Flashcards in Gait Cerebellar Function Deck (28)
What factors contribute to walking?
3. postural control
5. memory or concept of walking
What does a positive romberg sign indicate?
impaired proprioception, dosal column pathway
What does it indicate if someone has their eyes open but can't stand with feet together?
Broad-based ataxic gait
-could be dorsal(worse with closed eyes) or cerebellar
-tabes dorsalis from neurosyphilis
food drop or weak dorsiflexion
-unilateral foot drop may be from a lesion of peroneal nerve or L5 root
-bilateral food trop with severe polyneuropathy, motor neuron disease, or bilateral L5 root lesion
patient leans or bends the trunk to the left as the right food is raised and vice versa
weakness of the hip girdle muscles, usually in myopathy
advancing leg or foot tends to cross over the opposite lower limb
upper motor neuron (corticospinal lesion) affecting the lower limbs, as in spastic paraparesis
-increased spastic tone and tightness in the adductor muscles of the thigh tends to force the lower limb together when walking
slow, shuffling with decreased arm swing and a stooped forward posture
-festination of gait-having to lean forward in order to walk, followed by uncontrollable running to catch up with the center of gravity
uncoordinated, nonrhythmic, sloppy hand movements
tests and indications of cerebellar function
1. finger nose finger
2. heel shin knee
3. rapid alternating movements
4. rebound phenomenon
what are indications of cerebellar dysfunction
1. kinetic or action tremor
4. cerebellar dysarthria
5. cerebellar dysarthria
6. multidirectional nystagmus
left hemisphere of cerebellum
-thick, erratic, jerky or explosive
lesion of cerebellar hemisphere affects what?
unilateral lesions: ischemic infarct, hemorrhage, tumor, ms
bilateral: degenerative or toxic disease
Midline lesion of the cerebellar vermis affects what?
causes: tumor, hemorrhage, ms, and degenerative or toxic disorders, alcoholic cerebellar degeneration
alcoholic cerebellar degeneration
atrophy of anterior superior vermis-trunk and lower limbs
-gait ataxia, truncal unsteadiness, and lower limb dysmetria
begins in school-aged children and gradually worsens
1. spinocerebellar tract lesions
2. patchy loss of cerebellar purkinje cells--limb dysmetria, gait ataxia, dysarthria
3. corticospinal tract lesions-weakness and babinski sign
4. lesions of dorsal root ganglia-absent
5. lesions of dorsal columns
-loss of vibration, position sense and absent relexes
Non-neurological-scoliosis, high arched feet(pes cavus), cardiac hypertrophy, and potentially fatal cardiac arrhythmias
DIAGNOSIS: blood test-multiple trinucleotide repeats from a deficit in chromosome 9
When is choreoathetosis seen?
lesions in the caudate nucleus or its connecting pathways
What type of lesion causes hemiballismus?
lesion in the contralateral subthalamic nucleus
continual sustained and often painful contraction of muscles leading to spasms, turning and twisting of the limbs, head, neck or trunk into unnatural positions or fairly fixed postures
-focal: confined to muscles of the neck or shoulder (cervical dystonia or torticollis)
-generalized: hereditary and progressively disabling
brief, stereotyped often repetitive, focal muscle contractions that appear purposeful such as an eyeblink, facial twitch or sniff
hereditary commonly seen in boys
-accompanied by attention deficit and behavioral disorders
What are movement disorders which accompany encephalopathy?
1. myoclonus-rapid shock like lightning movements or jerks of the limbs and trunk
what is resting tremor of parkinsonism treated with?
essential tremor is treated with what
beta-adrenergic blocker drugs or barbiturates
choreoathetosis hemiballismus and tics may be treated with what
dystonia may be treated with what?
and botulinum toxin injections