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Flashcards in Neuropathology 1 Deck (192)
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151

Conductive Aphasia

A: Location of Lesion

B: Clinical Manifestation

A: [Arcuate Fasciculus (tract between Broca & Wernicke)] 

B: [Intermediate version of Wernicke's Aphasia]

152

GLOBAL Aphasia

A: Location of Lesion (3)

B: Clinical Manifestation (3)

A: [Broca + Wernicke + Arcuate Fasciculus] = ALL! 

B: [SEVERELY NONFLUENT / MUTE / poor comprehension]

153

A: Define Prosody

B: Lesions of which area --> AProsody

C: Name the 2 Types of AProsody

A: [Semantic & Emotional meaning] conveyed by the [TIP-Tone/Inflection/Pitch] of Language

B: [Nondominant Hemisphere lesions] in the [mirror image locations of cortical language center]

C: 

-[Sensory Receptive Aprosodia] -  [NonDominant Wernicke's lesion]

-[Motor Expressive Aprosida] - [NonDominant Broca's lesion]

154

[Sensory Receptive Aprosodia]

A: Location of lesion

B: Clinical Manifestation (3)

A:  [NonDominant Wernicke's lesion]

B: Speaks with Prosody but has [Poor prosodic comprehension when listening] and [unable to repeat prosody in others' speech] 

155

[Motor Expressive Aprosodia]

A: Location of lesion

B: Clinical Manifestation (3)

A:  [NonDominant Broca's lesion]

B: DOES NOT SPEAK with Prosody and [unable to repeat prosody in others' speech] but has [Good prosodic comprehension when listening] 

156

A: Describe Gait Apraxia

B: Describe Constructional Apraxia. What lesion causes this?

A: Pt are only unable to walk when commanded to walk, even though they have all the essentials to walk intact

B: PARIETAL LOBE LESION --> pt unable to draw when commanded to draw

Apraxia is not due to sensory/motor/language deficit

157

A: WhatType of Ataxic Gait is in image

B: Location of Lesion causing this (2)

A: [Broad-based Ataxic Gait]

B: 

1. [Dorsal Column and its associations]

or

2. [Cerebellum (Gait is constantly bad regardless of eyes open/close)] 

158

A: WhatType of Ataxic Gait is in image

B: Location of Lesion causing this 

A: [Hemiplegic Ataxic Gait]

B: Stroke

UE: [Upper limb flexed at elbow + DEC armswing] on affected side

159

A: Describe [Tabetic Ataxic Gait]

B: Associated Diseases (2)

A: [Stomping foot gait] where pt forcibly plants feet down on ground to "feel" floor & compesnate for impaired sensation

B: 

1. [Tabes Dorsalis Neurosyphilis]

or

2. [Severe Neuropathy]

160

A: WhatType of Ataxic Gait is in image

B: Causes (3)

A: [Steppage Ataxic Gait]

B: 

1. [peroneal n. lesion]

2. [L5 root lesion]

3. Peripheral Neuropathy

to prevent tripping over the toes, the hip is flexed even higher to elevate the drooping foot, which is lowered to the floor toe first

161

A: Describe [Waddling Ataxic Gait]

B: Associated Disease

A: [Pelvic vs. Hip muscles] can't support body when on 1 leg so swaying/leaning when foot is raised helps = alternatively wadduling like a duck! 

B: Myopathy

162

A: WhatType of Ataxic Gait is in image

B: Location of Lesion causing this

C: Disease Associated (2)

A: [Scissors Ataxic Gait]

B: 

1. CST lesions--> [spastic paraparesis]-->tightness in adductor muscles and knees-->legs cross over each other like scissor blades

C: 

-Cerebral Palsy

-Multiple Sclerosis

163

A: WhatType of Ataxic Gait is in image

B: Disease Associated

C: Describe this gait

A: [Parkinsonian Ataxic Gait]

B: Parkinson's 

C: [Slow shuffling gait] with Stooped forward posture and festination (leaning more & more forward to walk and then runs to catch up with center of gravity). Falls a lot.

164

Cerebellar Function Test:How do you use....

A: Speech

B: Eye mvmnts

C: Limb (4)

A: Dysarthria = slurred speech 2º​ to Articulation problems

B: [Nystagmus with erratic, jerky mvmnt]

C: 

1. Kinetic Tremor (rhythmic oscillations during limb mvmnt)

2. Dysmetria (overshooting/undershooting target)

3. Mvmnt Decomposition (jerky and broken down)

4. [Rebound Check response Deficit] (sudden release of contracted triceps from loss of check response from antagonist muscle-->pt hits himself)

165

A1: Describe Hemispheral Syndrome

A2: Cause

B1: Describe Vermal Syndrome

B2: Cause (2)

A1: Ipsilateral Limb [kinetic tremor/dysmetria/rebound check response loss] 

A2: Any Bilateral lesion in degenerative dz (MS)

B1: TRUNK [truncal unsteadiness with standing / walking / gait ataxia]

B2: 

-Alcoholic Cerebellar Degeneration (ANT SUP vermis atrophy)

-Any Bilateral lesion in degenerative dz

166

Spinocerebellar Degeneration

A: Most common type

B: Pgn

A: [Friedreich's Ataxia]

B: No curative tx and Older pts become wheelchair-dependent

 [Cerebellar and Spinal Cord Nc. and tract are affected]

167

A: Describe Choreoathetosis (2)

B: What areas are affected (3)

C: Causes (2)

A:

[slow continuing limb movements= Athetosis]

[Irregular dancelike movements = Chorea]

B: Limb, trunk and face

C: 

-[Caudate nc. lesion (Huntington's Dz)]

-[Dopaminergic medications]

168

A: Describe Tics

B: What disorder is this associated with? 

A: Brief repetitive contractions of muscle groups  (facial twitch vs. eye blink vs. sniffs vs. grunts)

B: Tourette's (inherited with variable penetrance-mostly boys)

 

169

A: Describe Myoclonus

B: Causes (2)

A: Asynchronous rapid shocklike mvmnts of limbs or body bilaterally

B: 

-Diffuse Encephalopathy (Creutzfeldt Jakob Dz)

-Medical Dz (Renal/Hepatic Failure vs. Anoxia)

170

A: Describe Asterixis

B: Causes (3)

A: Flapping Tremor of hand/foot from [postural tone loss] typically bialterally

B: 

-Diffuse Encephalopathy (Creutzfeldt Jakob Dz)

-Medical Dz (Renal/Hepatic Failure vs. Anoxia)

-Structural brain lesions - will be Unilateral

171

Tx for...

A: Essential Tremor (2)

B: Dystonia (3)

A: [Beta blockers vs. Barbiturates]

B: [Anticholinergics vs. Benzodiazepines vs. Botox]

172

A: [Thalamic RETICULAR nucleus] projects ONLY to _____ and NOT the _____. Neurons of this nuclei are ___ _____.

B: Thalamic Axons passing thru (incoming & outgoing) give off ____ which travel to [Thalamic RETICULAR nucleus].

C: Main Purpose of [Thalamic RETICULAR nucleus] is to inhibit _____ and therefore Enhances activity of _______

[Thalamic RETICULAR nucleus] projects ONLY to other thalamic nuclei and NOT the Cerebral Cortex. Neurons of this nuclei are [inhibitory GABAergic].

B: Thalamic Axons passing thru (both incoming & outgoing) give off collaterals to [Thalamic RETICULAR nucleus].

C: Main Purpose of [Thalamic RETICULAR nucleus] is to inhibit random background sensory activity ---> Enhances salient activity of 1 area of thalamic neurons.

173

A: What Thalamic Afferents travel TO the [ANTERIOR nc.]? [2]

B: Where does the Efferent fibers of the [ANTERIOR nc.] project to?

C: What type of Thalamic nucleus is the [ANTERIOR nc.]

[ANTERIOR nc.]

A: Aff= Mammillary body & Hippocampus ---> nc

B: Eff= nc---> projects to Cingulate Gyrus

C: [Specific Relay nuclei]

174

A: What Thalamic Afferents travel TO the VA[VENTRAL Anterior nc.]?

B: Where does the Efferent fibers of the [VENTRAL Anterior nc.] project to?

C: What type of Thalamic nucleus is the [VENTRAL Anterior nc.]

[VENTRAL Anterior nc.] A: Aff= Basal ganglia ( [substantia nigra] ) ---> nc

B: Eff= nc---> projects to PreFrontal Cortex

C: [Specific Relay nuclei]

175

A: What Afferents travel TO the Thalamic [VL>ant] nc. B: Where does the Efferent fibers of the Thalamic [VL>ant] nc. project to? C: What type of Thalamic nucleus is the [VL>ant]

[VENTRAL Lateral nc.]>ANT part (VL>ant)

A: Aff= Basal ganglia ([Globus Pallidus])---> nc

B: Eff= nc---> projects to Supplementary motor area C: [Specific Relay nuclei]

176

A: What Afferents travel TO the Thalamic [VL>PoST] nc.

B: Where does the Efferent fibers of the Thalamic [VL>PoST] nc. project to?

C: What type of Thalamic nucleus is the [VL>PoST]

[VENTRAL Lateral nc.]>PoST part

A: Aff= Cerebellum---> nc

B: Eff= nc---> MOTOR CORTEX

C: [Specific Relay nuclei]

177

A: What Afferents travel TO the Thalamic [VPM] nc. B: Where does the Efferent fibers of the Thalamic [VPM] nc. project to? C: What type of Thalamic nucleus is the [VPM] D: What type of info specifically is this Thalamic nucleus involved with?

[VENTRAL POSTEROMEDIAL nc.] A: (Somatic) Aff= Head --> nc B: Eff= nc---> Somatosensory Cortex C: [Specific Relay nuclei] D: Involved with relaying Vestibular information

178

A: What Afferents travel TO the Thalamic [VPL] nc. (2) B: Where does the Efferent fibers of the Thalamic [VPL] nc. project to? C: What type of Thalamic nucleus is the [VPL] D: What type of info specifically is this Thalamic nucleus involved with?

[VENTRAL POSTEROLateral nc.] A: (Somatic) Aff= [Trunk&Limbs] --> nc B: Eff= nc---> Somatosensory Cortex C: [Specific Relay nuclei] D: Involved with relaying Vestibular information

179

A: What Afferents travel TO the Thalamic [Lateral Geniculate] nc. (2) B: Where does the Efferent fibers of the Thalamic [Lateral Geniculate] nc. project to? C: What type of Thalamic nucleus is the [Lateral Geniculate]

[Lateral Geniculate nc.] A: Aff= Optic Tract & [SUP colliculus] --> nc B: Eff= nc---> [Area 17 CPVC] C: [Specific Relay nuclei]

180

A: What Afferents travel TO the Thalamic [medial Geniculate] nc. B: Where does the Efferent fibers of the Thalamic [medial Geniculate] nc. project to? C: What type of Thalamic nucleus is the [medial Geniculate]

[medial Geniculate nc.] A: Aff= [inf colliculus] --> nc B: Eff= nc---> Primary Auditory Cortex C: [Specific Relay nuclei]