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TBL 2 > TBL syndromes > Flashcards

TBL syndromes Flashcards

1
Q

Upper Motor Signs

A

Positive Babinski
Hyperflexia
Hypertonia

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2
Q

Lower Motor Signs

A 
Negative Babinski
Hypoflexia
Hypotonia
Fasciculation (random twitching)
Atrophy
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3
Q

Peripheral Neurological Syndromes

A

Neuropathy- dysfunction of nerves
Polyneuropathy- diffuse dysfunction of peripheral nerves
Mononeuropathy- dysfunction of single nerve
Radiculopathies- spinal nerve root dysfunction

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4
Q

Myopathy Syndrome

A

Diffuse skeletal muscle weakness

SYMMETRIC BILATERAL PROXIMAL LIMB WEAKNESS

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5
Q

Median Neuropathy (C5-T1)

A

THUMB ABDUCTION, thumb flexion, thumb
opposition
Sensation of all anterior & distal posterior
skin of thumbs, index fingers, middle fingers,
and lateral halves of ring fingers

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6
Q

Ulnar Neuropathy (C8-T1)

A

Adduction and abduction of all fingers
except thumb abduction; little finger
opposition; flexion of ring and little fingers
Sensation of anterior & posterior medial
hands including the little fingers and medial
halves of the ring fingers

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7
Q

Radial Neuropathy (C5-T1)

A

Finger and wrist extension
Sensation of the lateral posterior hands and
the proximal posterior skin of the thumbs,
index fingers, middle fingers, and the lateral
halves of the ring fingers; brachioradialis
reflexes

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8
Q

Seventh Cervical Radiculopathy

A

Elbow extension, wrist and finger extension
Sensation of the posterior forearms, hands,
and middle fingers; triceps reflexes

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9
Q

Sixth Cervical Radiculopathy

A

Shoulder abduction, elbow flexion
Sensation of the lateral forearms, lateral
hands, thumbs, and index fingers; biceps &
brachioradialis reflexes

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10
Q

Peroneal Neuropathy

A

Foot dorsiflexion, toe extension, foot
eversion
Sensation of the lateral lower legs and the
medial and superior feet

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11
Q

Lateral Femoral Cutaneous Neuropathy

A

Abnormal sensation of the lateral thighs

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12
Q

Fifth Lumbar Radiculopathy

A

Hip abduction, knee flexion, foot
dorsiflexion, toe extension, foot inversion &
eversion
Sensation of the lateral upper & lower legs
and medial & superior feet; difficult to elicit
stretch reflexes of the medial hamstrings

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13
Q

First Sacral Radiculopathy

A 
Hip extension, knee flexion, foot
plantarflexion, toe flexion
Sensation of the posterior upper & lower
legs AND lateral & inferior feet; Achilles
reflexes
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14
Q

Polyneuropathy

A

Symmetric distal limb weakness; lower
motor signs
Sensory loss of distal limbs

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15
Q

Neuromuscular Junctionopathy

A

Same symptoms as myopathy, drooping eyelid (ptosis) ophthalmoparesis.
Possible Dysarthria, dysphagia, dysphonia

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16
Q

Myelopathy

A

Syndrome of Spinal cord tracks

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17
Q

Lower Sacral Myelopathy and cauda equina syndrome

A

Dysfunction of cauda equina and lower sacral spinal cord.
Dysfunction to perineum, bladder, bowel and genitals
Legs not involved

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18
Q

Lumbosacral Enlargement Myelopathy

A

Affect myotomes of legs and include sacral myelopathy

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19
Q

Thoracic Myelopathy

A

Causes a horizontal line on abdomen, where below line you have dysfunction
Distal muscles weaker than promixal

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20
Q

Cervical enlargement Myelopathy

A

Deficits of thoracic myelopathy as well as deficits in myotomes of the arms
6th- lower motor neuron to biceps and myotome, UMN to tricepts

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21
Q

Upper Cervical Myelopathy

A

Dysfuncticuase horiztonal line encircling neck with somatosensory and UMN abnormality to below.
Look for Pronator Drift, clumsy quick motor movement. Respiratory weakness

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22
Q

Unilateral Myelopathy (Brown Sequard)

A

1)Ipsilateral lower motor abnormality at site of lesion
2)UMN abnormality of all ipsilateral myotomes below lesion
3) Loss of Vibration, Proprioceptin, Fine tounch ipsilateraly below lesion
4) loss of pain/ temp and crude touch, 2 below contalaterally
5)

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23
Q

Anterior Myelopathy

A

Due to anterior spinal blockage

1) Bilateral LMN loss to ventral horn
2) Loss of spinothalmic tract 2 below lesion
3) Initial Shock, then UMN sydrome takes over
4) Autonomic Functions lost below lession

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24
Q

Posterior Myelopathy

A

due to posterior spinal artery blockage

1) Dorsal Column lost.
2) total IPSILATERAL anesthesia at level.
3) possibly affect to descending motor

25
Q

Medial Cerebellar Syndrome

A

Symptoms-

1) Ataxia, dysarthria, vertigo, nystagmus, nausea

26
Q

Lateral Cerebellar Syndrome

A

Ataxia
Dysmetria
intentional tremor of ipsilateral limb

27
Q

Medulla Structures

A

Anterior- Pyramids
Lateral- Olives
Middle- Nucleus Ambiguis
CN 9,10,11,12

28
Q

Pons

A

Basil Pons

CN- 5, 6, 7, 8

29
Q

Midbrain

A

Anterior- Cerebral Peduncle
Posterior- SC colliculi
CN 3, 4

30
Q

Brainstem Blood Pathways

A

Medulla- Vertebral and Anterior Spinal, PICA
Pons- Basilar, AICA, SCA
Midbrain- PCA and PCA

31
Q

Lateral Cerebellar Syndrome

A

Ataxia
Dysmetria
intentional tremor of ipsilateral limb

32
Q

Medulla Structures

A

Anterior- Pyramids
Lateral- Olives
Middle- Nucleus Ambiguis
CN 9,10,11,12

33
Q

Pons

A

Basil Pons

CN- 5, 6, 7, 8

34
Q

Midbrain

A

Anterior- Cerebral Peduncle
Posterior- SC colliculi
CN 3, 4

35
Q

Accessory Neuropathy Syndrome

A

Unilateral dysfunction to ipsilateral SCM and trapezius
SCM strenght is tested contralateral
T is tested with ipsilateral shoulder raise

36
Q

Pupillary Dark reflex

A

3 neurons help dilate pupil via sympathetic innervation.
neuron 1 travels down to t1 sympathetic chain,
Neuron 2 travels to cervical ganglia
neuron 3 synapse on iris dilator muscle

37
Q

Upper eyelid elevation

A

Muscle: Levator papebrae via CN3

minor muscle- superior tarsal via sympathetics

38
Q

Horner’s Syndrome

A 
Unilateral dysfunction to efferent neuron in sympathetic trunk
Symptoms
1) Ptosis
2) flushed face
3) Constricted pupil
4) Lack of sweating
39
Q

Accessory Neuropathy Syndrome

A

Unilateral dysfunction to ipsilateral SCM and trapezius
SCM strenght is tested contralateral
T is tested with ipsilateral

40
Q

CN V

A

4 trigeminal nuclei at different brainstem levels
Main- Somatosensory and Brachiomotor to ipsilateral face
3 branches- opthalmic, maxilla and mandibular
1) pain and temp- enter at pons, descend to spinal nucleus V, cros and assend to TPV
2) Position, Proprioception, and fine touch, to chief sensory V in pons - then Dessucate to VMP
3) 1a, 1b, II fibers to nucleus Mesencephalon V nucleus in midbrain
4) LMN of muslce of mastication in motor nucleus in Pons- also innervate typani muslce

41
Q

Hypoglossal Neuropathy

A

LMN abnormality to ipsilateral tongue muscles
Tongue deviates to weak side
Problems with enunciating “la”

42
Q

Medial Medulla Syndrome

A

Lose:

1) Hypoglossal Nuclei
2) Trigeminal sensory (pain, temp) trackt
3) Medial lemniscus tract
4) Pyramidal tract

Results in: loss of LMN to ipsilateral tongue
UMN abnormality to contralateral Dorsal Column
3) loss of pain and temp to contralateral face.

43
Q

Conductive Hearing Loss

A

Weber test- lateralizes to bad ear

Rinne- sound louder on mastoid process

44
Q

Sensorineural hearing loss

A

Weber- lateralizes to good ear

Rinne- sound louder hearing than on mastoid

45
Q

Vagus Neuropathy

A

Dysarthria, dysphonia, dysphagia, nasal regurgitation, weakness in palate elevation, deminished efferent gag reflex, hard to pronounce ka and Ha.

46
Q

Glossopharyngeal neuropahthy

A

Somatosensory abnormalities to ipsilateral pharynx, and lowere motor neuron abnormalitiees to stylopharyngeus muslce. Afferent Gag reflex dysfucntion!
Parasympathetic, viscerosensory and tates abnormalities.

47
Q

Lateral Medullary Syndrome/ Wallenberg!

A

Due to PICA occulsion

1) Decrease pain, temp to ipsilateral face,
2) decreased pain and temp to contralateral body
3) ipsilateral limb ataxia
4) Ipsilateral Horner’s Syndrome
5) diminished ipsilateral tates (solitary nucleus)
6) vertigo, dysequilibriu, nausea, nystagmus- due to coclear nuclei
7) ipsilateral palate elevation, dysarthrai, dysphagia fue to ambiguus nuclease

48
Q

Abducens neuropathy

A

Horizontal diplopia from weakness in lateral rectus muscle- unable to abduct ipsilateral eye

49
Q

Internuclear ophthalmoparesis

A

Unilateral dysfunction of MLF causing ipsilateral adduction weakness and preserved convergence

50
Q

Medial Pontine Syndrome

A

1) UMN abnormalities to contralateral body
2) DCT to contralateral body
3) axatia from corticopontine tract
4) contralateral face has somatosensory abnormalities
5) anterior lesion- ipsilateral eye abduction
6) posterior- ipsilateral horizontal gaze paresis

51
Q

Locked In Syndrome

A

Only Able to move eyes-

Bilateral lesion to basis pontine

52
Q

Vestibulocochlear Neuropathy

A

ipsilateral hearing loss, vertigo, nystagmus, due to loss of cochlear nuclei and loss of vestibular nuclei

53
Q

Facial Neuropathy

A

LMN abnormality to upper and lower face
Hyperacusis (CN VII helps with one muslce in ear)
Decreased Lacrimation and salivation
Dysfunction to Corneal reflex
taste- solitary nucleus
Salivation/ Lacrimation- superior salivary nuclease

54
Q

Trigeminal Neuropathy

A

Loss of facial somatosensory,

LMN loss of mastication and hyperacusis

55
Q

Lateral Pontine Sydrome

A

1) somatosensory and LMN loss to ipsilateral face
2) ipsilateral hyperacusis
3) vertigo, dysequilibrium, nausea nystagmus
4) ipsilateral horner’s sydrome
5) loss of pain, temp, to contralateral body
6) ipsilateral ataxia

56
Q

Oculomotor Neuropathy

A

Ptosis, anisocoria worsens in light, weakness in elevation and adduction
Down and out,

57
Q

Trochlear Neuropathy

A

Depression when adducted, intortion when abducted

Goes up and medially

58
Q

Medial Midbrain Syndrome

A

1) ipsilateral oculomotor neuropahty
2) contralateral trochlear neuropahty
3) Ipsilateral/ contralateral ataxia
4)

59
Q

Lateral Midbrain Syndrome

A

UMN loss to contralateral lower face and body
Contralalateral ataxia
Somatosensory abnormality to contralateral body, face, arm leg.

TBL 2 (1 decks)

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