Exam 1 Ch5,6,7 combined Flashcards
(345 cards)
1
Q
3 cranial fossae
A
anterior
middle
posterior
2
Q
3 layers of meninges
A
- Dura
- Arachnoid
- Pia
3
Q
Cerebrospinal fluid: Made by
A
by ependymal cells in the 2 lateral ventricles
4
Q
CSF function
A
- mechanical protection (makes brain floating/absorb impact)
- Chemical protection (act as a buffer)
- nutrients waist transfer
5
Q
CSF Volume
A
150 cc
6
Q
CSF filtration rate
A
20 cc per Hour
7
Q
3 spaces (meninges)
A
epidural
subdural
subarachnoid
8
Q
_____ is a Common neurological symptom: benign, maybe bad
A
Headache
9
Q
Brain has nociceptors (true/false)
A
false
10
Q
Intracranial sensory nerves
A
V
IX
X
11
Q
Headeach + neck stiffness + fever =
A
meningitis
12
Q
Sudden explosive headache (worst headache ever) =
A
subarachnoid hemorrhage
13
Q
Types of headaches
A
Vascular
Inflammatory
Tension type
Increased ICP
Fatigue
Traumatic
Toxic/metabolic
Infectious
Referred
Low pressure
14
Q
Types of Vascular Headache
A
Migraine
Cluster
Dissection
15
Q
Migraine is most common in (men/women)?
A
women
16
Q
Type of migraine:
unilateral and throbbing, lasts a few hours, bright light and loud sound makes it worse, prodrome (aura)
A
Classic migraine
17
Q
Type of migraine:
same as classic + other neuro finding (blinding in 1 eye, tingling, weakness)
A
Complicated migraine
18
Q
Type of migraine:
doesn’t give a headache, causes nausea and other debilitating symptoms.
A
Atypical migraine
19
Q
Type of a vascular headaches:
middle aged men, unilateral behind 1 eye, last minutes, short and intense, alcohol and stress make it worse
A
Cluster
20
Q
Dissection (neurologic) causes damage to
A
the tunica intima
21
Q
Dissection (neurologic) results in
A
thrombus or embolism formation at this site resulting in ischemia
22
Q
Tension Type Headache aka
A
Cervicogenic/ subluxation
23
Q
Tension Caused by
A
dehydration
stress
psychological
24
Q
Tension Described as
A
squeezing (hatband)
25
Fatigue Headache is related to:
sleep deprivation
eye strain
26
Causes of Toxic/Metabolic Headachea
1. dehydration (hangover)
2. chemical exposure
3. rebound (withdrawal ie: caffeine)
27
Cuases of Referred Headache
1. dental
2. eye strain
3. sinus irritation (frontal or maxillary sinus)
4. neck pain suboccipital
28
Inflammatory Headache (Temporal) aka
giant cell arteritis
29
Inflammatory Headache common in (who)
elderly patients
30
Inflammatory Headache risks
inflammation of temporal aa
ophthalmic aa
31
Inflammatory cells invade tunica \_\_\_\_
media
32
Fibrotic change results in the tunica \_\_\_\_\_
intima
33
Inflammatory Headache Signs and symptoms:
Swelling of the superficial temporal artery
Will be hard and palpable
Scalp pain
34
Causes of neurological deficits?
(Increased Intracranial Pressure)
1. compression
2. destruction
3. herniation
35
Increased Intracranial Pressure-
Signs and symptoms (Cushing triad)
**increase bp** (pressure in skull)
**decrease HR** (due to the coratid receptor, dorsal nucleus of vagus)
**irregular respiration**
36
Increased Intracranial Pressure- Global symptoms
headache
changes in mental status
37
Increased Intracranial Pressure - Focal symptoms
specific to the area of brain preforming that function
38
Def: optic disc gets swollen and puffy (due to increased ICP)
Papilledema
39
Nervous System Herniation Locations:
1. cingulate gyrus
2. inferior media temporal lobe
3. cerebellar tonsil
4. new opening
40
Hydrocephalus happens due to
obstructed CSF flow
41
Hydrocephalus symptoms (adults)
increased ICP
Dementia
Urinary incontinence
Gait impairment
loss of forward and back ward stability
42
Hydrocephalus symptoms (children)
**increased ICP**
**big head** (skull is not fused)
**setting sun sign** (rolling down eye)
**high pitch** scream
**poor head control** (weight of water)
**transillumination** (shine a light on one side, and be visible on the other)
43
Intracranial tumors causes
1. increased ICP
2. Focal deficit (also global deficit)
44
Damage to the tunica intima leads to
blood flowing into the false lumen
45
Fibrotic change due to Inflammatory Headache leads to the closur of the \_\_\_\_
lumen
46
Intracranial tumors causes
1. increased ICP
2. Focal deficit (also global deficit
47
What do benign tumors do to the surrounding tissue?
push the tissue away
48
What do malignant tumors do to the surrounding tissue?
invade the surrounding tissue
49
is the benign tumor encapsulated?
if yes, what is the capsule made of?
Yes, with fiber/calcium
50
is the malignant tumor encapsulated?
if yes, what is the capsule made of?
No
51
benign tumor growth rate
slow
52
malignant tumor growth rate
fast
53
Benign tumor recurrence
less likely
54
Malignant tumor recurrence
more likely
55
Tumor types
mets (metastatic)
glioma
meningioma (benign)
pituitary tumor
Schwannoma
56
metastatic precentage of all tumors
23%
57
glioma precentage of all tumors
40%
58
what's the ratio of benign to malignant glioma
1:1
59
meningioma precentage of all tumors
17%
60
is meningioma benign or malignant
benign
61
pituitary tumor percentage out of all tumors
5%
62
Schwannoma percentage out of all tumors
5%
63
Trauma injury sites
Linear impact coup
Rebound impact Contrecoup
64
Rotational Shear Damage
1. Rotational component of injury affect the lower parts of brain
2. Basal ganglia and thalamus
3. Corpus callosum
65
the Cause of concussion
Mild head trauma
66
concussion symptoms
loss of consciousness
headache
vomiting
amnesia
disorientation
seizure
focal neurological deficit
fatigue
67
concussion Signs
oculomotor difficulties
vistibulo-ocular disturbance
balance and postural instability
68
# Define:
Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)
computerized baseline compared to post injury
69
ImPACT measures
1. attention span
2. working memory
3. sustained and selective attention time
4. response variability
5. nonverbal problems solving
6. reaction time
70
SCAT5 characteristic
* **Sport concussion** assessment tool
* Has **immediate** on field assessment
* Also has office assessment
71
On field assessment includes
* Red flags
* Observable neurologic signs
* Memory assessment
* Glasgow coma scale and cervical examination
72
Off Field assessment includes
* History of injury
* Symptoms scale
* Cognitive assessment
* Neurological and balance exam
* Delayed recall – short term memory
* Decision making – problem solving
73
Guidelines for Concussion Management
1. removal from contest following signs and symptoms of concussion
2. no return to play in current game
3. medical evaluation following injury
4. rule out more serious intracranial pathology
74
Step wise to return to play
* No activity rest until asymptomatic
* Light aerobic excersise
* Sport specific training
* Non-contract drills
* Full contract drills
* Game play
Generally about 24 hours per step
75
Post Concussive Syndrome can last
days to weeks after injury
76
Post Concussive Syndrome
sign & symptoms
* Fatigue
* difficulty concentrating
* irritability
* light sensitivity
* noise sensitivity
* emotional lability
* dizziness
* headache
* neck pain
* nausea
* vomiting
77
Contusion aka
Traumatic Intracerebral or Intraparenchymal Hemorrhage
78
Epidural Hematoma location
between dura mater and skull
79
Epidural Hematoma gets worse over the course of (time)
hours (rapidly)
80
Epidural Hematoma complications
* Rupture of middle meningeal artery
* Lens shaped convex hematoma
* Rapid progressing
* Displaces brain tissue
* Leads to herniation
81
Subdural hematoma complication
* rupture of bridging veins, slower in developing
* Shear force tear of bridging veins
* Crescent shaped bleed
82
Acute Subdural hematoma
within 24 hours severe neurologic deficits, 50% mortality
83
Subacute Subdural hematoma
1-14 days post injury with focal neurologic deficits
84
Chronic Subdural hematoma
2-6 weeks after injury
headache
balance problems
weakness
85
the worst type of hematoma
Subarachnoid hematoma
86
Subarachnoid hematoma complications
* Often from aneurysm
* Ticking time bomb
* **Worst headache of my life**
* Congenital aneurysms
* Blood fills subarachnoid space
* 40-50% mortality
87
Intracerebral hematoma caused by
high bp
diabetes
small vessels
88
Hypertensive hemorrhage
* High blood pressure threatens deep penetrating arteriols
* form micro aneurysms
* The micro aneurysms harden
* Continued pressure causes them to rupture
* Happens in basel ganglia pons cerebellum
89
Laceration
tearing of nervous system
90
Central Nervous System Infection can be caused by:
bacteria
viral
parasitic
prions
91
CNS infections Spread via
blood
92
the most common Symptoms with infections in the CSF
fever (bacterial & viral)
neck stiffness
headache
93
Bacterial meningitis may be fatal within \_\_\_\_\_
Hours of onset
94
the most fatal bacteria that cuause meningitis
Neisseria meningitis
Strep. pneumonia
Haemophilus influenzae
95
Bacterial meningitis signs and symptoms
1. headache
2. fever
3. neck stiffness
4. CSF cloudy full of puss
96
Def Brain abscess
pocket full of puss in the brain
97
Brain Abscess symptoms
headache
fever
neck stiffness
neurological signs specific to that area
98
Chances of survival with treatment (percentage)
80%
99
Lyme Disease is caused by
borelia burdoferri
100
Lyme Disease is transmitted by
deer tick
101
Lyme Disease stage 1 timing
Days to weeks after infection
102
Lyme Disease stage 1 symptoms
* Muscle + joint pain
* Swollen lymph nodes
* erythema migrans (thigh, groin, axilla)
103
Lyme Disease Stage 2 timing
Weeks to months
104
Lyme Disease Stage 2 symptoms
* Unilateral facial paralysis
* **Mild meningitis**
105
Lyme Disease Stage 3 timing
Months to years after untreated infection
106
Lyme Disease Stage 3 symptoms
* **Chronic Lyme arthritis** (MC knee)
* Nervous system problems: memory loss and difficulty concentrating
* chronic pain in muscles and unrestful sleep
107
describe lyme disease target rash
: pimple surrounded with a red ring
108
Viral meningitis aka
aseptic meningitis
109
what's a special sign about viral meningitis
Clear CSF
110
Defince Encephalitis
viral infections that involve the brain parenchyma
111
is Encephalitis (more/less) severe than typical viral meningitis?
more severe
112
encephalitis results in
meningoencephalitis
113
exapmle of primary viral infection
west nile
114
west nile is transmitted by
mosquito
115
example of secondary viral infection
herpetic rash
116
Subacute sclerosing panencephalitis is caused by
persistent measles infection
117
Subacute sclerosing panencephalitis symptoms
* Intellectual deterioration
* Forgetfulness
* Hallucination
* Seizures
* Neurological signs through CNS
118
Subacute sclerosing panencephalitis prognosis
Variable prognosis (recovery to death)
119
Sleeping Sickness aka
African trypanosoma
120
Sleeping Sickness stage 1 symptoms
fever
joint pain
headache
121
Sleeping Sickness stage 2 symptoms
sleep/wake cycle disruption
confusion
ataxia
tremor
122
Cysticercosis is caused by
tenia solium
123
Cysticercosis symptoms
* Headache
* Nausea
* Vomiting
* seizure
124
what are prions?
protein fragments
125
Creutzfeldt-Jakob disease symptoms
rapid progressive dementia
ataxia
hallucination
startle response
myoclonus
126
Prions Incubation period
2-25 years
127
prions are tramitted from
from organ transplant
beef with BSE
128
prions prognosis
death within 6-12 months
129
prions infections are differentiated using
lumbar puncture
spinal tap
130
lumbar puncture is taken at which level?
L4/L5 (below the spinal cord)
131
Too much fluid drawn or too fast during the lumbar puncture is the cause of
low pressure headache
132
list the Corticospinal pathway
1. Cerebral cortex
2. Midbrain
3. Pons
4. Medulla
5. Spinal cord
133
Corticospinal is Influenced by
cerebellum and basal ganglia
134
Corticobulbar Tract begins in
primary motor cortex
135
Corticobulbar Tract projects to
brain
136
how many lower motor neuron does the autonomic system have?
2
137
A 2 lower motor neuron pathway of the autonomic system are influenced by
1. hypothalamus
2. amygdala
3. nucleus tractus solitarius
138
Autonomic Neuron #1 location
brain stem or cord
139
Autonomic Neuron #2 location
peripheral ganglion
140
Parasympathetic division goal
Digestion & energy storage
141
Parasympathetic origin
III
VII
IX
X
sacral spinal cord
142
Parasympathetic has ____ preganglionic, and _____ postganglionic
Long preganglionic
Short post ganglionic
143
Transmitters used in both pre and post ganglionic
(parasympathatic division transmitters)
acetylcholine
144
Parasympathetic effect on eye (vision)
adapted to near vision
145
Parasympathetic effect on Digestion
activated by eating
146
Parasympathetic effect on Heart
decrease HR
147
Parasympathetic effect on lungs
Decrease RR
148
Parasympathetic effect on Peripheral capillaries
gets dilated
149
Parasympathetic effect on Skeletal muscle
tone relaxes
150
Sympathetic division goal
releases energy
151
Sympathetic division origin
Intermediolateral cell column (VII lamina) of spinal cord T1-L2
152
Sympathetic division has ____ preganglionic andd ____ post ganglionic
Short preganglionic
Long post ganglionic
153
Sympathetic Short preganglionic use ____ as a transimitter
acetylcholine
154
Sympathetic Long post ganglionic use ____ as a transimitter
norepinephrine
155
Options for signal distribution
1. sympathetic signal enter the **sympathetic chain**, synapse at the **same lvl**, **rejoin the same** spinal nerve **root**
2. sympathetic signal enter the sympathetic **chain**, **go up** several segments, synapse and **rejoin** spinal nerve **at a higher lvl**
3. sympathetic signal enter the sympathetic **chain**, **travel down** several segments, synapse and **rejoin** spinal nerve **at a lower lvl**.
4. sympathetic signal enter the sympathetic **chain**, **remain unsynapsed**, **leave** the chain **as a splanchnic nerve**, travel **to a prevertebral ganglion** (celiac, sup, and inf mesenteric) synapse and **travel to the target tissue**
5. sympathetic signal can **travel unsynapsed to the adrenal medulla**. **Releasing epinephrine and norepinephrine** (for distribution through the entire body via vascular system)
156
The preganglionic sympathetic neurons need to be long enough to reach
(3 structures)
the chain ganglia
the prevertebral ganglia
or the adrenal medulla
157
The post ganglionic neuron reaches from the ganglia to
target tissue
158
Sympathetic effect on eyes
get wild, pupil dilatate (to get as much light as possible)
vision shift to far away vision
159
Sympathetic effect on digestion
turn off blood going to, and stop secretion
160
Sympathetic effect on Heart
HR goes up
161
Sympathetic effect on lungs
RR goes up
162
Sympathetic effect on Peripheral capillaries
blood gets diverted from peripheral superficial capillary
163
Sympathetic effect on Skeletal muscle
receive more oxygenated blood
| (prepare the body to move)
164
why do peripheral superficial capillar narrow under the sypathetic effect
in case of getting a wound so it reduces the bleed
165
Enteric division reaches which organ
intestine
166
Enteric division contains 2 plexi:
Myenteric plexus (of Auerbach)
Submucosal plexus (of Meisner)
167
Myenteric plexus (of Auerbach) controls
muscle contraction
168
Submucosal plexus (of Meisner) controls
blood vessel size and secretory functio
169
Enteric division Regulated by parasympathetic via
division X and sacral
170
Enteric division Regulated by sympathetic via
splanchnic
171
Hirschprung Disease aka
Congenital Aganglionic Megacolon
172
in Hirschprung Disease, what happens to
the migrating cells of the myenteric and submucosal plexuses During development
do not continue to the distal colo
173
with Hirschprung Disease, the disctal colon can't:
can’t relax/contract properly to allow stool to pass
174
Hirschprung Disease results in
Lack of bowel sounds (MC LLQ)
dullness to percussion at LLQ
distention is palpable in that region
175
how can Hirschprung Disease be managed
by eating smaller meals more frequently
176
Describe the surgial solution for Hirschprung Disease
the aganglionic area is removed, and the normal part of the colon is connected to the sigmoid colon and the rectum
177
Term: Paresis
mild weakness
178
Term: plegia
total weakness/0 strength
179
Term: Paralysis
total weakness/0 strength (same as plegia)
180
Term: Palsy
nonspecific term than can mean paralysis or it can mean paresis
181
Term: Hemi
left or right
182
Term: Para
both legs
183
Term: Mono
one extremity
184
Term: Di
2 of the same extremity (usually legs)
185
Term: Quadra or tetra
all 4 extremities
186
quadriplegic means
can’t move any extremity
187
Motor System Testing order
Inspection
Look for abnormal posturing
Involuntary motions
Sings for muscular asymmetry
Preform circumferential mensuration
Measuring around the muscles to confirm asymmetry
Passive ROM (noting spasticity, or rigidity)
Muscle tests for strength
Stress test (holding arm up at shoulder hight for 30 s)
Checking reflexes (for changes in tendon reflexes and presence of uninhibited pathological reflexes)
188
3 Patterns of Weakness
Proximal weakness
Cranial Nerve Weakness
Distal Weakness
189
Proximal weakness includes
| (body parts)
shoulder and hip weakness
190
Proximal weakness signs
muscular dystrophy or muscle degeneration
191
Proximal weakness cuased by
| (etiology)
genetic x-linked (mostly males)
192
Worst form of proximal weakness
Duchene
193
Duchene Pt life expectancy
| (prognosis)
fatal by late teens/early 20’s
194
milder form of proximal weakness, and Pt can live longer
Diatonic muscular dystrophy
195
Proximal weakness Classical exam finding
Gower's sign
196
explain Gower's sign
pt is weaker at the hips, can’t stand up
197
where can Gower's sign spread to?
distal extremities (hand & feet)
198
Cranial Nerve Weakness Involves
1. facial expression
2. swallowing, chewing
3. eye motion
199
Cranial Nerve Weakness Suggest problem at
the neuromuscular junction
200
Cranial Nerve Weakness etiology
inadequate amount of neuro transmitter production
or
reduced number of muscular receptor
201
Distal Weakness includes
hands & feet
202
Distal Weakness origin
neurological
203
Upper motor neuron location
project from the cerebral cortex to lower motor neurons located in the anterior horn of the spinal cord
204
Lower motor neuron location
project via peripheral nerves to skeletal muscle
205
Upper vs Lower Motor Neuron Lesion
Sign
UMNL
LMNL
Weakness
Yes
Yes
Atrophy
No
Yes
Fasciculations
No
Yes
Reflexes
Increased
Decreased
Tone
Yes
No
Pathological reflexes
Increased
Decreased
206
Gait Disorders Can be caused by lesion in what part of the nervous system
almost anywhere in nervous system
![]()
207
Spastic gait caused by
lesion of upper motor neurons
(Stroke, MS/Degeneration, Cerebral palsy)
208
Spastic gait signs
triple flexion of the arm, elbow, wrist, & fingers.
riple flexion of the leg, hip, knee, and plantar flexion
Stiff legged circumduction
decreased arm swing
unsteadiness
falling
209
Functional gait disorder aka
psychologically based gait disorder
210
Functional gait disorder caused by
malingering patients or with psychological problem:
1. conversion disorder
2. factitious disorder
211
Functional gait disorder main signs
has no gait pattern
Pt will not fall
212
Functional gait disorder pt will not fall due to
intact postural and gait reflexes
213
If Functional gait disorder pt falls, then it's \_\_\_\_\_
intentional
214
Define Multiple Sclerosis
autoimmune demyelination of the CNS
215
Myelin in CNS is made by
oligodendrocytes
216
MS cuases
idiopathic
## Footnote
*(because of the overlapping etiology)*
217
some of the suggestions about cause of MS includes:
Vit D deficiency
genetic predisposition
diet
218
MS Pathological process
Lymphocytes attack CNS myelin only
219
MS Progression
Exacerbation
remission
220
MS Classic first suspicion is
two or more deficits separated anatomically and temporally
221
Definitive diagnosis is based upon
MRI study
222
how does MS look on MRI
multiple bright scars (*oligoclonal banding*), decreased nerve conduction, and oligoclonal bands (*immunoglobulin*) in CSF
223
oligoclonal banding is due
myelin destruction
224
Demyelination effect on conduction velocity and action potentials
slows conduction velocity
allows action potentials to disperse
225
Demyelination effects occurs more at what kind of temprature
at Higher temperatures
| (while taking hot bath/showers)
226
MS Female : male ratio
Female: male 2:1
227
the age range of MS onsit
20-40
228
Can MS pt have a normal life span
yes, with very strict management strategy
229
Multiple nerve demyelination leads to
signal dispersal
230
Hallmark neuro symptom
optic neuritis
231
deffine optic neuritis
bright white optic disc – inflammation of the optic disc
232
MS Motor symptoms
Weakness
Spasticity
UMNL sign
233
Def: Weakness in the conjugate movements of the eyes
Internuclear Ophthalmoplegia
234
Internuclear Ophthalmoplegia is due to
demyelination of the tract connecting the eyes
235
MS Sensory signs
| (Spinothalamic, Dorsal columns)
Impairment of vibratory/position sense
Impairment of pain, temperature, or touch sense
Pain (moderate to severe)
L'hermitte’s sign
236
MS Cerebellar signs
Lack of coordination (ataxia)
237
Other location signs:
1. Cranial nerve signs
2. Autonomic
3. Psychaiatric
238
Define L’Hermitte Sign
electric shock like sensation with neck flexion
239
L’Hermitte Sign is due to
inflammation of the spinal cord
240
the definitive diagnosis of MS is based on
complete neurological diagnosis
MRI
CSF analysis
241
MS management is mainly based on
* Inflammation management
242
MS inflammation management includes
prednisone
anti-inflammatory diet
increase venous drainage via chiropractic
243
Define prednisone
steroidal anti-inflammatory
244
long term use of prednisone can lead to
kidney damage
245
anti-inflammatory diet includes avoiding
(type of food)
wheat & dairy
246
increase venous drainage can reduce
metabolic waste
247
Motor Neuron Disease:
Amyotrophic lateral sclerosis (ALS) aka
Lou Gehrig disease
248
ALS is a degeneration of
both upper and lower motor neuron cell bodies
249
ALS prognosis
Prognosis respiratory failure and death usually in 3-5 years
250
respiratory failure happens due to a damage of which nerve
phrenic nerve
251
in ALS Upper motor neuron lesion signs in _____ extremeties
(upper/lower)
Lower extremity
252
Upper motor neuron lesion signs in the Lower extremity are
* weakness
* spasticity
* increased tendon reflexes
253
Lower motor neuron lesion signs in the _____ extremity
(Upper/Lower)
Upper extremity
254
Lower motor neuron lesion signs in the Upper extremity are
* weakness
* flaccidity
* decreased tendon reflexes
255
First symptom of ALS is usually
focal weakness
256
focal weakness in ALS spreads to other muscle groups including
intrinsic muscles of the hand & feet
257
ALS may start with what type of sings
bulbar signs
258
bulbar signs includes
Dysarthria
Dysphagia
259
Dysarthria means
weakness of the larynx
260
Dysphagia means
difficulty swallowing
261
Other possible diagnosis based on ALS symptoms
Lead poisoning
Dysproteinemia
Thyroid dysfunction
Vitamin B12 deficiency
Vasculitis
Neoplasms
Cervical spine compression
262
Normal MRI vs ALS MRI
263
Spinothalamic pathway carries
| (what kinde of sensory information)
crude touch
pain
Temprature
264
Dorsal Columns carry
| (what kinde of sensory information)
light touch
vibration
conscious proprioception
discriminating touch
265
Posterior (Dorsal) Columns fiber size
large in diameter, and longest
266
Posterior (Dorsal) Columns travels to
gracilus, cuneates nucleus
267
Posterior (Dorsal) Columns is joind by
trigeminal lemniscus
268
Posterior (Dorsal) Columns projcet info to
1. thalamus
2. posterior internal capsul
3. somatosensory cortex
269
Anterolateral Pathway contains
| (which pathways)
Spinothalamic
Spinoreticular
270
Spinoreticular ends in
reticular formation
271
Anterolateral Pathway fibers size
small
272
Anterolateral Pathway Synapse
immediate synapses
273
Anterolateral Pathway decussation
it decussates but it may take a few segments
274
Lateral spinal cord lesion effects
| (what sensation)
contralateral pain and temperature sensation
275
Lateral spinal cord lesion effects
| (what level)
beginning a few levels below the lesion
276
Spinothalamic carries
Discriminating pain and temp
277
Spinothalamic major relay
ventral posterior lateral (VPL) nucleus
278
Spinothalamic terminates in
thalamus
279
Spinoreticular carries
emotional and arousal aspects of pain
280
Spinoreticular terminates in
medullary–pontine reticular formation
281
Spinoreticular Projects into
**intralaminar thalamus**
for more broad distribution to whole cortex
282
All thalamic (Trigeminal) ascend to
parietal lobe
283
which cortex is responsible to tell you "when I got touched"
Primary sensory cortex
284
hich cortex is responsible to describe "how I got touched"
Secondary somatosensory cortex
285
sensory loss can happen in
| (which part of the sensory pathway)
anywhere in the sensory pathway
286
287
Define the term: Bar
pressure
288
Define the term: graph
writing
289
Define the term: top
mapping
290
Define the term: stereo
3D
291
Define the term: Dys
something isn't right
292
Define the term: allo
everywhere
293
Define the term: pall
vibration
294
Define the term: par
abnormal
295
Define the term: an/a
without
296
Define the term: algia
pain
297
Define the term: dynia
pain
298
Define the term: algesia
pain
299
Define the term: esthesia
feeling
300
Define the term: gonsis
knowledge
301
Define the term: pathia
something isn't wright
302
Define the term: parasthesia
tingling
303
Define the term: arthralgia
joint pain
304
Define the term: myalgia
muscle pain
305
Spinal Cord Lesions Usually correspond to
motor/ sensory deficit
306
the best way to identify Spinal Cord Lesions is by using
MRI
307
what level we look for at patients with Lumbar cord compression
Cauda equina
308
Describe Spinal cord shock
Temporary
traumatic
whiplash
extremity tingling
309
Spinal cord shock duration
24-48 hours
310
Term refers to the inflammation of spinal cord
myelitis
311
Spinal cord inflamation MRI Findings
water density in the spinal cord, changes to the myelin
313
Def: Myelomalacia
spinal cord softening
314
Myelomalacia caused due to
hemorrhage into cord or ischemia
315
Myelomalacia caused in eldarly by
osteophytes
stenosis
316
Myelomalacia caused in athletes by
disc lesion
317
describe the damage of Transverse cord lesion
all function lost below level of lesion
318
Transverse cord lesion causes
penetrating trauma
multiple sclerosis
myelitis
319
Hemisection the Brown Sequard Syndrome distributions
loss of contralateral pain
ipsilateral upper motor neuron lesion signs
320
Hemisection the Brown Sequard Syndrome causes
penetrating trauma
lateral compressive tumors
multiple sclerosis
321
Central cord syndrome size and location
small lesions in central commissure
322
Central cord syndrome Distribution
suspended sensory loss (bilateral) of pain and temperature
Cervical gives classic cape Distribution
Larger lesions may affect anterior horn cells
323
Central cord syndrome causes
syringomyelia
contusions
spinal cord tumor
324
Posterior cord syndrome distributions
blue man group (whole body except head)
325
Posterior cord syndrome causes
trauma
posterior tumor
multiple sclerosis
b12 defic
3\* syphilis (tabetic or steppage gait)
326
Anterior cord syndrome Distribution
anterior 2/3 of SC, loses motor function, and pain sensation below the lvl of the lesion
327
Anterior cord syndrome cuases
trauma
MS
anterior spinal artery compression
328
in Bladder Function Sense of fullness reaches
sensory cortex
329
Bladder Function Descending pathway is
medial frontal micturition center
330
Bladder Function Descending pathway activates
voluntary voiding
331
Detrusor reflex is contraction of
the top of the bladder
332
In Positive feedback results: the more the flow, the more \_\_\_\_\_\_\_\_\_\_\_\_\_\_
relaxation of sphincters
333
what happens when flow stops (empty or voluntary)
urethral sphincters contract
334
Urethral reflex is when
urethra contracts- detrusor relaxes
335
Bladder Lesion Sites
**Brain**- voluntary conscious control
**Spinal cord**- upper motor neuron
**Sacral nerves**- lower motor neurons
336
Bladder Malfunction happens due to
Lesion of bilateral medial frontal micturition center
337
Bladder Malfunction Results in
pontine and spinal micturition centers activation when bladder is full
338
with Bladder Malfunction, Urine flow and emptying are
normal But not voluntary
339
what diseases can lead to bladder malfunciton
hydrocephalus
parasagittal meningioma
neurodegenerative disorder
Lesion between pons and conus medullaris (spinal cord)
340
Bladder Malfunction makes the bladder become
hyperreflexic or spactic
341
Detrusor/sphincter dyssynergia symptoms
urgency, detrusor spasm, incomplete emptying
342
Detrusor/sphincter dyssynergia causes
trauma
tumor
transvers myelitis
multiple sclerosis (any spinal cord lesion)
343
Lesions of S2-4 nerves Symptoms
areflexive atonic bladder
344
Lesions of S2-4 nerves Caused by
diabetic neuropathy
vertebral body/disc degeneration
trauma
345
Lesions of S2-4 nerves results in
lack of sensory input from filling bladder
pt has overflow and stress incontinence
346
Bowel Incontinence can happen due to
medial frontal lesion as with the bladder
spinal cord lesion
conus or peripheral lesion
