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Neuro Exam 2 > Lesions > Flashcards

Lesions Flashcards

1
Q

Glossopharyngeal n. lesion

A

Diminished taste posterior tongue; loss of stylopharyngeus contraction ipsilaterally — gag reflex affected

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2
Q

Vagus nerve root lesion

A

Dysphagia, dysarthria, weak palate, uvula deviates to contralateral side

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3
Q

Nucleus ambiguus lesions

A

Contralateral palatal arch weakness and drooping

Ipsilateral uvula deviation

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4
Q

Hypoglossal nucleus lesion

A

Contralateral tongue deviation

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5
Q

Hypoglossal nerve lesion (LMN)

A

Ipsilateral tongue deviation, muscle paralysis and atrophy

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6
Q

Abducens n. lesion

A

Often d/t medial pontine syndrome

Ipsilateral flaccid paralysis of LR, opposite eye still adducts

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7
Q

Lesion to abducens nucleus

A

Ipsilateral LR paralysis + failure of contralateral eye to abduct (because both motor neuron and interneuron affected)

=LMN lesion + internuclear ophthalmoplegia

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8
Q

Lesions rostral to facial motor nucleus

A

Supranuclear facial palsy — contralateral lower half of face droop

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9
Q

Facial nerve root lesion

A

Bell’s palsy - ipsilateral

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10
Q

Oculomotor nerve/nucleus lesion

A

Ipsilateral paralysis of EOM (except SO and LR)

Diplopia, mydriasis, loss of accommodation

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11
Q

Accessory nerve root lesion

A

Ipsilateral shoulder droop, scapular winging, can’t turn head to opposite side against resistance

[similar findings with cervical cord damage or internal capsule damage]

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12
Q

Trochlear nerve root lesion

A

Ipsilateral SO paralysis

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13
Q

Trochlear nerve lesion in midbrain (MLF)

A

Contralateral SO paralysis, ipsilateral INO

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14
Q

Uncal herniation NOT involving kernohan’s notch causes limb weakness on which side?

A

Contralateral

[if affecting kernohans would be ipsilateral + respiratory compromise]

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15
Q

Falx herniation symptoms

A

Headache + contralateral leg weakness

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16
Q

ACA occlusion

A

Sensory and motor deficits of bilateral UEs, worse in distal muscles

17
Q

PICA occlusion

A

Lateral medullary syndrome

Contralateral loss of pain/temp over body with ipsilateral loss of pain/temp on face

18
Q

PCA occlusion

A

D/t thrombosis or uncal herniation —> ischemia of visual cortex

Contralateral homonymous hemianopsia with macular sparing

19
Q

Which nucleus is affected with phantosmia

A

Medial dorsal thalamic nucleus

20
Q

Lenticulostriate hemorrhage on right side

A 
Left spastic hemiparesis of extremities
Left facial paralysis
Left tongue deviation
Right uvula deviation
Variable R deficits of SCM/trap
21
Q

Horner’s syndrome is related to ipsilateral damage of what tract

A

Lateral reticulospinal

22
Q

Lesions to AWC

A

Bilateral analgesia (usually upper extremities)

23
Q

Unilateral damage to cochlear nerve or cochlear nucleus

A

Ipsilateral monaural deafness

24
Q

Unilateral damage at/above superior olivary nucleus in auditory pathway

A

Hearing issues on contralateral side

25
Q

Which type of aphasia may be induced by MCA occlusion

A

Wernicke’s

26
Q

Conduction aphasia is related to damage in what area

A

Arcuate fasciculus and left parietal region

[poor speech repetition]

27
Q

Associative visual agnosia is usually d/t occlusion of what a?

A

PCA —> infarct of occipital lobe + posterior corpus callosum

28
Q

Destruction of primary spinal trigeminal tract and secondarily in spinal lemniscus

A

Ipsilateral hemianalgesia of face

Contralateral hemianalgesia of body

[called alternating hemianalgesia]

29
Q

Unilateral trigeminal n. damage + corticospinal tract destruction in pons

A

Ipsilateral trigeminal anesthesia and paralysis

Contralateral spastic hemiplegia

[called alternating hemiplegia of trigeminal]

30
Q

Lesion to posterior limb of internal capsule

A

Contralateral complete hemiparesis of face, upper extremity, and lower extremity

[damaged lenticular striate artery]

31
Q

Lesion of spinothalamic path

A

Loss of pain/temp on contralateral side 1-2 levels below lesion

32
Q

Brown sequard syndrome = hemisection of spinal cord

A

Complete loss of p/t 1-2 levels below (Lissauers tract)

Ipsilateral tactile/proprioceptive loss below lesion

Ipsilateral loss of all sensation at level of lesion

Motor losses vary

33
Q

Syringomyelia

A

Loss of p/t bilaterally in shawl-like distribution

34
Q

Lesions to ACA vs. MCA vs. PCA

A

ACA —> tactile loss over CL LE

MCA —> tactile loss over CL UE + face

PCA —> tactile loss over CL body and head

35
Q

Lesions to primary somatosensory cortex affect what side of the body

A

Contralateral

36
Q

Lesions to fasciculus cuneatus or gracilis

A

Ipsilateral tactile loss at+below, sensory ataxia

Neuro Exam 2 (21 decks)

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