Oct2 A1,2-SG1 Neuro map Flashcards
what cortex gives
mental status and UMN (cell body there)
what brain gives
- CN I: smell
- CN II: vision
- position assessment (receives neuron with cell body in muscle)
- vibration assessment (receives neuron with cell body in skin)
- pain assessment (receives neuron with cell body in periphery: skin or muscle)
- temperature assessment (receives neuron with cell body in periphery: skin or muscle)
what brainstem gives
- CN III, IV and VI: EOM
- CN V: face sensation
- CN VII: face muscles
- CN VIII hearing and balance
- CN IX and X: speech and swallowing
- CN XI (SCM and trapezius)
- CN XII : tongue
what cerebellum gives
coordination
what spinal cord contains
- descending and ascending neurons of pain, temp, pos, vibration
- end of UMN from cortex
- cell body of LMN going to muscle via nerve
UMN injury gives what
muscle has
- normal bulk
- increased tone
- increased reflexes
- decreased power
LMN injury gives what
muscle has
- decreased bulk
- normal tone
- decreased power
- decreased reflexes
how motor info goes from cortex to muscle
- UMN body in cortex
- axon goes contralateral after brainstem before spinal cord
- axon stays contralateral and synapses on cell body of LMN in the spinal cord
- LMN goes to muscle contralateral where the UMN body was
how pain and temperature info goes from skin to the brain
- neuron goes to spinal cord
- crosses to contralateral side when reaches spinal cord
- then goes all the way up to the brain
how position and vibration info goes from muscle to brain
- neuron goes to spinal cord and goes to top of spinal cord by staying ipsilateral
- crosses to contralteral side after spinal cord, before brainstem
- then goes all the way up to the brain, in region contralateral to place of position and vibration detection
summary of motor, pain, temp, position and vibration mapping
- UMN goes contralateral after brainstem before spinal cord
- position and vibration go contralateral after spinal cord before brainstem
- pain and temperature go contralateral as soon as enter the spinal cord (at same spinal cord level)
what bilateral findings indicate (like bilateral numbness of the feet)
lesion in PNS (brainstem and spinal cord) bc there, pathways to and from both sides travel close together
(for bilateral finding to be caused by brain lesion, need big thing affecting both cerebral hemispheres)
localization: clumsy, weak leg indicates what
UMN or LMN lesion (weakness exists in lesion of both)
localization: urinary frequency meaning
spinal cord
-because coordination of sphincter relaxation and detrusor muscle contraction happens there
localization: normal mental status meaning
less likely to be a lesion in the cortex
localization: normal cranial nerves on neuro exam indicate what
not brainstem lesion
localization: stiffness and circumduction meaning
UMN
-bc the stiffness (can’t flex hip and knee) is caused by increased tone in the leg
localization: bilateral increased reflexes of the legs meaning
- increased reflexes = UMN
- bilateral = in spinal cord most likely
- so UMN lesion in spinal cord
localization: increased tone on the left leg meaning
UMN lesion
what is the TEST for the Babinski sign
scratch the sole of the foot in a hook shape
what is a negative Babinski test
a flexor plantar response (all toes do plantar flexion)
what is a positive Babinski test (what is a Babinski sign)
an extensor plantar response (the big toe extends/dorsiflexes and the other toes fan out (spce out))
when should you worry about a Babinski sign and what does it indicate
- in someone who is older than 2
- indicates UMN lesion
why does a Babinski sign not significant in children under 2
it can be a normal response because myelination is not completed in the corticospinal tract and so inhibition isn’t complete yet