Diseases/Symptoms/Lesions Flashcards

1
Q

Rigidity

A

resist motion in all directions (through all ROM)

maintained m contraction

cont activation of a-motorneurons

basal ganglia disease

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2
Q

spasticity

A

resists motion in given direction, collapse of resistance at end of ROM

hyperactive myotatic reflex

cont activation of gamma-motorneurons (contracts intrafusal m, lengthens nuclear bag and chain fibers, brainstem)

UMN

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3
Q

decerebrate posturing

A

lesion: rostral to pons, below red nucleus, above reticulospinal and vestibulospinal tracts

rigidity - activate a-motorneuron

not dependent of head position

UE - pronation/extension
LE - extension

on head and heels w back arched

central herniation

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4
Q

Lateral Pontine Syndrome

A

Ipsilateral - paralysis of face (facial nuc) /masticatory m (V motor nuc), horners (hypothalamospinal fibers), pain/temp from face (spinal v tract and nuc)

contralateral - pain/temp from body (als)

paralysis of conjugate horizontal gaze
ataxia, fall toward side lesion

N/V/Nsytamus/deaf/vertigo/tinnitus

MIllard Gubler Syndrome

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5
Q

Lateral Medullary Syndrome

A

wallenberg syndrome

dysphagia, soft palate paralysis, hoarseness, decreased gag reflex (nucleus ambiguus)

contralateral - pain/temp of body (ALS)

ipsilateral - pain/temp of face (spinal v tract/nuc), horners (hypothalamospinal), ataxia

N/diplopia, fall to ipsi side, nystagmus vertigo

PICA

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6
Q

Benign Paroxysmal Positional Vertigo

BPPV

A

otoconia dislodged into semi circular duct (cupulolithiasis), agitates ampulla, sends AP to CNS that they are moving when they aren’t

most common vestibular disorder (posterior semicircular canal is most common)

test: dix hallpike

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7
Q

Medial Medullary Syndrome

A

contra - hemiplegia of body, positions sense/vibratory/discriminative touch of body
tongue dev to ipsi side, m atrophy, fasciculations (CN VII in med or nuc)

Dejerine syndrome

ASA

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8
Q

Locked-In

A

CST and CNT

anterior pons

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9
Q

Webers Syndrome

A

contra hemiplegia (CST in crus cerebri)
damaged eye movement (CN III)
uncal herniation

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10
Q

central midbrain lesion

A

Claude Syndrome
CN III - ipsi eye
red nucleus and cerebral thalamic nucleus
contra - ataxia

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11
Q

Labyrinthine A Occlusion

A

vertigo, nystagmus, unstable gait

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12
Q

meniere’s disease

A

disruption of endolymph vol
endolymphatic hydrops
hearing loss, vertigo, nystagmus, nausea
can be unpredictable

tx: diuretics and salt restriction

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13
Q

dizziness

A

nonspecific term that gen means disorientation

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14
Q

vertigo

A

illusion of body motion, spinning with no real motion taking place

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15
Q

vestibular schwannoma

A

from schwann cells of vestibular root
in cerebellopontine angle and everything in internal acoustic
hearing loss, gait diff, tinnitus

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16
Q

vestibular neuritis

A

several vertigo, n/v
involve edema of vestibular n/gang (from acute infect - HSV/cold/URI/flu)
tx: antiemetics, corticosteroids, antiviral

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17
Q

spontaneous nystagmus

A

silences output from damaged side
spontaneous nystagmus, vertigo, falls, vomit
if central dam to brainstem/cerebellar: don’t have voluntary saccades, smooth pursuit

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18
Q

issues w/ dorsal root

A

diminished tone and reflexes (decreased spasticity)

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19
Q

issues w/ posterior columns

A

fas, gracilis, cuneatus

ipsi loss of prop, 2 pt tactile discrim below lesion

20
Q

issues w/ lateral corticospinal

A

ipsi UMN paralysis/paresis below lesion

21
Q

issues w/ lateral spinothalamic

A

contra loss of pain/temp 2 dermatomes below lesion

22
Q

issues w/ lateral reticulospinal

A

horner’s syndrome (above T1)
incontinence
autonomic function

23
Q

issues w/ anterior horn

A

LMN paralysis/paresis (flaccid)

24
Q

issues w/ anterior white commissure

A

bilateral analgesia
central cord - syringomyelia
(c4-c5)

25
Subfalcine Herniation
falx/falcine/cinguate herniation ``` Displace brain tissue under Falx cerebri (not in middle) ``` compresses: aca, frontal/parietal lobe, sensory/motor lower limbs sx: N/V/HA includes transtentorial hern
26
Transtentorial herniation
central hern Brain Downward toward tentorial notch compress: Upper brainstem, cn iii, lower structures (parasym, cn III dilated eyes), Basilar a and pca Decorticate rigidity, decerebrate rigidity
27
Uncal herniation
Uncus and parahippocampal gyrus over the tentorium cerebelli edge, through tentorial notch compress: midbrain dilated pupil, slowly (shows side 90%)
28
Uncal herniation: Kernoham
shift midbrain | ipsilateral CN III palsy and hemiparesis of body (motor) on same side
29
uncal herniation: damaged midbrain on same side
CN III palsy ipsilateral side hemiparesis contralateral side Weber's syndrome (superior alternating hemiplegia)
30
tonsillar herniation
cerebellar tonsils through foramen magnum medulla/upper sc cardaic/resp issues (centers located in medulla)
31
intracerebral hemorrhage
subpial hemorrhage bleed within brain substance (stroke), or in subarachnoid, stabbed, genetic MCA hypertension or degen arterial disease
32
vertebral basaliar insufficiency
decreased blood flow from VA | from: hyperextension of head, extreme head rotation (bow hunters syndrome)
33
subclavian steal syndrome
steals vertebral blood from arm occlusion proximal to VA, decreases pressure of subclavian distally so blood that flows up VA on oppo side, hits basilar, retrogrades down occluded VA side to supply arm
34
aqueductal stenosis
non-comm obstructive accum of CSF in lateral/3rd ventricle from: congential - x linked, pineal tumor, meningitis scarring, intrauterine infection inflammation
35
chiari II
down displacement of inferior cereballar vermis and tonsils in foramen magnum cerebellum fully grown, compress 4th ventricle (accum above) lumbosacral myelomeningoele non-comm
36
dandy walker
congenital brain malformation 4th ventricle outlet obstruction cerebellar hypoplasia (part or full missing) non-comm
37
normal pressure hydrocephalus
``` adults enlarged ventricles and cortical atrophy from CSF not drain or absorbing, increased viscosity, alter elasticity of ventircular walls TRIAD - wacky wobbly wet comm tx: lumbar puncture ```
38
holoprosencephaly
incomplete sep of cerebral hemi cyclopia, 1 nostril, facial cleft, premaxillary agensis SHH, decrease cholesterol
39
agenesis of corpus callosum
part of complete | asymptomatic, seizures/mental def
40
lissencephaly
genetic smooth brain - incomplete neuronal migration pachygryria, agyria, neuronal heterotopic start w seizures, mental def, mild spastic quadriplegia
41
Hemisection
``` Brown - Sequards Syndrome p/t contra side touch/prop ipsi side LMN at level of lesion (ipsi) UMN (ipsi) ```
42
complete transection of sc
1-2 below lesion bladder/bowel control lost spinal shock (loss tendon reflex) UMN below lesion, LMN at lesion
43
polyneuropathy
sensory, motor and autonomic distal to proximally (stocking and glove presentation) dying or impaired axon transport (demyelination?) diabetics
44
anterior cord syndrome
damage to anterior sc from infarction/ herniation/radiaton myelopathy STT and LCST
45
central cord syndrome
hyperextension of sc | damage to AWC - bilat pain and temp gone, can lose some motor function too
46
spinal shock
loss of reflexes due to loss of muscle tone and hyperpolarization axonal sprouting, 5HTC receptors can recover