Effect of Lesions Flashcards
C1-C5…
Mental status?
Gait (LMN or UMN)? Ataxia?
Cranial nerves?
Postural reaction?
Limb tone?
Reflexes?
Cutaneous trunci?
Mental status = NORMAL
Gait = UMN, long and flowy steps in thoracic and pelvic limbs
Ataxia = SPINAL ATAXIA (crossing over limbs, abduction, long stride) & SPASTIC HEMI/TETRAPARESIS
Cranial nerves = Mostly normal
Postural reaction = normal to delayed in all limbs
Limb tone = normal to increased in all limbs
Reflexes = hyperreflexive in all limbs
Cutaneous trunci = normal
C6-T2
Mental Status?
Gait?
Cranial nerves?
Postural reaction?
Limb tone?
Reflexes?
Cutaneous trunci?
Sensation
Others
Mental status = NORMAL
Gait = “2-engine gait”
LMN in FRONT; short & choppy
UMN in PELVIC; long and flowy
Cranial nerves = mostly normal
Postural reaction = NORMAL to DELAYED in ALL LIMBS
Limb tone = DECREASED in front, NORMAL to INCREASED in hind
Reflexes =
DECREASED to ABSENT in front NORMAL to INCREASED in HIND
Cutaneous trunci = NORMAL or COMPLETELY ABSENT (C8-T1)
Sensation = DECREASED IPSILATERAL and caudal to lesion
Other
- Horner’s syndrome
- Issues with diaphragmatic breathing?
- URINARY INCONTINENCE/DECREASED ABILITY TO EXPRESS BLADDER
T3-L3
Mental Status?
Gait?
Cranial nerves?
Postural reaction?
Limb tone?
Reflexes?
Cutaneous trunci?
3 other things?
Mental status = NORMAL
Gait?
NORMAL in front
UMN in hind (long and flowy)
Cranial nerves? = Normal
Postural reaction?
NORMAL in front
NORMAL to DELAYED in hind
Limb tone?
NORMAL in front
NORMAL to INCREASED in hind
Reflexes?
NORMAL in front
NORMAL to INCREASED in hind
Cutaneous trunci?
- COULD be normal if lesion is NOT SEVERE ENOUGH TO CAUSE A PROBLEM
- Can localize lesions 2-4 segments CRANIAL to where CUTANEOUS TRUNCI RETURNS
3 others?
1. UMN bladder = hard to express/overcome pressure of SPHINCTER
2. SPINAL SHOCK = absence of reflexes in hind correlate with SEVERITY of spinal damage
3. SCHIFF-SHERRINGTON POSTURE = hindlimbs PARAPARETIC, forelimbs SPASTIC/STIFF
L4-S1
Mental status?
Gait?
Cranial nerves?
Postural reactions?
Limb tone?
Reflexes?
Cutaneous trunci?
4 others?
Mental status = NORMAL
Gait?
NORMAL in front
LMN (short and choppy) in HIND
Cranial nerves? = NORMAL
Postural reactions?
NORMAL in front
DELAYED to ABSENT in hind
Limb tone?
NORMAL in front
DECREASED in hind
Reflexes?
NORMAL in front
DECREASED to ABSENT in hind
Cutaneous trunci? = NORMAL
4 others?
1. LMN bladder = FLACCID, constantly LEAKS
2. PSEUDO-HYPERREFLEXIA = issue with SCIATIC NERVE causes PATELLAR HYPERREFLEXIA
3. DECREASED TAIL TONE
4. DECREASED ANAL TONE
Peripheral nerve lesions
Gait
- Stiff, short-strided gait
- Flaccid paresis/paralysis
- Generalized weakness/exercise tolerance
Postural reactions
- Normal to diminished
Reflexes
- Hyporeflexia/areflexia
- Hypotonia/atonia/flaccidity
- Muscle atrophy
Other
- Fasciculations and muscle tremors
- +/- urinary and fecal incontinence
- Muscle atrophy
LMN spinal ataxia clinical signs…
Stride length?
Postural reactions?
Reflexes? (2)
Muscle tone?
Muscle atrophy
often caused by…
Stride = SHORT-STRIDED
Postural reactions = DECREASED
Reflexes =
1. DECREASED reflexes
2. WEAK WITHDRAWAL
Muscle tone = FLACCID
RAPID MUSCLE ATROPHY +
Often caused by peripheral nerve disease
UMN spinal ataxia clinical signs
Stride length?
Postural reactions?
Reflexes?
Muscle tone?
Muscle atrophy?
stride = LONG-STRIDED
postural reactions = DECREASED
reflexes = HYPERREFLEXIA
muscle tone = SPASTIC
NO RAPID MUSCLE ATROPHY bc limb can still be used
what are the 3 types of ataxia?
- spinal
- vestibular
- cerebellar
SPINAL ataxia..
aka?
3 characteristics?
aka PROPRIOCEPTIVE ataxia
3 characteristics?
1. crossing over limbs
2. INCREASED stride length
3. abduction/circumduction of limbs (moving AWAY from body)
VESTIBULAR ataxia…
caused by disease of what 3 possible structures?
3 structures?
1. inner ear
2. vestibular nuclei
3. cerebellum
CEREBELLAR ataxia…
aka?
characterized by what 3 signs?
aka DYSMETRIA
characterized by…
1. abnormal RATE or RANGE of motion
2. OVER-STEPPING/GOOSE-STEPPING
3. delayed onset of voluntary motion
dysmetria definition
the inability to control the distance, speed, and range of motion necessary to perform smoothly coordinated movements
name the 2 neurolocalizations where we can see MENTATION change
- forebrain
- reticular activating system in midbrain
what are 2 clinical signs & 1 dz that can originate from injury at C1-C5?
- Horner’s syndrome
- Cervical muscle spasms
- Urinary INCONTINENCE/DECREASED ABILITY TO EXPRESS BLADDER
what neurolocalization can cause acute respiratory distress & why?
C1-C5
because C3-C5 innervates the PHRENIC nerve, can inhibit respiration!
