Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Brain and Behavior Exam 3 > Lec 38 Cerebellum Clinical Correlations > Flashcards

Lec 38 Cerebellum Clinical Correlations Flashcards

1
Q

Will a unilateral cerebellar lesion result in ipsilateral or contralateral deficit?

A

ipsilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which outputs from cerebellum course in the superior cerebellar peduncle?

A

all outputs EXCEPT vestibular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is path of non-vestibular outputs from the cerebellum?

A
  • ascend in the ipsilateral cerebellar peduncle and decussate in the midbrain
  • target red nucleus OR cerebral cortex via thalamus
  • become descending motor tracts [rubrospinal and corticospinal] which then cross again as they descend ending up back on the ipsilateral side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are cardinal features of cerebellar dysfunction?

A
  • hypotonia
  • ataxia
  • dysarthria
  • tremor
  • ocular motor dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are classic symptoms of cerebellar vermis syndrome?

A

mostly affect trunk

  • wide based stance and gait
  • difficulty maintaing posture/balance
  • gait ataxia
  • normal or slight arm coordination impairment
  • nystagmus, ocular dysmetria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is one potential effect of cerebellar vermis syndrome due to its location?

A
  • caudal vermis is near 4th ventricle
  • large mass lesion/edema of vermis can obstruct 4th ventricle
  • -> obstructive hydrocephalus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is relationship alcoholism and cerebellar vermis syndrome?

A
  • alcohol and thiamine deficiency causes major cerebellar vermis degeneration
  • can cause vermis syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are signs of hemispheric syndrome?

A

most affect limbs

  • poor coordination ipsilateral limb movement [most noticeably speech + finger movements]
  • impaired rapid alternating movement
  • intention tremor [when voluntary movements performed]
  • dysmetria [impaired finger-nose/heel-knee-shin tests]
  • scanning or dysarthric speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is dysmetria?

A
  • inability to stop a movement at proper place

- seen in impaired finger to nose or heel-kneel-shin tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is pancerebellar syndrome?

A
  • combination of all other syndromes

- bilateral signs involving trunk, limbs, cranial musculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are possible etiologies of pancerebellar syndrome?

A
  • usually infectious/parainfectious
  • hypoglycemia
  • paraneoplastic disorder
  • toxic-metabolic disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What types of oculomotor dysfunction in cerebellar syndromes? can they help localize area of lesion?

A

frequently nystagmus especially in midline cerebellar lesions
- cannot help localize to specific area of cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What kind of cerebellar syndrome should you think if you see:

  • wide based gait
  • nystagmus
  • really bad headache
A

think cerebellar vermis syndrome

headache = due to 4th ventricle compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some possible etiologies of cerebellar vermis syndrome?

A
  • alcoholism, thiamine deficiency

- large mass, lesion, edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some possible etiologies of cerebellar hemispheric syndrome?

A
  • infart
  • neoplasm
  • abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What kind of gait do you see in cerebellar dysfunction? mid-cerebellum vs lateral cerebellum?

A
  • ataxic gait = walk is staggering/ lurching/ wavering
  • not benefitted by pts view of his surroundings = no romberg
  • mid-cerebellum –> movement in all directions
  • lateral cerebellum –> staggering/falling toward side of lesion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is position of feet in cerebellar gait?

A
  • ataxia less when pts stand on broad base [feet wide apart]
18
Q

Does coordination improve in cerebellar syndrome pts with eyes open/closed?

A
  • not improved by visual orientation
19
Q

How does cerebellar ataxia differ from posterior column disease ataxia?

A

posterior column disease = + romberg sign = ataxia made worse with eyes closed

cerebellar = negative romberg

20
Q

Where do you see cerebellar hypotonia? which type of lesions?

A
  • usually in acute cerebellar hemispheric lesions
  • less often seen in chronic lesion
  • ipsilateral to side of cerebellar lesion
  • more noticeable in upper limb
21
Q

What should you think if hypertonia in cerebllar disease?

A
  • may reflect compression of brainstem/corticospinal tract
22
Q

What do finger-nose and heel-shin tests tell you?

A
  • evaluate cerebellar dysmetria
  • if its jerky = sign of dysmetria
  • cerebllar dysmetria usually due to cerebellar hemispheric function
23
Q

What is dysdiadochokinesis?

A
  • decreased ability to perform rapidly alternating movements
24
Q

What does rapid alternating movement test tell you?

A
  • evaluate for dysdiadochokinesis
25
Q

What is cerebellar dysarthria?

A
  • abnormality in articulation and prosody
  • scanning/ slurring/ staccato/ explosive/ hesitant/ garbled speech
  • may be due to generalized hypotonia [disorder of muscle spindle function]
26
Q

Are hemisphere or vermal lesions more associated with speech disorders?

A

hemisphere lesion

27
Q

What is a tremor?

A

rhythmic, alternating, or oscillatory movement

- can be normal exaggeration of movement, primary disorder, or symptom of cerebellar disroder or parkinsons

28
Q

What is a resting tremor? what etiology?

A
  • tremor that is maximal at rest, decreases with activity

– usually suggests parkinsons diseases or other basal ganglia lesion

29
Q

what is a postural tremor? what etiology acute vs gradual?

A
  • tremor that is maximal with limb in a fixed position against gravity
  • gradual onset means physiologic or essential tremor
  • acute onset means toxic/metabolic disorder
30
Q

What is an intention tremor? possible etiology?

A
  • tremor that is maximal during movement toward target [like finger to nose test]
  • suggests cerebellar disorder OR MS, wilsons disease
31
Q

What is a physiologic tremor?

A
  • present normally in some people
  • usually very slight
  • predominantly postural
  • rapid frequency [8-13 Hz]
  • most visible when hands outstretched and in times of stress/anxiety

– can be suppressed by alcohol or sedatives

32
Q

What is an essential tremor?

A
  • benign hereditary tremor [senile tremor]
  • medium frequency [4-8 Hz]
  • minimal or absent at rest
  • usually bilateral, can affect hands/head/voice
33
Q

What is asterixis?

A
  • not a tremor
  • muscle tone lapses when wrist extension attempted
  • repetivie, nonrhythmic, non-oscillatory wrist flexion
  • 3-5 Hz
  • bilateral
  • sign of chronic renal or liver failure
34
Q

What should you think if you see asterixis?

A
  • chronic renal or liver failure

- if liver failure –> also may have hepatic encephalopathy [acute confused state]

35
Q

What is myoclonus?

A
  • quick movement of muscle
  • also can be confused with tremor
  • focal, segmented, or generalized
  • cannot be suppressed [unlike a tic]
36
Q

What is palatal myoclonus? possible etiologies?

A
  • involuntary rhythmic jerk of soft palate
  • not suppressed by sleep
  • pts aware of click
  • consider MS, lesion of central tegmental tract
37
Q

What causes cerebellar ataxia?

A

insult to cerebellum and connecting paths

38
Q

What are causes of acquired ataxias?

A

endocrine disorders –> hypothryoidism, hypoparathyrodism, hyoglycemia

hypoxia/hyperthermia due to purkinje cell damage

toxins especially alcohol cause midline atrophy, heavy metals

meds: chemotherapy + antiepileptic drugs

creutzfeld-jakob disease

autoimmune

vascular lesions in cerebellum

celiac

39
Q

What are some causes of inherited ataxias?

A
  • friedreich ataxia

- ataxia-telangiectasia

40
Q

What is fredreich ataxia?

A
  • chronic slow progressive cerebellar ataxia
  • onset ages 2-25
  • inheritance autosomal recessive
  • low extremity reflexes absent
  • ataxia due to degeneration sensory nerve tissue in spinal cord
41
Q

What is ataxia telangiectasia?

A
  • slow progressive ataxia
  • onset in infancy
  • inheritance autosomal recessive
  • pts present with ataxia + capillary dilations
42
Q

What is creutzfeldt jakob disease?

A
  • rapid progressive dementing illness
  • due to accumulation mutation prion protein
  • get UMN signs, ataxia
  • survival 7wk - 8 yrs

Brain and Behavior Exam 3 (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions