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Step 1 - Elise > Kaplan Videos > Flashcards

Kaplan Videos Flashcards

1
Q

Spinal tap location

A

between L3-L4 and L4-L5 because the conus medullaris (end of spinal cord) ends at L2 in adults

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2
Q

Nine layers pierced by lumbar puncture needle

A

Skin, superficial fascia, deep fascia, supraspinous ligament, interlaminar space, ligamentum flavum, epidural space, dura, (“pop”), ARACHNOID MATER (last tissue pierced), subarachnoid space with CSF

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3
Q

Motor origin

A

Ventral horn

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4
Q

Sensory Origin

A

Dorsal horn

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5
Q

Fibers in Dorsal Horn medial division, proprioception

A

1a, 1b fibers

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6
Q

Fibers in Dorsal Horn medial division, touch

A

2, A-beta fibers

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7
Q

Fibers in Dorsal Horn lateral division, sharp pain and cold

A

3, A-delta fibers

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8
Q

Fibers in Dorsal Horn lateral division, dull pain and warmth

A

4, C fibers

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9
Q

Motoneurons in Ventral Horn and what they innervate

A

Alpha MN innervate skeletal muscle NMJ.
Delta MN innervate skeletal muscle spindles.
(medial MN’s in ventral horn innervate proximal muscles. lateral MN’s innervate distal muscels).

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10
Q

If UMN CST lesion is between the cerebral cortex and medulla above the pyramidal decussation, where will the spastic paresis be present?

If the lesion is below the medulla, where will the spastic paralysis be present?

If the lesion is a LMN lesion, where will the deficit be?

A

Spastic weakness below and CONTRALATERAL to the lesion.

Spastic weakness below and IPSILATERAL to the lesion.

FLACCID weakness ipsilateral to the skeletal muscle their axons innervate.

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11
Q

Sensory system that controls: conscious proprioception, fine touch, vibration, pressure, 2-pt discrimination.

A

Dorsal column Pathway- Medal Lemniscal System

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12
Q

Sensory system that controls: conscious proprioception, fine touch, vibration, pressure, 2-pt discrimination.

  • Lesion: loss of senses __(above/below)__ lesion
  • Site of lesion: _(affected/unaffected)__ side of body
  • Location of decussation: (lesion above this is CL symptoms; below is ipsilateral symptoms)
A

Dorsal column Pathway - Medal Lemniscal System

  • Lesion: loss of senses __ABOVE__ lesion
  • Site of lesion: _AFFECTED__ side of body
  • Location of decussation: (lesion above this is CL symptoms; below is ipsilateral symptoms)
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13
Q

How to tell where the lesion of the dorsal column lies: Romberg test.

A

Decreased balance + eyes OPEN = cerebellar lesion.

Decreased balance + eyes CLOSED = DC-ML lesion (bc vision compensates for interrupted proprioceptive input from DC).

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14
Q

Sensory system that controls: Anesthesia (loss of Pain and Temperature sensation)

A

Spinothalamic Pathway - Anterolateral System

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15
Q

Sensory system that controls: Anesthesia (loss of Pain and Temperature sensation)

  • Lesion: loss of senses __(above/below)__ lesion
  • Site of lesion: _(affected/unaffected)__ side of body
  • Location of decussation: (lesion above this is CL symptoms; below is ipsilateral symptoms)
A
  • Lesion: loss of senses __1-2 segments BELOW and beyond__ the lesion
  • Site of lesion: _AFFECTED__ side of body
  • Location of decussation: in the Spinal cord, so always CL symptoms below the lesion. Tract intact rostral to the lesion
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16
Q

Thalamic nucleus that Dorsal column Pathway - Medal Lemniscal System and Spinothalamic Pathway - Anterolateral System.

A

VPL

17
Q

Where does Spinothalamic Pathway - Anterolateral System travel?

A

Neuron 1: travels from receptor to DRG.
Neuron 2: DRG, enters SC, travels 1-2 segments up/down in Lissauer’s tract. Decussates in SC and continues up through Medulla to VPL in thalamus.
Neuron 3: VPL in Thalamus to post central gyrus

18
Q

What tract mainly carries unconscious proprioceptive input form muscle spindles and GTOs to cerebellum?

A

Spinocerebellar tract

a) the dorsal spinocerebellar tract
b) the cuneocerebellar tract

19
Q

the subsets of spinocerebellar tract

A

a) the dorsal spinocerebellar tract - from lower limb to externeal cuneate nucleus in BS
b) the cuneocerebellar tract - from upper limb to Clarke’s nucleus in SC

both pass through inferior cerebellar peduncle and then end, ipsilateral ascent the entire time

20
Q

reflex contraction of skeletal muscle - name the two neurons involved in efferent and afferent signals.

A

1a dorsal root

LMN (aka alpha motor neurons)

21
Q

UMN have what net effect on muscle stretch reflex?

A

inhibitory

22
Q

Dorsal roots for prop/touch

For Pain/temp

A

Proprioception/touch: 1a, 1b, A-beta

Pain and temp: A-delta and C

23
Q

Infant with gait ataxia, dysarthria, hand clumsiness, loss of position sense, imparied vibratory sensation, and loss of tendon reflexes.

A

Friedreich’s ataxia. Frataxin gene, chromosome 9

24
Q

Bilateral paralysis with suppressed reflexes

Poliomyelitis, Werdnig-Hoffman Disease, ALS, or ASA occlusion?

A

Poliomyelitis, Werdnig-Hoffman Disease (LMN lesion only; VH)

25
Q

Bilateral spastic weakness in LL, bilateral flaccid weakess in UL.

Poliomyelitis, Werdnig-Hoffman Disease, ALS, or ASA occlusion?

A

ALS (UMN and LMN deficits - no sensory or bowel/bladder deficits

26
Q

Bilateral spastic weakness and bilateral loss of pain and temp.

Poliomyelitis, Werdnig-Hoffman Disease, ALS, or ASA occlusion?

A

ASA occlusion (spares DC and Lissauer tract - STT)

27
Q

Bilateral flaccid weakness, hypotonia and tongue fasciculations

Poliomyelitis, Werdnig-Hoffman Disease, ALS, or ASA occlusion?

A

Werdnig-Hoffman Disease (LMN lesion only; VH)

28
Q

Altered vibratory sense in LL, urine retention, pain, Romberg

Tabes Dorsalis, Brown Sequard Syndrome, Syringomyelia, Subacute Combined Degeneration (Vit B12)

A

Tabes Dorsalis (tertiary syphilis to demyelination of DC)

29
Q

Bilateral loss of vibratory sense, bilateral spastic weakness.

Tabes Dorsalis, Brown Sequard Syndrome, Syringomyelia, Subacute Combined Degeneration (Vit B12)

A

subacute combined degeneration (SCT, Lateral CST, DC)

30
Q

Bilateral loss of pain and temp initially, bilateral flaccid paralysis.

Tabes Dorsalis, Brown Sequard Syndrome, Syringomyelia, Subacute Combined Degeneration (Vit B12)

A

syringomyelia (STT damaged (2nd order neurons) by syrinx expansion/anterior white commissure damage)

31
Q

Ipsilateral loss of vibratory sense, ipsilateral spastic weakness, contralateral loss of pain and temp

Tabes Dorsalis, Brown Sequard Syndrome, Syringomyelia, Subacute Combined Degeneration (Vit B12)

A

Brown Sequard Syndrome

Step 1 - Elise (30 decks)

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