NE 2 Flashcards
(26 cards)
What is browns sequard?
- COntralateral
- ALS (2 segments below)
- Ipsilateral
- PCMLS below level of lesion
- Motor via CSp
- UMN signs
- LMNS signs
What is syringomyelia?
Cystic cavitation of central regions of spinal gray matter
impinge anterior white commisure
- C4-C5
- bilateral loss of ALS, and cape like distribution
- nondiscriminative tactile, nociceptive, thermal
- bilateral loss of ALS, and cape like distribution
May have LMNS signs if ventrial horns affected
May have UMN signs if lateral cortico spinal tract is affected
What is medullary syndrome?
lesion at medial portion of medulla
- contralateral loss of PCMLS,
- ALS in tact
- (dissociated sensory loss)
What is wallenberg syndrome?
“Lateral medullary syndrome”
- vascular lesion to PICA
- supplies ALS and Spino trigeminal nucleus and tract
- CL
- loss of pain and temp over body
- IL
- loss of pain and temp of face
How does the corneal reflex relate to the trigeminal tract?
V1 has cell bodies in V ganglion
TRigemmothalamic fiber send collaterals bilateral into facial motor nucleus of this reflex
in response to a stimulus that touches the cornea , THE EYES BLINK
What are the different lesions of the trigeminial nerve?
- Unilateral lesion
- Anesthesia and loss of genreal sensations in the trigemenial dermatomes
- loss of jaw jerk
- atrophy of muscles of mastication
- loss of IL and consensual corneal reflex
- Alterating analgesisa
- brainstem lesions in the upper medulla may destroy upper fibers
- ipsilateral hemianalgesia of the face and contralateral hemianalgesia of the body
- ALternating trigeminal hemiplegia
- unilateral destruction of the trigeminal nerge and CSp in the pons
- IL
- trigeminal anesthesia and paralysis
- CL
- spastic hemipegia
what is subflacine herniation?
- displaces brain tissue under falx cerebri (supratentorial)
- May comress ACA
- Frontal lobe
- parietal lobe
- may be come transtentorial
- sensory or motor loss of lower limb (from darrens Flashcards)
What is a transtentorial herniation?
- Brain displaced toward the tentorial notch
- compromises the upper brainstem, CN III, and possible Lower structures
- compresses basilar artery and PCAS
- Decorticate rigidity
- decerebrate rigidity
What is an uncal herniation?
uncus an d parahippocamapal are extrudeed over the edge of the tentorium cerebellum through the tentorial notch
impinge on midbrain
What is a tonsillar herniation?
cerebellar tonsils throught he foramen magnum
compression of the medulla and upper spinal cord
Signs of LMN elsions
- A/hypo-reflexia
- hypotonia
- denervation hypersenititivity
- fasciculations
- wasting or atrophy
- flaccid paralysis
LMNS signs are on the same level of lesions
Signs are UMN lesions
- loss of distal extrmity strength and dexterity
- babinski sign (inverted plantar relfex)
- hypertonia
- spasticity
- collapseof resistance at the end fo range of motions
- rigidiity
- basal ganglia disease
- spasticity
- hyper-reflelxia (may be seen as clonus)
- clasp knife phenomen
- UMN signs below level of lesion
Decorticate posture = above red nucleus (midbrain)
Decerebrate posture = below midbrain
What is a decorticate posture?
LEsions above the level of the red nucleus (Mid brain)
THumb tucked under felxed fingers in fisted position, pronation in forearm, flexion at elbow with the lower extemity in extensions with ooot inversion (a bad T rex impresseion )
What is decerebrate posture
lesions below red nucleus (midbrain)
“when you nut but she keeps sucking “
WHat is the anterior cord syndrome?
Compression or damage to anterior part of spinal cord
usually due to spinal cord infarction, intervertebral disc hernation and radiation myelopathy
What is the central cord syndrome?
- compression and damage to central portion of spinal cord
- mechanism of injury is usually cervical hyperextension
What is central seven palsy?
- Lesion of the corticobulbar tract involving the 7th CN
- muscles of upper face are bilateral innervated
- muscles of innervated by the contralateral hemissphere
- lesion rostral to facial motor nucleus results in drooping of muscles at the corner of the mouth
- on side opposite the lesion
Bells palsy is ipsilateral paralysis of upper and lower face
What is spastic cerebral palsy?
- Movement dysfunction
- abnormal supraspinal influences
- failure of normal neuronal selection
- consequent aberrant muscle development
- Motor disorders
- paresis (muscle weakness caused by nerve damage)
- abnormal tonic stretch refelexes
- both at rest and during movement
- reflex irradiation
- lack of postural preparation prior to movement
- abnormal concontraction of muscles
WHAT is ALS?
AMYOTROPHIC LATERAL SCLEROSIS
- destroys somatic motor neurons
- UMNS and brainstem and/or spinal cord LMNS
- Leads to paresis, myoplastic hyperstiffness, hyperreflexia, babinski sign, atrophy, fasciculations, and fibrillations,
- cranial nerve involvement leads to difficulty breathing, swallowing and speaking
what is polyneuropathy?
- involvment of sensory motor and automomic
- progressing from distal to proximal
- due to dyng back or axonal transport
- demyelization may also contribute
- “stocking/glove distribution”
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What is midline ataxia
Ataxic syndromes caused by vestibulocerebellar and spinocerebellar dieases are called midline ataxia
- truncal instability
- titubation: tremor of the trunk in ab anterior posterior plane
- gait taxia
- wide based irregulars steps with lateral veering
- equlibratory (gait) ataxias
- gait atacia: wide based, irregular steps with laeral veeering
What are signs for lesions in the cerebrocerebellum?
- dysarthia
- ataxia gait
- decomposition of movements
- limb ataxia
- dysdiadokinesia
- dysmetria
- action tremor
Wha is appendicular ataxia?
- Dysfunction of cerebellar hemispheres results in ataxia of the extremities (appendicular ataxia)
- ataxia of speech (scanning dysarthria)
- FIndings
- hypotonia
- decomposition of mvoement
- dysmetria: inability to accurately move an intended distance
- dysadiadochokinesia
What are lesions of vestibulocerebellum?
connections between the ebsitubular cerebellum and the flocculonodular lobe
nystagmus
truncal ataxia: diffculty maintainging sitting and standing balance
truncal instability( titubation)
- cant tandem walk
