Case studies Flashcards

1
Q

What are causes of spinal cord lesions?

A
  • Multiple sclerosis
  • Motor Neurone Disease (ALS,PLS)
  • Trauma
  • Tumour
  • Infection
  • Compression (disc)
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2
Q

List the 3 main tracts to think about when discussing spinal cord lesions

A
  • corticospinal tracts
  • dorsal columns medial lemniscus
  • spinothalamic
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3
Q

Corticospinal tract

A
  • voluntary motor
  • descending
  • 90% decussate at pyramids
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4
Q

Dorsal columns medial leminscus

A
  • proprioception
  • vibration
  • fine touch
  • decussate in medulla
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5
Q

Spinothalamic tract

A
  • pain
  • temperature
  • crude touch
  • itch
  • decussate at level of action
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6
Q

Dorsal columns

A
  • deep touch
  • proprioception
  • vibration
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7
Q

Lateral spinothalamic tract vs Ventral spinothalamic tract

A

Lateral
• pain
• temperature

Ventral
• crude touch, itch, tickle

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8
Q

Posterior cord syndrome

A
  • lesion of posterior columns

* loss of vibration and position sense everywhere except face

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9
Q

Anterior cord syndrome

A
  • lesion of lateral corticospinal tract (UMN), Anterior horn cells (LMN) and anterolateral pathways (pain and temp)
  • loss of pain ant temp AND motor loss everywhere except for face
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10
Q

What is central cord syndrome (small lesion)?

A
  • affects middle part of dorsal columns

* pain and temp loss on lateral aspect of arms

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11
Q

What is central cord lesion (large lesion)?

A

• loss everything everywhere except force and genitals

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12
Q

What happens in transverse cord lesion?

A

• loose everything below it

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13
Q

What happens with a hemicord lesion?

A

Ipsilateral:
• motor
• vibration and positions sense loss

Contralateral:
• pain and temp loss

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14
Q

Why is there a babinski reflex?

A

UMN lesion

-return of primitive reflex

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15
Q

What are the connections and the function of the cerebrocerebellum?

A

Dentate -> motor cortex -> corticospinal

• planning and timing for smooth and ordered complex movements

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16
Q

What are the connections and function of the Spinocerebellum?

A

Interposed

  • > motor cortex -> corticospial
  • > red nucleus -> rubdrospinal

• corrects and smooths movement

17
Q

What are the connections and function of the vestibulocerebellum?

A

Fastigial

  • > vestibular nuclei -> vestibulospinal
  • > reticular formation -> reticulospinal

• posture and tone

18
Q

List some basic symptoms of cerebellar lesions?

A
  • ipsilateral signs
  • vertigo, dizziness, nausea, vomiting
  • ataxia (truncal and appendicular)
  • nystagmus
  • tremor when moving
  • gait issues
  • balance and coordination issues
  • headache
19
Q

What can cause a cerebellar lesion?

A
  • stroke, infarct
  • tumour
  • toxic (alchohol, drugs)
  • trauma
  • infection
20
Q

What are the consequences of midline cerebellar lesions?

A
  • vermis or floculonodular lobes
  • truncal ataxia
  • nystagmus
  • vertigo
  • nausea
21
Q

What are the consequences of lateral cerebellar lesions?

A
  • lateral to the vermis

* appendicular ataxia

22
Q

Retrobulbar neuritis

A
  • optic nerve affected behind eyeball
  • optic disc appears normal
  • patient sees nothing and the doctor sees nothing
  • most frequent type in adults
  • often in MS
23
Q

Papillitis

A
  • optic nerve head affected
  • hyperaemia and oedema of optic disc
  • maybe with peripapillary flame-shaped haemorrhages
  • most common type in kids
24
Q

Neuroretinitis

A
  • concomitant swelling of optic nerve head (papillitis) and macula
  • macular star (exudate)
  • least common type
  • rare from demyelination
  • from viral infection
25
Q

What is the consequence of a lesion of the right optic tract?

A

Left homonymous hemianopia

26
Q

What is the consequence of a lesion the right optic radiations?

A

Left homonymous hemianopia

27
Q

What is the consequence of a longitudinal section of the optic chiasm?

A

bitemporal hemianopia