Clinical Correlates Flashcards
anterior spinal stroke
all motor neuron cell bodies/tractsare solely dependent on the anterior spinal artery
conduction aphasia?
stroke of the middle cerebral artery that causes a poor connection between Broca’s area (speech production) to Warnike’s area (speech comprehension)
- *RARE, acquired
- *usually involves arcuate fasciculus
- *intact auditory comprehension, but poor speech repetition, impaired word-finding ability, especially with longer train of thought
split brain?
=severed corpus callosum
**connection between the two hemispheres of brain is GONE; can do two things independantly
damage to corticospinal tract UNM and LMN can have damage where?
*damage to precentral gyrus, internal capsule, cerebral peduncles, pons, medullary pyramids, or descending tracts
damage to corticospinal tract (LMN)
paralysis or paresis, muscle atrophy, areflexia (all lesions we talked about last semester)
damage to corticospinal tract (UMN)
- affects contralateral side for lesions proximal to pyramidal decussation; ipsilateral side for lesions distal to decussaion for crossed fibers in lateral tract
- initial paralysis (hypotonia) most severe in limbs
what follows after UMN syndrome?
1) babinski sign
2) spasticity= hyperflex, hyperreflexia, clonis
babinski sign
scrap along bottom of foot
normal= toes flex down
babinski sign= toes extend up or fan out
***this is a NORMAL response until 2 years old because neurons are not myelinated yet
brown sequardsyndrome
*hemisection= knocked out half of spinal cord (tumer or penetrating wound)
Parkinson’s disease pathophysiology and definition
is a hypokinetic disorder
- too much indirect, not enough direct
- *loss of dopaminergic neurons of the substantia nigra; idiopathic
- encephalitis lethargica, head trauma, or carbon monoxide or manganese toxins
Huntington’s Disease pthophysiology
is a hyperkinetic disorder (too much direct, not enough indirect)
- *death of spiny neurons in the striatum, loss of cerebral cortical neurons
- autosomal dominant disorder (CAG repeat on chromosome 4), onset is 25-40 yrd
- other causes: rheumatic chorea, drug induced and lupus
Torticollis
abnormal contraction of SCM affecting ONE side; can be congenital due to damage of CN11 or muscle itself
*constant contraction to one side
How can you tell which SCM is affected with torticollis?
If the right SCM is affected, the head will be TURNED to the CONTRALATERAL side (left)
If torticollis is untreated. What happens?
result in plagiocephaly = flat spot on the back of the head; if baby couldn’t change the position of his head, he would develop a flat spot and need a helmet
*can inject botox to relieve tension in muscles or do physical therapy
What muscle does Torticollis affect if it is caused by a lesion to the CN11? Why? Test how?
trapezius
- *because the innervation to the SCM happens very high up and deep next to major arteries (like carotids) so you’d be worried about other things if that happened! Injuries typically occur in superficial posterior triangle and therefore only affect the innervation to trapezius
- *test by shrugging shoulders; the side that DOESN”T shrug is affected