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Neuro Exam 2 > lesions > Flashcards

lesions Flashcards

1
Q

Dorsal horns have CB of ______ neurons

A

sensory

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2
Q

Ventral (anterior) horns have CB of ________ neurons

A

motor

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3
Q

Spinothalamic tract (ALS) Info: Cross:

A

Pain, temperature, crude touch Crosses: After it ascends or descends via Lasseurs tract, on the dorsal horn

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4
Q

DCML Info: Cross:

A

Propioception, tactile information, vibration Enters dorsal root -> ipsilateral dorsal column (fasciulus cuneatus or gracilis) - > projects up Crosses: caudal medulla (nucleus cuneatus or gracilis) via internal arcuate fibers -> medial lemniscus tract

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5
Q

damage to hypoglossal nerve

A

tongue deviates to lesion

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6
Q

damage to vagus nerve

A

uvula will deviate to contralateral side

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7
Q

damage to vestibular cochealr of vestibular nuclei

A

N/V, nystagmus

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8
Q

hemiparesis

A

weakness on one side of the body

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9
Q

Webers syndrome

A

Damage to the midbrain: CB, corticospinal and CN 3 1. Corticospinal: contralateral UMN; hemiparesis 2. CB: uvula will go to ipsilateral side, tongue will go away from the lesion (because above where it branches), exaggerated gag reflex

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10
Q

Oculomotor palsy (CN3)

A

dialated pupil Eye is down and out eye

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11
Q

What are the rule of 4s?

A
  1. 4 CN: A. Above the midbrain (1, 2, 3, 4) B. Pons (5, 6, 7, 8) C. Medulla (9, 10, 11, 12) 2. 4 CN that divide into 12 have motor nuclei in the midline: (CN 3, 4, 6, 12) 3. the 4 that do not divide by 12 are all located laterally: 5, 7, 9, 11. 4. 4 midline columns that all start with M: A. Medial lemniscus B. Motor nucleus of 3, 4, 6, 12 C. MLF D. Motor pathway (corticospinal tract) 4. 4 lateral (side) columns that start with S A. Spinothalamic B. Sympathetic C. Spinal trigeminal (sensory to face) D. Spinocerebellar
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12
Q

This will allow you to tell:

A
  1. Is the lesion medial or lateral: which tracts are affected? Then, we can ask: 2. Midbrain, pons or medulla: which CN is affected?
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13
Q

medial medullary sundrome can be d/t

A

occlusion of anterior spinal a.

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14
Q

Damage to CN 4 (trochlear):

A

Eye cannot look down when looking at nose

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15
Q

Damage to CN5 (trigeminal)

A

ipsilateral facial sensory loss

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16
Q

Damage to CN6 (abducens)

A

ipsilateral eye abduction weakness (eye cant abduct)

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17
Q

Damage to CN7 (trigeminal)

A

?

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18
Q

Damage to CN8 (ipsilateral )

A

ipsilateral deafness

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19
Q

Damage to CN 9 (glossopharyngeal)

A

ipsilateral pharyngeal sensory loss

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20
Q

Damage to CN 10 (vagus)

A

ipsilateral palate weakness

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21
Q

Damage to CN 11 (spinal accessory)

A

ipsilateral shoulder weakness

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22
Q

Damage to CN 12 (hypoglossal)

A

ipsilateral weakness of tongue

23
Q

Damage to motor tract (corticospinal) in BS

A

contrlateral hemiparesis (weakness); UMN signs

24
Q

Damage to medial leminscus in BS

A

contralteral loss of propioception and vibration

25
Q

Damage to nucleus and nerve

A

ipsilateral motor loss of 3, 4, 6 ,and 12

26
Q

Damage to spinocerebellar path in BS

A

ipsilateral ataxia

27
Q

Damage to spinothalamic tract in BS

A

Contrlateral pain/temp/ crude touch loss in body

28
Q

Damage to sensory nucleus of V (face)

A

ipsilateral pain/temp loss in face

29
Q

Damage to sympathetic pathway

A

ipsilateral Homers syndrome

30
Q

If we see : “lost of sensory (pain and temp to the left face”, what do we conclude

A

ipsilalateral sensory (trigeminal) V tract dysfunction -> Left sided lesion DO NOT USE CN 5 TO LOCALIZE TO PONS, BC CN 5 TRAVELS THROUGHOUT ALL BS

31
Q

only use ______ to pick deficit is CN __

A

8

32
Q

If cranial nerve is involved, the lesion must be located where?

A

BRAINSTEM!

33
Q

What causes medial medullary syndrome?

A

Anterior spinal A.

34
Q

In the midbrain, what a is most responsible for damage?

A

Posterior cerebral A.

35
Q

In the pons, what as are responsible for damage?

A

Medial: paramedial branches of basilar (CN6) Lateral: long circumferential branches of basilar a (CN 5, 7, 8)

36
Q

In the medulla, what as are responsible for damage?

A

Medial: Anterior spinal A (damages CN 12) Lateral: PICA (damages CN 9, 10, 188)

37
Q

Sx: R sided weakness L eye is down and out. Use rules to figure out whats wrong?

A
  1. R sided weakness-> corticospinal tract -> medial lesion 2. L eye is down and out -> oculomotor palsy -> located in the midbrain Left medial midbrain lesion (webers) d/t PCA.
38
Q

Left eyelid droop (ptosis) and small pupil (miosis) ->

A

L Horners syndrome

39
Q

Loss of pain and temp to left face ->

A

damage to CN 5

40
Q

Loss of gag reflex in left throat

A

CN 9 (glossopharnygeal)

41
Q

Palate raised to the right side

A

CN 10

42
Q

hoarse voice

A

damage to CN 10

43
Q

corneal reflex

A

CN 5

44
Q

corneal reflex

A

CN 5

45
Q

facial spasms is d/t

A

CN 7

46
Q

How do rule of 4:

  1. Look for involvement of midline CN: 3,4,6, 12-> indicate a midline damage
  2. All other CN involvement indicate a lateral involvement
  3. Look for involvement of M tracks -> medial side involvement
  4. Look for involvement of S tracks -> lateral side involvement
A
47
Q

Complete transection of posterior columns in the cervical region would produce what impairment(s)?

A

Damage the fascilulus cuneatus and fasciulus gracilis -> complete loss of propioeption, vibratory, tactile info from cervical down

48
Q
A

ipsilateral

no change

decrease/loss of function

decrease/ loss of function

49
Q
A

Contralateral

no change

no change

loss of function

50
Q
A
  1. contralateral
  2. no change
  3. no change
  4. loss of function
51
Q

lesion to

anterior horn

A

ipsilateral LMN paralysis

52
Q

damage to Lateral corticospinal tract

A

ipsilateral spastic paralysis

53
Q

Posterior ______ sulcus is present throughout the entire SC.

Posterior _____ sulcus separates the cuneate fasiculus and the gracile fasiculus and disappears.

________ column is only present in the thoracic area

A

Posterior lateral sulcus is present throughout the entire SC.

Posteior intermediate

Lateral column

Neuro Exam 2 (12 decks)

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