Neurological System Disorders (Ch7) Flashcards
Stage of Parkinson’s: confined to wheelchair or bed, maximally assisted
Stage V
myelinated nerve fibers located centrally
white matter
paralysis of the upper brachial plexus, resulting in the “waiter’s tip” position
Erb’s palsy
which cerebral hemisphere does this? emotion
right
contain cell bodies that give rise to efferent (motor) neurons
anterior horns
manifested by loss of voluntary, but preservation of reflexive eye movements, bradykinesia, rigidity, axial dystonia, pseudobulbar palsy, and dementia
progressive supranuclear palsy
which cerebral hemisphere does this? visual reception from right field
left
acute, rapidly progressive form of polyneuropathy characterized by symmetric muscular weakness and mild distal sensory loss; onset of recovery is 2-4 weeks after 1st symptoms; may be accompanied by respiratory failure and dysphagia
Guillain-Barre Syndrome
MACS Level: handles objects easily and successfully
I
MACS Level: does not handle objects and has severely limited ability to perform even simple actions
V
GMFCS Level: walks with assistive mobility devices; limitations walking outdoors and in the community
III
tracts that are important for voluntary motor control
corticospinal tracts
contain afferent (sensory) neurons
posterior horns
masses of gray matter deep within the cerebral hemispheres; involved in motor planning
basal ganglia
which cerebral hemisphere does this? visual spatial processing
right
MACS Level: handles objects with difficulty; needs help to prepare and/or modify activities
III
variant of Duchenne muscular dystrophy that is slower to progress, less severe, and less predictable
Becker muscular dystrophy
how many thoracic vertebra are there?
12
if a patient with spina bifida presents with enlarged head, severe headache, vomiting, and/or irritability, what does this indicate?
shunt malfunction
which cerebral hemisphere does this? interpretation of abstract information
right
type of muscular dystrophy that involves the face, upper arms, and scapular region, causing masking, weakness, decreased facial mobility, and inability to lift arms above shoulder level; progresses slowly and rarely affects life expectancy
fascioscapulohumeral muscular dystrophy
a hypokinetic CNS movement disorder that is idiopathic, slowly progressive, and degenerative; begins with a resting “pill-rolling” tremor of one hand
parkinson’s disease
Presence of weakness, deformities, and associated joint contractures; position of rest for the UE tends to be IR of the shoulders, elbow extension, wrist flexion, hip flexion and IR, clubfeet
Arthrogryposis multiplex congenita
a lesion of the motor cortex will result in spasticity with flexor and extensor imbalance, which can be expressed as hypertonia or hyperreflexia
spastic cerebral palsy
Symptoms are onset of weakness, fatigue, muscle pain, joint pain, cold intolerance, atrophy, and loss of functional skills 15 years after recovery from Polio
Post-Polio Syndrome
which cerebral hemisphere does this? verbal memory
left
which cerebral hemisphere does this? movement of right side of body
left
protrusion of a sac through the spine, containing CSF and meninges as well as the spinal cord or nerve roots
spina bifida with myelomeningocele
GMFCS Level: self-mobility with limitations; children are transported or use power mobility outdoors and in the community
IV
a bony malformation with separation of vertebral arches of one or more vertebrae with no external manifestations; may not be discovered until late childhood
spinal bifida occulta
increased cranial pressure results in a portion of the cerebellum and medulla oblongata slipping down through the foramen magnum to the cervical spinal cord
Arnold-Chiari Syndrome
What Rancho Level is: purposeful, appropriate, stand-by assist on request?
IX
how many sacral vertebra are there?
5
an exposed pouch comprised of the spinal fluid and meninges; does not include the spinal cord
spina bifida cystica
how many cervical vertebra are there?
7
brief, rapid, involuntary movements, often resembling fragments of normal motor behavior; tend to be stereotyped and repetitive but not rhythmic
tics
If imaging shows degeneration in dopaminergic pathways in the basal ganglia, primarily in the substantia nigra, what disorder is present?
Parkinson’s disease
tracts that convey deep and chronic pain
spinoreticular tracts
caused by flexion injuries; symptoms are loss of motor function, pain, pinprick, and temperature sensation bilaterally below level of injury; proprioception and light touch are preserved
anterior cord syndrome
which cerebral hemisphere does this? processing sensory information from right side of body
left
which cerebral hemisphere does this? attention to incoming stimuli
right
delineates five levels of functional motor performance for children aged 6-12 years
Gross Motor Functional Classification System
abnormal, tangled collections of dilated blood vessels that result from congenitally malformed vascular structures
cerebral arteriovenous malformation
secretes hormones that influence the pituitary gland and several other organs; influences circadian rhythm
pineal gland
increased muscle tone
hypertonia
primary motor cortex for voluntary muscle activation
precentral gyrus
what is the Glasgow Coma Score of someone in a severe coma?
< 8
GMFCS Level: walks without restrictions; limitations in more advanced gross motor skills
I
What Rancho Level is: generalized response, total assist
II
Where was this stroke? Contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, aphasia, apraxia, spatial dysfunction
middle cerebral artery
involves the upper and lower extremity on the same side
hemiplegia
describes a lack of coordination while performing voluntary movements; may appear as clumsiness, inaccuracy, or instability; movements may appear disjointed or jerky
ataxia
characterized by choreiform movements, progressive intellectual deterioration, and psychiatric disturbance
Huntington’s Chorea
Stage of Parkinson’s: worsening of symptoms, first signs of impaired righting reflexes, onset of disability in ADL performance, can lead independent life
Stage III
integrates and relays sensory information from the body and relays motor information from the cerebellum
thalamus
which cerebral hemisphere does this? nonverbal memory
right
Symptoms are: paresthesias in extremities, trunk, or face; weakness or clumsiness, visual disturbances, emotional disturbances, balance loss or vertigo, bladder dysfunction, cognitive symptoms, spasticity, ataxia
MS
receives and processes auditory stimuli
temporal lobe
slowly progressive CNS disease characterized by patches of demyelination in the brain and spinal cord
Multiple Sclerosis
symptoms of this disorder include: tremor, rigidity, velocity-independent resistance to passive motion, akinesia, postural instability, festinating gait, falling backwards or forwards, mask face, micrographia
Parkinson’s disease
involves the lower extremities
paraplegia
injury that results in ipsilateral: paralysis, loss of position sense, loss of discriminative touch, and contralateral: loss of pain and thermal sense
Brown-Sequard syndrome
What Rancho Level is: automatic, appropriate, min assist for daily living skills?
VII
genetic, intrauterine, and or environmental factors contribute to the failure of the spinal column’s vertebral arches to fully form to enclose and protect the neural tube
spina bifida
progressive disorder of neuromuscular transmission characterized by episodic muscle weakness, ptosis, diplopia, dysarthria, dysphagia, fluctuating symptoms
myasthenia gravis
integrates and controls the functions of the autonomic nervous system and the neuroendocrine system; maintains body homeostasis
hypothalamus
brief, purposeless, involuntary movements of the distal extremities and face; usually considered to be a manifestation of dopamingergic overactivity in the basal ganglia
chorea
paralysis of the lower brachial plexus resulting in paralysis of the hand and wrist
Klumpke’s Palsy
motor neuron disease characterized by progressive degeneration of corticospinal tracts, occurring at an average age of 57
amyotrophic lateral sclerosis
receives and processes visual stimuli
occipital lobe
results from hyperextension injuries and presents as more UE deficits versus LE
central cord syndrome
spasmodic involuntary movements which are more proximal than distal and a lack of cocontractions
chorea
GMFCS Level: self-mobility is severely limited, even with the use of assistive technology
V
involuntary, nonrepetitive, but occasionally stereotyped movements affecting distal, proximal, and axial musculature in varying combinations; usually representative of basal ganglia disorders
dyskinesias
Where was this stroke? homonymous hemianopsia, thalamic pain, hemisensory loss, or alexia
posterior cerebral artery
which cerebral hemisphere does this? interpretation of tonal inflections
right
which cerebral hemisphere does this? left motor praxis
right
symptoms include: loss of motor function of the hips, thighs, pelvic area, and shoulders; enlarged calves; cardiac involvement
Becker muscular dystrophy
What Rancho Level is: confused, inappropriate, non-agitated, max assist?
V
These are symptoms of what? difficulties with bowel and bladder control, gait disturbances, and/or deformities of the feet, low back pain, scoliosis may result
tethered cord syndrome
a brief, rapid contraction of a muscle or group of muscles
myoclonus
regulates muscle tone, equilibrium, posture, voluntary movement
cerebellum
Stage of Parkinson’s: unilateral tremor, rigidity, akinesia, minimal or no functional impairment
Stage I
what is indicated for spina bifida if there is increased intracranial pressure?
a shunt
categorizes levels of manual ability performance for children with cerebral palsy
Manual Ability Classification System (MACS)
symptoms include: muscle weakness and atrophy, spasticity, dysarthria, dysphagia; prognosis is usually 2-5 years
ALS
which cerebral hemisphere does this? speech
left
What Rancho Level is: purposeful, appropriate, stand-by assist?
VIII
What scale allows for diagnosis of the stage of disease progression with Parkinson’s Disease?
Hoehn and Yahr’s five-stage scale
what is the Glasgow Coma Score of someone with a moderate coma?
9-12
Stage of Parkinson’s: requires help with some or all ADL, unable to live alone without some assistance, able to walk and stand unaided
Stage IV
excessive or inadequate muscle tone
dystonia
MACS Level: handles most objects but with somewhat reduced quality and/or speed of achievement
II
basic functions include feeding, aggression, emotions, endocrine aspects of sexual response, LTM formation
limbic system
What Rancho Level is: confused, appropriate, moderate assist?
VI
receives fibers conveying touch, proprioceptive, pain, and temperature sensations from opposite side of body
parietal lobe
increased intensity of reflex responses
hyperreflexia
injury results in proprioceptive loss, but pain, temperature, and touch are preserved
posterior cord syndrome
Type of muscular dystrophy that progresses slowly and initially affects the proximal muscles of the pelvis and shoulder
Limb-girdle muscular dystrophy
Where was this stroke? dysarthria, dysphagia, emotional instability, tetraplegia
vertebrobasilar system
tracts that convey proprioception information
spinocerebellar tracts
tracts that are important for control of muscle tone, postural reflexes
vestibulospinal tracts
which cerebral hemisphere does this? bilateral motor praxis
left
writhing involuntary movements which are more distal than proximal
athetosis
caused by an injury and/or disease prior to, during, or shortly after birth resulting in brain damage and secondary neurological and muscular deficits
CP
what is normal CSF pressure?
70-180mm/H20
characterized by ataxia, dysmetria, dysdiadochokinesia, hypotonia, movement decomposition tremor, dysarthria, and nystagmus
cerebellar disorders
What Rancho Level is: purposeful, appropriate, modified independent?
X
a lesion in the basal ganglia results in fluctuations in muscle tone, resulting in dystonia, athetosis, and chorea
dyskinetic cerebral palsy
involves less UE involvement and greater LE functional impairment
diplegia
tracts that convey sensations of pain, temperature, and crude touch
spinothalamic tracts
What Rancho Level is: no response, total assist?
I
usually characterized by involuntary flinging motions of the extremities; movements are often violent and have wide amplitudes of motions; continuous and random, involving proximal and/or distal muscles on one side of the body
hemiballismus
MACS Level: handles a limited selection of easily managed objects in adapted situations
IV
injury of the sacral cord and lumbar nerve roots resulting in LE motor and sensory loss, areflexic bowel and bladder
conus medullaris
symptoms include pseudohypertrophy, weakness of the proximal joints resulting in significant functional mobility impairments, weakness in involuntary muscles, behavioral and learning difficulties, delayed speech
Duchenne’s muscular dystrophy
progressive, most common muscular dystrophy that is sex-linked
Duchenne’s muscular dystrophy
a lesion in the cerebellum results in hypotonia and ataxic movments characterized by lack of stability so coactivation is difficult, resulting in more primitive total patterns of movement
ataxic cerebral palsy
which cerebral hemisphere does this? processing of nonverbal auditory information
right
what is the Glasgow Coma Score of a fully conscious person?
15
GMFCS Level: walks without assistive devices; limitations in walking outdoors and in the community
II
With this diagnosis, the child may present with primitive reflexes, automatic reactions, hyperresponsive reflexes, clonus, variable tone, asymmetry, involuntary movements, feeding difficulties, cognitive, and other developmental delays
CP
which cerebral hemisphere does this? processing of verbal auditory information
left
results in sustained abnormal postures and disruptions of ongoing movement resulting from alterations of muscle tone
dystonia
controls emotions, judgment, higher order cognitive functions such as ideation and abstraction
prefrontal cortex
weakness of the voluntary muscles of the shoulders, hips, thighs, and upper back which can result in spinal curvatures; muscles for breathing and swallowing can be affected
spinal muscular atrophy
Where was this stroke? contralateral hemiplegia, grasp reflex, incontinence, confusion, apathy, or mutism
anterior cerebral artery
which cerebral hemisphere does this? bilateral auditory reception
left
rhythmic, alternating, oscillatory movements produced by repetitive patterns of muscle contraction and relaxation
tremor
how many lumbar vertebra are there?
5
injury at the L1 level and below resulting in a lower motor neuron lesion; flaccid paralysis with no spinal reflex activity; areflexic bowel and bladder
cauda equina syndrome
What Rancho Level is: confused/agitated, max assist
IV
primary sensory cortex for integration of sensation
postcentral gyrus
what is the Glasgow Coma Score of someone in a deep coma or death?
3
What Rancho Level is: localized response, total assist
III
These are symptoms of what? sensory and motor deficits occurring below the level of the lesion, potentially resulting in LE paralysis and/or deformities, bowel and bladder incontinence, decubitus ulcer and DVT
spina bifida myelomeningocele
Stage of Parkinson’s: bilateral tremor, rigidity, or akinesia, with or without axial signs, independent with ADL, no balance impairment
Stage II
what is the average age of diagnosis of muscular dystrophy?
5
