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SS - Exam 1 > Neuro Lesion - Lesion 1 > Flashcards

Neuro Lesion - Lesion 1 Flashcards

1
Q

Efferent system analogy

A

Brain is light switch
Nerves are wires
Effector organ is lightbulb
Break in wire = no lightbulb on

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2
Q

Localization in brain

A

Forebrain
Brainstem
Cerebellum
Vestibular system

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3
Q

Localization of spinal cord

A

C1-5
C6-t2
T3-L3
L4-S3

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4
Q

Localizing within forebrain

A

Cerebrum - telencephalon
Thalamus - diencephalon

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5
Q

Localization within brainstem

A

Mid brain - Mesencephalon
Pons - ventral metencephalon
Medulla - myelencephalon

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6
Q

Localization within cerebellum

A

Dorsal metencephalon

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7
Q

Localization within vestibular system

A

Central - cerebellum, myelencephalon
Peripheral - vestibular apparatus and CNVII

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8
Q

Decusation

A

Idea that everything in the forebrain crosses over or descusates before making its way to the rest of the body
Brainstem and spinal cord are ipsilateral

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9
Q

Central vs PNS lesions

A

CNS lesions are often mixed motor or sensory deficits
PNS lesions are often sensory or motor

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10
Q

Encephalopathy

A

Lesions of the brain

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11
Q

Myelopathy

A

Lesions of spinal cord

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12
Q

Myopathy

A

Disease of muscle
Not to be confused with myelopathy

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13
Q

ANS

A

Originates from hypothalamus & ventral diencephalon
Two main divisions - SNS & PsNS

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14
Q

Branches of SNS and PsNS in spinal cord

A

Symp - branches from c7-L4
Parasympathetic - branches from CN 3,7,9,10 & sacral plexus - minus vagus nerve (doesn’t run in spinal cord)

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15
Q

Horner syndrome

A

Lack of sympathize innervation to head and head specifically in horses
Lesion location: hypothalamus, cervical myelopathy, cervical thoracic cavity lesion, trauma to neck, middle ear or guttural pouch = pupil dilation

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16
Q

Upper vs lower motor neuron

A

UMN - cells that arise from forebrain, brainstem & cerebellum
LMN - arise from spinal cord segment
Ventral nerve roots are form by axons of LMN
Nerve roots combine w other nerve roots to form named nerves
Lower are more hyperexcitable /spastic

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17
Q

Assessing lesions upper vs lower

A

Reflex, tone, atrophy

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18
Q

Reflexes

A

Reflexes intact - LMN are not affected
Decreased or absent reflex - LMN affected

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19
Q

UMN lesion

A

Normal to increased reflexes in affected limb
Normal to increased tone in affected limbs

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20
Q

LMN lesion

A

Decreased to absent reflexes in affected limb
Decreased to absent tone in the affected limbs

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21
Q

One purpose of UMN

A

Is to decrease spasticity of LMN, without influence of UMN the LMN become more spastic

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22
Q

C1-5 myelopathy

A

Thoracic limb reflex - normal to increased
Thoracic limb tone - normal to increased
Pelvic limb reflex - normal to increased
Pelvic limb tone - normal to increased

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23
Q

C6-t2 myelopathy

A

TLF and TLT - decreased to absent
PLR & PLT - normal to increased

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24
Q

T3-l3 myelopathy

A

TLR - normal
TLT - normal to increased
PLR & PLT - normal to increased

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25
L4-s3 myelopathy
TLR & TLR - normal PLR & PLT - decreased to absent
26
Spinal cord segments vs vertebra
Don’t always correlate (C8 spinal cord segments but 7 Cv) Wherever there’s a nerve root = spinal cord segments
27
Exits for nerves in cervical regions
Nerve roots exit cranial to the respective vertebra
28
Exits for nerves in thoracic and lumbar region
Nerve roots exit caudally
29
**thoracic and cranial lumbar region
Spinal cord segments and vertebra line up with corresponding numbers
30
Observation and tools fro neurological exam
Behavior, mentation, gait, posture Traction, plexor, hemostats, light, exam lens, cotton balls
31
Which nerve is actually visual ?
Cranial nerve 2
32
Behavior changes
Common behaviors for forebrain lesions Pacing Head pressing Circling Aggressive Blind Obsessive Incontinent Distant Seizures
33
Source of head pressing
Red nucleus in mid brain = gait generator Forebrain lesions = inhibitory effects of forebrain Lack of higher cognition from forebrain = head pressing to wall bc input from red nucleus = go
34
Source of circling
Circling with occur towards the side of the lesion due to hemineglect = ignoring one side of world /doesn’t exist
35
Source of mentation
Level of consciousness in patient 3 degrees of abnormal mentation Dull, depressed,lethargy could be secondary to intercranial or systemic disease
36
3 degrees of abnormal mentation
Obtunded - abnormal response to stimulus & not fully aroused (vague) Stuporous - patient only responsive to strong/noxious stim Comatose - patient has a heart beat, +/- breathing, not responsive to stim
37
Sources for mentation changes
Obtunded - could be secondary to diffuse forebrain lesion or from brainstem lesion Stuporous & comatose - secondary to brainstem lesion affecting ARAS
38
ARAS
Ascending reticular activating system - responsible for keeping patient alert. Located in brainstem
39
Modified Glasgow coma scale
Specifically for encephalopathy esp when secondary to head trauma 6 point scale, higher score = better prognosis
40
Categories for modified Glasgow coma scale
Motor activity Brainstem reflexes Level of consciousness
41
Gait abnormalities
Ataxia Paresis - weakness Paralysis - absence of movement Ambulatory vs nonabulatory - 10 unassisted steps Tetra or quad Para - pelvic limbs only Hemi - only one side of the body Mono - only one limb
42
3 types of ataxia
Proprioception Vestibular Cerebellar ataxia
43
Proprioceptive ataxia
Spinal or sensory ataxia Cross limbs, scuff/knuckle UMN component w proprioceptive ataxia
44
Vestibular ataxia
Drift towards one side Head tilt
45
Cerebellar ataxia
Diametria or hypermetria Over flexion or over extension of one limb
46
Lameness vs ataxia
Lameness is predictable with every step - localized pain to limb Ataxia is irregular - neurological deficits
47
Posture
Decerebrate Decerebellate Head turn/tilt Torticollis Opisthotonus Schiff Sherrington Risus sardonicus Spastic Flaccid Neck guarded Kyphosis
48
Decerebrate
Rigid in all limbs - opisthotonus Lesion within brainstem (midbrain) Patient is Stuporous or comatose
49
Decerebellate
Rigid in thoracic limb, flexed pelvic limbs Lesion to cerebellum or cerebellar peduncles Alert to obtunded
50
Head turn
Secondary to forebrain lesion Head outside longitudinal axis
51
Head tilt
Secondary to vestibular disease Head is out of horizontal axis
52
Torticollis
Secondary to cervical lesion causing flexion of neck or malformation Contracture or flexion of cervical muscles
53
Opisthotonus
Head in Dorso extension, often referred as star gazing Secondary to intracranial lesion or cranial cervical lesion
54
Risus sardonicus
Due to lack of inhibition to facial nerve causing contracture of the facial muscles Secondary to tetanus infection
55
Schiff Sherrington
Secondary to T3-L3 myelopathy Thoracic limbs have increased extensor tone (spasticity), pelvic limbs are paretic to plegic
56
Spasticity
Secondary to UMN lesion (except for Schiff Sherrington) All 4 limbs are spastic, C1-5 myelopathy is suspected If pelvic limbs the T3-L3 lesion is suspected
57
Flaccid
Secondary to LMN lesion Lesion can be diffuse or at intumescense of spinal cord
58
Neck guarded
Secondary to cervical pain
59
Kyphosis
Secondary to thoracolumbar pain, abdominal pain or malformation
60
C1-5 myelopathy
Respiratory depression
61
C6-T2 myelopathy
Horner syndrome Nerve root signature Absent cutaneous trunci
62
T3-L3 myelopathy
Schiff Sherrington Spinal shock Cutaneous trunci cutoff
63
L4-S3
Abnormal anal tone Flaccid tail

SS - Exam 1 (33 decks)

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