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PTH 606 Neuro disorders II > Exam2 material: spinal cord, MS, cerebellar > Flashcards

Exam2 material: spinal cord, MS, cerebellar Flashcards

1
Q

Cerebellar function

A
  • skilled, voluntary movements of extremities and speech
  • balance and equilibrium
  • VOR
  • planning and initiation of movement, rhythm
  • timing of neural processes
  • cognition and emotion
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2
Q

3 lobes of cerebellum

A
  • anterior
  • posterior
  • flocculonodular
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3
Q

middle region of cerebellum

A

vermis

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4
Q

cerebellum outer layer is white or gray matter?

A

gray is out

flipped from spinal cord

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5
Q

What are the 3 deep nuclei in cerebellum?

A

FID

fastigial
interposed
dentate

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6
Q

What are the 3 layers of cerebellar cortex? (superficial to deep)

A 
Molecular layer (superficial)
parking cell layer
granular layer (deep)
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7
Q

What cells are for input?

A

climbing fibers

mossy fibers

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8
Q

What cells are for output?

A

parking cell axon

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9
Q

Mossy fibers give input from what?

A

brainstem nuclei, spinal cord

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10
Q

Climbing fibers give input from what?

A

inferior olivary nucleus in medulla

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11
Q

Are purkinje cells excitatory or inhibitory? what what NT do they use?

A

inhibitory

-uses GABA

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12
Q

Vestibulocerebellum output

A
  • output is vestibular nuclei in brainstem

- flocculonodular lobe

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13
Q

Spinocerebellum (vermis and intermediate output)

A
  • vermis output to fastigial nucleus ***

- intermediate hemisphere to interposed nuclei ***

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14
Q

Cerebrocerebellum (nucleus is)

A

Lateral part of hemisphere to Dentate

initiation, planning, and timing

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15
Q

Vestibulocerebellum function

A
  • equilibrium and balance

- helps with eye stuff

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16
Q

Spinocerebellum function

A

-involved with detailed execution of movement

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17
Q

Cerebrocerebellum function

A

-planning, initiation, timing, visual guidance of movement

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18
Q

Overall role of cerebellum (5 things)

A
  • comparator (actual vs intended)
  • compensator (predict impact of other joints)
  • motor learning (learning new skills)
  • role in cognition (thinking, attention)
  • role in timing (“forward model” in motor tasks)
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19
Q

Cerebellar impairments

A
  • Hypotonia
  • Asthenia (general weakness)
  • impaired eye movement
  • Ataxia (gait, balance, dysmetria, dysdiadochokinesia, asynergia, intention tremor)

*** delay initiation, inaccurate range and direction, irregular alt movements

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20
Q

Asthenia def

A

generalized weakness

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21
Q

dysmetria defintion

A

inaccuracy in range and direction of movement

22
Q

dysdiadochokinesia def

A

-rapid alt movements

23
Q

asynergia

A

error in timing of complex movements

24
Q

intention tremor

A

-tremor at end of movement

25
Q

Cerebellar symptoms and lesion location

A
  • they are ipsilateral
  • decussates twice!
  • at superior cerebellar peduncle and then at corticospinal and rubrospinal tract
26
Q

Cerebellar midline lesions affect what?

A

-axial and trunk control

also speech due to dec facial control

27
Q

Cerebellar lateral lesions affect what?

A

-motor control of limbs and digits

28
Q

Friedreich’s ataxia (spinal ataxia)

A
  • hereditary
  • early onset
  • progressive ataxia, weakness, loss of sensation and proprioception
  • scoliosis, cardiomyopathy, foot deformities typical
  • life expectance 35-40
29
Q

Spinocerebellar Ataxia (SCA)

A
  • genetic (CAG-trinucleotide repeats)
  • multiple genes known
  • causes degeneration of spinocerebellar tracts and the cerebellum occur
  • *most common is SCA#6
  • onset 30-50
  • **loss of coordination, gait ataxia, impaired saccades, speech
  • life ex = close to normal
30
Q

Olivopontocerebellar atrophy (OPCA) -cerebellar ataxia– What is it, where is it, associated with what?

A
  • degeneration in inferior olives, pons, and cerebellum (look at name)
  • both inherited and non-inherited neurodegen syndromes
  • *** primarily associated with MSA (multiple system atrophy with cerebellar predominance)
31
Q

OPCA -olivopontocerebellar. symptoms

A
  • progressive ataxia with involved gait, weakness, incoordination
  • eventually pyramidal tract signs, autonomic disturbances, dementia
  • onset 30-5-
  • poor prognosis.
32
Q

Multiple system atrophy (MSA) -characterized by, cause, survival

A
  • damage to ANS which leads to postural hypotension, dysuria, and/or abnormal breathing during sleep
  • parkinsonism
  • ataxia due to OPCA

cause = unknown
survival less than 10 years after onset

33
Q

Pure cerebellar degeneration -cerebellar ataxias

A
  • atrophy of cerebellum itself WITHOUT spinal involvement
  • slow progressing
  • onset =40+

***ataxia of gait, imbalance, dysarthria (speaking), impaired gaze stabilization

34
Q

Cerebellar ataxias - nutritional disorders

A
  • Vit B1 (1/3 alcoholics)
  • Vit B12 (leads to pernicious anemia)

-treat with vitamin therapy. Some sx may be reversible

35
Q

Cerebellar ataxias - neoplastic and paraneoplastic disorders

A
  • primary
  • metastatic
  • benign tumors
36
Q

Cerebellar ataxia - vascular disorders

A
  • Ischemic stroke (PICA, AICA, SCA from basilar artery) ***presents with acute nausea, vomiting, dizziness, unsteady gait
  • hemorrhagic stroke (less common) ***presents with HA, vertigo, nausea, unsteady gait
37
Q

Cerebellar ataxia - traumatic injuries

A

-TBI to occipital or frontal region (coup - countercoup)

38
Q

Cerebellar ataxia - demyelinating disorders

A
  • MS

- may have lesion in cerebellum or in spinocerebellar tracts, resulting in cerebellar signs

39
Q

Ataxia rating scales - SARA

A
  • scale for assessment and rating of ataxia

- 8 items, 40 points

40
Q

Ataxia rating scales - ICARS

A
  • international cooperative ataxia rating scale

- 19 items, 100 points

41
Q

Ataxia rating scales - MICARS

A
  • modified ICARS

- 26 items, 120 points

42
Q

Ataxia rating scales - BARS

A
  • brief ataxia rating scale

- 5 items, 30 points

43
Q

MS commonly affects what CNS areas?

A
  • optic nerve
  • cerebellar peduncles
  • periventricular white matter
  • Spinal cord (corticospinal tract, and post columns)
44
Q

In order for a SCI to be incomplete it needs?

A
  • sensory or motor S4-5 AND

- either anal sphincter contraction OR sparing of motor fn. >3 levels below motor level

45
Q

SCI : Type A

A

-complete

46
Q

SCI: Type B

A

incomplete. no motor. sensation below level of lesion

47
Q

SCI: Type C

A

incomplete. at least half of key muscles below level less than or equal to 3/5 MMT

48
Q

SCI : Type D

A

incomplete. motor, key muscles greater than or equal to 3/5 MMT

49
Q

SCI : Type E

A

incomplete, normal motor and sensation

50
Q

Autonomic dysreflexia

A
  • overactive sympathetic NS
  • spinal cord injury ~T5 and above
  • cause: any noxious stim below level of injury
  • ascending info reaches major splanchnic sympathetic outflow stimulating a sympathetic response
  • *results in HTN, pounding HA, visual changes etc..
  • **parasympathetic NS is unable to counteract due to spinal cord injury (impulses cannot descend past the lesion)

PTH 606 Neuro disorders II (8 decks)

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