Zespoły Flashcards
1
Q
Upper motor neuron lesion
A
- Muscle weakness (pyramidal weakness)/ paresis
- Spasticity, increased muscle tone -> Clasp-knife response where initial higher resistance to movement is followed by a lesser resistance
- Increased deep tendon reflexes
- Decreased or absence of superficial reflexes
- Pathological reflexes: Babinski sign, pronator drift
2
Q
Lower motor neuron lesion
A
- Muscle paresis or paralysis
- Hypotonia or atonia – Tone is not velocity dependent
- Hyporeflexia (decreased or absence of both deep reflexes and cutaneous reflexes)
- Muscle atrophy
- Fibrillations or fasciculations (caused by increased receptor concentration on muscles to compensate for lack of innervation)
3
Q
Extrapyramidal symptoms
A
- Altered quantity and velocity of movement (bradykinesia/ hyperkinesia)
- Altered muscle tone (hypotonia/ hypertonia)
- Involuntary movement (tremors, chorea, dystonia, ballismus)
- Akathisia - a feeling of internal motor restlessness that can present as tension, nervousness, or anxiety
- Altered posture reflexes
4
Q
Cerebellar symptoms symptoms
A
- Ataxia
- Intention tremor
- Dysmetria (undershoot or overshoot of intended position with the hand, arm, leg, or eye)
- Dysdiadochokinesia (impaired ability to perform rapid, alternating movements)
- Dysarthria - speech disorder (motor, scanning speech)
- Nystagmus (involuntary movement of the eye)
- Ataxic Gait -> wide-based gait
- Muscle hypotonia
5
Q
Bulbar palsy symptoms symptoms
A
- dysarthria
- dysphagia (difficulty in swallowing)
- difficulty in chewing
- absent or decreased jaw jerk
- palate paralysis + absent/ decreased gag reflex
- atrophic tongue or its fasciculations or tongue paresis
6
Q
Pseudobulbar palsy symptoms symptoms
A
- dysarthria
- dysphagia (difficulty in swallowing)
- difficulty in chewing
- brisk jaw jerk
- Positive primitive (atavistic) reflexes = frontal release signs (ex. snout reflex = Pout)
- Small, stiff and spastic tongue
- Labile affect -> involuntary laugh or cry
7
Q
Frontal lobe lesion symptoms
A
- Contralateral muscle weakness/ paralysis
- Eyes look toward brain lesion
- Motor aphasia
- Frontal release (primitive) signs
- Dyspraxia/ Apraxia
- Loss of urinary sphincter control
- Behaviour symptoms
- Epileptic attack -> simple partial motor, adversive (sudden, long look of both eyes in one direction)
8
Q
Behaviour symptoms of frontal lobe lesion symptoms
A
- Disinhibition (lack of restraint, criticism)
- Deficits in concentration and orientation
- Impaired judgement
- Impaired ablitity to plan, abstract thinking
- Moria, overcheerfulness
9
Q
Nondominant parietal cortex lesion symptoms
A
- Impaired contralateral sensation
- Cortical sensory defects: contralateral agnosia, astereognosia, agraphesthesia, defects in two point discrimination
- Loss of lower quadrant of vision -> opposite to the lesion in both eyes
- Contralateral hemineglect
- Epileptic attack -> simple partial sensory
10
Q
Dominant parietal cortex lesion symptoms
A
- Symptoms of nondominant parietal cortex lesion +
- Agraphia
- Acalculia
- Finger (touching) agnosia
- Left-right disorientation
- Amnestic Aphasia
11
Q
Temporal cortex lesion symptoms
A
- Short memory amnesia
- Loss of upper quadrant of vision -> opposite to the lesion in both eyes
- Receptive (Wernicke) aphasia (only in dominating hemisphere)
- Depression
- Extensive irritability
- sexual disinhibition
- Epileptic attack -> complex partial
12
Q
Occipital cortex lesion symptoms
A
- Contralateral (visual field) hemianopsia (with intact macular fields)
- Inability to follow finger with eyes
- Visual agnosia, Color agnosia
- Alexia
- Epileptic attack -> simple visual
13
Q
Demetia general symptoms
A
- Amnesia and learning difficulties
- Impaired judgement, abstract thinking
- Impaired understanding, space orientation
- Other cortical defects: aphasia, apraxia, agnosia, acalculia, dysgraphia
- Behavioural changes: agression, arousal, depression
14
Q
Parkinsonism symptoms
A
Bradykinesia + 1 out of 2:
1. Rest tremor
2. Rigidity
+ postural instability
15
Q
Brainstem lesion symptoms
A
Ipsilateral
- Sensory deficits (face, V nerve)
- Horner syndrome
- IX and X nerve palsy
Contralateral
- Motor and Sensory deficits from spinal nerves
- Nystagmus
+ hiccup
+ Vertigo
16
Q
Horner syndrome symptoms
A
Ptosis - drooping of the upper eyelid Anhidrosis - decreased sweating Miosis - constriction of the pupil Enophthalmos - posterior displacement of the eyebal Loss of ciliospinal reflex
+ Heterochromia iridum -> in congenital Horner syndrome -> difference in coloration of the iris
17
Q
Meningitis symptoms
A
- Headache
- Nausea or Emesis
- Hypersensitivity
- Nuchal rigidity
- Positive meningeal signs: Brudziński, Kernig
18
Q
Capsular lesion symptoms
A
- Contralateral hemiparesis
- Contralateral sensory deficit
- Central facial paresis
19
Q
Thalamic lesion symptoms
A
- Contralateral sensory deficit (with the face)
- Pain in this location
- Contralateral thalamic hand
- Involumentary movements (choreoathetosis - chorea + athetosis [twisting and writhing])
- Consciousness disorders
- Cognitive disorders
20
Q
Cerebellopontine angle syndrome
A
- VIII nerve palsy (ear buzzing, hearing loss, vertigo)
- V nerve palsy
- VII nerve palsy
- Cerebellar symptoms (ipsilateral)
- Upper motor syndrome (contralateral)
- Advanced cases -> IX-XII palsy and intracranial hypertension
21
Q
Transverse myelitis symptoms
A
- Paraplegia / tetraplegia -> first flaccid then spasity
- Absent deep tendon reflexes
- Sensory deficits
- Sphincter disfunction
- Autonomic dysfunction: impotence, increasing sweating
22
Q
Conus medullaris symptoms
A
- Impaired sensation in perinaeum and medial thighs (S3-5)
- Flaccid paralysis of urinary bladder and anal sphincter + impotence
- Absent anal and bulbocavernous reflex
23
Q
Cauda equina syndrome symptoms
A
- Impaired sensation and pain in perinaeum, gluteus and dorsal part of thighs (saddle anesthesia)
- Low back and radicular pain
- Foot, Gluteus and knee flexors muscles paralysis
- Absent Achilles reflex, usually also knee reflex
- Sometimes sphincter disfunction and impotence
24
Q
Hemiparaplegic syndrome symptoms
A
= Brown-Séquard syndrome
- Ipsilateral spastic weakness
- Ipsilateral touch, vibration and location sense loss
- Contralateral pain and temprature sense loss
- Autonomic dysfunction -> sweating, vessels
- On the level of injury (segmental sings): flaccid paralysis, LMN symptoms and sensory deficit
25
Q
Central spinal cord syndrome symptoms
A
- First -> sensory loss (pain and temperature) at the level of the lesion
- Then: bilateral spastic muscle paralysis (affecting more muscle at the level of lesion)
- After that: spinobulbothalamic sensation loss
- After that: LMN and autonomic symptoms at the level of the lesion
26
Q
Radiculopathy symptoms
A
- Pain, parestesias and sensory loss in proper dermatome
- Muscle weakness supplied by appropiate root
- Appropiate muscle atrophy
- Absent or decreased reflexes in these muscles
- Fasciculation in these muscles
27
Q
Mononeuropathy symptoms
A
- Flaccid paralysis
- Absent / decreased reflex
- Sensory loss
- Tinel Sign -> lightly tapping over the nerve to elicit parastesias
- Sometimes autonomic disorders
28
Q
Polyneuropathy symptoms
A
- Distal sensory loss
- Paresthesias and burning pain
- Flaccid distal muscle weakness with atrophy
- Fasciculations
- Absent or decreased deep tendon reflexes
- Autonomic disorders
29
Q
Autonomic symptoms in polyneuropathy
A
- Orthostatic hypotension
2.
30
Q
Myopathy symptoms
A
1.
31
Q
Acute Encephalopathy symptoms
A
1.
32
Q
Chronic Encephalopathy symptoms
A
1.
33
Q
Subthalamic nucleus symptoms
A
1.
34
Q
Mammillary bodies bilateral symptoms
A
1.
35
Q
Amygdala symptoms
A
1.
36
Q
Dorsal midbrain symptoms
A
-> Parinaud syndrome
37
Q
Tabes dorsalis symptoms
A
1.
38
Q
Vitamin B12 deficiency symptoms
A
1.
39
Q
Anterior spinal artery syndrome symptoms
A
- Bilateral loss of motor (UMN below and LMN at the lesion level) and autonomic functions
- Loss of spinothalamic sensation -> pain, temperature
- Preservation of vibration, pressure, touch and proprioreception
40
Q
Hippocampus bilateral symptoms
A
1.
41
Q
Foramen magnum syndrome
A
- “around the clock pattern” -> first ipsilateral shoulder and arm than ipsilateral leg than contralateral leg and than contralateral arm
- smaller lesions -> only leg weakness (leg fibers cross more caudally to arm ones)
