Tutorial 1 Flashcards
What is multiple sclerosis?
In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged.
auto-immune disorder which attacks mylein sheaths surrounding axons in the CNS. Typically affects sensory pathways carrying information about proprioception, kinesthesia and vibration sense.
MS typically effects the sensory pathways carrying information about _____, _____ and ____ _____.
Proprioception, Kinesthesia, and Vibration sense.
What is proprioception?
Awareness of where your body is in space. In the limbs, the proprioceptors are sensors that provide information about joint angle, muscle length, and muscle tension, which is integrated to give information about the position of the limb in space.
What is kinesthesia?
Awareness of the position and movement of the parts of the body by means of sensory organs (proprioceptors) in the muscles and joints.
What is angina?
chest pain or pressure, usually due to not enough blood flow to the heart muscle. Angina is usually due to obstruction or spasm of the coronary arteries. Other causes include anemia, abnormal heart rhythms, and heart failure.
What is stereognosis?
ability to identify various objects of different shapes, textures and sizes by touch when placed in hand
What is graphesthesia?
ability to identify verbally letters, numbers or designs which have been traced on patient’s palm using a fingertip, the eraser end of a pencil or a thin wooden stick.
What is a two-point discrimination?
ability to perceive two points applied to the skin simultaneously as distinct point when they are separated by minimal distances.
What is tactile extinction?
(double simultaneous stimulation) ability to perceive two identical light touch stimuli applied simultaneously to both sides of the body.
Which nerve root supplies the biceps, brachioradialis and the wrist extensors?
C6
A 60 year-old man came to the clinic after awakening 4 weeks ago with severe left neck and shoulder pain and tingling sensation radiating down into the thumb and index finger of the left hand. Sensory testing revealed mildly decreased pinprick sensation in the left thumb and index finger. There was weakness of the left biceps, brachioradialis, and wrist extensor muscles. Reflexes were absent for left biceps and brachioradialis. On the basis of the symptoms and signs, which peripheral nerve/s or nerve root/s is/are affected?
C6 nerve root
A 38 year-old man suffered a serious fall at work in which his right arm hit forcefully against some metal bins while in the fully outstretched position. He had an abrasion and tenderness of his right upper arm. Neurologic exam was normal, except for Grade 4/5 strength of right thumb opposition, index and middle finger flexion, and wrist flexion. There was also decreased pinprick and light touch sensation in the right palm and on the palmar surfaces of the thumb and lateral two fingers. On the basis of the symptoms and signs, which peripheral nerve or nerve root is affected?
peripheral -> median nerve
A 55 year-old woman slipped on a wet floor and twisted her right foot towards the left, resulting in acute foot pain, followed by weakness. She had Grade 0/5 strength in the right tibialis anterior and extensor hallucis longus muscles, and 3/5 strength in her right foot evertors. There was decreased sensation to pinprick on the dorsum of the right foot, which was especially pronounced in the web space between the first and second toes. On the basis of the signs and symptoms, which peripheral nerve or nerve root is affected?
Peripheral –> Deep and superficial peroneal nerve
Following an accident in which a 45 year-old man was injured by an explosion while working on a road, he experienced low back pain with numbness and “pins and needles” running down his left leg into the lateral aspect of the left foot, including the small toe. Sensory testing revealed decreased light touchand pinprick sensation in the left posterolateral calf and lateral foot, including the small toe. On further assessment, there was weakness of the left gastrocnemius and hamstring muscles and absent Achilles tendon reflex on the left. On the basis of the signs and symptoms, which peripheral nerve or nerve root is affected?
Nerve root – > S1
