Clinical Sensory And Motor - 4/20 Stephens

Question 1

Unilateral lesion of primary neurons from FG results in what?

FC?

Secondary neurons?

Answer 1

Ipsilateral loss of proprioception/2pt below level of lesion

Same but for upper body

Contralateral deficits

Question 2

Destruction of the LCST results in what?

What clinical signs?

Affects what specifically?

Answer 2

Ipsilateral paralysis below the level of the lesion

Spastic paralysis, hyperreflexia, hypertonic, Babinski, clonus

UMN

Question 3

Transection of the spinal cord above S2 interrupts what?

Results in what?

Answer 3

LRST and SAN

Reflex bladder, loses voluntary voiding

Question 4

Unilateral lesions of LSTT result in what?

Answer 4

Contralateral loss of pain/temp 2 sensory dermatomes below levels of lesion

Question 5

Destruction of the AWC results in what?

Answer 5

Bilateral loss of pain/temp to upper extremities (yoke-like anesthesia)

Question 6

LMN paralysis results from what?

Where are they located?

Clinical symptoms?

Answer 6

Destruction of motor neurons/axons of 1 or more cranial or spinal motor nuclei

anterior (ventral) horn

Flaccid paralysis, areflexia, atonia, atrophy, fasciculations

Question 7

Congenital absence of C type fibers results in what?

Answer 7

Insensitivity to pain

Question 8

What does herpes zoster (shingles) infection compromise?

Clinical Sx?

Answer 8

Non-nociceptive A alpha/beta fibers

Increased sensitivity to pain from the sensory dermatome of the affected nerve

Question 9

What is the treatment for intractable pain?

Where does it take place?

Answer 9

Anterolateral cordotomy

LSTT transected in the Anterolateral quadrant 2 segments above and on opposite side of the area of pain

Question 10

What serves as the landmark bw the LSTT and the corticospinal fibers?

Answer 10

Denticulate ligaments

Question 11

Unilateral lesions of the SL result in what?

Answer 11

Contralateral hemianalgesia and thermal hemianesthesia

Question 12

A prefontal lobotomy was used as tx for intractable pain. What is a major side effect of this procedure?

Answer 12

Apathy

Question 13

Syringomyelia may occur secondary to what?

Answer 13

Central cord syndrome

Question 14

Enlargement of the syrinx results in what?

Answer 14

Destruction of AWC

Asymmetrical destruction of LCST

AH destruction

Posterior column destruction

Question 15

Destruction of the LCST results in what?

Affects what?

Answer 15

Spastic paralysis, hyperreflexia, hypertonia

UMN

Question 16

Destruction of Anterior horns results in what?

Affects what?

Answer 16

Flaccid paralysis, atrophy, areflexia, atonia of the upper limb musculature

LMN

Question 17

Destruction of posterior columns result in what?

Answer 17

Ipsilateral anesthesia (prop/2pt) below the level of the lesion

Question 18

The VSTT is associated with what?

Answer 18

Crude touch

Question 19

What structures are most commonly affected in Tabes dorsalis?

Results in bilateral ischemic necrosis of what?

Answer 19

Lumbosacral nerves and spinal cord segments

Posterior columns and dorsal roots

Question 20

5 most common signs and symptoms of Tabes Dorsalis?

Answer 20

Lightning pain from lower limbs due to irritation of type A pain fibers
Atonic bladder (dorsal root involvement)
Slapping gait due to loss of proprio
Positive Romberg test due to posterior columns
Argyll-Robertson pupils

Question 21

Acute anterior poliomyelitis involves what?

Answer 21

Motor neurons of the anterior (ventral) horns and cranial nerve motor nuclei

Question 22

What structures are most commonly involved in ALS, LMN and UMN?

Answer 22

LMN - AH cells, Hypoglossal Nucleus, Nucleus Ambiguus, Facial Motor Nucleus

UMN - degeneration of Corticospinal Tracts

Question 23

Clinical signs of ALS?

Answer 23

Dysarthria
Dysphagia
Paresis of tongue
Spastic paralysis
Hyperreflexia
Babinski sign
NO SENSORY DEFECTS

Question 24

Destruction of the dorsal roots of the spinal cord result in what?

What special condition?

Answer 24

Diminish motor reflexes including muscle tone

Atonic bladder