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Neurology > Exam of Somatosensory Systems > Flashcards

Exam of Somatosensory Systems Flashcards

1
Q

Define Anesthesia

A

loss of sensation

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2
Q

Define Hypesthesia

A

diminished sensation

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3
Q

Define Analgesia

A

loss of pain sensitivity

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4
Q

Define Hyperesthesia

A

excessive sensitivity

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5
Q

Define Allodynia

A

experiencing an innocuous stimulus as painful

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6
Q

Define Hyperpathia

A

magnified sensation of pain

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7
Q

Define Paresthesia

A

perception of a sensation when there is no identifiable stimulus

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8
Q

Define Dysesthesia

A

painful paresthesia (perception of a sensation when there is no identifiable stimulus)

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9
Q

Etiology of “Stock & Glove” distribution

A

polyneuropathy

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10
Q

Etiology of “dermatomal” distribution

A

nerve root damage

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11
Q

Etiology of sensory loss of large areas with distinct borders distribution

A

peripheral nerve damage (ie axillary n., radial n.)

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12
Q

Etiology of “hemianesthesia”/sensory level distribution

A

CNS/spinal cord damage

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13
Q

Etiology of “Brown-Sequard” syndrome

A

unilateral spinal cord injury

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14
Q

Etiology of “suspended sensory loss”/vest distribution distribution

A

lesions within the spinal cord (syringomyelia)

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15
Q

Etiology of “crossed-sensory loss” distribution

A

caudal brainstem lesion

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16
Q

Etiology of “hemianesthesia” distribution

A

thalamic lesions

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17
Q

Etiology of asterognosia

A

parietal association cortex

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18
Q

Definition of radiculopathy

A

set of conditions in which one or more nerves is affected and does not work properly

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19
Q

Definition of graphesthesia. Etiology of agraphesthesia?

A

ability to recognize writing on skin purely by sensation of touch

damage to parietal lobe or dorsal column pathway

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20
Q

Definition of myelopathy

A

damage to spinal cord

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21
Q

Definition of encephalopathy

A

diffuse alteration in brain function; disordered thinking

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22
Q

Definition of aphasia/dysphasia

A

language impairment; partial or total loss of the ability to articulate ideas or comprehend spoken/written language

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23
Q

Definition of dyspropsodia

A

inability to produce or comprehend tonal fluctuations in spoken language

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24
Q

Definition of agnosia

A

inability to perceive/understand sensory stimuli (visual, tactile, audio)

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25
Q

Definition of apraxia

A

inability to perform learned actions despite intact motor function (agraphia, constructional apraxia)

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26
Q

Definition of paraphasia. List the 3 subtypes.

A

production of well-articulated, but incorrect words

  • semantic
  • phonemic
  • neologism
27
Q

Characteristics and Etiology of Broca’s Aphasia

A
  • expressive aphasia

- dysfluent (s area

28
Q

Characteristics and Etiology of Aphemia

A

“cortical dumbness” - inability to produce speech despite intact comprehension, reading, and writing

Lesion is usually close to Broca’s area.

29
Q

Characteristics and Etiology of Wernicke’s Aphasia

A
  • receptive aphasia
  • poor comprehension
  • poor repetition
  • patient is not concerned

Lesion in superior temporal gyrus

30
Q

Characteristics and Etiology of Word Deafness

A

inability to comprehend words

Lesion to L or both superior temporal gyri

31
Q

Characteristics and Etiology of Conduction Aphasia

A

inability to repeat

Lesion in arcuate fasciculus

32
Q

Characteristics and Etiology of Global Aphasia

A

inability to comprehend, produce, or repeat speech

Lesion in L hemisphere (parietal+frontotemporal); large

33
Q

Declarative memory: episodic vs semantic

Non-declarative memory: procedural vs. conditioning
function + locations

A

declarative - conscious memory of facts

episodic - memory of events; hippocampus, mammillary bodies
semantic - concepts; cortical association areas

Non-declarative memory - skills + motor habits

procedural - basal ganglia
conditioning - amygdala

Working/Short-term memory - frontoparietal region

34
Q

Characteristics and Etiology of Visual Agnosia

A

inability to recognize objects despite normal vision but can recognize objects by touch/sound

lesion in bilateral parieto-occipital cortex

35
Q

Characteristics and Etiology of Anton’s syndrome

A

blindness without being aware of it

lesion in bilateral occpital lobe

36
Q

Characteristics and Etiology of prosopagnosia

A

visual agnosia; inability to recognize faces

lesion in bilateral occpital lobe

37
Q

characteristics of simultanagnosia

A

visual agnosia; patients can recognize objects or details in their visual field, but only one thing at a time

38
Q

Characteristics and Etiology of alexia

A

visual agnosia; inability to read

lesion in L temporoal-parieto-occipital lobe

39
Q

Subtypes of Visual Agnosia

A

Simultanagnosia
Anton’s Syndrome
Prosopagnosia
Alexia

40
Q

Subtypes of Tactile Agnosia

A

Astereognosia
Agraphesthesia
Asomatognosia

41
Q

Characteristics and Etiology of astereognosia

A

inability to recognize objects by feel (coins, pens)

Lesion in contralateral parietal lobe

42
Q

Characteristics and Etiology of Agraphestheia

A

inability to recognize numbers traced on hand

lesion in contralateral pareital

43
Q

Characteristics and Etiology of Asomatognosia

A

inability to correctly perceive one’s body parts

lesion in contralateral parietal

44
Q

Characteristics and Etiology of Auditory Agnosia

A

inability to recognize sounds despite normal hearing

lesion in non-dominant temporal lobe

45
Q

Characteristics and Etiology of Anosognosia

A

inability to recognize or understand the significance of one’s illnesses

lesion in non-dominant parietal lobe

46
Q

Characteristics and Etiology of neglect

A

inattention or underuse of body part or surrounding spaces

lesion in contralateral parietal lobe

47
Q

Definition of apraxia

A

inability to carry out a motor task despite intact motor pathways

48
Q

Characteristics and Etiology of agraphia

A

inability to write; often found with alexia

lesion in posterior frontal lobe

49
Q

Characteristics and Etiology of Gerstmann Syndrome

A

multiple dysfunctions (agraphia, finger agnosia, L/R disorientation, acalculia)

lesion in dominant angular gyrus

50
Q

Characteristics and Etiology of constructional apraxia

A

inability to copy or construct figures

lesion in non-dominant parietal lobe

51
Q

Characteristics and Etiology of ideomotor apraxia

A

inability to perform a specific task when asked

Lesion is a callosal lesion –> disconnection

52
Q

Characteristics and Etiology of ideational apraxia

A

inability to perform a motor tasks that require s a series of movements

Lesion is not particularly localizable

53
Q

Characteristics and Etiology of Gait apraxia

A

difficulty in initiating and coordination of gait

Lesion is in bilateral frontal lobe

54
Q

Difference between intraaxial vs extraaxial lesion

A

extra

  • widened CSF space
  • pushes brain inward
  • usually meningioma or schwannoma

intra

  • takes up space in parenchyma
  • usually metastasized tumor or astrocytoma
55
Q

Physical differences between acute vs chronic/old MI lesions

A

acute MI events:

  • brain expansion
  • midline shift away from lesion
  • crowded sulci
  • smaller ventricles

old MI events

  • lesions lose volume
  • widened spaces between sulci
  • larger ventricles
  • NO midline shift
56
Q

Define cytotoxic edema and vasogenic edema in terms of:

etiology
pathophysiology
GW/differentiation

A

Cytotoxic

  • etiology - stroke
  • pathophysiology - cell death -> less-dense cortex
  • GW/differentiation - decrease

Vasogenic

  • etiology - tumor, inflammation, HTN
  • pathophysiology - leaky capillaries
  • GW/differentiation - increase
57
Q

4 signs of Stroke on CT

A

loss of GM/WM differentiation
dense MCA (embolus may be more calcified)
loss of insular ribbon
sulci effacement

58
Q

What is diffusion imaging in stroke? What is it used for?

A

MRI that identifies dead brain parenchyma; stays positive for 2 weeks

59
Q

Compare epidural hematoma vs subdural hematoma in terms of:

  • croup vs counter croup
A

epidural hematoma

  • coup
  • middle meningeal a –> ARTERIAL bleed strips dura from bone
  • biconvex in shape
  • biconvex
  • bette prognosis

subdural hematoma

  • countercoup
  • bridging veins
  • crescent shape
  • worse prognosis
60
Q

Characteristics of Subarachnoid hemorrhage

A
  • tearing veins of subarachnoid space

- blood follows outline of sucli

61
Q

Sources of bleed in:

epidural hematoma
subdural hematoma
sub-arachnoid hemorrhage

A

epidural hematoma - middle meningeal a.
subdural hematoma - bridging veins
sub-arachnoid hemorrhage - veins in sub-arachnoid space

62
Q

Characteristics of contusions (bruise)

A

brain against bone

- common in anterior/inferior frontal lobe + anterior temporal lobe

63
Q

Characteristics of Diffuse Axonal Injury

A

axonal shear injury causes induced apoptosis in the neurons.

Neurology (3 decks)

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