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Midterm 4 > Görsev Hoca Soruları > Flashcards

Görsev Hoca Soruları Flashcards

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1
Q

Upper Motor Neuron vs Lower Motor Neuron?

A

UMN - LMN
Spastic paralysis - flaccid paralysis
No atrophy - Severe atrophy
Deep tendon reflex is increased - DTR is absent
Positive babinski sign - absent babinski sign
Absent superficial reflex - present sup reflex
No fasciculation and fibrillation - fasciculation and fibrillation could be present
Spasticity (clasp knife) - hypotonia

DİPNOT: Spasticity and rigidity are hypertonia types therefore they are not the same thing

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2
Q

Where does rigidity during movement originate from?

A

It originates from extrapyramidal system abnormality.

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3
Q

Spasticity (clasp knife) vs rigidity?

A

Spasticity–> increased tone of flexors of upper limb and extensor of lower limb

Rigidity–> equal resistance in both antagonists or agonists

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4
Q

What is myostatin mutation?

A

Myostatin-related muscle hypertrophy is a rare genetic condition characterized by reduced body fat and increased skeletal muscle size. Affected individuals have up to twice the usual amount of muscle mass in their bodies, but increases in muscle strength are not usually congruent.
Çocuklarda görüldüğünü hatırla, bir de kalpte hipertrofiye yol açabildiğini.

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5
Q

Match the motor strength abnormalities with their definitions

Quadriplegia
Hemiplegia
Paraplegia
Monoplegia

A

Quadriplegia - weakness in 4 limbs
Hemiplegia - weakness in one arm and leg on the same side
Paraplegia - weakness in both legs but no arms
Monoplegia - weakness in one limb

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6
Q

Which tractus is related with these followings: numbness, tightness, pins and needles, tingling or burning sensation in the face limbs or trunk

Corticospinal or spinothalamic?

A

Spinothalamic.

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7
Q

Which tractus is related with spastic walking?

A

Corticospinal

(Pyramidal tract cs tracti kapsar o nedenle pyramidal da denebilir)

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8
Q

Which tractus is related with these followings: weakness, stiffness heaviness or dragging of arms or legs

A

Corticospinal

(Pyramidal tract cs tracti kapsar)

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9
Q

Which type of paralysis is seen in internal capsule level?

A

Evenly distributed contralateral hemiplegia and central facial paralysis

Hemisensory loss could be present or not.

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10
Q

Fill the blanks with ipsilateral or contralateral hemiplegia

Cortex -
İnternal Capsule -
Brain Stem -
Spinal cord -

A

Cortex - contralateral
İnternal Capsule - contralateral
Brain Stem - crossed hemiplegia, ipsilateral CN palsy + contralateral hemiplegia or sensory loss
Spinal cord - A) Complete transverse spinal lesions –> 1) motor lesions 1-a) cervical cord lvl, quadriplegia 1-b) thoracal cord lvl, paraplegia 2) Sensory signs, a level of sensory loss below lesion 3) Autonomic, sphincter loss

B) Hemisections (Brown sequard syndrome)
Below the lesion –> contralateral loss in pain and temprature
İpsilateral UMN weakness n loss of proprioception

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11
Q

what is pyramidal tract?

A

The pyramidal tracts are part of the UMN system and are a system of efferent nerve fibers that carry signals from the cerebral cortex to either the brainstem or the spinal cord. It divides into two tracts: the corticospinal tract and the corticobulbar tract.

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12
Q

what is gowers sign and which disease is almost always associated with it?

A

Weakness in pelvic girdle, therefore the child uses hands to push his legs to stand.

Almost always associated with Duchenne muscular dystrophy

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13
Q

Why there is + babinski sign in UMN lesions?

A

Due to reflex arch. Mostly corticospinal tract s upper motor neurons inhibit the lower. So, if upper motor neuron is inhibited, the lower motor neurons cause accentuated reflex which causes + babinski reflex.

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14
Q

What does ‘‘Hemi’’ sensory loss indicate?

A

CNS disease, likely involving either the cortex or the thalamus.

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15
Q

What does Crossed deficits (affecting the face and the body on the opposite side) indicate?

A

brainstem disease.

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16
Q

what does Deficits involving both sides of the body below a certain level (e.g., T5) indicate?

A

spinal cord disease

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17
Q

What does A spinal cord level with “sacral sparing” indicate?

A

intraparenchymal spinal cord pathology

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18
Q

What does A spinal cord level without “sacral sparing” indicate?

A

myelopathy due to external pressure.

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19
Q

What does “stocking-glove” distribution indicate?

A

generalized peripheral nerve disease

20
Q

What is Syringomyelia?

A

Cyst or cavity formation within the spinal cord. It expands and elongates over time.

21
Q

What are the features of syringomyelia?

A

Pelerin gibi bir dağılım gösterir (cape like)
Loss of pain and temprature sensation in upper extremities. Preservation of light touch and proprioception.
Sacral and head sparing.

22
Q

What are dissociated sensory loss types?

A

Syringomyelia, lateral medullary stroke (wallenberg syndrome), anterior spinal artery stroke, brown sequard syndrome

23
Q

What is wallenberg syndrome (lateral medullary stroke) + features?

A

A rare form of brainstem stroke syndrome caused by the occlusion of posterior inferior cerebellar artery

Features: involves only pain and temperature loss
* completely spares light touch
* The pain and temperature loss in ipsilateral face
* because of involvement of the spinal tract of cranial nerve V,
* the contralateral body
* because of damage to the lateral spinothalamic tract,
* sparing the light touch pathways
* in the midline in the medial lemniscus.

24
Q

What is anterior spinal artery stroke + features?

A

Anterior spinal artery stroke involves the anterior two-thirds of the
cord,
* sparing the posterior columns, perfused by the posterior spinal arteries.
* The patients have (below the level in spinal cord)
* motor deficits
* sensory loss to pain and temperature,
* but normal touch, pressure, position, and vibration.

25
Q

What is brown sequard syndrome + features?

A

Ipsilateral loss of pain and
temperature
Contralateral loss of touch,
pressure, position, and vibration

26
Q

What are the cereballar examination abnormalities’ definitions?

Ataxia, Dysmetria, Dyssynergia, Dysdiadochokinesia, Hypotonia and Nystagmus

(dipnot: all deficits are ipsilateral to the cerebellar lesion)

(dipnot2: hypo ve hyperkinesia extrapyramidal symptom olarak geçiyor)

A

Ataxia (Incoordination of muscle groups during reaching or walking)

Dysmetria (Not to be able to reach the target point-(the nose or finger)

Dyssynergia (rapid repetitive movements)

Dysdiadochokinesia (rapid alternating movements)

Hypotonic

Nystagmus (Göz titremesi)

27
Q

Match features of chorea and parkinsonism

A

Parkinsonism–> poverty and slowness of movement, seen in basal ganglia as system, seen in substantia nigra seen as involved structure

Chorea–> Excessive abnormal uncontrollable involuntary movement, seen in basal ganglia as system, seen in nucleus caudatus as involved structure. Dancing gait!

28
Q

Extrapyramidal disorder signs
Rhythmic movement
* Tremor
Arrhythmic movements
* Athetosis: writhing, slow
* Chorea: rapid, irregular movements
* Dystonia: prolonged muscle contraction causing abnormal posture
* Hemiballismus: sudden and rapid movements with big amplitude

A

info card.

29
Q

Features of the following structures.

L Frontal Lobe (Broca’s area BA44):
L Temporal Lobe (Wernicke’s area BA22):
L Parietal Lobe:

A

L Frontal Lobe (Broca’s area BA44):
* Abnormality in Language Motoric expression (motor aphasia)

L Temporal Lobe (Wernicke’s area BA22):
* Abnormality in Language Comprehension (sensory aphasia)
* Contralateral upper quadrianopia

L Parietal Lobe:
* Loss of skilled movements of both sides’ extremities (apraxia),
* Abnormality in writing and calculation (agraphia, acalculia)
* Abnormality in repetition of phrases (conductive aphasia)
* Contralateral lower quadrianopia

30
Q

Features of the following structures.

R Frontal Lobe:
R Temporal Lobe:
R Parietal Lobe:

A

R Frontal Lobe:
* Loss of concern, empathy (especially in insular region)
R Temporal Lobe:
* Loss of prosody comprehension
* Loss of musical abilities (amusia)
* Contralateral upper quadrianopia
R Parietal Lobe
* Loss of constructional abilities (copying or drawing)
* Loss of navigational abilities (difficulty finding places)
* Contralateral lower quadrianopia

31
Q

Features of the following structures.

L or R occipital lobe:

A

L or R Occipital Lobe
* Contralateral homonym
hemianopia

32
Q

Info about Basal ganglia

A

The basal ganglia are interconnected deep
nuclei including the putamen, caudate,
globus pallidum and substantia nigra with
complicated interrelations.

They are involved in the integration of motor
and sensory inputs. when things go wrong,
they produce clinical syndromes of
involuntary movement.

33
Q

Info abt brain stem

A

The brain stem contains nuclei, including
the reticular formation, which maintains
consciousness, and those for the cranial
nerves (3– 12), and the large white
matter tracts running from the spinal
cord to more central structures and vice
versa

The descending motor tract, the
corticospinal tract, mostly crosses over
(decussates) in the pyramids in the
medulla. The ascending dorsal column
crosses in the medulla

The fact that these tracts cross in the
brain stem is helpful in localization of any
lesion. A brain stem lesion can produce a
cranial nerve lesion on one side and limb
signs on the other side

34
Q

Sympathetic and parasym system localization distribution?

A

Sympathetic ‘alarm’ system, which arises
from the spinal segments T1 to L2

Parasympathetic ‘holiday’ system, which
arises from the brain stem (associated
with cranial nerves 3, 7 and 9) and the
spinal segments S2–4

35
Q

CSF values?

A

no RBC’s,
* few WBC’s,
* Glucose 45-75mg/dl,
* Protein 15-45 mg/dl.

36
Q

What is anosmia and which disease is it related to?

A

Anosmia: Koku alamama.
Due to blocked nasal passages, trauma, a relative loss occurs with aging and Parkinson’s disease

37
Q

(Göz info kısmında da bulunuyor)
What are horner syndrome and Argyll Robertson pupil

A

Horner’s synrome: Caused by
interruption of the sympathetic
innervation of the pupillary dilator
muscle.

Argyll Robertson pupil: It is occasionally
seen in midbrain lesions (tectum). Some
favor the ciliary ganglion as the site of
the lesion. Its majör components:
responds to accommodation. Does not
respond to light, irregular

38
Q

What is sensory system consisting of?

A
  • Five sense
  • Peripheral Sensory System
    a) Spinothalamic
    b)Dorsal Column
  • Cortical-integrative Sensory System
  • Visceral Sensory System
39
Q

What are the features of spinothalamic tract (anterolateral system) and dorsal column (-Medial Lemniscal System)?

A

Spinothalamic system-Cutaneous
* Pain
* Temperature
* Light touch/pressure

Dorsal Column-Medial Lemniscal System-Proprioception
* Vibration
* Position

40
Q

what is cauda equina syndrome?

A

(CES) occurs when the nerve roots of the cauda equina
are compressed and disrupt motor and sensory
function to the lower extremities and bladder
* Patients with back pain should be aware of the
following “red flag” symptoms that may indicate CES:
* Severe low back pain
* Motor weakness, sensory loss, or pain in one, or more
commonly both legs
* Saddle anesthesia (unable to feel anything in the body areas
that sit on a saddle)
* Recent onset of bladder dysfunction (such as urinary
retention or incontinence)
* Recent onset of bowel incontinence
* Sensory abnormalities in the bladder or rectum
* Recent onset of sexual dysfunction
* A loss of reflexes in the extremities

41
Q

What is a seizure¿

A

Sudden and uncontrolled electrical disturbance in the brain that is causing a change in movement, behavior, sensation, or any other neurological function.

42
Q

What is the diagnostic criteria of epilepsy¿

A

Classical definition: two or more recurrent stereotypic unprovoked seizures.

Additional info: the Condition is characterized by a predisposition to recurrent stereotypic seizures of a CNS origin (caused by idiopathic reasons, tumors, strokes, etc.)

43
Q

What provokes seizure formation¿

A

Hyponatremia.

SSRI’s, increased water intake and diuretics might cause hyponatremia, therefore seizures too.

44
Q

What is a spell¿

A

Halk ağzı ile seizure.

(Bu kısımdan emin değilim) epileptik olmayan seizureları daha çok kapasıyor gibi.

İnfo: epileptik olmayan seizure örneği, vasovagal syncope.

45
Q

What are the key features of two seizure types, which are partial and generalized¿

A

Partial —> starts from cortex. Further divided into: simple, complex, secondary generalized.

Generalized —> starts from thalamus, whole cortex gets affected. Further divided into: absence, myoclonal, tonic, atonic, generalized tonic clonic

46
Q

Which medication types should be given to the patients who have seizures¿

A

GABA and K promoter, Na Cl Ca channel and Glutamate inhibitor

Midterm 4 (9 decks)

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