Neuro 3 Flashcards
Signs of injury to corticospinal tract in spinal cord?
UMN signs below lesion
Signs of injury to anterior horn of spinal cord?
LMN signs at level
Signs of injury to posterior columns?
IL loss of discriminitive touch, proprioception and vibration
Signs of injury to spinothalamic tract?
CL loss of pain and temperature
Signs of intramedullary tumor/central cord syndrome?
sensory loss, sacral sparring of motor function; maybe bowel/bladder disturbances
Deficits in anterior spinal syndrome?
UMN signs below lesion, LMN signs at level, loss of pain and temp below lesion, disc touch, proprioception and vibration intact
Deficits in tabes dorsalis?
loss of disc touch, proprioception and vibration below lesion, Romberg sign
Deficits in Brown-Sequard injury?
IL loss of discriminitive touch, CL loss of pain/temp, UMN signs below lesion, LMN signs at level
Deficits in Friedreich’s ataxia?
loss of disc touch, proprioception and vibration below lesion, Romberg sign, ataxia and UMN signs below lesion
Deficits in subacute combined degenration?
B12 deficiency; loss of disc touch, proprioception and vibration below lesion, UMN signs below lesion
Signs of conus medullaris syndrome?
sudden, bilateral onset; decrease calcaneal reflex, perianal sensory loss, impotence, urinary and fecal incontinence
Signs of cauda equina syndrome?
gradual, unilateral onset, calcaneal and patellar reflexes decreased, saddle sensory loss
Signs of tethered cord syndrome?
commonly associated with spina bifida, pain, weakness, sexual dysfunction
Signs of spinal cord transection at C6?
LMN signs at C6 (brachioradialis), UMN signs below; complete sensory loss below C6
Signs of spinal cord transection at L4?
LMN signs at L4 (quads), UMN signs below; complete sensory loss below L4
Deficits in medial medullary syndrome?
CL loss of discriminitive rouch, CL UMN signs, tongue deviates to lesion on protrusion (w/ fasciculations)
Artery involved in medial medullary syndrome?
alternating branches of anterior spinal artery
Deficits in lateral medullary syndrome?
IL loss of pain and temp on face, CL loss of pain and temp on body, dysphagia, hoarseness
Artery involved in lateral medullary syndrome?
PICA
Deficits in medial pontine syndrome?
CL loss of discriminitive rouch, CL UMN signs, IL CN VI palsy + INO maybe 1 1/2 syndrome
Artery involved in medial pontine syndrome?
basilar, paramedian branches
Deficits in lateral pontine syndrome?
IL loss of pain and temp on face, CL loss of pain and temp on body, CN VII or V palsy
Artery involved in lateral pontine syndrome?
basilar, circumferential branches
Deficits in Weber syndrome?
IL CN III palsy, CL UMN sign, CL lower facial paralysis
Deficits in Benedikt syndrome?
IL CN III palsy, CL ataxia [superior cerebellar peduncle]
Deficits in Claude syndrome?
IL CN III palsy, CL UMN sign, CL lower facial paralysis, CL ataxia
Arteries involved in midbrain syndromes?
paramedian branches from PCA
What signs/symptoms are characteristic of cortical injury?
aphasia, agnosia, anosognosia, primitive reflexes: grasp, snout, suck, root, magnetic gate, astereognosia, apraxia, contralateral neglect
Deficits in left inferior division MCA stroke?
receptive aphasia, CL homonymous hemianopsia
Deficits in left superior division MCA stroke?
expressive aphasia, CL UMN signs [face + UL], CL sensory loss [face + UL]
Deficits in right MCA main stem stroke?
CL UMN signs [face, UL + LL], CL sensory loss [face, UL + LL]
Deficits in left PCA stroke?
CL homonymous hemianopsia with macular sparring
Deficits in left ACA stroke?
CL UMN signs [LL], frontal lobe signs
Deficits in Parinaud syndrome?
vertical gaze palsy, obstructuve hydrocephalus
Deficits in anterior choroidal artery stroke?
CL UMN signs, CL homonymous hemianopsia
Deficits in lentriculostriate artery hemorrhage?
CL UMN signs, CL lower facial paralysis, tongue deviates away from lesion
Strokes that can lead to Horner syndrome?
lateral medullary, cervical spinal cord
Blood supply to thalamus?
posterior cerebral [thalamogeniculate + thalamoperforating]
Signs of thalamic hemorrhage?
CL sensory loss, CL homonymous hemianopsia
Signs of tonsillar herniation?
respiratory and cardiovascular arrest
Signs of uncal herniation?
CN III palsy, UMN signs, papilledema
Structure injured in contralateral neglect?
right parietal lobe
Signs of Gerstman’s syndrome?
acalulia, left-right confusion, finger agnosia; left parietal lobe
Structure damaged in alexia without agraphia?
left splenium of corpus callosum
Where is Broca’s area? Function?
left inferior frontal gyrus; expressive speech
Where is Wernicke’s area? Function?
left supramarginal, angular, superior temporal gyri; receptive speech
Signs of conduction aphasia?
normal comprehension and fluent speech; impaired repetition
Cause of Cushing’s disease?
ACTH-secreting pituitary adenoma
Signs of LH or FSH secreting adenoma?
hypogonadism and infertility
Signs of prolactin-secreting adenoma?
amenorrhea in females; hypogonadism in men; galactorrhea, infertility, hair loss, decreased libido, weight gain
Signs of diabetes insipidus?
polyuria, polydipsia
Signs of SIADH?
concentrated urine with osmolality > 300 mosm/L
SIADH treated with rapid infusion of hypertonic saline will cause?
central pontine myelinolysis
Signs of craniopharyngioma?
visual deficits, diabetes insipidus, adiposity, developmental delay, headaches, papilledema
Craniopharyngioma derived from?
remnant of Rathke’s pouch
Bladder problems in cortical lesions (paracentral lobule)?
uninhibited, spastic bladder
Bladder problems in brainstem/high spinal cord injury?
flaccid paralysis that becomes spastic [urge incontinence, hyperactive, empties too frequently]
Bladder problems in sacral spinal cord injury?
overflow incontinence
Disturbances of erection/ejaculation with spinal cord injury (above T12)?
loss of psychogenic erections, reflex erections intact; only reflex ejaculation
Disturbances of erection/ejaculation with sacral spinal cord injury?
loss of reflex erection, psycogenic may be preserved; ejaculation abolished
Signs of Horner syndrome?
constricted pupil, ptosis, red face, anhydrosis
Site of injury in pt. with miosis, ptosis and CN VI palsy?
cavernous sinus - ICA aneurysm (sympathetics follow the ICA and CN VI is riding on ICA)
Why no red face/anhysrosis in previous pt?
external carotid nerve is intact
Components of the limbic system?
parahippocampal gyrus, uncus, hippocampus, amygdala
Structures in the Papez circuit?
hippocampus, mamillary body (via fornix), ant nuc of thalamus, cingulate cortex
Function of hippocampus?
consolidation of short term memory
Part of hippocampus most vulnerable to seizure activity?
CA4
Part of hippocampus most susceptable to anoxia?
CA1
Structure affected in Korsakoff syndrome?
mammillary bodies, dorsomedial thalamus
Signs of Korsakoff syndrome?
amnesia, confabulation with short term memory intact
Metabolic deficency in Korsakoff syndrome?
thiamine
Signs of Wernicke-Korsakoff syndrome?
ophthalmoplegia, ataxia and disturbances of mentation and consciousness
Signs of injury in akinetic mutism?
immobile, mute and unresponsive but awake; bulateral lesion of cingulate gyrus
Signs of Kluvy-Bucy syndrome?
placid, visual agnosia, hyperorality
Brain region injured in Kluver-Bucy syndrome?
bilateral temporal lobe