Flashcards in Neurology p. 470-474 Deck (59):
1
What 2 Spinal tracts are ascending and sense pressure?
Dorsal column
Spinothalamic tract
2
which track has a 2nd synapse on NMJ?
Lateral corticospinal tract
3
Which 2 tracts decussate at the 2ND-ORDER NEURON?
Dorsal column
Spinothalamic tract (Anterolater)
4
Which 2 tracts decussate in medulla?
Dorsal column
Lateral corticospinal tract (pyramidal decussation)
5
Which 2 tracts sense pressure?
Spinothalamic tract
Dorsal column
6
Which 2 tracts cell body in dorsal root ganglion?
Spinothalamic tract
Dorsal column
7
Which tract decussates at anterior white commissure?
Spinothalamic tract
8
Where is the cell body of Lateral corticospinal tract?
cell body in 1° motor cortex
9
Which 2 tracts have a 3RD-ORDER NEURON end in Sensory cortex?
Spinothalamic tract
Dorsal column
10
Which tract sends vibration, fine touch, and proprioception to the cortex?
Dorsal column
11
Atrophy UMN or LMN?
LMN
12
Where does the Lateral corticospinal tract become LMN?
at spinal cord as 2ND-ORDER NEURON
13
Which tract sends
Lateral: pain, temperature
Anterior: crude touch,
Spinothalamic tract
14
Spastic paralysis UMN or LMN?
UMN
15
Which motor neuron sign is seen in both UMN and LMN?
Weakness
16
UMN or LMN in Werdnig-Hoffmann disease? Where is the distruction? And mode of inheritance?
LMN lesions only
destruction of anterior horns; flaccid paralysis.
Autosomal recessive
17
Fasciculations UMN or LMN?
LMN
18
A pt with weakness and fasciculations and spastic paralysis but has no sensory or oculomotor deficits suffers from what spinal coed dz?
ALS
19
Scanning speech, intention tremor, nystagmus are sx of what spinal cord dz?
MS
20
Clasp knife spasticity UMN or LMN?
UMN
21
Reflexes and Tone incr with UMN or LMN?
UMN
22
pt has impaired sensation and proprioception,
progressive sensory ataxia (inability to sense or feel
the legs causing poor coordination). What is the path?
Tabes dorsalis
23
Amyotrophic lateral sclerosis involves UMN or LMN? Name the cause?
both
defect in superoxide dismutase 1.
24
Lesion to what spinal artery destroys all but spares dorsal columns and Lissauer tract? and why is that part spared?
Complete occlusion of anterior spinal artery
because gracilis and cuneatus are supplied by Posterior spinal arteries.
25
⊕ Romberg sign is seen in which 2 spinal cord lesions?
Tabes dorsalis
ALS
Vit B12 def.
Friedreich's ataxia
Ménière's disease
26
Which artery supplies ASA below ∼ T8?
Adamkiewicz
27
MOA of Riluzole and what is treats?
incr modestly survival of ALS
decr presynaptic glutamate release
28
demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts i seen in which path?
Vit B12 def
29
Name 3 demyelination paths of the spinal cord?
MS
Tabes dorsalis
vit B12 def
30
Sx of Syringomyelia?
Where is it seen?
defect in what path?
- Bilateral loss of pain and temperature sensation (usually C8–T1)
- See in Chiari I malformation
- white commissure of spinothalamic tract (2nd-order
neurons)
31
What is frataxin and what path is it seen?
iron binding protein,
32
What test can help dx Polio?
stool sample - Virus recovered from stool or throat.
33
In Brown-Séquard syndrome which finding in is the only Contralateral finding?
pain and temperature loss below level of lesion (due to spinothalamic tract damage)
34
7 year old child presents with kyphoscoliosis, frequent falling and diabetes has a defect on chromosome 9. What is the pathphys and what will be the cause of death?
Friedreich ataxia - defected frataxin causes impairment in mitochondrial functioning. (oxidative stress)
MCC of death: hypertrophic cardiomyopathy around 7years
trinucleotide repeat disorder (GAA)
35
In which 6 paths do we find Horner syndrome?
Any lesion above T1
-Brown-Séquard syndrome
-PICA
-Cavernous sinus syndrome
-Bronchogenic apical lung tumor
-Pancoast tumor
-Clustera headaches
36
In Brown-Séquard syndrome at which levels are UMN sings and at which are there LMN signs?
UMN signs below the lesion
LMN signs at the lesion
37
"--- at the belly butten".
T10
38
"--- at the teat pore."
T4
39
" --- is IL (Inguinal Ligament)."
L1
40
"Down on ALL 4’s "
L4- knees
41
“ --- keep the penis off the floor.”
S2, 3, 4
42
Diaphragm and gallbladder pain referred to the
right shoulder via --- nerve
phrenic
43
Testing for reflexes:
Biceps =
Triceps =
Patella =
Achilles =
Biceps = C5 nerve root.
Triceps = C7 nerve root.
Patella = L4 nerve root.
Achilles = S1 nerve root
44
Level of cremaster reflex?
L1, L2
45
Level of anal wink reflex?
S3, S4
46
Describe Galant reflex?
Stroking along one side of the spine while newborn is in ventral suspension (face down) causes
lateral flexion of lower body toward stimulated side
47
Describe Rooting reflex?
Movement of head toward one side if cheek or mouth is stroked (nipple seeking)
48
Describe Plantar reflex?
Dorsiflexion of large toe and fanning of other toes with plantar stimulation
Babinski sign—presence of this reflex in an adult, which may signify a UMN lesion
49
Describe Moro reflex?
“Hang on for life” reflex—abduct/extend arms when startled, and then draw together
50
Gland for melatonin secretion, circadian
rhythms?
Pineal gland (neroectoderm)
51
CN nuclei that lie medially at brain stem:
III, IV, VI, XII. “Factors of 12, except 1 and 2.”
52
Area for conjugate vertical gaze center?
Superior colliculi
53
Area of midbrain for auditory?
Inferior colliculi
54
Midbrain contains which nuclei?
CN III, IV
55
Paralysis of conjugate vertical gaze due to lesion in superior colliculi Describes? What paths can cause that?
Parinaud syndrome ("suncken eye syndrome")
stroke, hydrocephalus, pinealoma
56
Pons contains nuclei of which CN?
CN V, VI, VII, VIII
57
Medulla contains nuclei of which CN?
CN IX, X, XII
58
Spinal cord contains nucleus of which CN?
CN XI
59