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Neurology > Sensory system > Flashcards

Sensory system Flashcards

1
Q

What types of sensation is transmitted by the dorsal columns?

A

Fine, discriminative touch, proprioception, vibration

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2
Q

What fibers are there in the dorsal columns?

A

large myelinated fibers

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3
Q

Where do the dorsal columns deccusate?

A

Medulla:
nucleus gracilis ( lower limbs)
nucleus nucleus cuneatus (upper limbs)

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4
Q

What is the course and destination of the dorsal columns?

A

medulla(deccusates) - medial lemiscus - thalamus - sensory cortex

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5
Q

What types of sensation is transmitted by the spinothalamic tracts?

A

poorly localized touch, pain, temperature

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6
Q

What fibers are there in the spinothalamic tracts?

A

small non-myelinated fibers (first affected by local anestheisa)

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7
Q

Where do the spinothalamic tracts deccusate?

A

at the level of cord entry

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8
Q

What is the course and destination of the spinothalamic tracts?

A

Lateral (fast pain, temp) cord
Anterior (touch, slow pain) cord

  • via the brainstemreticular formation
  • thalamus
  • sensory cortex
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9
Q

What are the five nuclei in the thalamus?

A 
Sensory
Motor
Limbic 
Association
Nonspecific
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10
Q

What are common causes of single nerve lesions?(5)

A

Diabetes, RA, hypothyroidism, trauma, vascular

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11
Q

What are common causes of glove and stocking polyneuropathy? (9)

A 
diabetes
uremia
malnutrition
paraproteinemias
cancer
colagenosis
toxings
inflammation
inherited neuropathies (i.e Charcot-Marie-Tooth)
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12
Q

What typically causes nerve root lesions?(2)

A

disc compression or tumor

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13
Q

What are causes of complete cord lesion?(4)

A

trauma, tumor, MS, inflammation

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14
Q

What are causes of hemisection of the spinal cord?(3)

A

inflammation, MS, intraspinal tumor

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15
Q

What is “central cord syndrome”?

And what are the typical causes(2)

A

Loss of temp. and pain sensation AT the level of the lesion (typically cervical)
large lesion may affect whole body under lesion

  • syringomyelia, intramedullary tumors
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16
Q

Isolated lesion of the dorsal columns are typically a result of which two diseases?

A 
Vit B12 deficiency
Tabes dorsalis (syphilis)
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17
Q

What is anterior spinal syndrome?

A
  • Loss of pain and temp. sensation below the lesion

- caused by occlusion of ant. spinal artery(Adamkiewicz a.)

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18
Q

A lesion in the sensory pathways of the brainstem will produce what sensory symptoms?

A

ipsilateral loss on the face

contralateral loss on trunk and limbs

19
Q

A lesion in the sensory pathways of the thalamus will produce what sensory symptoms?

A

loss on all sensation on the contralateral side

20
Q

A lesion in the sensory pathways of the internal capsule will produce what sensory symptoms?

A

loss on all sensation on the contralateral side

21
Q

A lesion in sensory cortex will produce what sensory symptoms?

A

no superficial sensory disturbances
unable to localize stimuli
loss of sterognosia(object shape) and discrimination

22
Q

What is the clinical presentation of Oculomotor lesion?

A

Lateral and downward eye
diplopia
Dilated and fixed pupil
Ptosis

23
Q

What nuclei is involved in the light reflex and the accomodation reflex

A

Edinger westfal nucleus

24
Q

What is the clinical manifestation of Horner syndrome?

A 
Unilateral:
Miosis
ptosis
anhidrosis
endopthalmos
vasodilation
25
Q

How does trochlear nerve palsy present clinically?

A

Head tilt and chin tuck to contralateral side

26
Q

What is internuclear ophtalmoplegia

A

lesion to LMF

problems with adduction on ipsilateral side and vertical nystagmus on other side

27
Q

bilateral internuclear opthalmoplegia is typical for which disease?

A

MS

28
Q

A lesion in the trigeminal nerve will result i what clinical findings?(3)

A

Pain/loss of sensation
loss of corneal reflex (V1)
Paralysis of ipsilateral chewing muscles

29
Q

What can be the clinical findings of facial nerve lesions? (5)

A

Paralysis of ipsilateral facial muscles (peripheral lesion)
Paralysis of lower contralateral face (central lesion)
Hyperacusis
Dry eyes
Dry mouth
loss of taste (ant 2/3) if proximal to chorda tympani

30
Q

What are the clinical signs of Vestibular nerve lesion?(4)

A

vertigo with falling to affected side
inabillity to maintain vertical posture
nystagmus and blurred vision
nausea and vomiting

31
Q

What are the clinical signs of Cochlear nerve lesion?(2)

A

Diminished hearing/deafness

Tinnitus

32
Q

What are the clinical signs of Glossopharyngeal lesion?(4)

A

Palatal palsy
Dysphagia
Loss of reflexes from carotid body and sinus
loss of taste/touch on post. third of tongue

33
Q

What are the clinical signs of Vagus nerve lesion?(4)

A

Dysphagia
palatal palsy(uvula deviates to opposite side)
Hoarseness
loss of vagal cardio/gastro/resp reflexes

34
Q

What are clinical signs of Spinal Accessory nerve lesion? (3)

A

weakness of head rotation
weakness of shoulder shrugging
vocal cord paralysis and hoarseness (carry vagal fibers)

35
Q

What are clinical signs of Hypoglossal nerve lesion?(3)

A

Paralysis and atrophy ipsilaterally
Dysarthria
Dysphagia

36
Q

Where is the nucles of CN3 located?

A

midbrain

37
Q

Where are the nuclei of CN 4,5,6,78 located?

A

Pons (CN5 also in medulla)

38
Q

Where are the nuclei of CN 10,12 located?

A

medulla

39
Q

Where are the nuclei of CN 11?

A

spinal cord

40
Q

What are the signs of bulbar palsy?(5)

A 
Dysarthria
Dysphagia
diminished mandibular reflex
paresis of pharynx and palate
loss of gag reflex
paralysed tongue
41
Q

where is the lesion in bulbar palsy?

A

CN 5,9,10,12

42
Q

What are the signs of pseudobulbar palsy?(7)

A 
Dysarthria
Dysphagia
increased mandibular reflex
increased pharyngeal reflex
paralysis of tongue(no atrophy or fasiculations)
Affect incontinence
Fronal release ( primitive reflexes)
43
Q

Where is the lesion in pseudobulbar palsy?

A

Bilateral lesion of corticonuclear fibers

Neurology (5 decks)

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