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Flashcards in Gait Cerebellar Function Deck (28):
1

What factors contribute to walking?

1. strength
2. coordination
3. postural control
4. sensation
5. memory or concept of walking

2

What does a positive romberg sign indicate?

impaired proprioception, dosal column pathway

3

What does it indicate if someone has their eyes open but can't stand with feet together?

cerebellar problem

4

Broad-based ataxic gait

feet spread
-could be dorsal(worse with closed eyes) or cerebellar

5

Tabetic gait

foot slapping
-tabes dorsalis from neurosyphilis

6

Steppage Gait

food drop or weak dorsiflexion
hip flexed

-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

7

Waddling gait

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

8

Scissors gait

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

9

parkinsonian gait

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

10

dysdiadochokinesia

uncoordinated, nonrhythmic, sloppy hand movements

11

tests and indications of cerebellar function

1. finger nose finger
2. heel shin knee
3. rapid alternating movements
4. rebound phenomenon

12

what are indications of cerebellar dysfunction

1. kinetic or action tremor
2. dysmetria
3. dysdiadochokinesia
4. cerebellar dysarthria
5. cerebellar dysarthria
6. multidirectional nystagmus

13

dysarthria

slurred speech
left hemisphere of cerebellum
-thick, erratic, jerky or explosive

14

lesion of cerebellar hemisphere affects what?

ipsilateral limb

unilateral lesions: ischemic infarct, hemorrhage, tumor, ms
bilateral: degenerative or toxic disease

15

Midline lesion of the cerebellar vermis affects what?

trunk
causes: tumor, hemorrhage, ms, and degenerative or toxic disorders, alcoholic cerebellar degeneration

16

alcoholic cerebellar degeneration

atrophy of anterior superior vermis-trunk and lower limbs
-gait ataxia, truncal unsteadiness, and lower limb dysmetria

17

friedreich's ataxia

autosomal-recessive
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

18

When is choreoathetosis seen?

lesions in the caudate nucleus or its connecting pathways
-Huntingtons

19

What type of lesion causes hemiballismus?

lesion in the contralateral subthalamic nucleus

20

dystonia

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

21

tics

brief, stereotyped often repetitive, focal muscle contractions that appear purposeful such as an eyeblink, facial twitch or sniff

22

tourette's syndrome

hereditary commonly seen in boys
-accompanied by attention deficit and behavioral disorders

23

What are movement disorders which accompany encephalopathy?

1. myoclonus-rapid shock like lightning movements or jerks of the limbs and trunk
2. asterixis

24

what is resting tremor of parkinsonism treated with?

anticholinergics

25

essential tremor is treated with what

beta-adrenergic blocker drugs or barbiturates

26

choreoathetosis hemiballismus and tics may be treated with what

dopamine antagonists

27

dystonia may be treated with what?

anticholinergics
benzodiazepines
and botulinum toxin injections

28

what does a deep brain stimulator inhibiting the thalamus help?

essential tremor