Exam2 material: spinal cord, MS, cerebellar Flashcards

(50 cards)

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
Cerebellar symptoms and lesion location
- they are ipsilateral - decussates twice! - at superior cerebellar peduncle and then at corticospinal and rubrospinal tract
26
Cerebellar midline lesions affect what?
-axial and trunk control | also speech due to dec facial control
27
Cerebellar lateral lesions affect what?
-motor control of limbs and digits
28
Friedreich's ataxia (spinal ataxia)
- hereditary - early onset - progressive ataxia, weakness, loss of sensation and proprioception - scoliosis, cardiomyopathy, foot deformities typical - life expectance 35-40
29
Spinocerebellar Ataxia (SCA)
- 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
Olivopontocerebellar atrophy (OPCA) -cerebellar ataxia-- What is it, where is it, associated with what?
- 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
OPCA -olivopontocerebellar. symptoms
- progressive ataxia with involved gait, weakness, incoordination - eventually pyramidal tract signs, autonomic disturbances, dementia - onset 30-5- - poor prognosis.
32
Multiple system atrophy (MSA) -characterized by, cause, survival
- 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
Pure cerebellar degeneration -cerebellar ataxias
- atrophy of cerebellum itself WITHOUT spinal involvement - slow progressing - onset =40+ ***ataxia of gait, imbalance, dysarthria (speaking), impaired gaze stabilization
34
Cerebellar ataxias - nutritional disorders
- Vit B1 (1/3 alcoholics) - Vit B12 (leads to pernicious anemia) -treat with vitamin therapy. Some sx may be reversible
35
Cerebellar ataxias - neoplastic and paraneoplastic disorders
- primary - metastatic - benign tumors
36
Cerebellar ataxia - vascular disorders
- 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
Cerebellar ataxia - traumatic injuries
-TBI to occipital or frontal region (coup - countercoup)
38
Cerebellar ataxia - demyelinating disorders
- MS | - may have lesion in cerebellum or in spinocerebellar tracts, resulting in cerebellar signs
39
Ataxia rating scales - SARA
- scale for assessment and rating of ataxia | - 8 items, 40 points
40
Ataxia rating scales - ICARS
- international cooperative ataxia rating scale | - 19 items, 100 points
41
Ataxia rating scales - MICARS
- modified ICARS | - 26 items, 120 points
42
Ataxia rating scales - BARS
- brief ataxia rating scale | - 5 items, 30 points
43
MS commonly affects what CNS areas?
- optic nerve - cerebellar peduncles - periventricular white matter - Spinal cord (corticospinal tract, and post columns)
44
In order for a SCI to be incomplete it needs?
- sensory or motor S4-5 AND | - either anal sphincter contraction OR sparing of motor fn. >3 levels below motor level
45
SCI : Type A
-complete
46
SCI: Type B
incomplete. no motor. sensation below level of lesion
47
SCI: Type C
incomplete. at least half of key muscles below level less than or equal to 3/5 MMT
48
SCI : Type D
incomplete. motor, key muscles greater than or equal to 3/5 MMT
49
SCI : Type E
incomplete, normal motor and sensation
50
Autonomic dysreflexia
- 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)