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aNeuro exam 4: Lindsey's > Neuro Review- First Aid- pg 466 -472 > Flashcards

Neuro Review- First Aid- pg 466 -472 Flashcards

1
Q

sensory nerve ending –> cell body in dorsal root ganglion –> ipsilateral ascension in dorsal column of spinal cord –> ipsilateral nucleus cuneatus or gracilis in the medulla –> decussates –> ascend contralaterally in medial lemniscus –> VPL –> sensory cortex

A

dorsal column/medial lemniscus (DCML)

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2
Q

Adelta and C fibers (sensory nerve ending) –> cell body in dorsal root ganglia –> spinal cord –> ipsilateral gray matter –> anterior white commissure –> decussates –> ascends contralaterally –> VPL –> sensory cortex

A

spinothalamic tract (ALS)

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3
Q

ascending pressure, vibration, fine touch, proprioception tract?

A

dorsal column

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4
Q

What nerve roots mediate the cremasteric reflex?

A

L1-L2, testicles move

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5
Q

T10 dermatome

A

umbilicus

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6
Q

Dx?

  • hemisection of spinal cord –>
    • ipsilateral UMN signs BELOW level of lesion (corticospinal tract damage)
    • ipsilateral loss of tactile, vibration, proprioception 1-2 levels below lesion (dorsal column damage)
    • contralateral pain/temp loss below level of lesion (spinothalamic/ALS damage)
    • ipsilateral loss of all sensation @ level of lesion
    • ipsilateral LMN signs at level of lesion
    • above T1 = can also have Horner syndrome (oculosypathetic pathway damage)
A

Brown-Sequard syndrome

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7
Q

polio

A
  • cause = poliovirus (fecal-oral) –> destruction of cells in anterior horn of the spinal cord –> LMN death
  • s/s = LMN signs (weakness, hypotonia, flaccid paralysis, fasciculations, hyporeflexia, muscle atrophy)
  • CSF findings = increased WBCs, slightly increase proteins, normal glucose
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8
Q

What is the function of the lateral spinothalamic (ALS) tract?

A

ascending pain/temp

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9
Q
  • UMN: 1a motor cortex –> descend ipsillaterally via internal capsule –> pyramids of caudal medulla –> decussate –> descend contralaterally –> anterior horn of spinal cord
  • LMN: leaves spinal cord –> NMJ
A

lateral corticospinal tract

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10
Q
  • Spinal cord problem = complete occlusion of anterior spinal artery
  • characteristics = ?
A

only spares dorsal columns and Lissaur tract

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11
Q

What is the function of the superior colliculi?

A

conjugate vertical gaze (superior = sight)

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12
Q

descending voluntary mvmt of contralateral limbs tract?

A

lateral corticospinal tract

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13
Q

Brown-Sequard syndrome

A
  • hemisection of spinal cord –>
    • ipsilateral UMN signs BELOW level of lesion (corticospinal tract damage)
    • ipsilateral loss of tactile, vibration, proprioception 1-2 levels below lesion (dorsal column damage)
    • contralateral pain/temp loss below level of lesion (spinothalamic/ALS damage)
    • ipsilateral loss of all sensation @ level of lesion
    • ipsilateral LMN signs at level of lesion
    • above T1 = also can have Horner syndrome (oculosypathetic pathway damage)
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14
Q

What is the function of the anterior spinothalamic tract?

A
  • crude touch
  • pressure
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15
Q

Dx?

  • degeneration of dorsal columns and roots –> impaired sensation and proprioception, progressive sensory ataxia, poor coordination
  • Charcot joints
  • shooting pain
  • Argyll Robertson pupils (small bilateral pupils that constrict to accommodation but not light)
  • no DTRs
  • positive Romberg test
  • cause = 3a syphilis
A

tabes dorsalis

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16
Q

L4 dermatome

A

knees (down on all 4s)

17
Q

What is the function of the lateral corticospinal tract?

A

descending voluntary mvmt of contralateral limbs

18
Q

What is the pathway of the dorsal column tract?

A

sensory nerve ending –> cell body in dorsal root ganglion –> ipsilateral ascension in dorsal column of spinal cord –> ipsilateral nucleus cuneatus or gracilis in the medulla –> decussates –> ascend contralaterally in medial lemniscus –> VPL –> sensory cortex

19
Q

What is the function of the dorsal column?

A
  • ascending
  • pressure
  • vibration
  • fine touch
  • proprioception
20
Q

tabes dorsalis

A
  • degeneration of dorsal columns and roots –> impaired sensation and proprioception, progressive sensory ataxia, poor coordination
  • Charcot joints
  • shooting pain
  • Argyll Robertson pupils (small bilateral pupils that constrict to accommodation but not light)
  • no DTRs
  • positive Romberg test
  • cause = 3a syphilis
21
Q

Dx?

  • damage of anterior white commissure of spinothalamic (ALS) tract –> bilateral loss of pain/temp
  • usually C8-T1
  • Chiari 1 malformation
  • can expand to affect other tracts
A

syringomyelia

22
Q

T7 dermatome

A

xyphoid process

23
Q

Amyotrophic Lateral Sclerosis (ALS) aka Lou Gehrig disease

A
  • combined UMN and LMN deficits
  • NO sensory, cognitive, or oculomotor deficits
  • fasciculations –> atrophy and weakness
  • tx = Riluzole to decrease presynaptic glutamate release (for Lou Gehrig, give riLOUzole)
  • prognosis = fatal
  • cause = maybe defect in superoxide dismutase 1?
24
Q

What can cause Horner Syndrome?

A

spinal cord lesion above T1 (pancoast tumor, Brown-Sequard syndrome, late stage syringomyelia)

25
Q
  • Spinal cord problem = vitamin B12 or vitamin E deficiency
  • characteristics = ?
A
  • subacute combined degeneration –> demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts
  • s/s = ataxic gait, paresthesia, impaired position/vibration sense
26
Q

What is the pathway of the lateral corticospinal tract?

A
  • UMN: 1a motor cortex –> descend ipsillaterally via internal capsule –> pyramids of caudal medulla –> decussate –> descend contralaterally –> anterior horn of spinal cord
  • LMN: leaves spinal cord –> NMJ
27
Q

What nerve roots mediate the anal wink reflex?

A

S3-S4, winks galore

28
Q

crude touch, pressure tract?

A

anterior spinothalamic tract

29
Q

What is the pathway of the spinothalamic tract (ALS)?

A

Adelta and C fibers (sensory nerve ending) –> cell body in dorsal root ganglia –> spinal cord –> ipsilateral gray matter –> anterior white commissure –> decussates –> ascends contralaterally –> VPL –> sensory cortex

30
Q

ascending pain/temp tract?

A

lateral spinothalamic (ALS) tract

31
Q

Babinksi sign in an adult could signify a ____ lesion.

A

UMN

32
Q

Dx?

  • combined UMN and LMN deficits
  • NO sensory, cognitive, or oculomotor deficits
  • fasciculations –> atrophy and weakness
  • tx = Riluzole to decrease presynaptic glutamate release
  • prognosis = fatal
  • cause = maybe defect in superoxide dismutase 1?
A

Amyotrophic Lateral Sclerosis (ALS) aka Lou Gehrig disease

33
Q

syringomyelia

A
  • damage of anterior white commissure of spinothalamic (ALS) tract –> bilateral loss of pain/temp
  • usually C8-T1
  • Chiari 1 malformation
  • can expand to affect other tracts
34
Q

A spinal cord lesion above T1 (pancoast tumor, Brown-Sequard syndrome, late stage syringomyelia) can cause what syndrome?

A

Horner syndrome

35
Q

What is the function of the inferior colliculi?

A

auditory

36
Q

Dx?

  • CSF findings = increased WBCs, slightly increased proteins, normal glucose
  • LMN signs
A

polio

37
Q

Dx?

  • subacute combined degeneration –> demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts
  • s/s = ataxic gait, paresthesia, impaired position/vibration sense
A

vitamin B12 or vitamin E deficiency

38
Q

T4 dermatome

A

nipple line

aNeuro exam 4: Lindsey's (37 decks)

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