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PTAE 113 CLINICAL PATHOLOGY > Chapter 7 Neuro through 11.13.18 > Flashcards

Chapter 7 Neuro through 11.13.18 Flashcards

1
Q

What would be an important distinction between the symptoms of an upper or lower motor neuron lesion?

A

the presence or absence of spasticity or flaccidity

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2
Q

an afferent nerve transmits what type of signal?

A

sensory information from the body to the CNS

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3
Q

An efferent nerve transmits what type of signal?

A

motor signals from the CNS to the muscles

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4
Q

CNS includes

A

brain and spinal cord

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5
Q

PNS includes

A

spinal and cranial nerves

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6
Q

frontal lobe

A

language, cognition, thoughts, memories (hippocampus); limbic (emotion and personality)

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7
Q

parietal lobe

A

sensory; premotor coordination

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8
Q

temporal lobe

A

auditory, language processing, interpretation

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9
Q

cerebellum

A

coordination

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10
Q

proprioception

A

motor cortex and somatosensory cortex work together

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11
Q

thalmus

A

gatekeeper; removes extra info

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12
Q

myelination

A

increases rate of synapse; on axons to propagate signals properly; oligodendricites and Schwann cells; comes over times; after birth still myelinating head to tail

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13
Q

spinal bifida

A

problems with the way tube is formed (neural tube)

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14
Q

neural tube

A

epithelial cells-neurons

cavity becomes spinal canal-center of cavity; central canal continuous into brain (CSF inside)

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15
Q

primitive reflexes

A

postural rxns, abnormal postural rxns

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16
Q

labyrinthine

A

rxns due to stimulation of vestibular system

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17
Q

primitive reflexes divided into:

A

supporting rxns

tonic neck and labyrinthine rxns: stimulated by the movement of the head on the body.

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18
Q

tonic neck reflex

A

ATNR; involuntary movement; fencing reflex; normally vanishes around 3 mths old

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19
Q

symmetric tonic neck reflex

A

flex babies neck and they’ll curl up

extend babies neck and the whole body extends

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20
Q

normal postural rxn

A

righting rxn: develop immediately after birth; right themselves if tilted to the side
equilibrium rxn: develop at about 7 months;

21
Q

motor abilities 1-3 months

A

head lag during pull to a sitting position; rising on forearms; prone creeping

22
Q

motor abilities 3-6 months

A

vertical head control; rolls from prone to supine; sits with trunk support; prone resting on forearms or hands with head control

23
Q

motor abilities 6-9 months

A

rolls supine to prone and back; sits without support; reaches to play with feet; maintains on all fours position; takes weight through feet and steps if help upright

24
Q

motor abilities 9-12 months

A

moves from lying to sitting; crawls; stands supported; pulls up to stand; cruises in standing holding on to furniture; walks with hand held or alone at 12 mths

25
Q

motor abilities 12-18 months

A

walks alone; wide BOS; kneels upright; squats when playing; stoops from standing to pick up toys; crawls up stairs-down on buttocks; starts to walk up stairs by 18 mths; starts to run stiffly by 18 mths

26
Q

motor abilities 18 mths-2 yrs

A

runs, changes direction and stops; walks upstairs and downstairs holding on, one step at a time; walks backwards with toys; throws ball and attempts to kick a ball

27
Q

motor abilities 2-2.5 yrs

A

climbs stairs without holding on, may alternate feet; descends stairs holding on, one foot at a time; run; climbs simple appartus; jumps both feet at once; stands on tiptoe; kicks large ball; walks with mature gait pattern; starts to ride a tricycle

28
Q

motor abilities 2.5-3 yrs

A

climbs stairs alternating feet; descends stairs alternating feet by 3 yrs; able to walk in all directions and avoid obstacles; runs and walks on tiptoe; stands on one leg for a few seconds; walks on narrow board with assistance

29
Q

motor abilities 3-4 yrs

A

climbs ladders and trees; hops on one leg; throws and catches a ball; uses a bat

30
Q

motor abilities 4-5 yrs

A

dances; skips; hops for several yards on either foot; walks along a narrow line

31
Q

nodal propagation

A

nodes of ranvier; signal jumps which makes it faster

32
Q

signs of upper motor neuron lesions

A 
weakness-more diffuse
atrophy-mild, general
atrophy vs weakness-severe weakness with mild atrophy
fasciculations-never seen
muscle tone-increases spasticity
muscle stretch reflex-increased
clonus-may be present
pathological reflexes-may be present
33
Q

signs of lower motor neuron lesions

A 
weakness-more focal
atrophy-severe, focal
atrophy vs weakness-severe atrophy with mild weakness
fasciculations-may be present
muscle tone-decreased
muscle stretch reflex-decreased to absent
clonus-never present
pathological reflexes-absent
34
Q

motor unit

A

motor neuron and muscle fibers it innervates

35
Q

what controls motor neurons

A

the primary motor cortex in the cerebrum

36
Q

stroke

A

medial cerebral artery affects face; look for face drop as a symptom

37
Q

upper motor neuron damage

A

immediate; flaccid paralysis; shuts everything down; return of some primitive reflex (babinski’s reflex); clasp knife effect; clonus
upper motor neuron damage means no inhibitory signal which causes a big reflex arc after stroke then makes muscles rigid and unable to move out of contracted position

38
Q

clasp knife effect

A

increase tone in hand; clasped tight; a stretch reflex with a rapid decrease in resistance when attempting to flex a joint; like a pocket knife

39
Q

clonus

A

stretch reflex; test in wrist an foot; stretch reflex will do a “beat” (moving several times before it stops); rapid intermittent contraction in response to a sudden stretch of a muscle

40
Q

to check for spasticity

A

rapid change in velocity at joint; flexion/extension slow then quick (velocity change); will see a reflexive rxn to the change; feel the change with the catch

41
Q

babinski

A

positive babinski test-foot withdrawn in plantar stimulation to foot is applied; present at birth and disappears by age 2; myelination completes by age 2

42
Q

parts of the brain in CNS

A

cerebrum (2 hemispheres); cerebellum; diencephalon (epithalamus, subthalamus, hypothalamus, thalamus); medulla, pons and midbrain; basal ganglia; spinal cord
meninges: dura mater; arachnoid mater; pia mater (dura mater is continuous through PNS around the spinal cord and peripheral nerves)

43
Q

arterial supply to the brain

A

internal carotid and vertebral arteries
internal carotid divides into middle cerebral artery (MCA) and is where a large majority of strokes happen and the anterior cerebral artery (ACA)

44
Q

blood brain barrier

A

combination of the arachnoid layer, the blood and cerebrospinal fluid and the selectively permeable endothelial cell layer of the cerebral capillaries; barrier prevents passage of bacteria and meds into the tissue of the brain

45
Q

CSF (in arachnoid layer) functions

A

shock absorber; bathes neurons of CNS and assists in transport of hormones activated by the nervous system; nutrients

46
Q

hydrocephalus

A

medical emergency that occurs when drainage system for the CSF is compromised in any way resulting in the amount of CSF within the ventricles to build up, expanding the ventricles resulting in increased pressure on the brain

47
Q

hydrocephalus signs and symptoms

A

fontanelle sign (pressure bubbles up in the fontanelle); headache; impaired vision; cognitive changes (child-digresses); loss of coordination; incontenence; balance disorders

48
Q

hydrocephalus treatment

A

meds-diuretics-forces body to expel fluids; not a long term fix
med proc-ventriculoperitoneal shunt (VP shunt); dumps CSF into abdomen for reabsorption

49
Q

signs of VP shunt malfunction

A

if shunt becomes kinked or blocked, maybe an autoimmune problem
headache, vomiting, letharg, swelling or redness along the shunt tract, confusion, seizures (immediate problem)

PTAE 113 CLINICAL PATHOLOGY (15 decks)

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