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Neuro Exam I > Anatomical Basis of Neural Deficits > Flashcards

Anatomical Basis of Neural Deficits Flashcards

1
Q

peripheral deficits

  • are defined by?
  • include which categories of disorders:
A
  • definition: defect of a peripheral nerve (including roots) that go out to an effector organ
  • include
    • muscle defects
    • neuromuscular defect
    • peripheral nerve defect
    • nerve root defect (ridiculopathy)
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2
Q

muscle type peripheral defect

  • presents what key sx?
  • does NOT present with what key sx?
A

motor weakness without sensory impairment

  • seen: motor weakness that
    1. is proximal - esp hip & thigh
    2. is symmetrical
    3. initially mild, then worsens from prox -> distal
    4. presents as trouble rising (climbing stairs, standed from seat)
  • not seen: sensory impairment ( numbness / weakness)
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3
Q

neuromuscular type peripheral defect

  • presents what key sx?
  • does NOT present with what key sx?
A

motor weakness + fatigue without sensory impairment

  • seen: motor weakness that
    1. is proximal - esp hips & thigh
    2. is mild / absent throughout course
    3. is largely presents as fatigue
  • no seen: sensory impairment (pain / numbness)
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4
Q

compare & contrast muscle vs neuomuscular peirpheral deficits

A
  • motor weakness without sensory deficits:
    • muscle: progressses from mild to worse, limits rising - on stairs / from a chair
    • neuromuscular: remains mild, presents as fatigue
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5
Q

periperhal nerve type peripheral defect

  • presents what key sx?
  • does NOT present with what key sx?
A

muscle weakness following sensory impairment

  • muscle weakness that is
    1. ​distal
    2. assymetric
    3. characterized by hyporeflexia, hypotonia
    4. matched to paraesthesia distribution
  • sensory impairment (numbness) that - prededes weakness
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6
Q

nerve root (ridiculopathy) type peripheral defect

  • presents what key sx?
  • does NOT present with what key sx?
A

pain +/- weakness

  • pain that
    • is ​shooting / stabbing
    • radiates from the spine outwards
  • muscle weakness that
    • does not effect tone
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7
Q

muscle deficits include what major disorders?

A
  • muscular dystrophies
  • polymyositis
  • thyroid disorders
  • toxin exposures
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8
Q

neuromuscular deficits include what major disorders?

A
  • myasthetnia gravis: rapid fatigue with quick recovery upon rest
  • eaton lambert syndrome: fatigue followed by strength improvement with exercise
  • extraocular muscles - ptosis, nystagmus
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9
Q

peripheral nerve deficits include what major disorders?

A
  • mononeuropathy
  • polyneuropathy
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10
Q

nerve root deficits (radiculopathy) include what major disorders?

A
  • sciatica (L5/S1)
  • upper extremitiy radiculopathy (C5/C6)
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11
Q

myasethenia gravis

  • cause
  • presentation
A
  • neuromuscular type (ACh deficient) perpheral disorder
  • presentation: rapid fatigue, but followed by quick recovery upon rest
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12
Q

eaton lambert syndrome

  • cause
  • presentation
A
  • neuromuscular type (ACh deficiency) peripheral disorder
  • presentation: fatigue that wanes as strength improves with exercise
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13
Q

mononeuropathy

  • cause
  • presentation
A
  • cause: peripheral nerve type peripheral defect - nerve entrapment / impairment often d/t
    • trauma
    • surgery
  • presentation: sensory loss distal to point of impingement
    • ​assymetrical
    • follows dermatome
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14
Q

peirpheral polyneurophathy

  • cause
  • presentation
A
  • cause: peripheral nerve type peripheral defect - due to metabolic disorder that disrupts long axons
    • diabetes
    • guillane barre
    • charcot marie tooth
  • presentation: sensory loss of distal extemities, symmettrically (“gloves and socks”)
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15
Q

sciata

  • cause
  • presentation
A
  • nerve root (radiculopathy): due to L5/S1 spinal nerve compression
  • presentation: pain that originates in buttocks then -> radiates along posterior thigh
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16
Q

upper extremity radiculopathy

A
  • cause: radiculopathy (nerve root) d/t C5/C6 inervertebral diss
  • presentation: pain that radiates along trapezius -> shoulder & can extend all down UE to thumb
17
Q

what are the major types of spinal deficits?

A
  • transection
  • hemisection
  • compression
  • commisural lesion
  • medullary lesion
18
Q

transection - presentation

A

= total loss of a spinal level

  • below damage, there will be a loss of:
    • motor loss (paralysis)
    • autonomic function
    • propioreception (touch)
    • pain + temp two spinal segments below
  • reflexes
    • normal superior to damage
    • absent at spinal level
    • exaggerated below damage
19
Q

hemisection - presentation

A

= brown-sequard syndrome

  • ipsilateral loss of
    • motor (corticispinal)
    • propioreception / touch (dorsal column)
  • contralateral loss of
    • pain + temperature (spinothalamic)
20
Q

compression - presentation

A

i.e., external presentation of the spinal cord

in this order:

  1. impairment of bladder then -> bowel
  2. motor dysfunction
  3. sensory dysfunction
21
Q

commisural lesion - presentation

A

lesion within the central canal that expands to disrupt ventral white commisure (dessucation site of spinothalamic)

  • bilateral pain + temperature loss in a single dermatomal pattern
22
Q

what is the infratentorium?

A

brainstem + cerebellum

aka posterior fossa

23
Q

infranteorial medial lesions can endanger what tracts / nuclei?

A
  • corticpinal motor tracts
  • medial lemniscus
  • medial longitudinal fasciculus
  • hypoglossal (XII) nucleus
24
Q

infratentorial medial lesions can lead to what deficits?

A
  • corticospinal motor tracts: contralateral hemiplagia (motor loss)
  • medial lemniscus: contralateral loss of touch / propioreception
  • medial longitudinal fasciculus: ipsilateal nystagmus
  • hypoglossal motor nucleus: ipsilateral impairment of tongue mobility
25
Q

infratentorial lateral lesions endanger what tracts / nuclei?

A
  • spinal lemniscus (spinothalamic)
  • spinal trigeminal (V)
  • spinocerebellar tract
  • sympathetic chain
26
Q

infratentorial lateral lesions can lead to what defecits?

A
  • spinal lemniscus (spinothalamic): contralateral pain + temp loss
  • spinal trigeminal (V): facial paresthesia
  • spinocerebellar tract: ipsilateral propioreception loss
  • sympathetic chain: ipsilateral Horner’s syndrome
27
Q

the medulla oglongota gives rise to what cranial nerves?

A
  • glossopharyngeal (IX)
  • vagus (X)
  • accessory (XI)
  • hypoglossal (XII)
28
Q

the pons give rise to what cranial nerves?

A
  • trigeminal (V)
  • abducens (VI)
  • facial (VII)
  • vestibuloacoustic (VIII)
29
Q

the midbrain gives rise to what cranial nerves?

A
  • oculomotor (III)
  • trochlear (IV)
30
Q

medulla oblongata lesions can lead to what deficits?

A
  • glossopharyngeal (IX): impaired gag reflex
  • vagus (X): dysarthria (trouble talking), dysphagia (trouble swallowing)
  • accessory (XI): neck weaness
  • hypoglossal (XII): palate deviation
31
Q

pontine lesions can lead to what deficits?

A
  • trigeminal (V): facial parasthesia
  • abducens (VI): diplopia, nystagmus
  • facial (VII): facial paralysis
  • vestibuloacoustic (VIII): deafness
32
Q

midbrain lesions can lead to what deficits?

A
  • oculomotor (III):dipoplia, nystagmus
  • trochlear (IV)
33
Q

cerebellar deficits can lead to?

(specify differences in LE vs UE)

A

(infratentorial defciti)

  • in general: ataxia - “appear as if drunk”
    • LE: gait ataxia - extra wide stance, staggering walk
    • UE{ pointing disorders, targetting difficulties, intention tremors

Neuro Exam I (15 decks)

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