SC Pathology

Question 1

how would you test for LMNs?

Answer 1

muscle testing
reflex testing
atrophy
hypotonia

Question 2

how would you test for UMNs?

Answer 2

reflex 
(disuse) atrophy- weakness
hoffman
babinski 
proprioception
romberg
tactile sensation
sensation testing
pain/temp
dull/sharp

Question 3

all of the CNs are in the head except for the ?

Answer 3

vagus nerve

CN10

Question 4

paralysis/paresis=

Answer 4

decreased voluntary motor unit recruitment

Question 5

ipsilateral segmental motor syndrome=

Answer 5

paralysis
hypotonia
areflexia
muscle atrophy
fasciculation, fibrillation

Question 6

polio is characterized by:

Answer 6

LMNL symptoms

nerve conduction’s are usually normal bc there are still some motor neurons alive

usually follows a phase of fever, myalgia (cramping/pain) and malaise (general discomfort)

asymmetrical weakness (focal or unilateral)

no sensory loss

Question 7

lesion of the dorsal column

Answer 7

lose discriminative sensation (touch/pressure) and conscious proprioception and kinesthetic sense

always going to be ipsilateral at lesion and down

can still feel pain/temp/gross touch bc the pain tracts are on contralateral side

+Romberg= dorsal column problem (unconscious proprioception)

bilateral loss is more exaggerated- wide, swaying gait, looking down

Question 8

tabes dorsalis is characterized by:

Answer 8

sensory symptoms and signs that indicate marked involvement of the posterior roots, esp in lumbosacral region

degeneration of dorsal column

Question 9

common complaints of pt with tabes dorsalis :

Answer 9

unsteadiness
sudden lacerating somatic pains
urinary incontinence
excruciating abdominal pain

Question 10

neuro exam for tabes dorsalis:

Answer 10

marked impairment of vibration and joint position

severe deficits in touch & pressure

ataxic gait

+romberg sign; abadie’s sign, tendon reflexes lost

later stages of pain fibers also become involved

Question 11

where are tabes dorsalis symptoms?

Answer 11

ipsilateral

at and below the level of lesion

Question 12

abadie’s sign of tabes dorsalis =

Answer 12

insensibility of the achilles tendon to pressure

Question 13

+hoffman’s reflex reflects:

Answer 13

presence of an UMN lesion from SC compression

Question 14

hemi section- brown sequard syndrome:

Answer 14

??

Question 15

horner’s syndrome:

Answer 15

ptosis, dry face, red, warm, miosis (constricted pupil)

UMN
any lesion T1 and above (esp C5)
eye gets affected mostly (drooping eyelid, restricted pupil, dryness of face

also common in medulla lesions; bc sympathetic innervation face is T1-3 (ipsilateral)

Question 16

lesion to the anterior white commissure:

Answer 16

bilateral pain and temp los

question is to what extent?

only get loss segmentally; nothing wrong above or below segment

if lesion is T8-L3, loss would be about T10-L5, goes up or down 1-2 segments

Question 17

syringomyelia:

Answer 17

anterior white commissure lesion gets larger and larger in any direction; usually goes ventrolateral

always about 2 segments below in

Question 18

amyotrophic lateral sclerosis (ALS)

Answer 18

sclerosis- hardening/plaquing disease on fibers in cortical spinal tract

as disease progresses it invade anterior horn cells (person now has both UMN and LMN symptom) these motor units continue to drop out – eventually die of respiratory insufficiency

“Lou Gehrigs Disease”
progressive hardening of pyramidal and rubospinal tracts; lose ability to control muscles. also affects anterior horn cells– mixed condition (UMN and LMN symptoms)

cells that are still alive are hyperreflexia and hypertonic

no sensory loss

+ Hoffman and Babinski

Question 19

UMNS for ALS:

Answer 19

ipsilateral

paralysis, paresis
spasticity
hyper-reflexia
clonus
babinski
hoffman

Question 20

LMNS for ALS:

Answer 20

ipsilateral

paralysis, paresis
hypotonia
hypo-reflexia
fibrillations
muscle atrophy

Question 21

what is the hallmark of ALS?

Answer 21

combo of UMN and LMN signs and symptoms

Question 22

common complaints of ALS patient:

Answer 22

early- weakness in legs and arms

sometimes mention atrophy or fasciculations

Question 23

neuro exam for ALS:

Answer 23

ms atrophy of small ms of hand and distal ms
fasciculations
hyperactive reflexes
\+ babinski and + hoffman
\+bing's reflex or sign

Question 24

Bing’s reflex:

Answer 24

pathological reflex in spastic symptom- complexes

extension of the great tow following prickling of the dorsum of the toe or foot with a pin, seen in pyrimidal tract lesions

Question 25

subtypes of ALS:

Answer 25

primary lateral sclerosis- pyrimidal tracts only

progressive muscular atrophy: AHCs only

progressive bulbar palsy- moto nuclei of BS

• slurred speech, problems with swallowing and coughing
• aspiration is a constant danger