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Neuro Test 1 > Day-Of Study Notes for neuro test > Flashcards

Day-Of Study Notes for neuro test Flashcards

1
Q

Relating to bladder function: The pons inhibits the ________ + __________

The pons controls the __________ which use ______ fibers to activate the bladder wall

A

pelvic floor muscles and external sphincter

Sacral urination center which uses parasympathetic fibers that activate the bladder wall

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2
Q

The _________ inhibits the pons when it’s not a good time to peepee

A

Frontal cortex

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3
Q

What tract releases seratonin?

What tract released Norepinephrine to help with tonic facilitation?

A

Raphespinal

Ceruelospinal

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4
Q

Flexor nerve are usually more _____ to extensor nerves

Distal nerves are usually more ______ to proximal nerves

A

distal

Lateral

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5
Q

What tract has to do with anticipatory postural changes?

A

Reticulospinal

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6
Q

The anterior spinocerebellar and the rostrospinal are both __________ and ________

A

Single fiber

Internal feedback

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7
Q

The rostrospinal is an (ipsi/contralateral) feedback tract from spinal levels ____

A

Ipsilateral

C1-T1

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8
Q

Subconcious temperature info is transmitted to the ________

A

Reticular formation and thalamus

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9
Q

The slow medial nocieption tract uses what fibers?

A

C fibers

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10
Q

What is the destination of the anterior/lateral spinothalamic tract?

A

Primary and secondary association somatosensory cortex

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11
Q

The anteriolateral spinothalamic 1st and 2nd order neurons synapse in the….

A

Substantia gelitanosa

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12
Q

What spinal levels control reflexive bladder function

A

T11-L2

+

S2-S4

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13
Q

During Hemi-cord syndrome (Brown-Sequard)

You typically see (contralateral/ipsilateral) absence of anteriolateral spinothalamic senses

and (contralateral/ipsilateral) of motor/DCML

A

Contralateral anteriolateral

Ipsilateral motor/DCML

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14
Q

_____ cord syndrome typically stretches the anterior c artery

A

Anterior cord syndrome

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15
Q

What tract functions are usually unaffected by anterior cord syndrome?

A

DCML

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16
Q

Central cord syndrome is usually caused by….

A

Extension/trauma

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17
Q

In central cord syndrome (usually cervical)

Small lesions usually cause ____

whereas large lesions _____

A

Small: nociceptive
& pain impaired at the
level of the lesion

Large: additionally
see upper limb motor
impairments

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18
Q

True or false: In Cauda Equina syndrome, complete lesion of cauda equina are common

A

False

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19
Q

True or false: In Cauda Equina syndrome, you typically see spasticity and hyperreflexia

A

False, they are abscent

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20
Q

Stretch injuries of the spinal cord or cauda equina during
child development/growth spurts can cause….

A

Tethered cord syndrome

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21
Q

In tethered cord syndrome

Stretching of the spinal cord causes ____

whereas damage to cauda equina causes ____

A

Upper motor neuron signs

Lower motor neuron signs

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22
Q

Tethered cord associated with ________

A

spina bifida
myelomeningocele (L4, L5, S1)

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23
Q

Damage to the lumbar
and/or sacral spinal roots

Sensory impairments

Flaccid paresis/paralysis of
lower limb muscles,
bladder, & bowels

These describe what?

A

Cauda equina syndrome

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24
Q

Spinal shock lasts at least 24 hours and may last ____

A

2-3 weeks

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25
Q

The end of spinal shock is marked by return of ____ reflexes

A

Anal reflexes

26
Q

With a spinal cord injury, Spinal neurons can become __________ , developing ___________ as
neuroplasticity develops new synapses in reflex pathway

A

Hyperexcitable, hyperreflexia

27
Q

Somatic reflexes are gone

Autonomic reflexes of smooth muscles are impaired or lost

Autonomic regulation of blood pressure is impaired

Temperature regulation is lost (sweating and goose bumps)

These are symptoms of…

A

Spinal Shock

28
Q

Injury at S2-S4 or related nerve roots causes flaccid areflexive bladder

What does this cause and how can it be treated in males?

A

Overfilling and leaking of bladder

Condom catheter

29
Q

Injury above S2-S4 interrupts descending tracts causing ________ and _______ bladder

A

hypertonic, hyperreflexive bladder

30
Q

Injury above S2-S4 interrupts descending tracts will require…..

A

Intermittent catheterization or indwelling catheter required

Note: Spasticity of bladder wall can potentially force urine back to kidneys

31
Q

Lesion between S2 and S4 reflex circuit in males causes….

A

Impotinence, genitial has no sensation

(worst one)

32
Q

Males with lesion between L2 and S2 will likely have what sexual function?

A

Normal sexual function due to intact L1-L2 aswell as parasympathetic nerves in S2-S4 being intact.

Genitial sensation is abscent however

33
Q

Males with a SCI above T12 will have what sexual function?

A

Loss of psychogenic erection, no sensation, reflexive erection/ ejaculation possible

34
Q

Sexual function:

Males after a SCI will have ____

Females after a SCI will have ____

A

Males: Low spermcount/fertility

Females:

Fertility returns to normal after
SCI

However, pregnancy can be
high risk due to lack of
sensation, muscle contractions
and may require Ceasarian
section

35
Q

Urination/defecation problems

Reduced or lost sensation in “saddle” area

LBP

Unilateral/B sciatica

LE weakness and sensory deficits

Reduced LE reflexes

These are symptoms of _______

A

cauda equina lesions

36
Q

What are 2 mechanisms for UMN overactivity?

A

Absence of corticospinal/ DORSAL reticulospinal inhibition

OR

Brain stem UMN overactivity

37
Q

What is clasp-knife phenomenon

A

Catch is build up of resistance to stretch initially

Basically initial rigidity followed by relaxation during PROM

38
Q

Spasticity arises when pyramid tract is interrupted at: ____ ____ ____

A

Cortex, Corona Radiata, Internal Capsule

39
Q

Lesions must include the _______ to produce spasticity

A

Pre-motor cortex

40
Q

What tract is found in the genus of the internal capsule?

A

Corticobulbar

41
Q

Where does the cortico-reticular tract arise?

A

Premotor and supplementary motor areas

42
Q

Where does the cortico-reticular tract go?

A

Medial and lateral/dorsal reticulospinal

43
Q

What is the ventromedial reticular formation?

A

Inhibitory area in medulla, dorsal to pyramids

Controlled by pre-motor cortex

INHIBITS SPINAL STRETCH REFLEX via dorsal/lateral reticulospinal tract

44
Q

The excitatory system of the extrapyramidal tracts facilitates ______ and inhibits ____

A

Facilitates: Spinal stretch reflex, extensor tone

Inhibits: flexors

(Note: under less cortical control than inhibitory system)

45
Q

True or false: Lesions of ventromedial reticular formation or the dorsal/lateral reticulospinal tract will produce spasticity

A

True

46
Q

What are the different kinds of spinal segmental inhibition?

A

1a presynaptic inhibition

1a reciprocal inhibiton

1b autogenic inhibiton

Renshaw cell inhibition

47
Q

1a presynaptic inhibition is mediated by the release of ________

A

GABA-ergic neurotransmitters that decrease efficacy of 1a afferent transmitters release

48
Q

Renshaw cells inhibit homonymous muscles and _____

A

Synergistic muscles

Note: they also inhbiit both gamma MN and 1a neurons

49
Q

Recurrent neurons excite renshaw cells using what neurotransmitter?

A

AcH

50
Q

What is the most common measurement of spasticity?

A

Modified Ashworth scale
Patient in relaxed position (generally supine)
Passively move joint rapidly through available PROM

Graded 0-4

51
Q

Describe the pathway of the consensual blink response

A

1st order neuron – trigeminal ganglion
2nd order neuron – spinal trigeminal nucleus
To interneuron in reticular formation
To B CN VII facial n to B orbicularis oculi to blink both eyes

52
Q

What nerve innervates the “Stapedius of ear”

A

Facial N

53
Q

Vestibular system considered central and peripheral .

what is the Peripheral part?

A

Peripheral part = peripheral vestibular n and vestibular apparatus

54
Q

True or false: Damage to 1 spinal segment or root cannot completely paralyze any limb muscle

A

True, due to the plexus

55
Q

Traumatic axonopathy:

If Schwann cells and connective tissues intact, can regrow at rate of __________
Occurs after crush injury or closed fracture

A

1mm/day

56
Q

Carpal tunnel syndrome is example of…

A

Traumatic myelinopathy

57
Q

Traumatic myelinopathy

A

Repeated mechanical pressures impair blood flow and cause changes to connective tissue of nerve

Myelin becomes damaged and with sensitization of nociceptors the n becomes excessively sensitive to mechanical or chemical stimuli

Can have full recovery

58
Q

How does polyneuropathy progress?

A

Distal to proximal (stocking glove)

59
Q

The first symptoms of polyneuropathy tend to be….

A

First symptoms tend to be sensory loss/dysfunction
Small fiber symptoms: pain, temperature, numbness, dysthesias
Large fiber symptoms: sensory ataxia, proprioception and vibration sense

60
Q

Guillain-Barré Syndrome

A

Inflammatory demyelinating syndrome that typically occurs after viral infection causing more motor than sensory problems, distal to proximal progression

Urgent need to seek medical help due to risk of respiratory failure

Sig # require ventilator support

Prognosis good for recovery for classical form; some rarer variants cause axonal injury

61
Q

CNS injuries vs PNS injuries on a NCV test

A

CNS injuries have normal nerve conduction velocity whereas PNS injuries have decreases velocity and amplitude

62
Q

What has faster muscle atrophy? A CNS injury or a PNS injury?

A

PNS

Neuro Test 1 (19 decks)

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