Neuromus Disorders Flashcards
Central Cord Syndrome
Resulting from hyperexten injuries and presenting as more UE deficits vs LE
Brown Sequard Syndrome (hemi-section)
Causes disruption of descending lat cotricospinal tracts, ascending dorsal column and ascending lat spinothalamic tracts; result is ipsilat paralysis, position sense, discrim touch & contral lat loss of pain/temp
Ant Cord Syndrome
Caused from flex injuries; motor fx, pain, pinprick & temp sensation are lost bilat below lesion; proprioception & light touch are preserved
Post Cord Syndrome
Least common; injury to post columns results in proprioceptive loss; pain/temp/touch are preserved; Motor fx preserved to various degrees
Conus Medullaris Syndrome
Injury of SC & lumbar nerve roots resulting in LE motor & sensory loss & an areflexic (flaccid, storing lots) B&B > if lesion is in sacral segs reflexes may be preserved
Cauda Equina Syndrome
Injury at L1 level & below resulting in LMN lesion; flaccid paralysis w no spinal reflex activity; areflexic B&B
Autonomic Dysreflexia
Abnorm response to noxious stim that results in extreme rise in BP, pounding headache & profuse sweating > deemed Med EMERGENCY if not reversed by quickly moving the stim
Prevention for Autonomic Dysreflexia
Edu pt/cg frequent pressure relief principles; ensure compliance w intermittent catheterization; practice well balanced diet habits; ensure med compliance; edu on signs/causes and initiate first aid procedures
Medical Mngt For SCI
Prevention for further damage via stabilization; traction/rest for unstable injuries; diuretic prescrip to decrease inflam; bladder care; ulcer prevention; control of autonomic dysreflexia/orthostatic HTN, prevention of thrombus formation & tx for heterotopic ossification
CP cause
Injury and/or disease prior to, during or shortly after birth resulting in brain damage and secondary neurolog & muscular deficits - lack of O, intracranial hemorrhage, meningitis, chronic alcohol abuse, toxicosis, infections, genetics, endocrine or metabolic disorders
CP is noprogressive however
Deformities & contractures could develop; may be accompanied w seizure, ID/DD or behavioral disorders
Spastic CP
Lesion of motor cortex will result in spasticity w flexor/extensor imbalance; Hypertonia: increased muscle tone or Hyperreflexia: increased intensity of reflex responses
Dyskinetic CP
Lesion in BG results in fluctuations in muscle tone: Dystonia (excess or inadequate muscle tone), Athetosis (writhing invol mvmts more distal), Chorea (spasmodic invol mvmts more prox w lack of co-contractions)
Ataxic CP
Lesion in cerebellum results in hypotonia & ataxic mvmts characterized by lack of stability so coactivation is difficult > results in more prim mvmt patterns; Gross Motor Fx Classification & Manual Ability Classification used
Plegia’s
Mono: 1 ex; Hemi: UE/LE on same side; Para: LEs; Quad: all ex; Di: less UE and greater LE fx’al impairment
CP Complications
50% seizures, lang/cog deficits in 50-75%, visual impairments in 40-50%, feeding disturbances & diminished sensation
Stabismus
Deviation of how one eye aligns with other
Nystagmus
Reflexive response of eyes triggered by head mvmts
Myopia, Hyperopia & Presbyopia
M= nearsightedness; H= farsightedness & P= decreased elasticity of lens resulting in diff w accomodation when focusing on objects nearby and when shifting focus from near to far
Dyskinesias
Invol, nonrepetitive but occasionally stereotyped mvmts affecting distal, prox and axial musculature in varying combo - most rep of BG disorders
Myoclonus
Brief & rapid contraction of muscle or muscle group
Tics
Brief rapid, invol mvmts often resembling fragments of normal motor behavior. Tend to be stereotyped and repetitive but no rhythmic
Chorea
Brief, purposeless, invol mvmts of distal ex and face; usually considered to be manifestation of dopaminergic overactivity in BG
Dystonia
Results in sustained abnorm postures and disruptions of ongoing mvmt resulting from alterations of muscle tone - maybe be generalized or focal
Ataxia
Lack of coord while performing vol mvmts - may appear as clumsiness/instability. Mvmts are jerky/disjointed
Hemiballismus
Characterized by invol flinging motions of ex; Mvmts are often violent and have wide amplitudes of motion - continuous & random & can involve prox/distal muscles on one side of the body
Parkinson’s Disease (PD)
Hypokinetic CNS mvmt disorder this is idiopathic (arises spontaneously), slowly progressive and degenerative; onset usually after 40; rate of deterioration ranges from 2-20yrs
PD Symptoms
Begins insidiously w resting pill-rolling tremor of 1 hand; cardinal signs include tremor, rigidity, resistance to passive motion that is not velocity dependent; akinesia, postural instability, festinating gait, retropulsion (falling backwards) or propulsion (falling forward), mask face & micrographia (tiny handwriting)
Hoehn and Yahr’s 5-stage scale
Used for PD. Stage I: unilat tremor, rigidity, akinesia (loss of vol mvmt) w min or no fx impair. Stage II: bilat tremor, rigidity, akinesia w or w/wo axial signs, I with ADL & no balance impair. Stage III: worsening sypmts, 1st sign of impaired righting reflex, onset of disability with ADL - can lead I lift. Stage IV: req help w some/all ADL, unable to live alone w/o some A, able to walk/stand unaided. Stage V: confined to wc/bed; max A
Spina Bifida
Etiology is unknown; it is the failure of the spinal columns vert arches to fully form to enclose/protect neural tube > may result in protrusion of neural tube (could be d/t lack of folic acid); Detected prenatally
Spinda Bifida Occulta
Body malformation w separation of vert arches of one or more vert w no external manifestations - may not be discovered until late childhood. * usually doesnt result in any symptoms
Occult Spinal dysraphism (OSD)
When ex manifestations such as red birthmark, patch of hair, dermal sinus , fatty benign tumor or dimple covering site are present
Spina Bifida Cystica
Exposed pouch comprised of SC and meninges
Spina Bifida Cystica w meningocele
Protrusion of a sac thru the spine containing CSF and meninges but does NOT include SC * usually doesnt present symptoms
Spina Bifida Cystica w myelomeningocele
Protrusion of a sac thru the spine containing CSF and meninges as well as SC or nerve roots. Results in sensory & motor deficit occurring below level of lesion & may result in LE paralysis or deformities, incontinence (lesions of S2-4), decubitius ulcer or DVT
Occult Spinal dysraphism (OSD) Symptoms
May result in SC being split (dyplomyelia) or tied down & tethered (disatematomyelia) which may lead to neurolog damage and developmental abnorm as child grows
Tethered Cord Syndrome
Occurs in tail end of SC when cord is stretched as a result of compression, being trapped w fatty mass/scar tissue, developmental abnorm or injury
Tethered Cord Syndrome Signs
Hairy skin patch, hemangioma (blood vessels that form a birthmark) and/or dimple of lower spine. Diff w B&B, gait, deform of feet, LBP, sclerosis may result and can go undiagnosed until one of these symptoms are found
