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6- Neuro Diag > Exam 1 Ch5,6,7 combined > Flashcards

Exam 1 Ch5,6,7 combined Flashcards

1
Q

3 cranial fossae

A

anterior

middle

posterior

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2
Q

3 layers of meninges

A
  1. Dura
  2. Arachnoid
  3. Pia
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3
Q

Cerebrospinal fluid: Made by

A

by ependymal cells in the 2 lateral ventricles

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4
Q

CSF function

A
  1. mechanical protection (makes brain floating/absorb impact)
  2. Chemical protection (act as a buffer)
  3. nutrients waist transfer
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5
Q

CSF Volume

A

150 cc

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6
Q

CSF filtration rate

A

20 cc per Hour

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7
Q

3 spaces (meninges)

A

epidural

subdural

subarachnoid

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8
Q

_____ is a Common neurological symptom: benign, maybe bad

A

Headache

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9
Q

Brain has nociceptors (true/false)

A

false

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10
Q

Intracranial sensory nerves

A

V

IX

X

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11
Q

Headeach + neck stiffness + fever =

A

meningitis

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12
Q

Sudden explosive headache (worst headache ever) =

A

subarachnoid hemorrhage

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13
Q

Types of headaches

A

Vascular

Inflammatory

Tension type

Increased ICP

Fatigue

Traumatic

Toxic/metabolic

Infectious

Referred

Low pressure

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14
Q

Types of Vascular Headache

A

Migraine

Cluster

Dissection

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15
Q

Migraine is most common in (men/women)?

A

women

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16
Q

Type of migraine:

unilateral and throbbing, lasts a few hours, bright light and loud sound makes it worse, prodrome (aura)

A

Classic migraine

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17
Q

Type of migraine:

same as classic + other neuro finding (blinding in 1 eye, tingling, weakness)

A

Complicated migraine

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18
Q

Type of migraine:

doesn’t give a headache, causes nausea and other debilitating symptoms.

A

Atypical migraine

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19
Q

Type of a vascular headaches:

middle aged men, unilateral behind 1 eye, last minutes, short and intense, alcohol and stress make it worse

A

Cluster

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20
Q

Dissection (neurologic) causes damage to

A

the tunica intima

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21
Q

Dissection (neurologic) results in

A

thrombus or embolism formation at this site resulting in ischemia

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22
Q

Tension Type Headache aka

A

Cervicogenic/ subluxation

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23
Q

Tension Caused by

A

dehydration

stress

psychological

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24
Q

Tension Described as

A

squeezing (hatband)

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25
Q

Fatigue Headache is related to:

A

sleep deprivation

eye strain

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26
Q

Causes of Toxic/Metabolic Headachea

A
  1. dehydration (hangover)
  2. chemical exposure
  3. rebound (withdrawal ie: caffeine)
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27
Q

Cuases of Referred Headache

A
  1. dental
  2. eye strain
  3. sinus irritation (frontal or maxillary sinus)
  4. neck pain suboccipital
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28
Q

Inflammatory Headache (Temporal) aka

A

giant cell arteritis

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29
Q

Inflammatory Headache common in (who)

A

elderly patients

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30
Q

Inflammatory Headache risks

A

inflammation of temporal aa
ophthalmic aa

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31
Q

Inflammatory cells invade tunica ____

A

media

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32
Q

Fibrotic change results in the tunica _____

A

intima

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33
Q

Inflammatory Headache Signs and symptoms:

A

Swelling of the superficial temporal artery

Will be hard and palpable

Scalp pain

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34
Q

Causes of neurological deficits?

(Increased Intracranial Pressure)

A
  1. compression
  2. destruction
  3. herniation
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35
Q

Increased Intracranial Pressure-

Signs and symptoms (Cushing triad)

A

increase bp (pressure in skull)

decrease HR (due to the coratid receptor, dorsal nucleus of vagus)

irregular respiration

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36
Q

Increased Intracranial Pressure- Global symptoms

A

headache

changes in mental status

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37
Q

Increased Intracranial Pressure - Focal symptoms

A

specific to the area of brain preforming that function

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38
Q

Def: optic disc gets swollen and puffy (due to increased ICP)

A

Papilledema

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39
Q

Nervous System Herniation Locations:

A
  1. cingulate gyrus
  2. inferior media temporal lobe
  3. cerebellar tonsil
  4. new opening
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40
Q

Hydrocephalus happens due to

A

obstructed CSF flow

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41
Q

Hydrocephalus symptoms (adults)

A

increased ICP

Dementia

Urinary incontinence

Gait impairment

loss of forward and back ward stability

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42
Q

Hydrocephalus symptoms (children)

A

increased ICP

big head (skull is not fused)

setting sun sign (rolling down eye)

high pitch scream

poor head control (weight of water)

transillumination (shine a light on one side, and be visible on the other)

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43
Q

Intracranial tumors causes

A
  1. increased ICP
  2. Focal deficit (also global deficit)
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44
Q

Damage to the tunica intima leads to

A

blood flowing into the false lumen

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45
Q

Fibrotic change due to Inflammatory Headache leads to the closur of the ____

A

lumen

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46
Q

Intracranial tumors causes

A
  1. increased ICP
  2. Focal deficit (also global deficit
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47
Q

What do benign tumors do to the surrounding tissue?

A

push the tissue away

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48
Q

What do malignant tumors do to the surrounding tissue?

A

invade the surrounding tissue

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49
Q

is the benign tumor encapsulated?

if yes, what is the capsule made of?

A

Yes, with fiber/calcium

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50
Q

is the malignant tumor encapsulated?

if yes, what is the capsule made of?

A

No

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51
Q

benign tumor growth rate

A

slow

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52
Q

malignant tumor growth rate

A

fast

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53
Q

Benign tumor recurrence

A

less likely

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54
Q

Malignant tumor recurrence

A

more likely

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55
Q

Tumor types

A

mets (metastatic)

glioma

meningioma (benign)

pituitary tumor

Schwannoma

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56
Q

metastatic precentage of all tumors

A

23%

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57
Q

glioma precentage of all tumors

A

40%

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58
Q

what’s the ratio of benign to malignant glioma

A

1:1

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59
Q

meningioma precentage of all tumors

A

17%

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60
Q

is meningioma benign or malignant

A

benign

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61
Q

pituitary tumor percentage out of all tumors

A

5%

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62
Q

Schwannoma percentage out of all tumors

A

5%

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63
Q

Trauma injury sites

A

Linear impact coup

Rebound impact Contrecoup

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64
Q

Rotational Shear Damage

A
  1. Rotational component of injury affect the lower parts of brain
  2. Basal ganglia and thalamus
  3. Corpus callosum
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65
Q

the Cause of concussion

A

Mild head trauma

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66
Q

concussion symptoms

A

loss of consciousness

headache

vomiting

amnesia

disorientation

seizure

focal neurological deficit

fatigue

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67
Q

concussion Signs

A

oculomotor difficulties

vistibulo-ocular disturbance

balance and postural instability

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68
Q

Define:

Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)

A

computerized baseline compared to post injury

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69
Q

ImPACT measures

A
  1. attention span
  2. working memory
  3. sustained and selective attention time
  4. response variability
  5. nonverbal problems solving
  6. reaction time
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70
Q

SCAT5 characteristic

A
  • Sport concussion assessment tool
  • Has immediate on field assessment
  • Also has office assessment
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71
Q

On field assessment includes

A
  • Red flags
  • Observable neurologic signs
  • Memory assessment
  • Glasgow coma scale and cervical examination
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72
Q

Off Field assessment includes

A
  • History of injury
  • Symptoms scale
  • Cognitive assessment
  • Neurological and balance exam
  • Delayed recall – short term memory
  • Decision making – problem solving
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73
Q

Guidelines for Concussion Management

A
  1. removal from contest following signs and symptoms of concussion
  2. no return to play in current game
  3. medical evaluation following injury
  4. rule out more serious intracranial pathology
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74
Q

Step wise to return to play

A
  • No activity rest until asymptomatic
  • Light aerobic excersise
  • Sport specific training
  • Non-contract drills
  • Full contract drills
  • Game play

Generally about 24 hours per step

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75
Q

Post Concussive Syndrome can last

A

days to weeks after injury

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76
Q

Post Concussive Syndrome

sign & symptoms

A
  • Fatigue
  • difficulty concentrating
  • irritability
  • light sensitivity
  • noise sensitivity
  • emotional lability
  • dizziness
  • headache
  • neck pain
  • nausea
  • vomiting
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77
Q

Contusion aka

A

Traumatic Intracerebral or Intraparenchymal Hemorrhage

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78
Q

Epidural Hematoma location

A

between dura mater and skull

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79
Q

Epidural Hematoma gets worse over the course of (time)

A

hours (rapidly)

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80
Q

Epidural Hematoma complications

A
  • Rupture of middle meningeal artery
  • Lens shaped convex hematoma
  • Rapid progressing
  • Displaces brain tissue
  • Leads to herniation
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81
Q

Subdural hematoma complication

A
  • rupture of bridging veins, slower in developing
  • Shear force tear of bridging veins
  • Crescent shaped bleed
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82
Q

Acute Subdural hematoma

A

within 24 hours severe neurologic deficits, 50% mortality

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83
Q

Subacute Subdural hematoma

A

1-14 days post injury with focal neurologic deficits

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84
Q

Chronic Subdural hematoma

A

2-6 weeks after injury

headache

balance problems

weakness

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85
Q

the worst type of hematoma

A

Subarachnoid hematoma

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86
Q

Subarachnoid hematoma complications

A
  • Often from aneurysm
  • Ticking time bomb
  • Worst headache of my life
  • Congenital aneurysms
  • Blood fills subarachnoid space
  • 40-50% mortality
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87
Q

Intracerebral hematoma caused by

A

high bp

diabetes

small vessels

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88
Q

Hypertensive hemorrhage

A
  • High blood pressure threatens deep penetrating arteriols
  • form micro aneurysms
  • The micro aneurysms harden
  • Continued pressure causes them to rupture
  • Happens in basel ganglia pons cerebellum
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89
Q

Laceration

A

tearing of nervous system

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90
Q

Central Nervous System Infection can be caused by:

A

bacteria

viral

parasitic

prions

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91
Q

CNS infections Spread via

A

blood

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92
Q

the most common Symptoms with infections in the CSF

A

fever (bacterial & viral)

neck stiffness

headache

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93
Q

Bacterial meningitis may be fatal within _____

A

Hours of onset

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94
Q

the most fatal bacteria that cuause meningitis

A

Neisseria meningitis

Strep. pneumonia

Haemophilus influenzae

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95
Q

Bacterial meningitis signs and symptoms

A
  1. headache
  2. fever
  3. neck stiffness
  4. CSF cloudy full of puss
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96
Q

Def Brain abscess

A

pocket full of puss in the brain

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97
Q

Brain Abscess symptoms

A

headache

fever

neck stiffness

neurological signs specific to that area

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98
Q

Chances of survival with treatment (percentage)

A

80%

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99
Q

Lyme Disease is caused by

A

borelia burdoferri

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100
Q

Lyme Disease is transmitted by

A

deer tick

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101
Q

Lyme Disease stage 1 timing

A

Days to weeks after infection

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102
Q

Lyme Disease stage 1 symptoms

A
  • Muscle + joint pain
  • Swollen lymph nodes
  • erythema migrans (thigh, groin, axilla)
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103
Q

Lyme Disease Stage 2 timing

A

Weeks to months

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104
Q

Lyme Disease Stage 2 symptoms

A
  • Unilateral facial paralysis
  • Mild meningitis
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105
Q

Lyme Disease Stage 3 timing

A

Months to years after untreated infection

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106
Q

Lyme Disease Stage 3 symptoms

A
  • Chronic Lyme arthritis (MC knee)
  • Nervous system problems: memory loss and difficulty concentrating
  • chronic pain in muscles and unrestful sleep
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107
Q

describe lyme disease target rash

A

: pimple surrounded with a red ring

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108
Q

Viral meningitis aka

A

aseptic meningitis

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109
Q

what’s a special sign about viral meningitis

A

Clear CSF

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110
Q

Defince Encephalitis

A

viral infections that involve the brain parenchyma

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111
Q

is Encephalitis (more/less) severe than typical viral meningitis?

A

more severe

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112
Q

encephalitis results in

A

meningoencephalitis

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113
Q

exapmle of primary viral infection

A

west nile

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114
Q

west nile is transmitted by

A

mosquito

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115
Q

example of secondary viral infection

A

herpetic rash

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116
Q

Subacute sclerosing panencephalitis is caused by

A

persistent measles infection

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117
Q

Subacute sclerosing panencephalitis symptoms

A
  • Intellectual deterioration
  • Forgetfulness
  • Hallucination
  • Seizures
  • Neurological signs through CNS
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118
Q

Subacute sclerosing panencephalitis prognosis

A

Variable prognosis (recovery to death)

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119
Q

Sleeping Sickness aka

A

African trypanosoma

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120
Q

Sleeping Sickness stage 1 symptoms

A

fever

joint pain

headache

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121
Q

Sleeping Sickness stage 2 symptoms

A

sleep/wake cycle disruption

confusion

ataxia

tremor

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122
Q

Cysticercosis is caused by

A

tenia solium

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123
Q

Cysticercosis symptoms

A
  • Headache
  • Nausea
  • Vomiting
  • seizure
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124
Q

what are prions?

A

protein fragments

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125
Q

Creutzfeldt-Jakob disease symptoms

A

rapid progressive dementia

ataxia

hallucination

startle response

myoclonus

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126
Q

Prions Incubation period

A

2-25 years

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127
Q

prions are tramitted from

A

from organ transplant

beef with BSE

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128
Q

prions prognosis

A

death within 6-12 months

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129
Q

prions infections are differentiated using

A

lumbar puncture

spinal tap

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130
Q

lumbar puncture is taken at which level?

A

L4/L5 (below the spinal cord)

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131
Q

Too much fluid drawn or too fast during the lumbar puncture is the cause of

A

low pressure headache

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132
Q

list the Corticospinal pathway

A
  1. Cerebral cortex
  2. Midbrain
  3. Pons
  4. Medulla
  5. Spinal cord
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133
Q

Corticospinal is Influenced by

A

cerebellum and basal ganglia

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134
Q

Corticobulbar Tract begins in

A

primary motor cortex

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135
Q

Corticobulbar Tract projects to

A

brain

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136
Q

how many lower motor neuron does the autonomic system have?

A

2

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137
Q

A 2 lower motor neuron pathway of the autonomic system are influenced by

A
  1. hypothalamus
  2. amygdala
  3. nucleus tractus solitarius
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138
Q

Autonomic Neuron #1 location

A

brain stem or cord

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139
Q

Autonomic Neuron #2 location

A

peripheral ganglion

140
Q

Parasympathetic division goal

A

Digestion & energy storage

141
Q

Parasympathetic origin

A

III

VII

IX

X

sacral spinal cord

142
Q

Parasympathetic has ____ preganglionic, and _____ postganglionic

A

Long preganglionic

Short post ganglionic

143
Q

Transmitters used in both pre and post ganglionic

(parasympathatic division transmitters)

A

acetylcholine

144
Q

Parasympathetic effect on eye (vision)

A

adapted to near vision

145
Q

Parasympathetic effect on Digestion

A

activated by eating

146
Q

Parasympathetic effect on Heart

A

decrease HR

147
Q

Parasympathetic effect on lungs

A

Decrease RR

148
Q

Parasympathetic effect on Peripheral capillaries

A

gets dilated

149
Q

Parasympathetic effect on Skeletal muscle

A

tone relaxes

150
Q

Sympathetic division goal

A

releases energy

151
Q

Sympathetic division origin

A

Intermediolateral cell column (VII lamina) of spinal cord T1-L2

152
Q

Sympathetic division has ____ preganglionic andd ____ post ganglionic

A

Short preganglionic

Long post ganglionic

153
Q

Sympathetic Short preganglionic use ____ as a transimitter

A

acetylcholine

154
Q

Sympathetic Long post ganglionic use ____ as a transimitter

A

norepinephrine

155
Q

Options for signal distribution

A
  1. sympathetic signal enter the sympathetic chain, synapse at the same lvl, rejoin the same spinal nerve root
  2. sympathetic signal enter the sympathetic chain, go up several segments, synapse and rejoin spinal nerve at a higher lvl
  3. sympathetic signal enter the sympathetic chain, travel down several segments, synapse and rejoin spinal nerve at a lower lvl.
  4. sympathetic signal enter the sympathetic chain, remain unsynapsed, leave the chain as a splanchnic nerve, travel to a prevertebral ganglion (celiac, sup, and inf mesenteric) synapse and travel to the target tissue
  5. sympathetic signal can travel unsynapsed to the adrenal medulla. Releasing epinephrine and norepinephrine (for distribution through the entire body via vascular system)
156
Q

The preganglionic sympathetic neurons need to be long enough to reach

(3 structures)

A

the chain ganglia

the prevertebral ganglia

or the adrenal medulla

157
Q

The post ganglionic neuron reaches from the ganglia to

A

target tissue

158
Q

Sympathetic effect on eyes

A

get wild, pupil dilatate (to get as much light as possible)

vision shift to far away vision

159
Q

Sympathetic effect on digestion

A

turn off blood going to, and stop secretion

160
Q

Sympathetic effect on Heart

A

HR goes up

161
Q

Sympathetic effect on lungs

A

RR goes up

162
Q

Sympathetic effect on Peripheral capillaries

A

blood gets diverted from peripheral superficial capillary

163
Q

Sympathetic effect on Skeletal muscle

A

receive more oxygenated blood

(prepare the body to move)

164
Q

why do peripheral superficial capillar narrow under the sypathetic effect

A

in case of getting a wound so it reduces the bleed

165
Q

Enteric division reaches which organ

A

intestine

166
Q

Enteric division contains 2 plexi:

A

Myenteric plexus (of Auerbach)

Submucosal plexus (of Meisner)

167
Q

Myenteric plexus (of Auerbach) controls

A

muscle contraction

168
Q

Submucosal plexus (of Meisner) controls

A

blood vessel size and secretory functio

169
Q

Enteric division Regulated by parasympathetic via

A

division X and sacral

170
Q

Enteric division Regulated by sympathetic via

A

splanchnic

171
Q

Hirschprung Disease aka

A

Congenital Aganglionic Megacolon

172
Q

in Hirschprung Disease, what happens to

the migrating cells of the myenteric and submucosal plexuses During development

A

do not continue to the distal colo

173
Q

with Hirschprung Disease, the disctal colon can’t:

A

can’t relax/contract properly to allow stool to pass

174
Q

Hirschprung Disease results in

A

Lack of bowel sounds (MC LLQ)

dullness to percussion at LLQ

distention is palpable in that region

175
Q

how can Hirschprung Disease be managed

A

by eating smaller meals more frequently

176
Q

Describe the surgial solution for Hirschprung Disease

A

the aganglionic area is removed, and the normal part of the colon is connected to the sigmoid colon and the rectum

177
Q

Term: Paresis

A

mild weakness

178
Q

Term: plegia

A

total weakness/0 strength

179
Q

Term: Paralysis

A

total weakness/0 strength (same as plegia)

180
Q

Term: Palsy

A

nonspecific term than can mean paralysis or it can mean paresis

181
Q

Term: Hemi

A

left or right

182
Q

Term: Para

A

both legs

183
Q

Term: Mono

A

one extremity

184
Q

Term: Di

A

2 of the same extremity (usually legs)

185
Q

Term: Quadra or tetra

A

all 4 extremities

186
Q

quadriplegic means

A

can’t move any extremity

187
Q

Motor System Testing order

A

Inspection

Look for abnormal posturing

Involuntary motions

Sings for muscular asymmetry

Preform circumferential mensuration

Measuring around the muscles to confirm asymmetry

Passive ROM (noting spasticity, or rigidity)

Muscle tests for strength

Stress test (holding arm up at shoulder hight for 30 s)

Checking reflexes (for changes in tendon reflexes and presence of uninhibited pathological reflexes)

188
Q

3 Patterns of Weakness

A

Proximal weakness

Cranial Nerve Weakness

Distal Weakness

189
Q

Proximal weakness includes

(body parts)

A

shoulder and hip weakness

190
Q

Proximal weakness signs

A

muscular dystrophy or muscle degeneration

191
Q

Proximal weakness cuased by

(etiology)

A

genetic x-linked (mostly males)

192
Q

Worst form of proximal weakness

A

Duchene

193
Q

Duchene Pt life expectancy

(prognosis)

A

fatal by late teens/early 20’s

194
Q

milder form of proximal weakness, and Pt can live longer

A

Diatonic muscular dystrophy

195
Q

Proximal weakness Classical exam finding

A

Gower’s sign

196
Q

explain Gower’s sign

A

pt is weaker at the hips, can’t stand up

197
Q

where can Gower’s sign spread to?

A

distal extremities (hand & feet)

198
Q

Cranial Nerve Weakness Involves

A
  1. facial expression
  2. swallowing, chewing
  3. eye motion
199
Q

Cranial Nerve Weakness Suggest problem at

A

the neuromuscular junction

200
Q

Cranial Nerve Weakness etiology

A

inadequate amount of neuro transmitter production

or

reduced number of muscular receptor

201
Q

Distal Weakness includes

A

hands & feet

202
Q

Distal Weakness origin

A

neurological

203
Q

Upper motor neuron location

A

project from the cerebral cortex to lower motor neurons located in the anterior horn of the spinal cord

204
Q

Lower motor neuron location

A

project via peripheral nerves to skeletal muscle

205
Q

Upper vs Lower Motor Neuron Lesion

A

Sign

UMNL

LMNL

Weakness

Yes

Yes

Atrophy

No

Yes

Fasciculations

No

Yes

Reflexes

Increased

Decreased

Tone

Yes

No

Pathological reflexes

Increased

Decreased

206
Q

Gait Disorders Can be caused by lesion in what part of the nervous system

A

almost anywhere in nervous system

207
Q

Spastic gait caused by

A

lesion of upper motor neurons

(Stroke, MS/Degeneration, Cerebral palsy)

208
Q

Spastic gait signs

A

triple flexion of the arm, elbow, wrist, & fingers.

riple flexion of the leg, hip, knee, and plantar flexion

Stiff legged circumduction

decreased arm swing

unsteadiness

falling

209
Q

Functional gait disorder aka

A

psychologically based gait disorder

210
Q

Functional gait disorder caused by

A

malingering patients or with psychological problem:

  1. conversion disorder
  2. factitious disorder
211
Q

Functional gait disorder main signs

A

has no gait pattern

Pt will not fall

212
Q

Functional gait disorder pt will not fall due to

A

intact postural and gait reflexes

213
Q

If Functional gait disorder pt falls, then it’s _____

A

intentional

214
Q

Define Multiple Sclerosis

A

autoimmune demyelination of the CNS

215
Q

Myelin in CNS is made by

A

oligodendrocytes

216
Q

MS cuases

A

idiopathic

(because of the overlapping etiology)

217
Q

some of the suggestions about cause of MS includes:

A

Vit D deficiency

genetic predisposition

diet

218
Q

MS Pathological process

A

Lymphocytes attack CNS myelin only

219
Q

MS Progression

A

Exacerbation

remission

220
Q

MS Classic first suspicion is

A

two or more deficits separated anatomically and temporally

221
Q

Definitive diagnosis is based upon

A

MRI study

222
Q

how does MS look on MRI

A

multiple bright scars (oligoclonal banding), decreased nerve conduction, and oligoclonal bands (immunoglobulin) in CSF

223
Q

oligoclonal banding is due

A

myelin destruction

224
Q

Demyelination effect on conduction velocity and action potentials

A

slows conduction velocity

allows action potentials to disperse

225
Q

Demyelination effects occurs more at what kind of temprature

A

at Higher temperatures

(while taking hot bath/showers)

226
Q

MS Female : male ratio

A

Female: male 2:1

227
Q

the age range of MS onsit

A

20-40

228
Q

Can MS pt have a normal life span

A

yes, with very strict management strategy

229
Q

Multiple nerve demyelination leads to

A

signal dispersal

230
Q

Hallmark neuro symptom

A

optic neuritis

231
Q

deffine optic neuritis

A

bright white optic disc – inflammation of the optic disc

232
Q

MS Motor symptoms

A

Weakness

Spasticity

UMNL sign

233
Q

Def: Weakness in the conjugate movements of the eyes

A

Internuclear Ophthalmoplegia

234
Q

Internuclear Ophthalmoplegia is due to

A

demyelination of the tract connecting the eyes

235
Q

MS Sensory signs

(Spinothalamic, Dorsal columns)

A

Impairment of vibratory/position sense
Impairment of pain, temperature, or touch sense
Pain (moderate to severe)
L’hermitte’s sign

236
Q

MS Cerebellar signs

A

Lack of coordination (ataxia)

237
Q

Other location signs:

A
  1. Cranial nerve signs
  2. Autonomic
  3. Psychaiatric
238
Q

Define L’Hermitte Sign

A

electric shock like sensation with neck flexion

239
Q

L’Hermitte Sign is due to

A

inflammation of the spinal cord

240
Q

the definitive diagnosis of MS is based on

A

complete neurological diagnosis

MRI

CSF analysis

241
Q

MS management is mainly based on

A
  • Inflammation management
242
Q

MS inflammation management includes

A

prednisone

anti-inflammatory diet

increase venous drainage via chiropractic

243
Q

Define prednisone

A

steroidal anti-inflammatory

244
Q

long term use of prednisone can lead to

A

kidney damage

245
Q

anti-inflammatory diet includes avoiding

(type of food)

A

wheat & dairy

246
Q

increase venous drainage can reduce

A

metabolic waste

247
Q

Motor Neuron Disease:

Amyotrophic lateral sclerosis (ALS) aka

A

Lou Gehrig disease

248
Q

ALS is a degeneration of

A

both upper and lower motor neuron cell bodies

249
Q

ALS prognosis

A

Prognosis respiratory failure and death usually in 3-5 years

250
Q

respiratory failure happens due to a damage of which nerve

A

phrenic nerve

251
Q

in ALS Upper motor neuron lesion signs in _____ extremeties

(upper/lower)

A

Lower extremity

252
Q

Upper motor neuron lesion signs in the Lower extremity are

A
  • weakness
  • spasticity
  • increased tendon reflexes
253
Q

Lower motor neuron lesion signs in the _____ extremity

(Upper/Lower)

A

Upper extremity

254
Q

Lower motor neuron lesion signs in the Upper extremity are

A
  • weakness
  • flaccidity
  • decreased tendon reflexes
255
Q

First symptom of ALS is usually

A

focal weakness

256
Q

focal weakness in ALS spreads to other muscle groups including

A

intrinsic muscles of the hand & feet

257
Q

ALS may start with what type of sings

A

bulbar signs

258
Q

bulbar signs includes

A

Dysarthria

Dysphagia

259
Q

Dysarthria means

A

weakness of the larynx

260
Q

Dysphagia means

A

difficulty swallowing

261
Q

Other possible diagnosis based on ALS symptoms

A

Lead poisoning

Dysproteinemia

Thyroid dysfunction

Vitamin B12 deficiency

Vasculitis

Neoplasms

Cervical spine compression

262
Q

Normal MRI vs ALS MRI

A
263
Q

Spinothalamic pathway carries

(what kinde of sensory information)

A

crude touch

pain

Temprature

264
Q

Dorsal Columns carry

(what kinde of sensory information)

A

light touch

vibration

conscious proprioception

discriminating touch

265
Q

Posterior (Dorsal) Columns fiber size

A

large in diameter, and longest

266
Q

Posterior (Dorsal) Columns travels to

A

gracilus, cuneates nucleus

267
Q

Posterior (Dorsal) Columns is joind by

A

trigeminal lemniscus

268
Q

Posterior (Dorsal) Columns projcet info to

A
  1. thalamus
  2. posterior internal capsul
  3. somatosensory cortex
269
Q

Anterolateral Pathway contains

(which pathways)

A

Spinothalamic

Spinoreticular

270
Q

Spinoreticular ends in

A

reticular formation

271
Q

Anterolateral Pathway fibers size

A

small

272
Q

Anterolateral Pathway Synapse

A

immediate synapses

273
Q

Anterolateral Pathway decussation

A

it decussates but it may take a few segments

274
Q

Lateral spinal cord lesion effects

(what sensation)

A

contralateral pain and temperature sensation

275
Q

Lateral spinal cord lesion effects

(what level)

A

beginning a few levels below the lesion

276
Q

Spinothalamic carries

A

Discriminating pain and temp

277
Q

Spinothalamic major relay

A

ventral posterior lateral (VPL) nucleus

278
Q

Spinothalamic terminates in

A

thalamus

279
Q

Spinoreticular carries

A

emotional and arousal aspects of pain

280
Q

Spinoreticular terminates in

A

medullary–pontine reticular formation

281
Q

Spinoreticular Projects into

A

intralaminar thalamus

for more broad distribution to whole cortex

282
Q

All thalamic (Trigeminal) ascend to

A

parietal lobe

283
Q

which cortex is responsible to tell you “when I got touched”

A

Primary sensory cortex

284
Q

hich cortex is responsible to describe “how I got touched”

A

Secondary somatosensory cortex

285
Q

sensory loss can happen in

(which part of the sensory pathway)

A

anywhere in the sensory pathway

286
Q
A
287
Q

Define the term: Bar

A

pressure

288
Q

Define the term: graph

A

writing

289
Q

Define the term: top

A

mapping

290
Q

Define the term: stereo

A

3D

291
Q

Define the term: Dys

A

something isn’t right

292
Q

Define the term: allo

A

everywhere

293
Q

Define the term: pall

A

vibration

294
Q

Define the term: par

A

abnormal

295
Q

Define the term: an/a

A

without

296
Q

Define the term: algia

A

pain

297
Q

Define the term: dynia

A

pain

298
Q

Define the term: algesia

A

pain

299
Q

Define the term: esthesia

A

feeling

300
Q

Define the term: gonsis

A

knowledge

301
Q

Define the term: pathia

A

something isn’t wright

302
Q

Define the term: parasthesia

A

tingling

303
Q

Define the term: arthralgia

A

joint pain

304
Q

Define the term: myalgia

A

muscle pain

305
Q

Spinal Cord Lesions Usually correspond to

A

motor/ sensory deficit

306
Q

the best way to identify Spinal Cord Lesions is by using

A

MRI

307
Q

what level we look for at patients with Lumbar cord compression

A

Cauda equina

308
Q

Describe Spinal cord shock

A

Temporary

traumatic

whiplash

extremity tingling

309
Q

Spinal cord shock duration

A

24-48 hours

310
Q

Term refers to the inflammation of spinal cord

A

myelitis

311
Q

Spinal cord inflamation MRI Findings

A

water density in the spinal cord, changes to the myelin

313
Q

Def: Myelomalacia

A

spinal cord softening

314
Q

Myelomalacia caused due to

A

hemorrhage into cord or ischemia

315
Q

Myelomalacia caused in eldarly by

A

osteophytes

stenosis

316
Q

Myelomalacia caused in athletes by

A

disc lesion

317
Q

describe the damage of Transverse cord lesion

A

all function lost below level of lesion

318
Q

Transverse cord lesion causes

A

penetrating trauma

multiple sclerosis

myelitis

319
Q

Hemisection the Brown Sequard Syndrome distributions

A

loss of contralateral pain

ipsilateral upper motor neuron lesion signs

320
Q

Hemisection the Brown Sequard Syndrome causes

A

penetrating trauma

lateral compressive tumors

multiple sclerosis

321
Q

Central cord syndrome size and location

A

small lesions in central commissure

322
Q

Central cord syndrome Distribution

A

suspended sensory loss (bilateral) of pain and temperature

Cervical gives classic cape Distribution

Larger lesions may affect anterior horn cells

323
Q

Central cord syndrome causes

A

syringomyelia

contusions

spinal cord tumor

324
Q

Posterior cord syndrome distributions

A

blue man group (whole body except head)

325
Q

Posterior cord syndrome causes

A

trauma

posterior tumor

multiple sclerosis

b12 defic

3* syphilis (tabetic or steppage gait)

326
Q

Anterior cord syndrome Distribution

A

anterior 2/3 of SC, loses motor function, and pain sensation below the lvl of the lesion

327
Q

Anterior cord syndrome cuases

A

trauma

MS

anterior spinal artery compression

328
Q

in Bladder Function Sense of fullness reaches

A

sensory cortex

329
Q

Bladder Function Descending pathway is

A

medial frontal micturition center

330
Q

Bladder Function Descending pathway activates

A

voluntary voiding

331
Q

Detrusor reflex is contraction of

A

the top of the bladder

332
Q

In Positive feedback results: the more the flow, the more ______________

A

relaxation of sphincters

333
Q

what happens when flow stops (empty or voluntary)

A

urethral sphincters contract

334
Q

Urethral reflex is when

A

urethra contracts- detrusor relaxes

335
Q

Bladder Lesion Sites

A

Brain- voluntary conscious control

Spinal cord- upper motor neuron

Sacral nerves- lower motor neurons

336
Q

Bladder Malfunction happens due to

A

Lesion of bilateral medial frontal micturition center

337
Q

Bladder Malfunction Results in

A

pontine and spinal micturition centers activation when bladder is full

338
Q

with Bladder Malfunction, Urine flow and emptying are

A

normal But not voluntary

339
Q

what diseases can lead to bladder malfunciton

A

hydrocephalus

parasagittal meningioma

neurodegenerative disorder

Lesion between pons and conus medullaris (spinal cord)

340
Q

Bladder Malfunction makes the bladder become

A

hyperreflexic or spactic

341
Q

Detrusor/sphincter dyssynergia symptoms

A

urgency, detrusor spasm, incomplete emptying

342
Q

Detrusor/sphincter dyssynergia causes

A

trauma

tumor

transvers myelitis

multiple sclerosis (any spinal cord lesion)

343
Q

Lesions of S2-4 nerves Symptoms

A

areflexive atonic bladder

344
Q

Lesions of S2-4 nerves Caused by

A

diabetic neuropathy

vertebral body/disc degeneration

trauma

345
Q

Lesions of S2-4 nerves results in

A

lack of sensory input from filling bladder

pt has overflow and stress incontinence

346
Q

Bowel Incontinence can happen due to

A

medial frontal lesion as with the bladder

spinal cord lesion

conus or peripheral lesion

6- Neuro Diag (10 decks)

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