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NEURO > SC Pathology > Flashcards

SC Pathology Flashcards

1
Q

syndrome

A

collection of S/S associated with each other, suggest common origin

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2
Q

Myopathy

A
  • disease of motor unit
  • weakness, endurance
  • tends to be proximal
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3
Q

Muscular Dystrophies

A
  • hereditary myopathy

- progressive weakness, wasting

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4
Q

Myotonic Disorders

A
  • abnormality of fiber membrane
  • muscle can’t relax, increased stiffness
  • can come from CNS dysfunction
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5
Q

Myasthenia Gravis

A
  • autoimmune – antibodies attack Ach receptors
  • affects synapse
  • patchy/fluctuating weakness, decreased endurance
  • eyes (ptosis)
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6
Q

Chromatolysis

A
  • cell and nucleus swell, nucleus migrates peripherally

- occurs at cell body of injured axon

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7
Q

Wallerian Degeneration

A
  • neurofilaments/axons break up
  • myelin broken down, phagocytized
  • occurs anterograde to lesion
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8
Q

synaptic stripping

A

synaptic terminals withdraw from neurons and are replaced by processes of glial cells

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9
Q

Central Lesion (4 factors leading to poor regrowth)

A
  • poor regrowth
  • scarce glia
  • oligodendrocytes inhibit growth
  • no neurolemma sheath
  • no trophic factors for regeneration
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10
Q

Peripheral Lesion (4 factors for good regrowth)

A
  • chemotrophic factos secreted by schwann cells attract axons
  • adhesive molecules in distal stump promote axon growth
  • ihibitory molecules in perineurium prevent regenerating axons from growing astray
  • neurolemma sheath
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11
Q

Paralysis/Paresis Defined

A

decreased voluntary motor unit recruitment

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12
Q

Ipsalateral Segmental Motor Syndrome (lesion to ventral horn)

A
  • paralysis
  • hypotonia
  • areflexia
  • atrophy
  • fasiculation, fibrillation
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13
Q

Polio

A
  • LMNL sx (loss of ventral horn)
  • normal nerve conduction
  • usually follows phase of fever, myalgia (pain and cramping), and malaise
  • asymmetrical weakness (focal or unilateral)
  • NO sensory loss
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14
Q

Tabes Dorsalis

A
  • syphilis
  • S/S indicate marked involvement of dorsal roots, esp. lumbosacral region
  • results in degeneration of dorsal columns
  • S/S are IPSA and BELOW level of lesion
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15
Q

Tabes Dorsalis – common complaints (4)

A
  1. unsteadiness
  2. sudden lacerating somatic pains
  3. urinary incontinence
  4. excruciating abdominal pain
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16
Q

Tabes Dorsalis – neuro exam (5)

A
  1. marked impairment of vibration, jt position
  2. severe deficits in touch/pressure
  3. ataxic gait
  4. positive Rhomberg
  5. Abadie’s sign - no achilles reflex
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17
Q

Brown Sequard Syndrome – ipsa signs (4)

A
  1. UMN signs
  2. loss of kinesthesia and discrim. touch
  3. LMN signs (segmental)
  4. autonomic signs
18
Q

Homer’s syndrome

A
  • associated with Brown Sequard
  • ptosis, dry/warm/red face, miosis (contracted pupil)
  • due to loss of SNS, PSNS takes over, blood vessels dilate
19
Q

Brown Sequard – Contra and bilat signs

A
  1. Bilat - segmental loss P&T

2. Contra - loss P&T

20
Q

Anterior White Commissure pathology

A
  • bilateral, segmental loss P&T

* goes up down 1-2 segments – eg) T8-L3 lesion = T10-L5 loss

21
Q

Syringomyelia – early lesion

A
  • knocks out AWC - crossing fibers of LSTT

- bilateral loss P&T 2 seg below

22
Q

Amyotrophic Lateral Sclerosis

A
  • affects pyramidal, rubrospinal tracts, AHC, brain stem
  • LMN and UMN sx
  • cells still alive are hyperreflexive, hypertonic
  • NO sensory loss
23
Q

Primary Lateral Sclerosis

A
  • affects pyramidal tracts only

- only UMN sydrome

24
Q

Progressive Muscular Atrophy

A
  • AHC only

- LMN only

25
Q

Progressive Bulbar Palsy

A
  • motor nuclei of BS
  • slurred speech, problems swallowing/coughing
  • constant danger of aspiration
  • C/L regions affected most
26
Q

Friedrich’s Ataxia

A
  • combined systems disease affecting UMN (motor tracts) and dorsal column, spinocerebellar tracts
  • coordination problems, ataxia
  • clonus, hypertonia, hyperreflexia
27
Q

UMNS (5)

A

IPSA:

  1. paralysis/paresis
  2. spasticity
  3. hyper-reflexia
  4. clonus
  5. babinski
28
Q

LMNS (5)

A

IPSA:

  1. paralysis/paresis
  2. hypotonia
  3. hypo/areflexia
  4. fibrillations
  5. atrophy
29
Q

Subacute Combined Degeneration

A
  • combined systems disease often seen with pernicious anemia (B12)
  • dorsal/lateral funiculi degeneration, esp lumbosacral cord
  • distal paresthias, dysesthesia, extremity weakness
  • septic paraparesis with ataxia follows
  • Lhetmitte’s sign (electric shock upon head flexion)
  • difficulty walking
30
Q

MS

A
  • multiple plaques causing demyelination in CNS
  • usu. absent abdominal reflexes due to loss of pyramidals
  • bilateral partial paralysis/weakness of LE
  • loss of coordination, ataxia
  • hyperreflexia (UMN)
31
Q

Benign MS

A
  • few mild attacks then clearing of sx
  • minimal or no disability
  • ~20% cases
32
Q

Relapsing-Remitting MS

A
  • more frequent early attacks with less clearing
  • long periods of stability
  • some degree of disability
  • ~25%
33
Q

Secondary Chronic Progressive MS

A
  • more attacks, more often with less complete remissions
  • may continue to worsen for many years then level off with mod/severe disability
  • ~40%
34
Q

Primary Progressive

A
  • most severe
  • severe onset, progressive course without clearing of sx
  • least common ~15%
35
Q

Anterior Spinal Artery Syndrome

A
  • supplied most of ant 2/3 of SC
  • abrupt onset S/S
  • early LMNL s/s due to spinal shock - impaired bowel/bladder, dissociated sensory loss (P/T)
  • followed by UMNL - some develop painful dysesthesia due to sparring of spinoreticulothalamic
  • alteration of CNS processing of sensory info due to imbalance caused by intact dorsal column with impaired LSTT
  • LMN at level, UMN below level
36
Q

Traumatic Spinal Cord Injury - early stage

A

=Spinal Shock

  • flaccid, bilat paralysis of ALL ms innervated by segment and all seg below
  • loss sensation at level & below
  • loss all bladder/bowel
  • loss all sexual functions
37
Q

Traumatic SCI – late stage

A
  • UMNL sx
  • loss all sensations at level and below
  • automatic reflex neurogenic bladder
  • intermittent automatic reflex defecation
  • reflex erection, ejaculation
  • menstrual irregularites/cessation
38
Q

Traumatic SCI - autonomic syndromes

A

=autonomic dysreflexia

  • for SCI above T5 (above C4 = death)
  • stimulus (bladder/bowel distention) –> sweating, flushing, HTN, headache, reflex bradycardia
  • respiratory: decreased vital capacity, decreased response to CO2
39
Q

Autonomic Respiratory Dystunction Syndrome (SCI)

A
  • due to loss of ascending
  • resp arrest or sleep apnea
  • hypotension, hyponatremia (low Na), inappropriate ADH secretion, hyperhidrosis
40
Q

Automatic Bladder

A
  • incontinence, loss of pee control
  • bladder empties incompletely due to loss of spinal reflexes that trigger pontine pee center
  • bilat SC lesion ABOVE sacral level
41
Q

Uninhibited Reflex Neurogenic Bladder (UMN type)

A
  • lose voluntary control of filling/emptying
  • bladder functions by pontine reflexes only
  • normal filling/empyting just no sensation/perception
  • bilateral FRONTAL LOBE lesion
42
Q

Non-Reflexive Bladder

A
  • flaccid wall, incr capacity of bladder
  • bladder fills and overflows –> constant dribbling
  • pt doesn’t perceive distention
  • infection risk
  • bilat lesion to SACRAL CORD or PELVIC NERVES

NEURO (10 decks)

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