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On Call Neurology > Anatomic Localization > Flashcards

Anatomic Localization Flashcards

1
Q

General principles of lesion: cortex?

A

Localization in the Upper Motor Neuron (Pyramidal) System

Principle: Tone Is Increased, Causing Spasticity and Hyperreflexia

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2
Q

General principles of lesion: corona radiata?

A

Localization in the Upper Motor Neuron (Pyramidal) System

Principle: Tone Is Increased, Causing Spasticity and Hyperreflexia

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3
Q

General principles of lesion: internal capsule?

A

Localization in the Upper Motor Neuron (Pyramidal) System

Principle: Tone Is Increased, Causing Spasticity and Hyperreflexia

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4
Q

General principles of lesion: brain stem?

A

Localization in the Upper Motor Neuron (Pyramidal) System

Principle: Tone Is Increased, Causing Spasticity
and Hyperreflexia

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5
Q

General principles of lesion: spinal cord?

A

Localization in the Upper Motor Neuron (Pyramidal) System

Principle: Tone Is Increased, Causing Spasticity
and Hyperreflexia

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6
Q

General principles of lesion: anterior horn?

A

Localization in the Lower Motor Neuron System

Principle: Tone Is Decreased, Causing Flaccidity
and Hyporeflexia

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7
Q

General principles of lesion: root/plexus?

A

Localization in the Lower Motor Neuron System

Principle: Tone Is Decreased, Causing Flaccidity
and Hyporeflexia

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8
Q

General principles of lesion: nerve?

A

Localization in the Lower Motor Neuron System

Principle: Tone Is Decreased, Causing Flaccidity
and Hyporeflexia

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9
Q

General principles of lesion: neuromuscular junction?

A

Localization in the Lower Motor Neuron System

Principle: Tone Is Decreased, Causing Flaccidity
and Hyporeflexia

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10
Q

General principles of lesion: muscle?

A

Localization in the Lower Motor Neuron System

Principle: Tone Is Decreased, Causing Flaccidity
and Hyporeflexia

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11
Q

General principles of lesion: midbrain?

A

Localization within the brain stem

Principle: specific cranial nerve involvement guides localization

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12
Q

General principles of lesion: pons?

A

Localization within the brain stem

Principle: specific cranial nerve involvement guides localization

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13
Q

General principles of lesion: pontomedullary junction?

A

Localization within the brain stem

Principle: specific cranial nerve involvement guides localization

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14
Q

General principles of lesion: medial medullar (rare)?

A

Localization within the brain stem

Principle: specific cranial nerve involvement guides localization

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15
Q

General principles of lesion: lateral medulla (wallenberg syndrome)?

A

Localization within the brain stem

Principle: specific cranial nerve involvement guides localization

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16
Q

General principles of lesion: hemicord (brown-sequard syndrome)?

A

Localization in the Spinal Cord

Principle: Localization Is Assisted by the Combination of Tracts Involved

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17
Q

General principles of lesion: anterior cord?

A

Localization in the Spinal Cord

Principle: Localization Is Assisted by the Combination of Tracts Involved

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18
Q

General principles of lesion: central cord?

A

Localization in the Spinal Cord

Principle: Localization Is Assisted by the Combination of Tracts Involved

19
Q

General principles of lesion: posterior cord?

A

Localization in the Spinal Cord

Principle: Localization Is Assisted by the Combination of Tracts Involved

20
Q

General principles of lesion: foramen magnum?

A

Localization in the Spinal Cord

Principle: Localization Is Assisted by the Combination of Tracts Involved

21
Q

General principles of lesion: conus medullaris?

A

Localization in the Spinal Cord

Principle: Localization Is Assisted by the Combination of Tracts Involved

22
Q

General principles of lesion: cauda equina?

A

Localization in the Spinal Cord

Principle: Localization Is Assisted by the Combination of Tracts Involved

23
Q

Signs and symptoms of cortex lesion?

A

signs:
- differential weakness of limbs and face
- sensory symptoms
- language, visual or attentional alterations

symptoms:

  • fractionated weakness (e.g. arm greater than face and leg)
  • cortical and primary sensory loss
  • aphasia, hemianopia, or hemineglect
  • cognitive dysfunction
24
Q

Signs and symptoms of corona radiata lesion?

A

signs:
- differential weakness of limbs and face

symptoms:

  • fractionated weakness
  • primary sensory loss
25
Signs and symptoms of internal capsule lesion?
symptoms: - weakness only signs: -face, arm and leg affected equally and densely
26
Signs and symptoms of brain stem lesion?
symptoms: - unilateral or bilateral weakness - diploplia, vertigo, dysarthria, or weakness signs: - dense hemiparesis - ocular or oropharyngeal dysphagia - motor posturing
27
Signs and symptoms of spinal cord lesion?
symptoms: - difficulty with gait + walking - urinary incontinence signs: - no face involvement - spastic quadriparesis (cervical) or paraparesis (thoracic) - sensory level
28
Signs and symptoms of anterior horn?
symptoms: - progressive flaccid weaknesses signs: - wasting, weakness, fasciculations - no sensory loss
29
Signs and symptoms root/plexus?
Symptoms: - single-limb weakness and sensory loss - pain in the neck, back or limb signs: - weakness in radicular/plexus distribution - EMG shows denervation in affected muscles
30
Signs and symptoms of nerve lesion?
Symptoms: - focal weakness (mononeuritis) - distal weakness (polyneuropathy) Signs - focal or distal weakness - atrophy in affected distribution - fasciculations - hyporeflexia -slowing or low amplitude on conduction studies; denervation on EMG
31
Signs and symptoms of neuromuscular junction lesion?
Symptoms: - fluctuating weakness - diplopia Signs: - positive edrophonium test - decremental response with repetitive stim on EMG Note: - edrophonium is a readily reversible acetylcholinesterase inhibitor - prevents breakdown of acetylcholine + competitively inhibits enzyme acetylcholinesterase, mainly at the neuromuscular junction.
32
Signs and symptoms of muscle lesion?
Symptoms: - proximal weakness - difficulty climbing stairs and brushing hair? - muscle aches Signs: - proximal weakness - polyphasic, low-amplitude motor units on EMG
33
Signs and symptoms of midbrain lesion?
- impaired vertical gaze - contralateral motor signs - CN 3 palsy (plus contralateral abduction nystagmus suggest ipsilateral INO) - CN 4 palsy (hemiparesis suggests Weber syndrome; ataxia suggests Claude syndrome; tremor or chorea suggests Benedikt syndrome)
34
Signs and symptoms of pons lesion?
- dysarthria - dysphagia - ataxia - contralateral hemiparesis or hemisensory loss - ipsilateral facial sensory loss (CN5) - ipsilateral gaze palsy (PPRF) or one and a half syndrome (PPRF and MLF) - locked in syndrome (bilateral basis pontis; associated with ocular bobbing) - horizontal nystagmus (often brachium pontis)
35
Signs and symptoms of pontomedullary junction lesion?
- Vertigo (CN 8) - dysarthria - horizontal or vertical nystagmus - contralateral hemisensory loss and hemiparesis
36
Signs and symptoms of lateral medullar (Wallenberg syndrome)?
- ipsilateral horner syndrome - ipsilateral limb ataxia - ipsilateral face and contralateral body numbness - gait ataxia - vertigo, dizziness, nausea (CN 8) - dysphagia (CN 9 - 12 palsises)
37
Signs and symptoms and medial medulla (rare)?
- contralateral hemiplegia - contralateral posterior column sensory loss - ipsilateral tongue weakness (CN 12 palsy)
38
Features of and causes of hemicord (brown-sequard syndrome)?
S&S: - ipsilateral hemiparesis - contralateral spinothalamic sensory loss - ipsilateral dorsal column sensory loss - sphincter dysfunction Causes: - penetrating trauma - extrinsic cord compression
39
Features of and causes of anterior cord?
S&S: - upper and lower motor paralysis - spinothalamic sensory loss - sphincter dysfuntion - sparing of posterior columns Causes: - anterior spinal artery infarction (often involves T4-T8)
40
Features of and causes of central cord?
S&S: - paraparesis - lower motor paralysis; wasting and fasciculations in arms - sensory loss in 'shawl' distribution (if in cervical region)
41
Features of and causes of posterior cord?
S&S - proprioceptive and vibratory sensory loss - segmental tingling and numbness - sensation of constricting "bands" Causes: - vitamin B12 deficiency - demyelinations (multiple sclerosis) - extrinsic compression
42
Features of and causes of foramen magnum?
S&S: - spastic quadriparesis - neck pain and stiffness - C2-C4 and upper facial numbness - ipsilateral horner syndrome - ipsilateral tongue and trapezius muscle weakness causes: - tumor (meningioma, chordoma) - atlantoaxial subluxation
43
Features of and causes of conus medullaris?
S&S: - lower sacral saddle sensory loss (S2-S5) - sphincter dysfunction; impotence - aching back or rectal pain - L5 and S1 motor deficits (ankle and foot weakness) Causes: - intrinsic tumor - extrinsic cord compression
44
Features of and causes of cauda equina?
S&S: - sphincter dysfunction - paraparesis with weakness in the distribution of multiple roots - sensory loss in multiple bilateral dermatomes causes: - extrinsic tumor - carcinomatous meningitis - arachnoiditis - spinal stenosis

On Call Neurology (4 decks)

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