Assorted points about cases Flashcards
(18 cards)
A radiculopathy presents with ____ when compared with a peripheral nerve lesion, which presents with _____
Paresis and sensory symptoms (i.e. numbness) over 1 dermatome
Paralysis distal to the lesion
A spinal cord lesion involves ______ symptoms
Both sensory and motor
Why might a pt with a spinal cord injury present initially with hyporeflexia but later develop hyperreflexia? What does it mean if a pt has flaccid paralysis with hyperreflexia later?
Spinal shock/edema masks true response initially
There is damage to both the ventral horn (cell bodies, LMN-> flaccid paralysis) and to the lateral white matter (UMN axons -> hyperreflexia) of the cord
A pt that presents with mostly sensory symptoms may have _____. A pt with diffuse motor symptoms may have_______.
Dorsal root disease
ALS
What can be used to localize a SCI?
Anesthesia over 1 dermatome (b/c no input there)
A inability to urinate or defecate indicates involvement of _____ which also receives sensory input from the _____
Sacral spine
Peri-anal/anal area
A patient in decerebrate posture has a lesion _____ whereas a patient with a decorticate posture has a lesion ____
Below the red nucleus (i.e. in the pons)
Above the red nucleus (i.e. in the midbrain)
A lesion that affects a nucleus or a cranial nerve will cause _____ signs. A lesion that affects descending cortical control of the Cr (i.e. ___ tract) will cause _____ signs.
LMN
Corticobulbar tract
UMN
Cerebellar signs include (midline ) _____ which indicate damage to the _____ and (lateral) ________ which indicate damage to the _____
Ataxia, gaze-induced nystagmus, broad-based gait, hypotonia
Vermis, paravermal areas and flocculus
Dysmetria, intention tremor, trouble with rapidly alternating movements
Cerebellar hemispheres
finger-to-nose and heel-to-shin tests assess integrity of the ….
cerebellar hemispheres (lateral cerebellum)
If a tremor goes away when a patient makes a movement, you could call it a ___ which is characteristic of…..
resting tremor
Parkinson’s disease
(compare to an intention tremor with lateral cerebellar problems)
Parkinson’s is a disease of ____ causing _____kinesia. Hemiballism and Huntington’s also affect the ___, causing ____kinesia
Both affect the basal ganglia
Hypo
Hyper
Symptoms such as ____ make you consider a lesion to the basal ganglia
involuntary (flinging) movements
writhing, jerky movements
These are specific for hemiballism
Cognitive deficits over a period of time and of a progressive nature should make you think ____ as an etiology
Dementia/disease process
Meningitis presents with ____. The inflammation of the meninges causes ____ which causes the symptoms.
A stiff neck and (if infectious) a high WBC in the CSF
Communicating/non-obstructive hydrocephalus
If a pt’s symptoms are all over the neuraxis and cannot be localized with 1 focal lesion, you should consider ____ as an etiology
A disease process (i.e. MS, ALS, thiamine deficiency)
MS involves _____. ALS involves ______.
Several separate lesions (i.e. brain stem, spinal cord, cortex)
Motor neuron degeneration (mostly LMN signs with some UMN signs) at no one segmental level
An aneurysm of the posterior communicating artery is in close proximity to ___ so it may cause ____
Cr 3
problems with parasympathetic innervation of the eye (accommodation, pupillary light reflex/pupil is dilated) and if it progresses further, trouble with eye movements
