from severe cortical or pyramidal tract damage. It can occur with a cerebrovascular disorder, degenerative neuromuscular disease, trauma, tumor, or central nervous system infection.... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Acute (Developing in Hours)
Spinal cord injury
Spinal cord hemorrhage (secondary to vascular malformation, coagulopathy, anticoagulant therapy, trauma)
Spinal cord infarct (secondary to spinal artery thrombosis,
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... Vocal cord paralysis results from disease of or injury to the superior or, most commonly, the recurrent laryngeal nerve. It may also be congenital.
Causes
Vocal cord paralysis commonly results from the accidental severing of the recurrent... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Analgesia, the absence of sensitivity to pain, is an important sign of central nervous system disease, often indicating a specific type and location of spinal cord lesion. It always occurs with loss of temperature sensation (thermoanesthesia) because these... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Paralysis, the total loss of voluntary motor function, results from severe cortical or pyramidal tract damage. It can occur with a cerebrovascular disorder, degenerative neuromuscular disease, trauma, tumor, or central nervous system infection. Acute paralysis may be an early... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Paralysis of the vocal cords results from disease of or injury to the superior or, most often, the recurrent laryngeal nerve.
Causes
Vocal cord paralysis commonly results from the accidental severing of the... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Analgesia — the absence of sensitivity to pain — can help to identify the type of nervous system lesion and determine its location. For example, thermanesthesia (loss of temperature sensation) without other sensory changes can occur because although all sensory nerve impulses... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Paralysis, the total loss of voluntary motor function, results from severe cortical or pyramidal tract damage. It can occur with a cerebrovascular disorder, degenerative neuromuscular disease, trauma, tumor, or central nervous system infection. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Paralysis, the total loss of voluntary motor function, results from severe cortical or pyramidal tract damage. It can occur with a cerebrovascular disorder, degenerative neuromuscular disease, trauma, tumor, or central nervous system infection. Acute paralysis may be an early indicator of a... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Analgesia, the absence of sensitivity to pain, is an important sign of central nervous system disease, commonly indicating a specific type and location of spinal cord lesion. It always occurs with loss of temperature sensation (thermanesthesia) because... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Paralysis, the total loss of voluntary motor function, results from severe cortical or pyramidal tract damage. It can occur with a cerebrovascular disorder, degenerative neuromuscular disease, trauma, tumor, or central nervous system infection.... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
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A facial palsy is usually considered to be Bell palsy and it frequently
is. Nevertheless, the clinician who begins treatment without ruling out
other possibilities will eventually get burned. Anatomy is the key to
recalling these possibilities before the... Pictures
... READ EXCERPTS »
...
This symptom, as opposed to generalized weakness and fatigue , is almost invariably due to a
neurologic disorder. Consequently, a comprehensive list of causes is
developed using neuroanatomy. Muscle weakness or paralysis may be
due to disease of... Pictures
... READ EXCERPTS »
...
When the clinician tries to recall the causes of a mass in the
extremities, he or she should consider the anatomy. As the clinician
dissects downward from the skin, he or she encounters the subcutaneous
tissue, veins,... Pictures
... READ EXCERPTS »
... Author:
Russell Cross, MD
What to Do - Gather Appropriate Data
A trauma evaluation requires a complete and thorough examination beyond
the ABCs of resuscitation. Secondary assessment includes careful examination of distal pulses. Absent lower... Suggested Readings
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... Author:
Michael Clemmens, MD
What to Do - Interpret the Data
Perform a thorough physical exam and consider radiographs of both the area
in question, as well as those areas proximal and distal.
Lower extremity pain may be a sign... Suggested Readings ... Pictures
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When prostate cancer spreads, a common site is bone. This results in weakened bones that cause pain and are prone to fracture. Learn how these bone...
This year over 300,000 people in the United States will suffer a stroke, many of whom are elderly. Following the immediate crisis there are long term...
After suffering a stroke, many people experience post-stroke spasticity, muscle tightness that not only impairs mobility, but also impacts the life...