Neuromus Disorders

Question 1

Central Cord Syndrome

Answer 1

Resulting from hyperexten injuries and presenting as more UE deficits vs LE

Question 2

Brown Sequard Syndrome (hemi-section)

Answer 2

Causes disruption of descending lat cotricospinal tracts, ascending dorsal column and ascending lat spinothalamic tracts; result is ipsilat paralysis, position sense, discrim touch & contral lat loss of pain/temp

Question 3

Ant Cord Syndrome

Answer 3

Caused from flex injuries; motor fx, pain, pinprick & temp sensation are lost bilat below lesion; proprioception & light touch are preserved

Question 4

Post Cord Syndrome

Answer 4

Least common; injury to post columns results in proprioceptive loss; pain/temp/touch are preserved; Motor fx preserved to various degrees

Question 5

Conus Medullaris Syndrome

Answer 5

Injury of SC & lumbar nerve roots resulting in LE motor & sensory loss & an areflexic (flaccid, storing lots) B&B > if lesion is in sacral segs reflexes may be preserved

Question 6

Cauda Equina Syndrome

Answer 6

Injury at L1 level & below resulting in LMN lesion; flaccid paralysis w no spinal reflex activity; areflexic B&B

Question 7

Autonomic Dysreflexia

Answer 7

Abnorm response to noxious stim that results in extreme rise in BP, pounding headache & profuse sweating > deemed Med EMERGENCY if not reversed by quickly moving the stim

Question 8

Prevention for Autonomic Dysreflexia

Answer 8

Edu pt/cg frequent pressure relief principles; ensure compliance w intermittent catheterization; practice well balanced diet habits; ensure med compliance; edu on signs/causes and initiate first aid procedures

Question 9

Medical Mngt For SCI

Answer 9

Prevention for further damage via stabilization; traction/rest for unstable injuries; diuretic prescrip to decrease inflam; bladder care; ulcer prevention; control of autonomic dysreflexia/orthostatic HTN, prevention of thrombus formation & tx for heterotopic ossification

Question 10

CP cause

Answer 10

Injury and/or disease prior to, during or shortly after birth resulting in brain damage and secondary neurolog & muscular deficits - lack of O, intracranial hemorrhage, meningitis, chronic alcohol abuse, toxicosis, infections, genetics, endocrine or metabolic disorders

Question 11

CP is noprogressive however

Answer 11

Deformities & contractures could develop; may be accompanied w seizure, ID/DD or behavioral disorders

Question 12

Spastic CP

Answer 12

Lesion of motor cortex will result in spasticity w flexor/extensor imbalance; Hypertonia: increased muscle tone or Hyperreflexia: increased intensity of reflex responses

Question 13

Dyskinetic CP

Answer 13

Lesion in BG results in fluctuations in muscle tone: Dystonia (excess or inadequate muscle tone), Athetosis (writhing invol mvmts more distal), Chorea (spasmodic invol mvmts more prox w lack of co-contractions)

Question 14

Ataxic CP

Answer 14

Lesion in cerebellum results in hypotonia & ataxic mvmts characterized by lack of stability so coactivation is difficult > results in more prim mvmt patterns; Gross Motor Fx Classification & Manual Ability Classification used

Question 15

Plegia’s

Answer 15

Mono: 1 ex; Hemi: UE/LE on same side; Para: LEs; Quad: all ex; Di: less UE and greater LE fx’al impairment

Question 16

CP Complications

Answer 16

50% seizures, lang/cog deficits in 50-75%, visual impairments in 40-50%, feeding disturbances & diminished sensation

Question 17

Stabismus

Answer 17

Deviation of how one eye aligns with other

Question 18

Nystagmus

Answer 18

Reflexive response of eyes triggered by head mvmts

Question 19

Myopia, Hyperopia & Presbyopia

Answer 19

M= nearsightedness; H= farsightedness & P= decreased elasticity of lens resulting in diff w accomodation when focusing on objects nearby and when shifting focus from near to far

Question 20

Dyskinesias

Answer 20

Invol, nonrepetitive but occasionally stereotyped mvmts affecting distal, prox and axial musculature in varying combo - most rep of BG disorders

Question 21

Myoclonus

Answer 21

Brief & rapid contraction of muscle or muscle group

Question 22

Tics

Answer 22

Brief rapid, invol mvmts often resembling fragments of normal motor behavior. Tend to be stereotyped and repetitive but no rhythmic

Question 23

Chorea

Answer 23

Brief, purposeless, invol mvmts of distal ex and face; usually considered to be manifestation of dopaminergic overactivity in BG

Question 24

Dystonia

Answer 24

Results in sustained abnorm postures and disruptions of ongoing mvmt resulting from alterations of muscle tone - maybe be generalized or focal

Question 25

Ataxia

Answer 25

Lack of coord while performing vol mvmts - may appear as clumsiness/instability. Mvmts are jerky/disjointed

Question 26

Hemiballismus

Answer 26

Characterized by invol flinging motions of ex; Mvmts are often violent and have wide amplitudes of motion - continuous & random & can involve prox/distal muscles on one side of the body

Question 27

Parkinson’s Disease (PD)

Answer 27

Hypokinetic CNS mvmt disorder this is idiopathic (arises spontaneously), slowly progressive and degenerative; onset usually after 40; rate of deterioration ranges from 2-20yrs

Question 28

PD Symptoms

Answer 28

Begins insidiously w resting pill-rolling tremor of 1 hand; cardinal signs include tremor, rigidity, resistance to passive motion that is not velocity dependent; akinesia, postural instability, festinating gait, retropulsion (falling backwards) or propulsion (falling forward), mask face & micrographia (tiny handwriting)

Question 29

Hoehn and Yahr’s 5-stage scale

Answer 29

Used for PD. Stage I: unilat tremor, rigidity, akinesia (loss of vol mvmt) w min or no fx impair. Stage II: bilat tremor, rigidity, akinesia w or w/wo axial signs, I with ADL & no balance impair. Stage III: worsening sypmts, 1st sign of impaired righting reflex, onset of disability with ADL - can lead I lift. Stage IV: req help w some/all ADL, unable to live alone w/o some A, able to walk/stand unaided. Stage V: confined to wc/bed; max A

Question 30

Spina Bifida

Answer 30

Etiology is unknown; it is the failure of the spinal columns vert arches to fully form to enclose/protect neural tube > may result in protrusion of neural tube (could be d/t lack of folic acid); Detected prenatally

Question 31

Spinda Bifida Occulta

Answer 31

Body malformation w separation of vert arches of one or more vert w no external manifestations - may not be discovered until late childhood. * usually doesnt result in any symptoms

Question 32

Occult Spinal dysraphism (OSD)

Answer 32

When ex manifestations such as red birthmark, patch of hair, dermal sinus , fatty benign tumor or dimple covering site are present

Question 33

Spina Bifida Cystica

Answer 33

Exposed pouch comprised of SC and meninges

Question 34

Spina Bifida Cystica w meningocele

Answer 34

Protrusion of a sac thru the spine containing CSF and meninges but does NOT include SC * usually doesnt present symptoms

Question 35

Spina Bifida Cystica w myelomeningocele

Answer 35

Protrusion of a sac thru the spine containing CSF and meninges as well as SC or nerve roots. Results in sensory & motor deficit occurring below level of lesion & may result in LE paralysis or deformities, incontinence (lesions of S2-4), decubitius ulcer or DVT

Question 36

Occult Spinal dysraphism (OSD) Symptoms

Answer 36

May result in SC being split (dyplomyelia) or tied down & tethered (disatematomyelia) which may lead to neurolog damage and developmental abnorm as child grows

Question 37

Tethered Cord Syndrome

Answer 37

Occurs in tail end of SC when cord is stretched as a result of compression, being trapped w fatty mass/scar tissue, developmental abnorm or injury

Question 38

Tethered Cord Syndrome Signs

Answer 38

Hairy skin patch, hemangioma (blood vessels that form a birthmark) and/or dimple of lower spine. Diff w B&B, gait, deform of feet, LBP, sclerosis may result and can go undiagnosed until one of these symptoms are found