II- Clinical Localization and Its Diagnostic Significance Flashcards
(77 cards)
1
Q
Give me the areas of dysfunction.
A
- Meninges
- Cortex
- Diencephalon (basal ganglia, thalamus, internal capsule)
- Brainstem (pons, midbrain, medulla)
- Cerebellum
- Spinal Cord
- Peripheral Nerve
- Autonomic Nervous System
- Neuromuscular Junction
- Muscle
2
Q
Give me the Meningeal Diseases
A
- Meningitis
- Subarachnoid Bleeds
- Chemical irritation of meninges
- Tumors stretching meninges
3
Q
What type of disease is meningitis?
A
Infectious Disease
4
Q
What type of disease is subarachnoid bleed?
A
Vascular Disease
5
Q
What type of disease is chemical irritation of meninges?
A
Traumatic Disease
6
Q
What type of disease is tumor stretching meninges?
A
Neoplastic Disease
7
Q
Diseases affecting the cortex
A
- Strokes
- Encephalitis (infectious)
- Demyelinating Disease
- Tumors
- Trauma
- Congenital
- Metabolic
- Degenerative
8
Q
Diseases of the basal ganglia
A
- Parkinson’s Disorders
- Movement Disorders (usually degenerative disease)
- Strokes (Putaminal bleed is common)
- Infarcts of candelabra branches of middle cerebral artery
- tumors
9
Q
Diseases affecting thalamus and internal capsule
A
- Strokes (both infarcts and thalamic bleed) Internal capsular lacunar stroke is common
- Tumors
- Demyelinated Disease (internal capsule)
10
Q
Diseases affecting the brainstem
A
- Stroke (bleed and infarcts)
- Tumors (2/3 pediatric tumors)
- Demyelinated Disease
- Infections ( brainstem encephalitis or bickerstaff)
- Craniopathies
11
Q
Cerebellar Diseases
A
- Strokes
- Tumors
- Brain abscess
- Demyelinated disease
- Trauma
- Congenital (dandy walker syndrome)
12
Q
Spinal Cord Disease
A
- Trauma
- Tumors
- Demyelinating Disease
- Infections (viral: transverse myelitis) (tuberculosis: potts disease)
- Vascular (infarcts or AVM)
- Congenital (spinal muscular atrophy)
13
Q
Peripheral Nerve Disease
A
- Neuropathies (polyneuropathy, mononeuropathy, mononeuropathy complex)
- Trauma
- Demyelinated Disease: Guillain-Barre Syndrome
- Degenerative Disease (Charcot Marie Tooth)
14
Q
Disease of the Muscle
A
- Myopathies
- Infectious (polymyositis, dermatomyositis)
- metabolic (hypokalemic paralysis)
- Congenital (muscular dystrophy)
15
Q
stiffness of flexion of head (neck stiffness)
A
nuchal rigidity
16
Q
- start with knees flexed, then extend the knee
- sign
A
- Kernig’s sign
- Pain in the back area
17
Q
- flex the head
- sign
A
- Brudzinski’s Sign
- Flexion of the head, flexion of the knee.
18
Q
reponsible for the voluntary movement and for all conscious awareness
A
cortex
19
Q
cortical signs
A
- Aphasia
- Apraxia
- Agnosia
- Visual field defects (homonymous hemianopsia and bitemporal hemianospia)
20
Q
- tap the glabella while asking the patient to keep the eyes open
- sign
A
- Glabellar Tap or Meyerson’s Reflex
- Everytime you tap, the patient blinks the eyes
21
Q
Frontal release signs implies what?
A
Lobe dysfunction
22
Q
- Stroke the inner palm
- sign
A
- Grasp reflex
- Thumb will adduct
23
Q
- stroke the thenar eminence of the palm
- sign
A
- Palmomental reflex
- dimpling under the chin
24
Q
it resides under the cortex
A
diencephalon
25
gray matter contains what structure?
basal ganglia and thalamus
26
white matter contains what structure?
internal capsule
27
too much movement
hyperkinesia
28
irregular jerk of hands or feet (distal irregular movements)
chorea
29
snake like movement
athetosis
30
wild flailing movement of UE and LE
ballismus
31
accumulating snake like movement (more prolonged)
dystonia
32
rigidity by examining the UE
bradykinesia
33
when there is tremors, when patient is not moving then absent when patient is moving
resting tremors
34
3 types of tremors
1. resting tremors
2. intention/essential tremors
3. physiologic tremors
35
cortex basal ganglia loop and present at rest, but when you move the extremity, tremors are absent
resting tremors
36
brainstem cerebellar loop (red nucleus-midbrain) , at rest there is no tremor but when a person moves, there are tremors.
intention/essential tremors
37
spinal cord muscle loop, fine tremors, and these are enhanced tremors in certain people when they are nervous or anxious
physiologic tremors
38
this type of tremors are not specific to basal ganglia and irregular, non-rhythmic jerks seen proximally, and either from cortical or spinal origin
myoclonus
39
these part of the diencephalon have non-specific signs of sensory loss or paralysis but allude this area for exclusion
thalamus and internal capsule
40
cerebellar signs
1. ataxia
2. titubation
3. dysmetria
4. dysdiadochokinesia
41
wide based gait
ataxia
42
whenever the medial malleoli to medial malleoli distance is more than 3 inches
ataxia
43
when a px has a to and for movement of the head or the body (either back and forth to side to side movement)
titubation
44
do this by finger to nose test heel to shin test
dysmetria
45
abnormalities in alternating movement
dysdiadochokinesia
46
what is the one prerequisite to consider that it is a cerebellum affectation?
motor strength is normal
47
have two phases: rapid phase and correcting slow phase
nystagmus
48
nystagmus may be due to:
1. vestibular nuclei
2. cerebellum
3. paresis of eye muscles
49
what structure is affected if the most prominent signs are cranial nerve dysfunction?
brainstem
50
what CN are seen in the brainstem?
CN 3, 4, 5
51
paralysis of downward or medial eye movement
midbrain
52
ptosis, medial rectus palsy, and dilated non-reactive pupils. what structure is affected?
midbrain
53
infratentorial means
ipsilateral
54
supratentorial means
contralateral
55
no vertical eye movement. what cranial nerve?
CN3
56
this means eyes are to one side, not always pontine.
preferential gaze
57
both eyes move together
frontal gaze center
58
one eye may not move with the other eye
pontine gaze center
59
this structure involves the cranial nerve 7
pons
60
eyes cannot abduct; eyes are towards the middle. what condition?
lateral rectus palsy
61
distinguish from central type
peripheral nerve palsy
62
pt cannot lift the eyebrow
peripheral
63
pt can life the eyebrow
central
64
poor gag reflex
dysphagia
65
deviated uvula. what CN is responsible?
CN 9 and CN 10
66
1. due to pharyngeal involvement. what condition is this?
2. What CN responsible?
1. dysphonia
2. CN 10
67
deviated tongue. what CN responsible?
CN12
68
1. localizing; specific to the level; lesion is plus or minus.
2. What structure is affected?
1. dermatomal cuts
2. spinal cord
69
distribution of paralysis in spinal cord.
quadriplegia or hemiplegia
70
Sx: urinary or bowel incontinence. What structure is affected?
spinal cord
71
seen when the corticospinal tract is damaged. what can you infer from the Sx?
hyperreflexia and babinski
72
1. hyporeflexia
2. sensory loss follows nerve distribution
3. paralysis fits nerve distribution
4. paralysis-distal
what structure is affected?
peripheral nerve
73
1. pure motor loss
2. proximal paralysis (pectoral and pelvic girdle)
3. no sensory abnormality
what structure is affected?
muscles
74
cerebral cortex. what cranial nerve are on this structure?
CN 1 and CN 2
75
midbrain. what cranial nerve are on this structure?
CN 3, 4, & 5
76
pons. what cranial nerve are on this structure?
CN 5, 6, 7, 8
77
medulla. what cranial nerve are on this structure?
CN 5, 8, 9, 10, 11, 12
