Clinical Implications (rebby) Flashcards
(92 cards)
4D’s of Brainstem Dysfunction
Dysphagia
Dysarthria
Diplopia
Dysmetria
Blockage of PCA or Basilar artery causes ________ Syndrome
Anteromedial Midbrain Syndrome (Weber’s)
Patient presents with
* CL hemiparesis
* IL loss of eye movements, paralysis of eyelid, dilated pupil
* CL loss of motor coordination, Lability, Ataxia
What are the primary structures affected? What is the syndrome?
- Corticospinal Tract
- Oculomotor Nerve Nucleus
- Red Nucleus
Anteromedial Midbrain Syndrome (Weber’s)
What are 2 symptoms of CN III palsy?
- Ptosis (droopy eyelid)
- Eye deviated down and out
Blockage of AICA leads to ________________ Syndrome
Lateral Inferior Pontine Syndrome
Patient presents with
* IL hearing loss
* Dysequilibrium
* IL horner’s syndrome
* IL facial pain
* Decreased tears & salivation
* CL pain and temp sensation lost
* IL weakness of facial expressions
What is the syndrome?
Lateral Inferior Pontine syndrome
Name the 7 primary structures affected with Lateral Inferior Pontine Syndrome
- Cochlear Nucleus
- Vestibular Nucleus
- Impaired sympathetics
- Trigeminal Nerve
- Salivatory Nucleus
- Spinothalamic Tract
- Facial Nerve
Bell’s Palsy is damage to what CN?
CN VII
Horner’s Syndrome is what 3 things?
Ptosis-eyelid drooping
Miosis-excessive constriction
Anhidrosis- little/no sweat
Thrombosis or stenosis of basilar artery will affect ________ bilaterally and cause ________ syndrome
Ventral Pons
Locked-In Syndrome
Patient presents with
* Paralysis below the head
*Paralysis of facial, swallowing, chewing, talking muscles
* inability to abduct eyes
What structures are affected?
B corticospinal tracts
B corticobulbar tracts
B abducens nerve nuclei
Which of the following is not affected in Lateral Inferior Pontine Syndrome?
A. Vestibular Nucleus
B. Impaired sympathetics
C. Vagus Nerve nucleus
D. Salivatory Nucleus
C. Vagus Nerve nucleus
this is a primary affected structure in Wallenberg Syndrome
Which of the following is not affected in both Lateral Inferior Pontine syndrome and Wallenberg?
A. Solitary Nucleus
B. Salivatory Nucleus
C. Trigeminal Nerve
D. Spinothalamic Tract
A. Solitary Nucleus
only in Wallenberg
Blockage of Anterior Spinal Artery leads to ______ Syndrome
Medial Medullary Syndrome
Patient presents with
* IL tongue protrusion
*CL loss of vibration, proprioception, light touch
*CL hemiparesis
What structures are affected? What is the syndrome?
Hypoglossal Nucleus
DCML
Pyramids
Medial Medullary Syndrome
Blockage of PICA leads to _____ Syndrome
Wallenberg/Lateral Medullary Syndrome
Which of the following is not a clinical manifestation of Wallenberg Syndrome?
A. Increased HR
B. Ataxia
C. Horner’s syndrome
D. Can’t abduct eyes
D. Can’t abduct eyes
this is a manifestation of Locked In syndrome –> B abducens
In the thalamus, when relay sensory neurons disrupt CONTRALATERAL sensation, what sensation is most commonly affected?
Proprioception
What is a common clinical implication of a thalamic lesion?
Lateropulsion aka Pusher syndrome aka Contraversive Pushing
In Pusher Syndrome, does the patient push to the strong or weak side?
Weak side
Push with strong side towards the weaker side & accompanied by POSTERIOR push
What type of tumor makes up 10-17% of intracranial neoplasms? (in hypothalamus)
Pituitary adenomas
Larger pituitary adenomas can push on surrounding structures (of the hypothalamus) such as _______ _______ and cause _______ _______
Optic chiasm
Bitemporal hemianopsia
When there is too much Basal Ganglia inhibition of motor thalamus, PPN, and midbrain locomotor region, this will cause __________
Hypokinesia
In Parkinson’s, there is ______ (decreased/increased) dopamine from SNc leading to ________ (under/over) activity of GPi
Decreased
Over
