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Flashcards in lesions Deck (62):
1

damaged oculomotor nerve (midbrain)

-IPSILATERAL oculomotor palsy
-diplopia
-dilated pupil

2

damaged cerebellothalamic fibers (midbrain)

-CONTRALATERAL ataxia,
-tremor
-red nucleus hyperkinesias

3

damaged corticonuclear fibers (midbrain)

-CONTRALATERAL facial weakness lower face
-tongue deviation to contralateral side on protrusion
-IPSIlateral trapezius and sternoCM weakness

4

damaged occulomotor fibers (midbrain)

-IPSILATERALoculomotor paralysis
-diplopia,
-dilated pupil

5

damaged cortico spinal fibers (midbrain

contralateral hemiplegia

6

lesion to subthalamic nucleus deficits?

HEMIBALLISUMUS(corticospinal)
= rapid and unpredictable flailing of contralateral extremities; movements are usually more obvious in UE

7

occlusion of lenticulostriate branches to internal capsule: deficits

- CONTRALATERAL hemiplegia (corticospnal)
- loss or decreased pain, temp, proprio (thalamocortical fibers thru posterior capsule)
- maybe: partial CONTRALATERAL paralysis of facial muscles/tongue (genu/corticonuclear fibers)

8

occlusion of distal brances of MCA: deficits

- CONTRALATERAL motor and sensory loss of UE, trunk, face (precentral, postcentral gyri)
- deviation of eyes to ipsilateral side (frontal eye fields)

9

occlusion of distal branches of ACA:deficits

- motor and sensory losses in contralateral foot, leg, thigh (ant. post. paracentral gyrus)

10

antrior watershed infarct: where? deficits?

- ACA/MCA junction
- contralateral hemiparesis (usually leg)
- expressive language
- behavioral changes

11

posterior watershed infarct: where? deficits?

- MCA/PCA junction
- visual deficits
- language problems

12

anterior choroidal artery syndrome: deficits?

- HOMOnymous hemianopsia (optic tract)
- LOWER portions of basal nuclei
- hemiplegia, hemianesthesia (LOWER aspects of internal capsule)

13

clinical presentation of parkinsons

- stooped posture
- resting tremor
- rigidity
- shuffling or festinating gait
- trouble maintaining mvmt (a-, hypo-, or bradykinesia)
- dimentia (later)

14

medial midbrain lesion damages what STRX, what blood vessel

- corticspinal fibers in crus cerebri
- occulomotor nerve
- maybe corticobulbar fibers
- maybe substantia nigra, but usually no noticeable deficits
- paramedian branches of PCA

15

deficits of lesion to corticospinal fibers in crus cerebri?
blood vessel to area?

- CONTRALATERALhemiplegia of UE, trunk, LE (from occlusion of paramedian branches of PCA)

16

deficits of lesion to occulomotor nerve ?
blood to area?

- IPSILATERAL paralysis of eye movement: eye is "DOWN AND OUT"
- pupil dilated, fixed
- paramedian branches of PCA

17

deficits of lesion to corticobulbar fibers in crus cerebri?

- in tongue deviating to OPPOSITE side of lesion upon protrusion
- paralysis of lower half of facial muscles on CONTRALATERAL side

18

central midbrain lesion damages what structures

- oculomotor nerve
- red nucleus and CBELLOthalamic fibers
- maybe ML
- maybe ventral trigeminothalamic fibers

19

deficits of lesion to red nucleus and CBELLOthalamic fibers/

- CONTRALATERALataxia
- tremor of CBELLAR origin

20

pineocytoma can impinge?

- superior colliculi
- cerebral aquaduct
- trochlear/occulomotor nerve
- MLF

21

deficits of pineocytoma?

- paralysis of upward gaze (superior colliculi)
- hydrocephalus (cerebral aquaduct)
- failure of eye mvmt (trochlear/occulomotor nerve)
- nystagmus (MLF)

22

initial signs of uncal herneation

- dilation of pupils (uni or bipolar)
- slow reaction to light
- followed by weakness of occulomotor movement

23

progressive symptoms of uncal herniation

- fully dilated pupils
- eyes deviate laterally b/c of unapposed abducens nerves
- weakness on CONTRALATERAL side (crtocospinal fibers in crus)

24

symptoms of an especially large or bilateral supratentorial lesion

decorticate rigidity
= flexion and adduction of UE; extention of LE with internal rotation and plantar flexion

25

symptoms of an intratentorial lesion

decerebrate rigidity
= UE and LE extended, toes point inward, pronated forearm, head and neck extended

26

opisthotonos symptoms

EXTENDED head and neck

27

midline optic chiasm lesion

- BITEMPORAL hemianopia
- may have relative afferent pupillary defect (RAPD)

28

lateral optic chiasm lesion

- BINASAL hemianopia
- may have RAPD

29

optic tract lesion

- HOMOnymous hemianopia on ipsilateral side
- may have RAPD

30

total optic radiation lesion

- ipsilateral HOMOnymous hemianopia (also in lesion or total primary visual cortex)

31

cuneus lesion

- ipsilateral INFERIOR homonymous quadrantopia

32

lingual gyrus lesion

- ipsilateral SUPERIOR homonymous quadrantopia

33

optic nerve lesion

- ipsilateral blindness in that eye
- loss of pupillary light reflex in both eyes when light is shined into the blinded eye

34

what is enopthalmos

- a slight sinking of the eyeball into the orbit
- often MENTIONED for patients with Horner's, but not always SEEN

35

lesion of the abducens root: muscle, and movement?

- ipsilateral lateral rectus muscle
- loss of lateral gaze
- when looking straight ahead, lesioned eye will deviate SLIGHTLY toward midline

36

lesion of abducens root: complaint

- diplopia
- especially when trying to look toward the lesioned size in the HORIZONTAL plane

37

caudal basilar pontine lesion: symptoms

- alternating hemiplegia (paralysis of lateral rectus on ipsilateral side; paralsis of body on contralateral side)
- diplopia

38

internuclear ophthalmoplegia symptoms

- loss of medial gaze

39

internuclear ophthalmoplegia lesion?

lesion in the MLF on the SAME side as the paralysis

40

lesion of abducens nucleus: damages?

- ALPHA motor neurons to ipsilateral lateral rectus muscle
- interneurons that terminate on alpha motor neurons in the contralateral oculomotor nucleus

41

lesion of abducens nucleus: symptoms

- loss of horizontal gaze in both eyes TOWARD lesion side
- normal horizontal gaze in both eyes AWAY lesioned side
- basically internal opthalmoplegia lesion plus abducens root lesion

42

one and a half syndrome: symptoms

- loss of medial and lateral voluntary eye mvmt on one side
- loss of medial mvmt on the contralateral side

43

one and a half syndrom: damages?

- abducens nucleus on one side
- the MLF right next to affected nucleus
- usually also affects paramedian pontine reticular formation aka "horizontal gaze center"

44

radiculopathy

- results from spinal nerve root damage
- radiating pain in a dermatomal patern
- weakness
- hyporeflexia

45

symptoms of cauda equina syndrome

- weakness of LE
- saddle anesthesia ( sensory deficits )
- urinary retention (decreased sphincter tone)
- decrease in sexual fxn
- sciatica

46

broca's aphasia symptom and location

- inferior frontal gyrus (areas 44/45)
- motor, expressive, nonfluent aphasia
- NO vocal paralysis
- patients are well aware of their deficits

47

telegraphic speech

- associted with broca's aphasia
- familiar single wordes or short phrases with left out words

48

wernicke aphasia

- supramarginal (area 40) and angular gyri (area 39(
- sensory, receptive, or fluent aphasia
- speek freely, but words may not make sense
- may not be aware of their deficits

49

paraphasia

- "word salad"
- associated with wernicke

50

structures that may be affected in uncal herniation

- CBellum
- uncus (temporal lobe)
- hypothalamus
- optic tract

51

aneurysms affecting the occulomotor nerve

aneurysm of basilar bifurcation
aneurysm of posterior communicating/PCA intersection

52

third nerve injury deficits

- dilated pupil
- loss of most eye mvmt
- diplopia

53

angterior choroidal artery syndrome (strx)?

optic tract and crus cerebri

54

damage to vestibular nuclei(medulla)

- nystagmus,
- vertigo
- nausea

55

damage to nucleus ambiguous (medulla)

-dysphagia,
- hoarseness
- deviation of uvula to contralateral side

56

spinal trigeminal tract nucleus

- ipsilateral loss of pain and thermal sense on face

57

conductive deafness

caused by problems of external ear or disorders of the middle ear

58

middle ear causes of conductive deafness

- otitis media
- otosclerosis

59

nerve deafness is from

diseases involving cochlea or the cochlear portion of the vestibulocochlear nerve

60

central deafnes results from

damage to the cochlear nuclie or their central connections

61

damage to cochlear part of the eighth nerve can be from __ and result in ___

vestibular schwaanoma
- tinnitus and or deafness
- presbyacusis (hard time hearing high pitch sound)

62

auditory agnosia is?
it can be from?

difficulty understanding and/or interpreting sounds
damage to secondary auditory cortex in the temporal lobe