Review Questions Flashcards
what auto immune disease produces antibodies against the acetylcholine receptors?
Myasthenia gravis
degrees of weakness increases with activity and improves with rest
motor dysfunction without sensation, cognitive, or autonomic symptoms
what disease is an immune related response in which the antibodies induce demyelination and oligodendrocyte apoptosis?
multiple sclerosis
Neurologic symptoms
decerebrate rigidity
occurs with transections of the brainstem between the midbrain and the pons
may be present persistently or elicited by stimuli
plantarflexion, extension of arms, extension of neck, wrist flexion - rigidity
decerebrate rigidity
decorticate rigidity
occurs with transections superior midbrain, or severe bilateral lesions of the cerebral cortex
Higher up damage
neck extended, plantar flexion, elbows flexed, wrists flexed, internally rotated upper extremity- rigidity
decorticate rigidity
medial motor tracks
postural proximal muscle control
reticulospinal
Medial vestibulospinal
Lateral vestibulospinal
Medial corticospinal
lateral motor tracts
Fractionated movement
Distal muscle control
Rubrospinal
Lateral corticospinal
reticulospinal
postural and gross limb movement
APAs, reaching, neck reflexive movement
medial vestibulospinal
postural, neck and upper back
medial corticospinal
Neck, shoulder, trunk muscles
lateral vestibulospinal
postural, extensors
rubrospinal
Distal upper extremity extensors
lateral corticospinal
Fractionation
upper motor neuron signs and symptoms
paresis
Hyperreflexia
Hypertonia
Positive Babinski
spasticity, exaggerated reflexes
lower motor neuron signs and symptoms
Paresis with atrophy
Hyporeflexia
Hypotonia
Absence of Babinski
weakness , muscle atrophy
cell bodies are located in ventral horn of spinal cord
Parkinson’s disease true
Gradual progression
Good response to L dopa
Gait Instability starts later
asymmetrical onset
Resting tremor
Diseases like Parkinson’s, parkinsonism
rapid progression
Poor response to L dopa
Early symptoms of falling, dementia, hallucinations
Often have a symmetrical onset
MSA autonomic nervous system, blood pressure, respiration, bladder functions
Utricle
Oriented horizontally
Detect head movement in horizontal plane
walking falling forward
Lateral vestibulospinal tract
saccule
oriented vertically
Detect vertical displacement of the body
riding in an elevator, jumping up and down
Lateral vestibulospinal tract
semi circular canals
detect the movement of the head on the body
Angular acceleration
Head bobbing spinning in a circle
Medial vestibulo spinal tract
Asia scale-A
complete
no sensory or motor function at S4/5
asia scale b
sensory incomplete
sensory but no motor function at S4/5
Asia scale C
Motor incomplete
More than half of muscles below the neurological level of injury have a grade less than three
Asia scale D
Motor incomplete
Half or more of key muscles below the neurological level of injury have a grade greater than or equal to three
Asia scale E
Normal
More Gray matter in which area
sacral
white matter- cervical
where is more gray matter?
Sacral
Cervical has more white matter
weber test
poorer ear- tone referred to this ear indicates conductive hearing loss
better ear- tone referred to this ear indicates perceptive impairment
rinne test
normal- air conduction is twice as long as bone conduction
Conductive loss - bone conduction longer or equal to air conduction
Receptive- air conduction longer than bone conductions both variably shortened
upper motor neuron lesion on the right
Patient can wrinkle forehead on both sides, but lacks the ability to keep the left eye closed
lower face affected, but the upper will be preserved
lesion on left facial nerve
Both upper and lower face will be affected on that side
place a vibrating tuning fork on the vertex of a persons cranium the sound is louder on the right side
Conductive hearing loss on the right
Brainstem rule of four
two cranial nerves in midbrain- 3 and four
Four cranial nerves and pons- 5678
Four cranial nerves in medulla- 891012
four tracks to the side that begin with the letter S
Spinothalamic
Sympathetic tract
Spinocerebellar
Spinal trigeminal tract
four motor mediately located nuclei in the brainstem
3 4 6 12
Four structures near the midline that begin with the letter M
Motor nuclei that move eyes and tongue-34 612
Motor tract corticospinal
Medial longitudinal fasciculus
DCML medial lemniscus
four ds of brain stem dysfunction
dysphasia
dysarthria
diplopia
dysmetria
horners syndrome
decreased sweating anhidyrosis
drooping eye ptosis
miosis decreased pupil size
pica brainstem strokes
ataxia
l horners
l facial numbness
hoarse voice
decreased pin prick right side
