Neuro Review Flashcards

1
Q

Difficulty in initiation of movement; Problems in preparation of movement

A

Akinesia
- In PD, Increased preparation needed for movements; Increased reaction time, particularly for simple tasks; Not as great an increase for complex tasks

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2
Q

What will you see in Parkinson’s in terms of movement?

A
  1. Akinesia
  2. Bradykinesia
  3. rigidity
  4. Tremors (primarily at rest)
  5. Freezing
  6. Difficulty in Walking (narrow based gait, shuffling)
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3
Q

Slow and hesitant movements; Difficulties energizing muscles; may also be associated with rigidity or tremors and depression

A

Bradykinesia

  • Increased reliance on visual feedback
  • Movement becomes reliant on cortical control; Movement plans in the basal ganglia cannot be used
  • Cannot produce movement forces as quickly, accurately or smoothly as normal subjects
  • responds beter to dopamine treatment
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4
Q

Increased, uniform resistance to passive stretch; Due to exaggerated tonic stretch reflexes

A

rigidity

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5
Q

Involuntary rhythmic movement at rest

A

Tremor

  • Most noticeable in distal extremities; Pill-rolling tremor; Often starts unilaterally; Most evident following movement; May be worse in specific postures
  • Resting tremor result of imbalance between basal ganglia and cerebellum
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6
Q

Sudden cessation of movement in the middle of an action sequence

A

Freezing

  • Most often affects walking; Can also affect speech, arm movements, and blinking
  • environment can trigger
  • Uncommon in early stages, increases over time
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7
Q

In PD, _____ responses are frequently absent for the first step, which may increase instability

A

Preparatory postural

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8
Q

What symptoms will you see with Huntington’s disease?

A
  1. chorea
  2. hypotonia (rigidity may occur with progression, or in young-onset HD and more akinesia in young-onset)
  3. eventually WILL develop dementia
  4. wide-based, staggering gait
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9
Q

Damage to cerebral cortex causes problems on the [contralateral/ipsilateral] side. Damage to cerebellum causes problems on the [contralateral/ipsilateral] side.

A
  • contralateral

- ipsilateral

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10
Q

What does injury to the Cerebrospinocerebellum cause?

A
  1. Disturbances in skilled coordinated movements

2. speech

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11
Q

What does injury to the spinocerebellum cause?

A

Truncal ataxia

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12
Q

What does injury to the vestibulocerebellum cause?

A

Abnormalities in posture and eye movement

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13
Q

Incoordination or clumsiness of movement not due to strength problems

A

ataxia

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14
Q

Difficulty in bringing a limb smoothly and accurately to a specific target

A

dysmetria

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15
Q

Slurred speech due to lack of coordination of muscles

A

dysarthria

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16
Q

Inability to perform rapidly alternating movements

A

Dysdiadochokinesia

17
Q

When a complex movement deteriorates into a series of successive simple movements rather than one, smooth coordinated movement

A

Decomposition of movement

18
Q

What symptoms would you see in a cerebellar injury (general injury)?

A
  1. dysdiadochokinesia
  2. decomposition of movment
  3. action tremors
  4. dysarthria
  5. dysmetria
  6. ataxia
  7. abnormalities in posture
  8. abnormal eye movements
19
Q

What are causes of cerebellar damage?

A
  1. Tumors - Lung (50%), breast, kidney, melanoma
  2. Multiple sclerosis
  3. Cerebellar hemorrhage
  4. Stroke
  5. Chronic alcoholism (Primarily in legs, Due to vitamin deficiency)
20
Q

What would you expect muscle tone to be like following a stroke?

A
  • initially, hypotonia (may persist if stroke is restricted to primary motor cortex)
  • hypertonia replaces hypotonia eventually (spasticity)
21
Q
  • due to damage to premotor, supplementary motor or parietal cortices in dominant hemisphere
  • Unable to conceptualize and organize or plan complex movement sequences
  • Particularly evident when imitating movements or when performing sequential movements
A

apraxia

- able to do the movement, but can’t do it voluntarily

22
Q

What symptoms are seen specifically with R sided lesions?

A

Motor impersistence – inability to maintain steady grip or posture
- visual perceptual problems

23
Q

What symptoms are seen specifically with L sided lesions?

A
  • Difficulty performing fast-paced repetitive movements
  • Difficulty in sequencing movements
  • speech and language problems
24
Q

what are the negative prognostic variables with stroke?

A
  1. Advanced patient age
  2. Profound motor or sensory loss
  3. Visuospatial perceptual deficits
  4. Incontinence
  5. Magnitude of initial lesion – major factor
25
Q

What is the most common stroke?

A

middle cerebral artery

26
Q

What are the descending tracts of the SC?

A

lateral and ventral

27
Q

What are the ascending tracts of the SC?

A

dorsal, lateral, and ventral columns

28
Q

What sensory info is in the dorsal columns?

A

discriminative touch

proprioception

29
Q

What sensory info is in the lateral columns?

A

pain and temp

30
Q

What sensory info is in the anterior columns?

A

pain and temp

31
Q

what regions of the cortex do the corticospinal tract UMN originate?

A
  1. primary motor
  2. supplementary cortex
  3. premotor area
  4. primary somatosensory cortex
    - travel in fiber bundle in forebrain, posterior limb of internal capsule to the pyramids in the medulla (brainstem), where some fibers cross in the caudal medula
    - lateral corticospinal cross
    - ventral corticospinal do not cross
32
Q

AKA: anterolateral system
Modalities - Pain, Temperature (hot and cold), Crude touch (light touch, tickle, itch, pressure sensations from bladder and bowel, sexual sensations)

A

spinothalamic tracts

33
Q

Spinal tract: from mechanoreceptors; Modalities - discriminative touch, conscious proprioception

A

DCML

34
Q

what are S & S of SC lesions?

A
  1. Pain
  2. Paresthesias and numbness
  3. Muscle weakness
  4. Abnormal somatic reflexes and muscle tone
35
Q

where is the most common site of injury to UMN?

A

Lateral comuns

36
Q

where is the most common site of injury to UMN?

A

ventral horn or axons as they leave the spinal cordd

37
Q

What are the characteristics of an UMN injury?

A
  1. hyperreflexia
  2. spasticity
  3. abnormal reflex responses
38
Q

What are the characteristics of an LMN injury?

A
  1. atrophy
  2. hypotonia
  3. hyporeflexia or areflexia
  4. fasciculations