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Neuroscience > lesions > Flashcards

lesions Flashcards

1
Q

damaged oculomotor nerve (midbrain)

A
  • IPSILATERAL oculomotor palsy
  • diplopia
  • dilated pupil
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2
Q

damaged cerebellothalamic fibers (midbrain)

A
  • CONTRALATERAL ataxia,
  • tremor
  • red nucleus hyperkinesias
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3
Q

damaged corticonuclear fibers (midbrain)

A
  • CONTRALATERAL facial weakness lower face
  • tongue deviation to contralateral side on protrusion
  • IPSIlateral trapezius and sternoCM weakness
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4
Q

damaged occulomotor fibers (midbrain)

A
  • IPSILATERALoculomotor paralysis
  • diplopia,
  • dilated pupil
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5
Q

damaged cortico spinal fibers (midbrain

A

contralateral hemiplegia

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6
Q

lesion to subthalamic nucleus deficits?

A

HEMIBALLISUMUS(corticospinal)

= rapid and unpredictable flailing of contralateral extremities; movements are usually more obvious in UE

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7
Q

occlusion of lenticulostriate branches to internal capsule: deficits

A
  • CONTRALATERAL hemiplegia (corticospnal)
  • loss or decreased pain, temp, proprio (thalamocortical fibers thru posterior capsule)
  • maybe: partial CONTRALATERAL paralysis of facial muscles/tongue (genu/corticonuclear fibers)
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8
Q

occlusion of distal brances of MCA: deficits

A
  • CONTRALATERAL motor and sensory loss of UE, trunk, face (precentral, postcentral gyri)
  • deviation of eyes to ipsilateral side (frontal eye fields)
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9
Q

occlusion of distal branches of ACA:deficits

A
  • motor and sensory losses in contralateral foot, leg, thigh (ant. post. paracentral gyrus)
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10
Q

antrior watershed infarct: where? deficits?

A
  • ACA/MCA junction
  • contralateral hemiparesis (usually leg)
  • expressive language
  • behavioral changes
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11
Q

posterior watershed infarct: where? deficits?

A
  • MCA/PCA junction
  • visual deficits
  • language problems
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12
Q

anterior choroidal artery syndrome: deficits?

A
  • HOMOnymous hemianopsia (optic tract)
  • LOWER portions of basal nuclei
  • hemiplegia, hemianesthesia (LOWER aspects of internal capsule)
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13
Q

clinical presentation of parkinsons

A
  • stooped posture
  • resting tremor
  • rigidity
  • shuffling or festinating gait
  • trouble maintaining mvmt (a-, hypo-, or bradykinesia)
  • dimentia (later)
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14
Q

medial midbrain lesion damages what STRX, what blood vessel

A
  • corticspinal fibers in crus cerebri
  • occulomotor nerve
  • maybe corticobulbar fibers
  • maybe substantia nigra, but usually no noticeable deficits
  • paramedian branches of PCA
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15
Q

deficits of lesion to corticospinal fibers in crus cerebri?

blood vessel to area?

A
  • CONTRALATERALhemiplegia of UE, trunk, LE (from occlusion of paramedian branches of PCA)
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16
Q

deficits of lesion to occulomotor nerve ?

blood to area?

A
  • IPSILATERAL paralysis of eye movement: eye is “DOWN AND OUT”
  • pupil dilated, fixed
  • paramedian branches of PCA
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17
Q

deficits of lesion to corticobulbar fibers in crus cerebri?

A
  • in tongue deviating to OPPOSITE side of lesion upon protrusion
  • paralysis of lower half of facial muscles on CONTRALATERAL side
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18
Q

central midbrain lesion damages what structures

A
  • oculomotor nerve
  • red nucleus and CBELLOthalamic fibers
  • maybe ML
  • maybe ventral trigeminothalamic fibers
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19
Q

deficits of lesion to red nucleus and CBELLOthalamic fibers/

A
  • CONTRALATERALataxia

- tremor of CBELLAR origin

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20
Q

pineocytoma can impinge?

A
  • superior colliculi
  • cerebral aquaduct
  • trochlear/occulomotor nerve
  • MLF
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21
Q

deficits of pineocytoma?

A
  • paralysis of upward gaze (superior colliculi)
  • hydrocephalus (cerebral aquaduct)
  • failure of eye mvmt (trochlear/occulomotor nerve)
  • nystagmus (MLF)
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22
Q

initial signs of uncal herneation

A
  • dilation of pupils (uni or bipolar)
  • slow reaction to light
  • followed by weakness of occulomotor movement
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23
Q

progressive symptoms of uncal herniation

A
  • fully dilated pupils
  • eyes deviate laterally b/c of unapposed abducens nerves
  • weakness on CONTRALATERAL side (crtocospinal fibers in crus)
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24
Q

symptoms of an especially large or bilateral supratentorial lesion

A

decorticate rigidity

= flexion and adduction of UE; extention of LE with internal rotation and plantar flexion

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25
Q

symptoms of an intratentorial lesion

A

decerebrate rigidity

= UE and LE extended, toes point inward, pronated forearm, head and neck extended

26
Q

opisthotonos symptoms

A

EXTENDED head and neck

27
Q

midline optic chiasm lesion

A
  • BITEMPORAL hemianopia

- may have relative afferent pupillary defect (RAPD)

28
Q

lateral optic chiasm lesion

A
  • BINASAL hemianopia

- may have RAPD

29
Q

optic tract lesion

A
  • HOMOnymous hemianopia on ipsilateral side

- may have RAPD

30
Q

total optic radiation lesion

A
  • ipsilateral HOMOnymous hemianopia (also in lesion or total primary visual cortex)
31
Q

cuneus lesion

A
  • ipsilateral INFERIOR homonymous quadrantopia
32
Q

lingual gyrus lesion

A
  • ipsilateral SUPERIOR homonymous quadrantopia
33
Q

optic nerve lesion

A
  • ipsilateral blindness in that eye

- loss of pupillary light reflex in both eyes when light is shined into the blinded eye

34
Q

what is enopthalmos

A
  • a slight sinking of the eyeball into the orbit

- often MENTIONED for patients with Horner’s, but not always SEEN

35
Q

lesion of the abducens root: muscle, and movement?

A
  • ipsilateral lateral rectus muscle
  • loss of lateral gaze
  • when looking straight ahead, lesioned eye will deviate SLIGHTLY toward midline
36
Q

lesion of abducens root: complaint

A
  • diplopia

- especially when trying to look toward the lesioned size in the HORIZONTAL plane

37
Q

caudal basilar pontine lesion: symptoms

A
  • alternating hemiplegia (paralysis of lateral rectus on ipsilateral side; paralsis of body on contralateral side)
  • diplopia
38
Q

internuclear ophthalmoplegia symptoms

A
  • loss of medial gaze
39
Q

internuclear ophthalmoplegia lesion?

A

lesion in the MLF on the SAME side as the paralysis

40
Q

lesion of abducens nucleus: damages?

A
  • ALPHA motor neurons to ipsilateral lateral rectus muscle

- interneurons that terminate on alpha motor neurons in the contralateral oculomotor nucleus

41
Q

lesion of abducens nucleus: symptoms

A
  • loss of horizontal gaze in both eyes TOWARD lesion side
  • normal horizontal gaze in both eyes AWAY lesioned side
  • basically internal opthalmoplegia lesion plus abducens root lesion
42
Q

one and a half syndrome: symptoms

A
  • loss of medial and lateral voluntary eye mvmt on one side

- loss of medial mvmt on the contralateral side

43
Q

one and a half syndrom: damages?

A
  • abducens nucleus on one side
  • the MLF right next to affected nucleus
  • usually also affects paramedian pontine reticular formation aka “horizontal gaze center”
44
Q

radiculopathy

A
  • results from spinal nerve root damage
  • radiating pain in a dermatomal patern
  • weakness
  • hyporeflexia
45
Q

symptoms of cauda equina syndrome

A
  • weakness of LE
  • saddle anesthesia ( sensory deficits )
  • urinary retention (decreased sphincter tone)
  • decrease in sexual fxn
  • sciatica
46
Q

broca’s aphasia symptom and location

A
  • inferior frontal gyrus (areas 44/45)
  • motor, expressive, nonfluent aphasia
  • NO vocal paralysis
  • patients are well aware of their deficits
47
Q

telegraphic speech

A
  • associted with broca’s aphasia

- familiar single wordes or short phrases with left out words

48
Q

wernicke aphasia

A
  • supramarginal (area 40) and angular gyri (area 39(
  • sensory, receptive, or fluent aphasia
  • speek freely, but words may not make sense
  • may not be aware of their deficits
49
Q

paraphasia

A
  • “word salad”

- associated with wernicke

50
Q

structures that may be affected in uncal herniation

A
  • CBellum
  • uncus (temporal lobe)
  • hypothalamus
  • optic tract
51
Q

aneurysms affecting the occulomotor nerve

A

aneurysm of basilar bifurcation

aneurysm of posterior communicating/PCA intersection

52
Q

third nerve injury deficits

A
  • dilated pupil
  • loss of most eye mvmt
  • diplopia
53
Q

angterior choroidal artery syndrome (strx)?

A

optic tract and crus cerebri

54
Q

damage to vestibular nuclei(medulla)

A
  • nystagmus,
  • vertigo
  • nausea
55
Q

damage to nucleus ambiguous (medulla)

A
  • dysphagia,
  • hoarseness
  • deviation of uvula to contralateral side
56
Q

spinal trigeminal tract nucleus

A
  • ipsilateral loss of pain and thermal sense on face
57
Q

conductive deafness

A

caused by problems of external ear or disorders of the middle ear

58
Q

middle ear causes of conductive deafness

A
  • otitis media

- otosclerosis

59
Q

nerve deafness is from

A

diseases involving cochlea or the cochlear portion of the vestibulocochlear nerve

60
Q

central deafnes results from

A

damage to the cochlear nuclie or their central connections

61
Q

damage to cochlear part of the eighth nerve can be from __ and result in ___

A

vestibular schwaanoma

  • tinnitus and or deafness
  • presbyacusis (hard time hearing high pitch sound)
62
Q

auditory agnosia is?

it can be from?

A

difficulty understanding and/or interpreting sounds

damage to secondary auditory cortex in the temporal lobe

Neuroscience (23 decks)

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