Lesions and Diseases Flashcards
(67 cards)
1
Q
spinal root damage leads to ____
A
radiculopathy
2
Q
common causes for radiculopathy
A
intervertebral disc disease/protrusion
spondylolysis
3
Q
radiculopathy symptoms
A
pain radiating in a root or dermatomal distribution, weakness, and hyporeflexia of the muscles served by the affected root
4
Q
common levels of radiculopathy
A
C6-C7
C5-C6
L4-L5
L5-S1
5
Q
lumbar puncture
A
between L4-L5 or L3-L4 to collect a sample of cerebrospinal fluid from the lumbar cistern
6
Q
cauda equina syndrome
A
seen when extruded disc impinges on the cauda equina or tumor, trauma, other conditions
- bilateral symptoms
- significant weakness, paraplegia and hypo or areflexia of LE
- saddle anesthesia
- urinary retention or incontinence, decreased sphincter tone, and fecal incontinence
- decrease in sexual function
- possible LBP or sciatica
7
Q
broca’s aphasia
A
lesion in inferior frontal gyrus (44, 45)
- also called motor, expressive, or nonfluent aphasia
- difficulty turning ideas into meaningful speech
- aware of deficit and may have mutism or slow, labored speech that consists of words left out (telegraphic speech)
8
Q
Wernicke aphasia
A
lesions in the supramarginal and angular gyri
- also called sensory, receptive, or fluent aphasia
- speak freely and without hesitation, but make little sense (paraphasia or word salad)
- unaware of deficit
9
Q
lesion of precentral gyrus
A
motor deficits on contralateral side of body
10
Q
lesion of postcentral gyrus
A
loss of sensory perception on contralateral side of body
11
Q
lesion of visual structures caudal to the optic chiasm
A
contralateral homonymous hemianopia or quadrantanopia
12
Q
infarction of ACA at paracentral branches
A
motor/sensory deficit of lower extremity, hip, and lower trunk b/c in the longitudinal fissure
13
Q
aneurysm at basilar bifurcation
A
CN III injury
14
Q
aneurysm of posterior communicating and PCA intersection
A
CN III injury
15
Q
aneurysm of superior cerebellar artery
A
CN III injury
16
Q
CN III injury symptoms
A
dilated pupil
loss of eye movement
diplopia
17
Q
aneurysm of anterior communicating artery
A
CN II injury
18
Q
aneurysm of anterior cerebral artery
A
CN II injury
19
Q
aneurysm of internal carotid artery
A
CN II injury
20
Q
aneurysm of aberrant branches of superior cerebellar artery
A
CN V injury
21
Q
aneurysm of labyrinthine artery
A
CN VI injury
22
Q
aneurysm of anterior inferior cerebellar artery
A
CN VI injury
23
Q
aneurysm of aberrant branch of anterior inferior cerebellar artery
A
CN VII injury
24
Q
CN of pons-medulla junction
A
VI, VII, VIII
25
CN of the cerebellopontine angle
VII, VIII, IX, X
26
vestibular schwannoma
CPA lesion - CN VII and VIII
27
meningioma of the skull base
CPA lesion
28
CPA lesion
possible injury to CN VII, VIII, IX, X
| possible injury to CN V if > 2 cm
29
tumor of the jugular foramen
CN IX, X, XI
30
anterior choroidal artery syndrome
contralateral hemiplegia (crus cerebri damage) and contralateral hemianopia (optic tract damage)
31
colloid cyst
congenital growth that causes obstructive hydrocephalus in adults
- HA, unsteady gait, weakness of LEs, visual or somatosensory disorders, and/or personality changes or confusion
- enlarged lateral ventricle
- thinning of corpus callosum
32
fetal PCA
PCA perfused from internal carotid artery
| -also called persistent fetal PCA
33
azygous ACA
one internal carotid artery gives origin to both right and left ACA
34
artery of Percheron
single stem vessel originates from one P1 and branches to serve both thalami
-occlusion affects cortical arousal, consciousness, and contributes to drowsiness, stupor, or coma
35
aneurysms of medial striate artery
damage to optic nerve, chiasm, and tract, adjacent gyri of the frontal lobe, subarachnoid cisterns, and lamina terminalis
36
hemorrhage of lenticulostriate artery
lesion within the hemisphere with sparing of the cerebral cortex
37
intraxial brainstem lesions frequently result in _____ deficits
both sensory and motor
38
stereoanesthesia
vibratory sensation, lesion of peripheral nerves that results in an inability to perceive proprioceptive and tactile sensations
39
graphesthesia
position sense
40
tactile localization
discriminitive touch
41
Brown-Sequard syndrome
ipsilateral loss of vibratory sensation, position sense, and discriminitve touch below the level of lesion in the posterior column
42
causes of bilateral stereoanesthesia
tabes dorsalis [tabetic neurosyphilis] or subacute combined degeneration of the spinal cord
43
bilateral stereoanesthesia, ataxia, loss of muscle stretch reflexes, severe lancinating pain over the body below the head, bladder dysfunction
tabes dorsalis
44
tabes dorsalis symptoms
bilateral stereoanesthesia, ataxia, loss of muscle stretch reflexes, severe lancinating pain over the body below the head, bladder dysfunction
45
type of ataxia seen in posterior column lesions
sensory ataxia
46
sensory ataxia
lack of proprioceptive input and position sense
47
subacute combined degeneration of the spinal cord symptoms
1. posterior column involvement
2. corticospinal tract damage: spastic weakness of legs, increased muscle stretch reflexes [hyperreflexia], Babinski sign
48
1. posterior column involvement
2. corticospinal tract damage: spastic weakness of legs, increased muscle stretch reflexes [hyperreflexia], Babinski sign
subacute combined degeneration of the spinal cord
49
medial lemniscus lesion rostral to sensory decussation
contralateral losses that include the entire body excluding the head
50
large lesion in the forebrain
complete contralateral loss of modalities carried in posterior columns and anterolateral symptoms, or may produce pain or paresthesia (thalamic syndrome)
51
posterior column lesion
ipsilateral loss of proprioception, discriminitive touch, and vibratory sense below lesion
52
spinal cord hemisection
- ipsilateral loss of proprioception, discriminitive touch, and virbatory sense below lesion
- contralateral loss of pain and thermal sensation beginning 2 levels below lesion
- ipsilateral paralysis below lesion
- ipsilateral Horner syndrome if lesion is at a cervical level
53
medial lemniscus lesion in medulla
loss of proprioception, discriminitive touch, and vibratory sense of contralateral extremities
- tongue weakness: deviates to ipsilateral side on protrusion
- hemiplegia of contralateral extremities
54
lesion in caudal pons
- proprioception and pain/thermal loss to contralateral extremities
- ipsilateral facial and lateral rectus paralysis (CN VII, VI)
- loss of pain/thermal sense on ipsilateral face
- ipsilateral Horner syndrome
55
lesion in mid-to-rostral pons
- loss of proprioception, discriminitive touch, and virbatory, pain, and thermal senses on contralateral extremities
- loss of discriminitive touch, pain, and thermal sense on ipsilateral side of face; paralysis of muscles of mastication if trigeminal nuclei are involved
56
lesion in posterior column-medial lemniscus system in midbrain
loss of proprioception, discriminitive touch, and vibratory sense on contralateral LE (and UE if medial part involved)
-loss of pain and thermal sensation on contralateral extremities
57
lesion at ventral posterolateral thalamic nucleus
- diminution/losss of proprioception, discriminitive touch, vibratory sense, pain, and thermal sense on contralateral extremities, plus face and oral cavity if VPM involved
- paresthesias
- transient right hemiplegia
58
syringomyelia
damage to anterior white commissure by a cavitation in the central cord area
-bilateral loss of pain and temperature sensations in a dermatomal distribution
59
hydromyelia
central cord cavitation lined by ependymal cells
60
acute cervical cord syndrome
vascular lesions in the spinal cord
| -bilateral and splotchy loss of pain and thermal sense below the lesion (dual vascular supply)
61
posterior inferior cerebellar artery syndrome
vascular lesion in lateral medulla --> ALS
| -loss of pain and thermal sensation over the entire contralateral side of the body and ipsilatearl face
62
anterior inferior cerebellar artery occlusion
vascular lesion in lateral pons --> ALS
| -loss of pain and thermal sensation over the entire contralateral side of the body and ipsilatearl face
63
thalamic syndrome
profound loss of posterior column and anterolateral system
- intractable pain
- paresthesias
64
anterolateral quadrant lesion
-loss of pain/thermal sensation beginning about 2 levels below lesion on the contralateral side of body
65
lesion of spinal trigeminal tract and nucleus and ALS in medulla
loss of pain/thermal sense on contralateral extremities and ipsilateral side of face
- dysarthria and dysphagia (nucleus ambiguous)
- vertigo, ataxia, and nystagmus (vestibular nucleus; restiform body)
- nausea, vomiting, and singultus (area postrema, reticular formation)
- ipsilateral Horner
66
lesion in ALS of midbrain
loss of pain and thermal sensation of contralateral extremities
-loss of proprioception, discriminitive touch, and vibratory sense on contralateral LE (and UE if medial part of ML involved)
67
lesion to ventral posterolateral nucleus
diminution/loss pain, thermal, and vibratory senses, discriminitive touch, and proprioception on contralateral face and oral cavity and contralateral extremities
- paresthesias on contralateral face, trunk, extremities
- transient contralateral hemiplegia
