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SUMMED2 > 2NEURO Primer- Spinal Cord_Patho > Flashcards

2NEURO Primer- Spinal Cord_Patho Flashcards

1
Q

What is reversed with brain and spinal cord?

A

Brain white matter-(myelin fat) inside, gray matter-(some cells )outside, Butterfly Spinal cord- gray matter

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2
Q

Within spinal cord gray matter this horn brings sensory info from periphery to brain at that level?

A

Dorsal- spinothalmic tract contralateral. SC cross at level lower

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3
Q

This gray matter horn had motor neurons for the limbs, info from periphery to cortex?

A

Ventral

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4
Q

Where are you in the spinal cord if there is a lateral horn?

A

Anywhere from T1-T12

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5
Q

Within the white matter of spinal cord this section is vibration, proprioception, touch

A

DORSAL POSTERIOR COLUMNS-fasiculus, info TO BRAIN

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6
Q

What are we testing for DM neuropathy for vibration?

A

Posterior Dorsal column tract

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7
Q

This tract within white matter in spinal cord carries touch temp, pain to thalamus?

A

Spinalthalmic tracts- most sensory is hear, testing integrity of ant and lateral spinal cord

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8
Q

What is the lateral white matter of spinal cord that comes from cortex to spinal cord to land on ventral horn which will form the ventral root of a spinal cord?

A

Corticospinal tract

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9
Q

Lesion in the posterior column sense to cortex would have symptoms where?

A

DEC tactile and proprioception on Ipsilaterally

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10
Q

Why ant spinathalmic tract have little changes if injured?

A

Touch, temp, pain cross EARLY within spinal cord to deliver info. BUT overlap with posterior column

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11
Q

Which lesion prodcued here results in complete loss of pain and thermal sense on OPPOSITE side of body?

A

LATERAL spinothalamic tract

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12
Q

Spinocerebellar is crossed or uncrossed?

A

Both tracts, anterior crossed, uncrossed posterior. Positional

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13
Q

What occurs with brainstem lesion that target ST, PC, which result in loss of pain and temp without sparing position and tactical?

A

Dissociated Sensory Loss

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14
Q

What occurs if lesion is within corticospinal tract?

A

3 tracts formed a the junction of medulla and spinal cord where fiber cross. LESION above cross would produce. 1. loss of voluntary movements distally, 2. spastic, 3. hyperreflexia of DTR 4. Babinsk + present w/ injury. 5 Infants drunk sleeping Babinski alway positive

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15
Q

What is difference with crosses in sensory vs. motor?

A

Sensory info crosses when it comes to level of target. MOTOR- info descending crosses at medulla as it enters spinal cord L side vs R side brain

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16
Q

This condition is when the spinal cord lesion produces loss of pain and thermal on the CONTRALATERAL side and loss of sense of position and movement on the ISPILATERAL (inferior to the lesion).

A

Brown Sequard syndrome

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17
Q

This neuron initiate motor activity and its axon is corticospinal tract?

A

UPPER MOTOR NEURON- 1. spastic paralysis, 2. preserve bulk, 3 No movement 4. hypereflexes, 5. babinski present. MS, CVA

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18
Q

What leave the ventral horn after a synapse and leaves the ventral root called a new nerve, this also comes from spinal cord to msk, anter horn cells?

A

LOWER MOTOR NEURON- 1. atrophy (not early, later) 2. Flaccid paralysis 3. fasciculation from spontaneous APs 4. Reflexes DEC 5. Babinksi absent 6. Neuropathy

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19
Q

If a nerve is denervated why is there atrophy?

A

NT are trophic, loss equals no tone

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20
Q

Spasmodic alteration of muscular contractions between antagonistic groups overing shooting

A

Clonus-caused by hyperactive stretch reflex (UMN)

21
Q

Constant resistance to passive stretch, independent of velocity of movement, resulting in “lead pipe” phenomenon.

A

Rigidity

22
Q

Transient, velocity dependent resistance to passive stretch followed by relaxation.

A

Spasticity: faster HCP passively moves the Pt should contract, BUT passive stretch is present no matter what the velocity is“Clasp knife phenomenon”-UMN

23
Q

Constant resistance to passive stretch throughout range of motion.

A

Lead pipe rigidity- (Parkinsonism)

24
Q

Typically seen at the wrist when a resting tremor is superimposed on a “lead-pipe” rigidity.

A

Cogwheel rigidity-(Parkinsonism)

25
Q

Patient extends and adducts arm in supine position, closes eyes and is distracted by shaking head “no.” Positive sign is the subtle pronation, abduction and internal rotation of the arm.

A

Pronator Drift: UMN

26
Q

When sensation is is felt above the dermatone but no below?

A

Truncal sensory level. -focal spinal cord lesion thoracic

27
Q

What are signs of impaired SNS control- miosis constricted, anhidrosis, sweat, ptosis drooping of the face due to lesion btwn hypothalamus and cervical sympathetic ganglia?

A

HORNERS syndrome- Image cervical cord and neck, SNS is cervical in nature and T1-L2

28
Q

What is reason for tremors in Parkinson?

A

Impaired basal ganglia, over shooting impaired postural control.

29
Q

What is full of dopamine, but impaired in Parkinson, due to dopamine being inhibitory controlling movement?

A

Substaninanigra full of dopamine within Basal Ganglia

30
Q

What is used to treat Parkinson last minute?

A

LDOPA

31
Q

Pt has tremor at rest, short gait, slumped, bradykinesia, rigidity?

A

Parkinson- early pill rolling

32
Q

What are DDX of tremors

A

a. Tremors: isolated chin, cerebellar, voice, orthostatic, psychogenic
b. Med effect: Antidepressants, beta agonists, Depakote, Dopamine, lithium, theophylline, thyroid, etc
c. Metabolic: hyperthyroid, b-12 deficiency, hyperparathyroid, hypocalcemia, hyponatremia, renal dz, liver dz
d. Toxics: EtOH, Arsenic, caffeine, DDT, Lead Nicotine, Toluene, Withdrawal
e. REFER FOR W/U!

33
Q

This dz has a CAG Repeat disorder on Gene “huntingtin” on Chromosome 4. The Length of repeat correlated with age of onset. Result in excess excitation in the basal ganglia.

A

Huntington Disease- hereditary, Choreatic dance like movement to control excess movement

34
Q

What is disrupted cellular in Huntingtons?

A

Altered- Mitochondrial transport, transcription, axonal transport, calcium signaling

35
Q

What is progression of Huntingtons?

A

Late dz, movement inhibited ex paralytic. NOT TX, DEATH

36
Q

What conditions often stereotype of having impaired cognition?

A

Cerebral Palsy-Normal IQs

37
Q

What is pathogenic of CP?

A

Hypoxia at birth or traumatic delivery. Loss of brain tissue

38
Q

What is characteristic of CP regarding the lesion?

A

UMN- tone is INC, spastic

39
Q

Baby Jane prefers her L hand with grasping at at 18mo, and also has hypertone in biceps. What else seen in early CP?

A

Asymmetric crawling

40
Q

What is destruction in myelin sheath around central neuron white matter of brain. CP- Diplopia, and episode of loss of sensory separated by space and time?

A

Multiple sclerosis

41
Q

What cause he multiple episodes?

A

Early in the dz, plaques and Oligodendrocytes will come and re-myelinate, then sx’s will go away and this keeps happening in a cycle

42
Q

Why do ions not meet to the synapse overtime in MS?

A
  1. lose of myelination 2. body temp rises inc ion leakage 3. Result is impaired nerve conduction
43
Q

What do the following CP imply in MS:sensory loss, muscle cramping/spasticity, loss of function (bowel, bladder, sexual); Optic neuritis, diplopia (region in the brain responsible for conjugate gaze demyelinates), HEAT INTOLERANCE, fatigue

A

Poor electrical transduction. Uthoff phenomonum- warm baths worse.

44
Q

Why do nerves conduction better in cold wire vs. warm?

A

AP leaps from node to node in between myelon and this is called salutatory conduction (jumping) this occurs because ions subject to motion. If you don’t have a myelon you are losing positive charge that is leaking out. The hotter you are the more motion and more leak of ions

45
Q

demyelination in the Medial longitudinal fasciculus causes intra-nuclear ophthalmalegia?

A

Dis conjugated gaze.

46
Q

What stage no disability and return to normal btwn attacks?

A

Benign MS never progresses

47
Q

What stage each episode gets little worse after previous episode btwn attacks?

A

Relapsing + Remitting MC- never new disability btwn attacks

48
Q

What stage is no new disability btwn attacks followed by steady increase in that disability?

A

Secondary Progression Multiple Sclerosis

49
Q

What stage is steady increase in disability with new attacks?

A

Primary progression multiple sclerosis

SUMMED2 (38 decks)

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