Neuro flashcards Patient Assesment
if you damage the anterior horn
weakness or paralysis (polio)
[some kind of motor effect]
where do the ventral horn cells receive information from
they are motor, so they get input from the brain, they can also get input from the dorsal horn neurons
what does it mean that the spinal cord is a mixed nerve?
it carries both sensory afferent information and motor efferent information
what does the central sulcus divide?
frontal from parietal lobe
descending pathway will land on the anterior ventral horn which contains neurons that are motor
those neurons intervate skeletal muscle
ascending
dorsal root, sensory
descending
anterior ventral horn, motor
two major ascending sensory pathways?
the spinothalamic tract (also called the anterolateral tract), and the posterior (or dorsal) column tract
spinothalamic tract
carries the sensory information of pain, temperature, crude touch, and pressure
hot stove->spinal cord->dorsal root ganglion->dorsal root->crosses over the gray and white matter->ascends to the thalamus-> reaches the post central gyrus of the parietal lobe-> “That’s hot!”
anesthesia vs analgesia
absent touch vs absent pain
posterior (dorsal) column tract
carries sensation of proprioception, 2 pt discrimination, vibration, position and light touch
vibration sense->spinal cord->dorsal root ganglion->dorsal root->DOES NOT CROSS OVER HERE-> ascends to the level of medula->NOW IT CROSSES OVER–>thalamus->post central gyrus of the parietal lobe-> “i feel vibration”
what is ipsilateral in the cord, and contralateral in the brain?
the posterior dorsal column tract
how can we test dorsal column function?
position sense (with holding digit by the side and moving up and down with eyes closed), observe pt walking, Romberg,
excessive swaying with eyes open or closed
cerebellar deficit (cerebellar ataxia)
excessive swaying only when eyes are closed
proprioceptive deficit (sensory ataxia), example-> pernicious anemia
the eyes are able to compensate
what does the cerebellum do?
coordination, smoothing out, processing
stereognosis
the ability to recognize an object based on touch. carried by the dorsal column tract
-interpretation is in the contralateral parietal lobe cortex
astereognosis–> if they cant do it
graphesthesia
the ability to recognize number or letters written on the skin
carried by the dorsal column tract
-need functional parietal lobe (contralateral)
tests for cerebellar function
finger to nose, with eyes closed, rapid alternating movements like patty cake, heel to shin, heel to toe, walking naturally
what would the sensory findings be if only one half of the spinal cord were affected? below and above
what syndrome is this?
Brown-Sequard Syndrome below:
contralateral loss of pain and temperature (spinothalamic tract)
ipsilateral loss of 2pd, proprioception, vibration, etc (dorsal column tract)
corticospinal tract pathway
precentral gyrus of the frontal lobe, crosses at the medulla-> synapse with the dorsal horn neurons->synapse with anterior horn, the anterior horn intervates skeletal muscle
where are lower motor neurons located?
the anterior horn
hallmarks of UMN lesion
spastic hemiplegic gait (upper arm flexion with lower leg extension)
clonus
Babinski
hyperreflexia
pronator drift that turns into spasticity and paralysis
hallmarks of lower motor damage
flaccid muscle tone, paralysis
hyporeflexia
motor effect of injury of the right side of the brain
contralateral spastic paralysis (UMN)
motor effect of injury to the anterior horn (one side only)
ipsilateral flaccid paralysis at the level of the lesion only (LMN)
motor effect of injury to the corticospinal tract in the cord on one side
ipsilateral spastic paralysis below the level of the lesion (UMN)
what would be the motor effects if the spinal cord was completed cut in half
initially, pronator drift followed by spastic paralysis
can you have a stroke that only has sensory signs?
yes if the damage is limited to just the sensory cortex of the brain
