Patterns of sensory loss Flashcards
is the dorsal column pathway fast or slow conducting fibres
fast conducting fibres
what type of sensation does the dorsal column have
fine discrete touch, position.
sense.
vibration
uncrossed in cord.
is the spinothalamic pathway slow fibres or fast fibres
slow fibres
what type of sensation does the spinothalamic pathway carry
pain and temperature
where does the dorsal column pathway run in the spinal cord
ipisilateral
or contralateral
ipsilateral
where does the spinothalamic pathway run in the spinal cord
contra laterally.
how do fibres enter the cord in both the dorsal column and spinothalamic pathway
via the dorsal root ganglion
what are the presenting symptoms in Bernard sequard syndrome
pain and temperature loss on contralateral side
discriminative touch and and propricoeption loss on the ipsilateral side.
what is horn’s syndrome and which organ does it affect
loss of sympathetic sensation in the eye
how might a lateral medulla lesion (wallenburg) present
pain and temperature of contralteral body but ipsilateral face.
cranial nerves 10 and 11 leave here therefore they are also affected.
pain and temperature are split in the body up until which point of the brainstem.
medulla
how do a patient with anterior spinal syndrome present
pain and temperature lost- spinothalamic pathway is anterior
2 point touch and discrimination is present.
paraplegia-loss of motor function below lesion (in legs)- ventral and lateral corticospinal tract.
If a patient suffers form loss of sensation on one whole side of the body, both face and body then were must the lesion be.
thalamus
Until the medulla both the face and body are separate
what are the risk factors of a lacunar stroke
high BP, smoking ,diabetes
what is a lacunar stroke
affecting small perforating vessels.
what are the common presenting signs of parietal lobe deficit (cortical lesion)
Dysgraphesthesia- difficulty recognising letters or words which are drawn on the back of a patents hand.
Hemisensory neglect
R/L confusion
define syringomelia.
Syringomyelia is a type of disorder that occurs when a cyst forms within the spinal cord- in the middle of the spinal cord
what are the clinical presentations of syringomelia
2 point touch and proprioception is not affected.
loss of pain and temperature in both hands and across the body in a cape like distribution.
wasting in small muscles of arm
weakness in muscles of the legs
what is the treatment for syringomelia
shunt to remove CSF which is filling in the canal, if this is not done then it will lead to paralysis.
what 2 pathways are affected by syringomelia
corticospinal pathway and spinothalamic pathway
takes of crossing pathways- close to the vertebral canal.
what chemical levels are affect sensory neuronal pathways
arsenic
in peripheral neuropathies what is the term used for the distribution of sensory loss
gloves ans stokcings- affects arms and legs
are reflexes often absent in peripheral neuropathies
Yes
what are the main causes of peripheral neuropathies
diabetes melitus autoimmune (Guilain Barre, CIDP, vasculitis) toxic vitamin deficiency paraneoplastic chronic kidney and liver disease
what causes a purely sensory stroke
thalamic infarct
where do lesions occur in dissociated sensory loss
spinal cord and brainstem
what condition can cause a peripheral neuropathy dementia
antibodies which cause B12 deficiency.
Antibodies in the stomach damage parietal cells so that it cannot be absorbed.
