Wednesday, 4-20-Clinical Aspects Of The Sensory And Motor Pathways (Stephens)

Question 1

This part of the SC contains UMN’s

Answer 1

Lateral Corticospinal tract (LCST)

Question 2

This part of the SC is associated with pain and temperature from the opposite side of the body

Answer 2

Lateral Spinothalamic tract (LSTT)

Question 3

LMN’s are associated with this part of the SC:

Answer 3

Anterior Horn

Question 4

Control of the bladder is associated with this part of the SC:

Answer 4

Lateral Reticulospinal Tract (LRST)

Question 5

Destruction of the dorsal roots may diminish motor reflexes, including muscle tonicity. Involvement of the dorsal roots in the sacral region results in ___

Answer 5

Atonic bladder and painless retention of urine

Question 6

Complete unilateral lesions of the posterior columns results in __

Answer 6

Ipsilateral loss of proprioception, 2 pt tactile discrimination and vibratory sensations below the level of the lesion

Question 7

A unilateral lesion of the FG results in:

Answer 7

Ipsilateral loss of proprioception, 2-pt tactile discrimination and vibratory sensations from the lower 1/2 of body and LE

Question 8

A unilateral lesion of the FC results in:

Answer 8

Ipsilateral loss of proprioception, 2 pt tactile discrimnation and vibratory sensations from the upper 1/2 of the body and UE

Question 9

A destruction of the ___ and associated motor tracts in the lateral funiculus results in spastic paralysis, hyperreflexia, hypertonia, Babinski’s sign, clonus, and disuse atrophy. These are ipsilateral deficits.

Answer 9

LCST

Question 10

Transection of the SC above S2 interrupts the ___ to the sacral autonomic nucleus and the pt is unable to voluntarily void his bladder, i.e., there is urinary retention. After spinal shock, the bladder reflex may return without voluntary control and the pt will have automatic reflex voiding or a reflex bladder

Answer 10

LRST

Question 11

Unilateral lesions of this tract results in contralateral loss of pain and temperature sensation 2 sensory dermatomal segments below the level of the lesion

Answer 11

LSTT

Question 12

Destruction of the ___ results in bilateral loss of pain and temperature sensations to the upper extremities (yoke-like anesthesia)

Answer 12

AWC

Question 13

___ paralysis results from the destruction of the motor neurons or axons of 1 or more of the cranial or spinal motor nuclei. This paralysis is characterized by flaccid paralysis, areflexia, atonia, atrophy, and fasciculations

Answer 13

LMN

Question 14

Congenital absence of __ fibers allows the non-nociceptive fibers to “close” the gate. The person will be insensitive to pain

Answer 14

C type

Question 15

A herpes zoster infection may compromise the __ fibers, thereby allowing the nociceptive C fibers to “open” the gate and the person will have an increased sensitivity to pain from the sensory dermatome of the affected nerve

Answer 15

Non-nociceptive A alpha/beta fibers

Question 16

Neurosurgically, the ___ may be transected for the relief of intractable pain. The anterolateral quadrant of the cord is cut 2 segments above and on the opposite side of the area of the pain and the procedure is known as an anterolateral cordotomy

Answer 16

LSTT

Question 17

The ___ serves as a landmark between the LSTT (Anteriorly) and the corticospinal fibers (posteriorly) in an anterolateral cordotomy (tractotomy)

Answer 17

Denticulate ligament

Question 18

Unilateral lesions of the ___ result in a contralateral hemianalgesia and thermal hemianesthesia

Answer 18

Spinal lemniscus (SL)

Question 19

The ___ play a significant role in the emotional importance and response we have to pain

Answer 19

Prefrontal lobes

Question 20

A prefrontal lobotomy will have what affect on a patient?

Answer 20

Pt loses anxiety and emotional component that is so often associated with pain. Although the pt is indifferent to pain, he is very much aware of the pain

Question 21

What neuroanatomical structure is destoryed in syringomyelia?

Answer 21

AWC

-Destruction of AWC with a bilateral loss of pain and temp sensations to the UE’s (yoke-like anesthesia)

Question 22

What region of the SC is affected in syringomyelia?

Answer 22

Cervical regions

Question 23

If there is asymmetrical destruction of the LCST in syngomyelia, what is result?

Answer 23

Spastic paralysis, hyperreflexia, hypertonia of the LE

Question 24

If the anterior horns are destroyed (uni- or bilaterally) in syringomyelia, what is the result?

Answer 24

LMN paralysis [flaccid paralysis, atrophy, areflexia, and atonia] of the associated upper limb musculature

Question 25

If part of the posterior columns are affected in syringomyelia, what is the result?

Answer 25

Ipsilateral anesthesia (proprioceptive and 2-pt tactile sensation) below the level of the lesion

Question 26

Tabes dorsalis is a meningovascular inflammation of the BVs as they pierce through the pia at the junction of ___

Answer 26

Dorsal rootlets and posterior columns

Question 27

Tabes dorsalis occurs during the tertiary (late) stage syphilis and results in bilateral ischemic necrosis of the ___

Answer 27

Posterior columns and the dorsal roots at this level

Question 28

Paroxysmal lancinating (piercing/stabbing pain) pain in the lower limbs of long duration is a common feature of tabes dorsalis and is probably due to irritation of the ___ pain fibers in the dorsal roots.

Answer 28

Type A (epicritic) pain fibers

Question 29

Involvement of the dorsal roots in the sacral region in tabes dorsalis results in ___

Answer 29

Atonic bladder and painless retention of urine

Question 30

A positive Romberg test in tabes dorsalis suggests involvement of ___

Answer 30

Posterior columns and/or cerebellum

Standing with feet together and arms extended out in front, the pt falls when closing their eyes

Question 31

What type of pupil(s) are likely in tabes dorsalis?

Answer 31

Argyll-Robertson pupils –> unreactive to light, but constrict during accomodation

Question 32

__ paralysis results from the destruction of the motor neurons or the axons of 1 or more of the cranial or spinal motor nuclei

Answer 32

LMN

Question 33

Acute anterior poliomyelitis selectively involves the motor neurons of the ___

Answer 33

Anterior (ventral) horns and the cranial nerve motor nuclei

Question 34

ALS may be due to a defect in __ metabolism.

Answer 34

Glutamate

Question 35

ALS leads to ___ paresis and atrophy of the intrinsic muscles of the hands followed later by the arms and shoulder musculature. Patients may develop dysarthria, dysphagia, and paresis of the tongue. Involvement of the ___ tract leads to spastic paralysis, hyperreflexia and a Babinski sign. There are no ___ deficits

Answer 35

LMN

Corticospinal

Sensory

Question 36

This part of the SC is associated with Proprioception and 2-pt tactile discrimination

Answer 36

Posterior columns –> FG, FC