Pathology Flashcards
Muscular Dystrophy
Weakness progression: proximal LE and pelvis, shoulders and neck, UE, respiratory mm
Inherited
Central Cord Syndrome
Distal > proximal, UE > LE (usually hands most affected)
Incomplete SCI, often resulting from cervical hyperextension
Sensory involvment possible bur more rare
ALS
Starts unilateral
Distal to proximal
Progressive - death within 5 years
UMN & LMN
Guillan-Barre Syndrome
Progressive LMN disorder - sensory and motor impairment
Symmetrical, distal to proximal, starts in LE’s and moves superiorly - may have respiratory paralysis
Autoimmune response to previous respiratory infection, influenza, immunization, or surgery
Majority has full recovery, 20% have remaining neuro deficits, and 3-5% of pts die from respiratory complications.
Myasthenia gravis pattern of weakness
Proximal > distal
Anterior Interosseous Syndrome
Entrapment of AIN (branch of median n.)
No sensory fibers => no sensory sx
Weakness in FPL, pronator quadratus, FDP in 1st and 2nd digits
General cerebellar disorders
Generalized weakness
Hypotonia (especially in acute lesions)
Difficulty with posturalcontrol of axial muscles
Motor learning impairments: Decreased anticipatory control, feedback and learning delays.
Deficits in inormation procession, attention deficits.
Emotional dysregulation
Dysmetria, nystagmus, dysdiadochokinesia
Bell’s Palsy
Compression of CN VII
Muscles of facial expression on one side weak/paralyzed
Loss of control of salivation/lacrimation
Acute onset, max severity in hours/days
Commonly preceded by 1-2 days of pain behind ear
Most recover in weeks/months
Normal sensation
ACA Stroke
Contralateral sensory loss & hemiparesis (leg>arm)
Polyneuropathy
Bilateral symmetrical involvement of peripheral nerves
Usually legs>arms
Distal segments earlier and more involved
Autonomic Dysreflexia
Noxious stimulus produces pathological autonomic reflex:
- Paroxysmal HTN
- Bradycardia
- H/ache
- Diaphoresis (sweating)
- Flushing
- Diplopia
- Convulsions
Lesions at or above T6
What to do during episode of Autonomic Dysreflexia
Elevate head
Check for irritating stimuli
Check/empty catheter
Neocerebellar lesion sx
Ataxic limb movements
Intension tremor: Irregular, oscillatory voluntary movements
Dysdiadochokinesia
Dysmetria
Dyssynergia: Abnormal timing, movement decomposition of agonist/antagonist interactions. Impairments of multi-joint coordination, movement sequences, complex motor tasks.
Errors in timing related to perceptual tasks
PCA stroke
Occlusions Produce:
Contralateral homonymous hemianopsia
Contralateral sensory loss
Thalmic syndrome
Involuntary movements (choreoathetosis, interntion tremor, hemiballismus)
Transient contralateral hemiparesis
Weber’s syndrome: Occulomotor nerve palsy with contralateral hemiplegia
Visual symptoms (paralysis of vertical eye movements, miosis, ptosis, decreased light reaction).
Anterior cord syndrome
Loss of motor function, pain and temp
Preservation of light touch, proprio, position sense
Relapsing/remitting MS
Abrupt onset of neurological dysfunction occurring over several hours or days. This is followed by recovery, which may be complete, more commonly is partial so that there is a residual disability
Secondary progressive MS
Secondary progressive MS starts as relapsing/remitting disease. After a period of time, the secondary progressive phase begins. This is characterized by slow worsening of baseline symptoms. Attacks may, or may not continue during the progressive phase. Secondary progressive MS differs from relapsing/remitting MS in that the baseline slowly worsens between attacks
Primary progressive MS
Slowly worsens from the onset. By definition, patients do not have attacks. Progression may be steady or may have periods of faster or slower progression. There may even be periods of slight improvement. It is the complete absence of attacks that identifies this subtype.
Progressive/relapsing MS
Begins like primary progressive, but relapses then develop later in the disease course. Following these relapses, there may be recovery or no recovery.
Erb’s Palsy
Upper brachial plexus injury or palsy resulting from difficult birth – C5-C6 affected, sometimes C7 as well
Motor and possibly sensory sx
S&S of anemia
Heart palpitations, SOB