Clinical Sensory & Motor Paths - S Flashcards
Dorsal root lesions in the sacral region may lead to what?
Atonic bladder
If a patient experiences ipsilateral loss of proprioception, 2pt tactile, and vibratory sensations in the UE.. What is lesioned? LE?
FG (fasciculus gracilis), G for ground.. LE!
FC (fasciculus cuneatus)
If autonomic control of bladder and bowels is lost, or a SC transection has occurred above S2 causing urinary retention and a reflex bladder.. What has been lesioned?
LRST (lateral reticulospinal tract)
If volitional control of limb musculature is lost, what has been lesioned?
LCST
If a pt loses pain and temp on one side of the body, what lesion has occured?
LSTT lesion on the contralateral side 2 sensory dermatomal segments above the pain
A patient comes in with bilateral loss of pain and temp sensations to the UE, a “yolk-like” anesthesia. What lesion has occurred?
Lesion of the AWC
A patient presents with Flaccid paralysis, areflexia, atonia, atrophy, and fasciculations. What has been lesioned?
LMN on ipsilateral side
What does a congenital absence of C-type fibers lead to? Why?
Insensitivity to pain
Allows for non-nociceptive fivers to overcome/outcompete pain signals “closing the pain gate”
What does the Herpes Zoster virus due to increase pain sensitivity?
Compromises non-nociceptive fibers (A alpha-beta) leaving pain fiber signals unopposed to opening the “pain gate”
What is an anterolateral cordotomy/tractotomy used for?
LSTT transection 2 segments above the pain on the opposite/contralateral side to treat intractable pain
If a pt comes in experiencing bilateral loss of pain and temp sensations to the UEs (“yolk-like anesthesia), what has been lesioned? Under what circumstances might this happen?
AWC
Syringomyelia
How would one test position sensation?
With the pts eyes closed, gently flex and extend the pt’s finger or toe, pt should be able to indicate if bent/straight/unchanged
If you were testing vibratory sensations, where would the tuning fork be placed?
Medial malleolus or MCP joint
How far apart should paperclip point be when testing 2pt tactile? Where is this best tested?
1 cm
Palms or soles of feet
What is Tabes Dorsalis? What parts of the spinal column are most often affected?
Memingovascular inflammation of blood vessels as they pierce through the pia mater at the junction of dorsal rootlets and posterior columns
Lumbosacral nn
When does Tabes Dorsalis most often occur?
During the late stage of syphilis
What does Tabes Dorsalis lead to? What are hallmark symptoms?
Bilateral ischemic necrosis of posterior columns and dorsal roots at the ischemic level
Lightning pains, locomotor ataxia (slapping of feet), positive Romberg test, Argyll-Roberston
What is Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig’s disease)? Is an etiology known?
A disease where a hypothesized defect in glutamate metabolism causes bulbar paralysis which involves vital respiratory centers
No known cause
Pts with ALS (amyotrophic lateral sclerosis) die from bulbar paralysis, but what are the symptoms prior to that? What defects are not associated with ALS?
LMN paresis and atrophy of muscles in the hands, arms, and shoulders
Dysarthria, dysphagia, and paresis of the tongue
Spastic paralysis (UMN damage), hyperreflexia, Babinksi sign positive
SENSORY!
What are the LMN sections involved in amyotrophic lateral sclerosis (ALS)?
AH cells, hypoglossal nucleus (tongue musculature), nucleus ambiguous (larynx and pharynx), facial motor nucleus
If there’s a diminished motor reflex and lack of muscle tone in a region of the body, what would be lesioned?
Dorsal root(s)
