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neuropathophys york test 1 Flashcards

1
Q

Posterior Circulation to Brain

A

Vertebral Artery—- Basilar Artery —— Posterior Cerebellar Artery

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2
Q

Vertebral Artery origin

A

Subclavian artery

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3
Q

Vertebral Artery supplies

A

Ventrolateral Medulla

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4
Q

Vertebral Artery branches

A

Anterior Spinal Artery
Posterior Spinal Artery (2)
Posterior Inferior Cerebellar Artery

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5
Q

Posterior Inferior Cerebellar Artery supplies

A

Supplies Lateral Medulla + Cerebellum

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6
Q

Posterior Spinal Artery (2) supplies

A

Supplies Posterior Funiculus + Dorsal Horn; Dorsal Medulla

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7
Q

Anterior Spinal Artery

A

Supplies Ventral + Lateral Funiculi + Lateral Horn (Symp. T1-L2); Ventral Medulla

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8
Q

Basilar Artery formed by

A

Vertebral aa. join at the Pontomedullary Junction

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9
Q

Posterior Cerebellar Artery formed by

A

Basilar a. branches in the Midbrain

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10
Q

Anterior Circulation to Brain

A

Internal Carotid Artery——> OPAAM

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11
Q

OPAAM

A
  1. Internal Carotid Artery
  2. Ophthalmic Artery
  3. Posterior Communicating Artery
  4. Anterior Cerebral Artery
  5. Anterior Choroidal Artery
  6. Middle Cerebral Artery
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12
Q

Arteries of the Pons

A
  1. Anterior Inferior Cerebellar Artery – Supplies Cerebellum + Pons
  2. Labyrinthine Artery – Supplies ears
  3. Pontine Arteries (3) - Supplies Pons
  4. Superior Cerebellar Artery - Supplies Cerebellum & Pons
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13
Q 
Vertebrobasilar Insufficiency (VBI or VBAI)
symptoms
A
  1. Dizziness
  2. Diplopia (double vision)
  3. Drop Attack (spontaneous fall)
  4. Dysarthria (slurred speech)
  5. Dysphagia (difficulty swallowing)
  6. Nausea
  7. Numbness
  8. Nystagmus (involuntary rapid eye movement)
  9. Ataxia (inability to control voluntary muscles)
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14
Q

Arterial Circle of Willis

what is it?

A

•Anastomose of anterior and posterior circulation of the brain; specifically Posterior Communicating + OPAMM

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15
Q

Most likely place for blood clot in the brain ?

A

Arterial Circle of Willis

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16
Q

Circle of Willis

arteries included

A
  1. Anterior Cerebral Artery
  2. Posterior Cerebral Artery
  3. Middle Cerebral Artery
  4. Anterior Communicating Artery
  5. Posterior Communicating Artery
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17
Q

Terminal Branches of the Internal Carotid Artery

A

Anterior Cerebral Artery

Middle Cerebral Artery

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18
Q

Three Main Cerebral Arteries give rise to

A

give rise to numerous branches that travel in the subarachnoid space over the surface of the Brain and into the sulci

  1. Anterior Cerebral Artery
  2. Middle Cerebral Artery
  3. Posterior Cerebral Artery (terminal branch of Basilar part of posterior circulation)
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19
Q

Middle Cerebral Artery (MCA):key facts

A
  1. Supplies 80% of the blood to the brain (forebrain) Telencephalon & Diencephalon
  2. Telencephalon —–>Limbic System, Corpus Callosum, Corpus Striatum + Olfactory Bulb
  3. Diencephalon —->Thalamus, Hypothalamus
  4. Midbrain —->Oculomotor Complex, SC + IC, SN, RN; Hemibolismus + Parkinson’s
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20
Q

What artery is most frequently affected by stroke?

A

Middle Cerebral Artery

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21
Q

What supplies the entire lateral neocortex?

A

Middle Cerebral Artery

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22
Q

T or F

The striate cortex is supplied by the MCA.

A

F

Posterior cerebral artery

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23
Q

Middle Cerebral Artery (MCA)

Superior Division Branches

A
  1. Orbitofrontal Arteries: supplies Orbits & Parietal lobes
  2. Pre-Rolandic Arteries: supplies Area 6 (pre-motor); anterior to the Central fissure (fissure of Rolando)
  3. Rolandic Arteries: supplies Area 4 (1° Motor)
  4. Post Rolandic Arteries: supplies Areas 3,1,2 (1° Somatosensory)
  5. Posterior Parietal Arteries:
  6. Angular Arteries
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24
Q

Middle Cerebral Artery (MCA)

Inferior Division Branches

A
  1. Anterior Temporal Arteries:

2. Posterior Temporal Arteries (Anterior Occipital Arteries): – evidence that it branches from MCA or PCA

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25
Q

Occlusion of the Middle Cerebral Artery (MCA) mostly affects what?

A

upper body

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26
Q

Superior Division Occluded MCA

symptoms

A

• Contralateral Paralysis or muscle weakness
• Motor loss in the upper body (Area 4- 1° Motor)
• Sensory loss possible- Contralateral face & arm
• Dysarthria (difficulty speaking)
• Broca’s Aphasia/ Expressive or Non-Fluent Aphasia (inability to form words)
- Left Area 44
- Articulation of speech, Motor Speech and Language

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27
Q

Lower Division Occluded:symptoms

A

• Confusion
• Agitation
• Wernicke’s Aphasia/ Semantic/ Receptive or Fluent Aphasia (inability to comprehend speech)
- Left Area 22 (Caudal), Areas 40 + 39
- Semantic Speech (the meaning, recognition + comprehension of speech)

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28
Q

Stem of Middle Cerebral Artery Occluded: symptoms

A

• Symptoms of both upper & lower division

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29
Q

Deep Territory Occluded:symptoms

A

• Combination of Superior, Lower + Stem

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30
Q

Anterior Cerebral Artery supplies

A

most of the MEDIAL SURFACE (cortex) of the Brain

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31
Q

Branches of the Anterior Cerebral Artery

A
  1. Orbital Artery: supplies orbits & frontal lobe
  2. Frontopolar Artery: supplies frontal lobe
  3. Pericallosal Artery:
  4. Callosomarginal Artery:
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32
Q

Occlusion of the Anterior Cerebral Artery

Orbital Artery or Frontopolar Artery

A
  1. Apathy (lack of motivation)
  2. Some memory loss
  3. Behavior abnormalities
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33
Q

Occlusion of the Anterior Cerebral Artery

Callosomarginal Artery

A

• May affect cingulate gyrus, area 3,1,2 (1°Somatic Sensory)
• Contralateral Paralysis and muscle weakness of the lower body
• May lead to urinary incontinence and abnormalities in pain perception (allodynia)
o Urinary Incontinence Possibly Cauda Equina Syndrome due to “Saddle Anesthesia”

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34
Q

Cauda Equina Syndrome

signs

A
  1. weakness of the muscles of the lower extremities innervated by the compressed lumbar roots (often paraplegia)
  2. detrusor weaknesses causing urinary retention and post-void residual incontinence
  3. there may be decreased anal tone and consequent fecal incontinence; sexual dysfunction; saddle anesthesia; bilateral (or unilateral) sciatic leg pain and weakness; and absence of ankle reflex
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35
Q

acute Cauda equina syndrome

Red Flag Symptoms

A

sciatic leg pain and/or severe back pain, with altered sensation over saddle area (genitals, uretha, anus, inner thighs), urine retention or incontinence.

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36
Q

Posterior Cerebellar Artery

major branches

A
  1. Posterior Temporal Arteries
  2. Internal Occipital Arteries
  3. Posterior Choroidal Arteries
  4. Posterolateral Arteries (Thalamogeniculate Arteries)
  5. Posteromedial Arteries
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37
Q

Posterior Temporal Arteries supply

A

Striate Cortex/ Area 17 (1° Visual area)

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38
Q

Internal Occipital Arteries supplies

A

Striate Cortex/ Area 17 (1° Visual area)

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39
Q

Posterior Choroidal Arteries supplies

A

Inferior & Superior Colliculus

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40
Q

Posterolateral Arteries (Thalamogeniculate Arteries) supplies

A

posterior + part of middle thalamus

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41
Q

Posteromedial Arteries supplies

A
  1. Hypothalamus, Hypophysis (pituitary stalk)
  2. Anterior & Middle Thalamus (part of middle not supplied by Posterolateral)- done by Thalamoperforating Artery
  3. Mammillary Bodies, Subthalamic Nucleus, Red Nucleus, Substantia Nigra, Crus Cerebri
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42
Q

Occlusion of the Posterior Cerebral Artery

symptoms

A
  • Hemianopia (decreased vision or blindness takes place in half the visual field of one or both eyes)
  • Aphasia (inability to form words)
  • Sensory loss (contralateral)
  • Hemiparesis (contralateral)
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43
Q

Thalamoperforating Arteries occlusion symptoms

A

• Reaches Anterior and Subthalamus
• Damage to Subthalamic Nucleus  Hemiballismus (post stroke)
o Basal Gangia: Subthalamic Nucleus, Substantia Nigra, Striatum (Putamen + Caudate Nucleus), Globus Pallidus + Nucleus Accumbens

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44
Q

Thalamogeniculate Arteries occlusion symptoms

A
  • Contralateral numbness
  • Damage to VPL (area 3,1,2), VPM, MG, LG
  • May get a “Thalamic P! Syndrome” – everything is painful (area 43- pain) including normal movement & touch
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45
Q

Wallenberg Syndrome (Lateral Medullary Syndrome)

A

• Neurological condition caused by stroke in Vertebral Artery or Posterior Inferior Cerebellar Artery (PICA)

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46
Q

Wallenberg Syndrome (Lateral Medullary Syndrome) symptoms

A
  • Dysphagia (difficulty swallowing)
  • Hoarseness
  • Dizziness
  • Nausea & vomiting
  • Nystagmus (involuntary rapid eye movement)
  • Problems with balance & gait (ataxia)
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47
Q

Wallenberg Syndrome (Lateral Medullary Syndrome) possible symptoms

A
  • Lack of pain & temperature sensation on ½ of the face
  • Pattern of symptoms on opposite side of body
    o Numbness + Paralysis on right side of face with Numbness + Weakness of left limbs
  • Uncontrollable hiccups
  • Loss of sensation to ½ of tongue
  • Horner’s Syndrome (occurs due to damage of the Medulla)
    o Ptosis – drooping eyelid
    o Anhydrosis- lack of sweat (sympathetic)
    o Miosis- pinpoint pupils (parasympathetic)
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48
Q

Wallenberg Syndrome (Lateral Medullary Syndrome) treatment

A

Try to fix the symptoms; G-Tube, Epileptic drugs, Speech + Physical Therapy

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49
Q

Wallenberg Syndrome (Lateral Medullary Syndrome) ataxia occurs where in the brain and causes what problem?

A
  1. Cerebellum

2. Sensory loss on face

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50
Q

Strokes

general info

A
  • Third Leading cause of death in the US
  • 750,000 new cases every year (150,000 die)
  • 2/3 of strokes occur over age 65
  • Higher incidence in males and African
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51
Q

PCA stroke affects

A

midbrain

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52
Q

MCA stroke affects

A

lateral brain

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53
Q

Risk Factors for stroke

A
  • Use of Oral Contraceptives
  • Previous Stroke and/or family history
  • Systemic or diastolic (bottom number) hypertension (120/80 = normal)
  • Smoking
  • Hypercholesterolemia
  • Heavy alcohol consumption
  • Diabetes
  • Type A Personality (possibly)
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54
Q

Two Types of Stokes

A
  1. Transient Ischemic Attack (TIA)

2. Cerebrovascular Accident (CVA)

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55
Q

Characteristics of Transient Ischemic Attack (TIA)

A
  • Blood flow to area of brain is cut off for a few seconds
  • No permanent tissue damage
  • Patient will feel weak for a couple minutes to a ½ hr
  • At 24 hrs no markings of stroke on CT or MRI
  • Usually put patients on blood thinners*
  • Predictor of CVA
  • Also known as “Mini- Stroke”
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56
Q

Characteristics of Cerebrovascular Accident (CVA)

A
  • Blood Supply cut off to artery long enough to destroy tissue
  • Death of some brain tissue
  • At 24 hrs damage will be visible on a CT or MRI
  • Full Blown Stroke
  • Can recover- must build new pathways to destroyed area of brain
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57
Q

Differences btw TIA + CVA:

A
  • Length of time without blood
  • Tissue Damage
  • Signs + Symptoms
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58
Q

Polio general info

A
  • Fecal/Oral Transmission (water supply 3rd world countries)

* Somatic Alpha Neuron in Lamina IX is destroyed by Retrosynapse- can no longer contract skeletal muscle

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59
Q

Lower Motor Neuron Lesion (LMN)

Muscle Tone

A

Decreased muscle tone (hypotonic)

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60
Q

Lower Motor Neuron Lesion (LMN)

Paralysis (Flaccid or Spastic)

A

Flaccid Paralysis

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61
Q

Lower Motor Neuron Lesion (LMN)

Deep Tendon Reflex (DTR)

A

Hyporeflexia or Absent

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62
Q

Lower Motor Neuron Lesion (LMN)

Superficial Reflex

A

Absent (only in area affected)

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63
Q

Lower Motor Neuron Lesion (LMN)

Muscle Atrophy

A

Present

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64
Q

Lower Motor Neuron Lesion (LMN)

Clonus

A

Absent

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65
Q

Upper Motor Neuron Lesion (UMN)

Muscle Tone

A

Increased muscle tone (hypertonic)

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66
Q

Upper Motor Neuron Lesion (UMN)

Paralysis (Flaccid or Spastic)

A

spastic Paralysis

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67
Q

Upper Motor Neuron Lesion (UMN)

Deep Tendon Reflex (DTR)

A

Hypereflexia

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68
Q

Upper Motor Neuron Lesion (UMN)

Superficial Reflex

A

Absent (only in area affected)

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69
Q

Upper Motor Neuron Lesion (UMN)

Muscle Atrophy

A

Absent

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70
Q

Upper Motor Neuron Lesion (UMN)

Clonus

A

Present

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71
Q

Lower Motor Neuron Lesion (LMN)

Fasciculations or Fibrillations

A

Both Present

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72
Q 
Lower Motor Neuron Lesion (LMN)
Pathological Reflex (Babinski)
A

absent

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73
Q

Upper Motor Neuron Lesion (UMN)

Fasciculations or Fibrillations

A

Both Absent

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74
Q 
Upper Motor Neuron Lesion (UMN)
Pathological Reflex (Babinski)
A

Present

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75
Q

Clonus:

A

Very rapid movement from contraction to relaxation; Tonic would be sustained relaxation

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76
Q

Fasciculations:

A

Can be seen, unlike Fibrillations; Occur when only a few fibers of a muscle are contracting

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77
Q

Babinski:

A

Reflex of foot/toe; Stroke the foot and watch for movement of the toes- Abnormal if big toe and little toes move in opposite direction

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78
Q

LMNL: info/example

A

All occur in the PNS; Myasthenia Gravis, Bell’s Palsy, Polio

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79
Q

UMNL: info/example

A

Encephalitis, Meningitis, MS, Brain Tumor, Stroke

80
Q

Segmental Arteries info

A
  • Anastomose with Anterior & Posterior Spinal Arteries
  • Effectiveness varies person to person
  • Minority of supply
  • Supply all areas of the cord
81
Q

Amyotrophic Lateral Sclerosis (ALS) Lou Gehrig’s Disease info

A
  • All features of Lower Motor Neuron Lesion (LMN) except has increased deep tendon reflex
  • Considered both LMN & UPN
82
Q

activities of daily living

A

the things we normally do in daily living including, self-care, work, homemaking, and leisure

83
Q

abasia

A

inability to walk due to impaired muscle coordination

84
Q

afebrile

A

a condition where no associated fever exists with an illness

85
Q

agnosia

A

the inability to view or percieve things

86
Q

alimentation

A

giving or receiving of nourishment

87
Q

allodynia

A

a condition in which pain arises from a stimulus that would normally be experienced as painful

88
Q

analgesic

A

a drug used to relieve pain

89
Q

anesthesia

A

total loss of sensation

90
Q

aneurysm

A

an abnormal swelling in a blood vessel

91
Q

anhidrosis

A

abscence of sweating

92
Q

anisocoria

A

pupils of different sizes

93
Q

ankylosis

A

partial or complete stiffness of a joint

94
Q

anosmia

A

abscence of the scence of smell

95
Q

antalgic posture

A

a posture or gait assumed to avoid or lessen pain

96
Q

anoxia

A

abscence of oxygen supply to an organ or a tissue

97
Q

anuria

A

a condition which is characterized by complete abscence of urine flow

98
Q

aphagia

A

a reflexive action which makes it partially or totally impossible to swallow

99
Q

aphasia

A

a cortico-motor disorder resulting in a complete inaility to form words; loss of language expression or comprehension

100
Q

aphonia

A

the partial or total inability to speak in a coherent fashion

101
Q

appendicular

A

of or pertaining to an appendage or limb.

102
Q

aponeurosis

A

a whitish, fibrous membrane that connects a muscle to a bone or fascia.

103
Q

apraxia

A

loss of previous ability to perform a skilled act without loss of motor or sensory

104
Q

arteriosclerosis

A

degenerative changes in the arteries, characterized by thickening of the vessel walls and accumulation of calcium with consequent loss of elasticity and lessened blood flow.

105
Q

Arthalgia

A

pain in a joint

106
Q

Ascites

A

an accumulation of fluid in the abdomen

107
Q

astasia

A

a lack of motor coordination marked by an inability to stand or sit without assistance

108
Q

ataxia

A

loss of coordination of the muscles, especially of the extremities.

109
Q

atherosclerosis

A

a common form of arteriosclerosis in which fatty substances form a deposit of plaque on the inner lining of arterial walls.

110
Q

athetosis

A

condition, chiefly in children, of slow, involuntary, wormlike movements of the fingers, toes, hands, and feet, usually resulting from a brain lesion.

111
Q

autonomic nervous system

A

the system of nerves and ganglia that innervates the blood vessels, heart, smooth muscles, viscera, and glands and controls their involuntary functions, consisting of sympathetic and parasympathetic portions.

112
Q

aura

A

a sensation, as of lights or a current of warm or cold air, preceding an attack of migraine or epilepsy.

113
Q

axial

A

skull, thorax, vertebral column

114
Q

bradykinesia

A

extremely slow or abnormal deliberate movement

115
Q

bursa

A

small sacs that cushion joints between tendons and bones

116
Q

caudal

A

tail, or base

117
Q

causalgia

A

a neuralgia distinguished by a burning pain along certain nerves, usually of the upper extremities.

118
Q

cephalic

119
Q

chorea

A

quick, jerky, purposeless involuntary movements

120
Q

claudication

A

limping, lameness

121
Q

clonus

A

alternate involuntary muscular contraction and relaxation in rapid succession

122
Q

cogwheel rigidity

A

Rigidity in which the muscles respond with cogwheel-like jerks to the use of force in bending the limb, as occurs in Parkinson’s disease.

123
Q

concentric contraction

A

a muscle shortens in length and develops tension

124
Q

coronal

A

vertebral body plane, divides body into front and back

125
Q

coprolalia

A

involuntary swearing or the involuntary utterance of obscene words

126
Q

decubitus

A

lying down

127
Q

dermatome

A

an area of skin that is mainly supplied by a single spinal nerve root

128
Q

diaphoresis

A

excessive sweating

129
Q

DDX

A

a diagnosis made by comparing symptoms of two or more diseases

130
Q

diplopia

A

double vision

131
Q

distal

A

farthest from center

132
Q

diuresis

A

frequent urination

133
Q

drop attack

A

sudden spontaneous falls while standing or walking

134
Q

dysesthesia

A

impaired or abnormal interpretation of mornal stimuli

135
Q

dysarthia

A

a disturbance of speech function due to emotional stress

136
Q

dyskinesia

A

impairment of voluntary movement; inability to make physical motion

137
Q

dysphagia

A

difficulty swallowing

138
Q

dysphasia

A

partial or incomplete impairment of the ability to communicate resulting from brain injury

139
Q

dystonia

A

a movement disorder that causes muscles to contract and spasm involuntarily usually producing a twisting and repetitive movements

140
Q

eccentric contraction

A

the development of tension whilst the muscle is being lengthened

141
Q

echolalia

A

the uncontrollable and immediate repetition of words spoken by another person

142
Q

embolism

A

the lodging of an embolus that obstructs circulation

143
Q

embolus

A

a small clot or foreign substance detached from inside a blood vessel

144
Q

emesis

145
Q

enuresis

A

bed wetting

146
Q

epistaxis

A

nose bleeds

147
Q

fascia

A

a band or sheath of connective tissue investing, supporting, or binding together internal organs or parts of the body.

148
Q

fasciculation

A

a small visible muscle contractio and relaxation

149
Q

febrile

A

pertaining to fever

150
Q

fibrillation

A

uncontrolled twitching or quivering of muscular fibrils

151
Q

flaccid paralysis

A

weakness or loss of muscle tone resulting from injury or disease of the nerves innervating the muscles

152
Q

formication

A

a tactile hallucination involving the belief that something is crawling on the body or under the skin.

153
Q

gait

A

manner of walking

154
Q

graphesthesia

A

the ability to recognize writing on the skin purely by the sensation of touch

155
Q

hemoptysis

A

coughing up blood

156
Q

hypoxia

A

insufficient levels of oxygen in blood or tissue

157
Q

iatrogenic

A

induced py a patient by a physician’s activity, manner, or therapy

158
Q

idiopathic

A

of unknown cause

159
Q

incontinence

A

involuntary leakage of urine or the inability to control one’s bowels

160
Q

intermitten claudication

A

pain, tension, and weakness in the legs on walking, which intensifies to produce lameness

161
Q

ischemia

A

insufficent blood flow to part of the body

162
Q

isometric contraction

A

the muscle contracts but does not shorten giving no more

163
Q

isotonic contraction

A

the muscle contracts and shortens given movement

164
Q

intussesception

A

a problem with the intestine iin which one portion of the bowel slides into the next, much like the pieces of a telescope

165
Q

incontinence

A

involuntary leakage of urine or the inability to control ones bowels

166
Q

intermittent claudication

A

pain, tension, and weakness in the legs on walking, which intensifies to produce lameness and is relieved by rest it is seen in occlusive arterial disease

167
Q

ischemia

A

local deficiency of blood supply produced by vasoconstriction or local obstacles to the arterial flow.

168
Q

isometric contraction

A

the muscle contracts but does not shorten giving no move

169
Q

isotonic contraction

A

the muscle contacts and shortens, giving movement

170
Q

myelopathy

A

disease of the spinal cord

171
Q

myelitits

A

inflammation of the spinal cord

172
Q

myoclonus

A

abrupt. suppen irregular mm contraction (MS)

173
Q

neuralgia

A

pain along the course of a nerve

174
Q

neuritis`

A

inflammation of a nerve

175
Q

nystagmus

A

involuntary jerking eye movements

176
Q

palliative

A

relieving pain

177
Q

paralysis

A

a complete loss of motor function

178
Q

paresis

A

a partial loss of motor function

179
Q

paresthesia

A

sensation of tingling, pricking, numbness

180
Q

paroxysm

A

a sudden attack or recurrence of symptoms

181
Q

proprioception

A

detection of the body’s orientation in space

182
Q

ptosis

A

drooping of the eyelid

183
Q

ridiculopathy

A

disease of the nerve root

184
Q

radiculitis

A

inflammation o the nerve root

185
Q

space occupying lesion

A

any abnormal tissue

186
Q

spastic paralysis

A

a chronic pathological condition in which muscles are affected by persistant spasms

187
Q

stenosis

188
Q

stereognosis

A

the ability to perceive and recognize the form of an object when the eyes are closed

189
Q

strabismus

A

cross-eyed

190
Q

syncope

191
Q

syrinx

A

cavity or tube

192
Q

thrombus

A

formation of a clot inside a blood vessel

193
Q

tics

A

compulsive, repetitive, inappropriate stereotyped movements, ususally affecting the face and shoulders

194
Q

tonic

A

sustained contraction

195
Q

tremors

A

involuntary movements involving alternate contraction and antagonistic mm

196
Q

vertigo

A

a type of dizziness, where there is a feeling of motion when one is stationary

197
Q

varus

A

denoting a deformity where an anatomical part is turned inward toward the midline of the body

Anatomy (22 decks)

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