Clinical Sensory & Motor Paths - S

Question 1

Dorsal root lesions in the sacral region may lead to what?

Answer 1

Atonic bladder

Question 2

If a patient experiences ipsilateral loss of proprioception, 2pt tactile, and vibratory sensations in the UE.. What is lesioned? LE?

Answer 2

FG (fasciculus gracilis), G for ground.. LE!

FC (fasciculus cuneatus)

Question 3

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?

Answer 3

LRST (lateral reticulospinal tract)

Question 4

If volitional control of limb musculature is lost, what has been lesioned?

Answer 4

LCST

Question 5

If a pt loses pain and temp on one side of the body, what lesion has occured?

Answer 5

LSTT lesion on the contralateral side 2 sensory dermatomal segments above the pain

Question 6

A patient comes in with bilateral loss of pain and temp sensations to the UE, a “yolk-like” anesthesia. What lesion has occurred?

Answer 6

Lesion of the AWC

Question 7

A patient presents with Flaccid paralysis, areflexia, atonia, atrophy, and fasciculations. What has been lesioned?

Answer 7

LMN on ipsilateral side

Question 8

What does a congenital absence of C-type fibers lead to? Why?

Answer 8

Insensitivity to pain

Allows for non-nociceptive fivers to overcome/outcompete pain signals “closing the pain gate”

Question 9

What does the Herpes Zoster virus due to increase pain sensitivity?

Answer 9

Compromises non-nociceptive fibers (A alpha-beta) leaving pain fiber signals unopposed to opening the “pain gate”

Question 10

What is an anterolateral cordotomy/tractotomy used for?

Answer 10

LSTT transection 2 segments above the pain on the opposite/contralateral side to treat intractable pain

Question 11

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?

Answer 11

AWC

Syringomyelia

Question 12

How would one test position sensation?

Answer 12

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

Question 13

If you were testing vibratory sensations, where would the tuning fork be placed?

Answer 13

Medial malleolus or MCP joint

Question 14

How far apart should paperclip point be when testing 2pt tactile? Where is this best tested?

Answer 14

1 cm

Palms or soles of feet

Question 15

What is Tabes Dorsalis? What parts of the spinal column are most often affected?

Answer 15

Memingovascular inflammation of blood vessels as they pierce through the pia mater at the junction of dorsal rootlets and posterior columns

Lumbosacral nn

Question 16

When does Tabes Dorsalis most often occur?

Answer 16

During the late stage of syphilis

Question 17

What does Tabes Dorsalis lead to? What are hallmark symptoms?

Answer 17

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

Question 18

What is Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig’s disease)? Is an etiology known?

Answer 18

A disease where a hypothesized defect in glutamate metabolism causes bulbar paralysis which involves vital respiratory centers

No known cause

Question 19

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?

Answer 19

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!

Question 20

What are the LMN sections involved in amyotrophic lateral sclerosis (ALS)?

Answer 20

AH cells, hypoglossal nucleus (tongue musculature), nucleus ambiguous (larynx and pharynx), facial motor nucleus

Question 21

If there’s a diminished motor reflex and lack of muscle tone in a region of the body, what would be lesioned?

Answer 21

Dorsal root(s)