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Semester 5 PMNM Exam 6 > Movement Disorders Cbm > Flashcards

Movement Disorders Cbm Flashcards

1
Q

Massive amounts of ___ info enters the cbm

A

sensory

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2
Q

Cerebellar output is vital for

A

normal movement

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3
Q

Sever damage to cbm does NOT interfere with

A

sensory perception

muscle strength

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4
Q

Severe damage to cbm interferes with

A

postural control

coordination of movement

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5
Q

Cerebellar clinical disorders

A

Stroke
Tumors
Degeneration - acquired, hereditary

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6
Q

Vestibulocerebellar

A

Output to vestibular nuclei to impact eyes and postural control

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7
Q

Spinocerebellar

A

Vermis (trunk, posture?)
Paravermis (limbs?)
Gait and limb ataxia

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8
Q

Cerebrocerebellar

A

Higher order deficits

Connected with motor cortex

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9
Q

Unilateral lesions of the cbm affect which side of the body

A

same side

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10
Q

Why are cbm sign ipsilateral

A

double crossing of cerebellar efferents and the red nucleus descending tracts

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11
Q

Ataxia is what

A

without order

a movement disorder common to most lesions of the cbm

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12
Q

Ataxia describes what

A

the voluntary, normal strength, jerky, and inaccurate movement that are not caused by spasticity or contracture

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13
Q

Ataxia - common s/s

A

disorganized
poorly coordinated
clumsy

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14
Q

What are the D’s of ataxia

A

Dysdiadochokinesia
Dysmetria
Decomposition

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15
Q

Rebound, impaired check - why

A

impaired agonist/antagonist - losing the muscle spindle/GTO integration in the cbm

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16
Q

Differentiating cerebellar from somatosensory ataxia

A

Not all ataxia is caused by cerebellar lesions

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17
Q

If not a cerebellar lesion, what else can cause ataxia

A

interference with transmission of somatosensory information to the cbm with by lesions of spinocerebellar tracts or by peripheral neuropathy

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18
Q

What tests can be used to differentiate between cerebellar and somatosensory ataxia

A

Romberg
Proprioception tests
Vibration sense
Ankle reflexes

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19
Q

Romberg test measures what

A

the ability to use proprioceptive info for standing balance

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20
Q

Criteria for failure of Romberg

A

moving the arms to maintain balance
opening the eyes during ec
beginnin to fall
requiring assistance

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21
Q

Romberg - sensory ataxia

A

they will be able to stand steady with feet together and EO for 30 sec, but impaired balance with ec

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22
Q

Romberg - cerebellar ataxia

A

impaired balance no matter what

normal vibratory sense, proprioception, and ankle reflexes

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23
Q

Muscle strength - cerebellar lesion

A

normal

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24
Q

Muscle bulk - cerebellar lesion

A

normal

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25
Q

Involuntary mm contraction - cerebellar lesion

A

none

26
Q

Muscle tone - cerebellar lesion

A

normal

27
Q

movement speed and efficiency - cerebellar lesion

A

ataxic

28
Q

postural control - cerebellar lesion

A

depends on location of lesion

29
Q

Stroke can be

A

ischemic or hemorrhagic

Hemorrhagic is generally worse outcomes

30
Q

Stroke - what arteries

A

SCA
AICA
PICA

31
Q

Where does SCA come off of

A

basilar

32
Q

where does AICA come off of

A

basilar

33
Q

where does PICA come off of

A

vertebral

34
Q

What percentage of all strokes are cerebellar

A

Less than 5%

35
Q

Onset - cerebellar stroke

A

HA, nausea, vomit

Vertigo, nystagmus, ataxia, tremor

36
Q

Studies on cerebellar stroke show what with outcome measures

A

Recovery is generally good!

37
Q

stroke - Admission FIM score is generally higher in who

A

ischemic

BUT no statistical difference in d/c FIM

38
Q

stroke - Better prognosis associated with who

A

those that presented with HA, vomit, nausea, BUT NOT weakness or impaired conciousness

39
Q

Stroke - better prognosis with what arteries

A

AICA and PICA

40
Q

Complications of cerebellar stroke

A

hydrocephalus

brain stem compression

41
Q

Tumors - astrocytomas common with

A

children

19-33% of all childhood tumors

42
Q

Tumors - astrocytomas - metastasis?

A

Slow growing and generally do not metastasize

43
Q

Tumors - astrocytomas - s.s

A

Ipsilateral limb ataxia
dysmetria
gait ataxia
maybe also nystagmus

44
Q

Tumors - astrocytomas - prognosis

A

Good with removal of the tumor

45
Q

Tumors - medulloblastoma - what is it

A

Cancerous tumor that starts in the region of the brain at the base of the skull called the posterior fossa

46
Q

Tumors - medulloblastoma - tends to spread where

A

brain and spinal cord

47
Q

Tumors - medulloblastoma - how common is it

A

most common malignant brain tumor of childhood
250-500 cases a year in US
more in M than F
Usually under age 16

48
Q

Tumors - medulloblastoma - signs and symptoms

A

HA, morning nausea, vomit that gets worse, clumsiness, problems with handwriting, visual problems

49
Q

Tumors - medulloblastoma - signs and symtpoms if spread to spinal cord

A

back pain, trouble walking, problems controlling bowel and bladder functions

50
Q

Tumors - medulloblastoma - does it spread

A

Yes

51
Q

Tumors - medulloblastoma - how do you know if it spread

A

LOOK UP MORE

s/s

52
Q

Tumors - medulloblastoma - treatment

A

Surgery
Radiation therapy
Chemotherapy

53
Q

Tumors - medulloblastoma - survival rates

A

depend on age and how much spread
If has not spread - about 70-80%
If has spread to sc - 60%
Children under age 3 have lower survival rate because their disease is more aggressive

54
Q

Diseases that cause cerebellar degeneration can also involve other areas of the CNS including

A

the spinal cord, medulla oblongata, cerebral cortex, brainstem

55
Q

Cerebellar degeneration may be the result of

A

inherited genetic mutations that alter normal production of proteins that are needed for survivial of neurons
OR it can be acquired

56
Q

Spinocerebellar ataxias (SCA)

A

Group of disorders - hereditary and progressive
60 diff types of gene mutations
All will end up wc bound and PT will be compensatory

57
Q

Acquired cerebellar degeneration can be from

A

Chronic alcoholism
Fetal alcohol syndrome
Small cell lung CA, ovarian CA

58
Q

Acquired cerebellar degeneration - chronic alcoholism

A

Chronic alcohol use can lead to damage of the cbm due to nutritional deficiencies, thiamin B1 deficiency
P cells more vulnerable if thiamine deficient

59
Q

Acquired cerebellar degeneration - FAS

A

Hypoplasia, dysgenesis of cbm (incomplete or abnormal dev)

Cbm is so involved and vulnerable during development so gets targeted with FAS

60
Q

Acquired cerebellar degeneration - Small cell lung CA, Ovarian CA

A

Cancers cause remote effects in cbm

Death of P cells

61
Q

PT in cerebellar dysfunction - is it effective

A

YES

62
Q

PT in cerebellar dysfunction - what do we do

A

Visual fixation on a stationary target
Active eye head movements btw 2 stationary targets
Visual fixation on moving target (VOR cancellation)
Visual fixation on moving target (gaze stability)
Imaginary visual fixation

Semester 5 PMNM Exam 6 (6 decks)

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