Term
| Where do the motor pathways stem from? What do they control? |
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Definition
| -frontal lobe, skeletal muscle |
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Term
| where do the somatosensory pathways stem from? what do they control? |
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Definition
-post central
-where the information is going to and is processed |
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Term
| What is the difference between UMN and LMN? |
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Definition
-UMN= corticospinal tract to the anterior horn
-LMN= anterior horn cell to the muscle |
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Term
| What is LMN weakness a direct result of? |
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Definition
| loss of function or destruction of anterior horn cells or their axons in the anterior roots and nerves |
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Term
| WHat does the crossing of nerve fibers happen? |
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Definition
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Term
| UMN or LMN weakness is associated with increased tone/spasticity and hyperreflexia? |
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Definition
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Term
| What is the purpose of the Babinski reflex test? |
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Definition
| to test UMN weakness/lesion. A positive response is normal in children under the age of two. In adults it means that there is damage to the corticospinal tract |
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Term
| UMN or LMN weakness is associated with decreased tone/flaccidity/hypotonia, hyporeflexia, atrophy, fasiculations? |
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Definition
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Term
| Define -paresis, -plegia, -paralysis, and palsy |
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Definition
-paresis= weakness (partial paralysis)
-plegia= no movement
-paralysis= no movement
-palsy= imprecise term for weakness or no movement |
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Term
| Define hemi-, para-, mono-, di-, quadri or tetra- |
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Definition
-hemi= one side of the body
-para= both legs
-mono= one limb
-di= both sides of the body equally affected
-quadri or tetra= all four limbs |
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Term
| What is the term for a hemiparesis or hemiplegia with no sensory deficits? |
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Definition
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Term
| Where is the lesion in a pure motor hemiparesis? What side is affected ? Common cause? |
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Definition
-corticospinal tract below the cortex (internal capsule, basis pontis)
-contralateral lesion to the weakness
-lacunar infarct |
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Term
| what area is affected in hemiparesis or hemiplegia that has sensory deficits? what side is the weakness on? common cause? |
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Definition
-entire motor cortex plus other areas posteriorly
-contralateral to lesion weakness
-MCA infarct, tumor |
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Term
| Does the MCA supply both motor and sensory areas of the brain? |
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Definition
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Term
| Pronator drift is an example of what? |
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Definition
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Term
| Spastic gait is due to a lesion where? what are some characteristics of it? |
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Definition
-corticospinal tract
-stiff legged circumduction, scissoring, toe-walking |
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Term
| cerebellar ataxia abnormal gait is due to a lesion where? describe it |
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Definition
-midline cerebellar
-wide based, staggering, can't do tandem gait |
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Term
| sensory ataxia abnormal gait is due to a lesion where? describe it |
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Definition
-peripheral nerve or posterior column
-wide based staggering gait, can't do tandem, POSITIVE ROMBERG |
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Term
| in a vertiginous abnormal gait where is the lesion? describe it |
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Definition
-vestibular system
-wide based, staggering, can't do tandem gait, SUBJECTIVELY DIZZY |
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Term
| Where is the lesion in a parkinsonian abnormal gait? describe it |
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Definition
-substantia nigra
-slow, shuffliung, small steps, narrow based, stooped, no arm swing |
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Term
| what is another name for a painful abnormal gait? describe it |
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Definition
-"antalgic"
-avoids putting pressure on affected limb, grimacing |
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Term
| where is the lesion in a foot drop abnormal gait? describe it |
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Definition
-peroneal nerve
-high step with affected limb |
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Term
| What is the cause of a functional abnormal gait? describe it |
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Definition
-psychological based (anterior motives?)
-contradictory, severe but never fall |
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Term
| Common peroneal nerve (associated with foot drop) can be damaged due to a break of what bone? |
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Definition
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Term
| What is the prototype for demyelinating disorders of the CNS? |
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Definition
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Term
| Why is MS describes as intermittent? |
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Definition
-bouts of inflammatory demyelination (relapses)
-usually followed by some degree of recovery (remissions)
*usually a change in location in the CNS with a new relapse |
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Term
| What is characteristics of MS on an MRI? |
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Definition
| -two or more white matter lesions |
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Term
| What cells are affected in MS? |
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Definition
| schwann cells bc they are what cause myelination of the axon |
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Term
| What is thought to be the cause of MS? |
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Definition
-uncertain
-probably an exposure to a ubiquitous virus that leads to an autoimmune process in susceptible individuals (possible genetic influence) |
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Term
| WHat is the 3 step pathogenesis of MS? |
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Definition
1. breakdown of BBB
2. perivenular mononuclear infiltrates
3. circumscribed areas on myelin breakdown (patches of demyelination, not loss of whole schwann cell which makes matters worse) |
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Term
| T cell immunity is _________-mediated immunity. What is it associated with?> |
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Definition
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Term
| What are two examples of monocytes? |
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Definition
| basophils and eosinophils |
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Term
| What are 5 typical symptoms of MS? |
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Definition
-unilateral vision impairment
-double vision (diplopia)
-paresthesias
-unsteadiness
-fatigue |
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Term
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Definition
-optic neuritis
-nystagmus
-spasticity |
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Term
| What are two ways to confirm a MS diagnosis? |
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Definition
-MRI
-CSF (oligoclonal bands implying increased immunoglobulin production in the CNS) |
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Term
| Why do we have respiratory failure when our motor neurons are not working? as opposed to cardiac failure? |
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Definition
-cardiac muscle has its own pacemaker, it is a function of the autonomic NS.
-respiratory failure occurs bc the diaphragm is what keeps you breathing and the phrenic nerve (which is a motor nerve) is affected |
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Term
| What areas of the brainstem control respiration? |
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Definition
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Term
| Why should a person with COPD never be given nyquil, valium, or anything like it? |
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Definition
| because it suppresses the respiratory center and they can die since they already have serious respiratory problems |
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Term
| What is paresthesias due to? |
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Definition
| a lesion somewhere along the somatosensory pathway |
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Term
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Definition
| an unpleasant abnormal sensation |
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Term
| what is hyperpathia or allodynia? |
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Definition
| paniful sensation provoked by minor stimulus |
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Term
| Parasthesia can accompany what? What are some other things that can cause parasthesia? |
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Definition
-stroke
-cell phone syndrome, tennis elbow |
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Term
| What are the 2 most common causes of spinal cord lesions? |
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Definition
| compression due to trauma and metastatic cancer |
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Term
| where does prostate cancer first metastasize to? |
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Definition
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Term
| A lesion at the primary somatosensory cortex level (post central gyrus) of the somatosensory cortex causes what sensory loss pattern? |
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Definition
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Term
| A lesion at the lateral medulla of the somatosensory cortex causes what sensory loss pattern? |
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Definition
| wallenberg's syndrome (loss on contralateral body and ipsilateral face) |
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Term
| lesion at the spinal cord level of the somatosensory cortex causes what sensory loss pattern? |
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Definition
| loss to the corresponding dermatome |
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Term
| peripheral neuropathy causes what type of sensory loss pattern? |
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Definition
| "glove and stocking" distribution |
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Term
| What is the consequence of a transverse cord lesion of the spinal cord? |
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Definition
| -issues with sensory level corresponding to the level of the lesion |
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Term
| Brown Sequard syndrome is due to what type of lesion of the spinal cord? |
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Definition
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Term
| what are 2 characteristics of brown sequard syndrome? |
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Definition
-ipsilateral UMN weakness and loss of joint position and vibration
-contralateral loss of pain and temperature
**bc of damaged ipsilateral corticospinal tract and posterior columns, AND contralateral anterolateral system |
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Term
| What is the consequence of posterior cord syndrome of the spinal cord? |
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Definition
| -just lose vibration and position sense (B12 deficiency trauma, MS) |
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Term
| Pain fibers are carried by what fibers? |
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Definition
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Term
| What carries sensation? motor? |
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Definition
-posterior column
-anterior column |
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Term
| pain and temperature pathways often cross at the level of the ___________ |
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Definition
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Term
| Do anterior nerve pathways cross? lateral? |
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Definition
anterior DOES
lateral DOES NOT cross |
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Term
| What does B12 deficiency cause? |
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Definition
| pernicious anemia (aka megaloblastic anemia) |
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