S3: Pathway Lesions and SX Flashcards Preview

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Flashcards in S3: Pathway Lesions and SX Deck (20)
1

Ipislateral loss of epicritic sense can occur from X of the

Dorsal column/lemniscal sys.

1. dorsal root axons

2. gracile or cuneate fasiculus (spinal cord)

3. gracile or cuneate nuceli (medulla)

2

Contralateral loss of epicritic sense can occur from X of the

1. medial lemniscus going up the medulla, pons, midbrain to thalamus

2. VPL in thalamus

3. post central gyrus

3

what does loss of epicritic sense include?

loss of

1. sterogenesis (cant recognize tactile shapes in hand)

2. position sense - can lead to shuffling gait, reaching inaccuracies

3. loss of vibration - insesntive to high frequency stimulation

3. simpe touch intact but sensitivity decreased

 

4

why is EPICRITIC information coming into the spinal cord suspectible to injury?

it comes in as large diameter dorsal root axons -- vulnerable to insult from ischemia, toxicity, bacteria, etc

 

so: early sx of peripheral nerve disease shows as epicritic

 

5

ipsilateral loss of protopathic informaiton is seen witn

ALS

1. dorsal root axons

2. lissaeurs tract or dorsolateral fasciulus

3. dorsal horn

6

spinocerebellar carries ___ information from the ___

proprioceptive (muscle and joint position) from the trunk and limbs

7

ipislateral loss of propathic from head and neck

caused by X of 

1. spinal tract of CN 5

2. spinal n. of 5 in the medull

8

contralateral loss of propathic from head and neck

caused by X of 

1. after the spinal nulceus in the medulla (where it crosses) so a pons or midbrain region

2. in the vpm 

9

loss of proprocpetive from face on the same side can be due to

X trigmeminal nerve

X mescephalic nucleus of 5

X menscephalic tract of CN 5

X motor n. of 5 in the pons 

X cerebellum

10

loss of chewing on the same side can be caused by

 X motor n. of 5 in the pons

X trigeminal nerve 

11

corticobulblar controls hypoglossal cranial nerve ncueli mostly

contralaterally

12

corticobulblar controls facial  cranial nerve ncueli mostly

both

13

  The bilateral projections from the surviving CB can sustain considerable movement on both sides of the patient

 

Usually only the___ and ___ are affected by a unilateral CB lesion

tongue and face (CN 7)

14

damage to the corticospinal in the brainstem therefore impairs movement mainly on the ____ side of the body. 

opposite

 

since mostly lateral corticopsinal which crosses and the pyrmida decessations

15

unilateral patholgoy of the corticobulbar tract sx

will weaken movement of the head and neck opposite of the X

does not significantly weakend since most cn actually get bilateral input from CB

16

damage to lateralc orticiospinal tract occurs with

X to the tract below the pyramids decussations in the medulla

17

In the few surgical case studies of isolated CS damage (lesion of the medullary pyramid), the sx were

modest: temporary weakness, permanent Babinski’s sign, and permanent loss of independent finger movements.

 

mostly the pyramidal tracts are damaged with the brainstem tracts so sx area outright pralysis

18

Frontal lobe lesions often cause ___ 

severe paralysis because the precentral (motor) and premotor areas of cortex contribute to both direct and indirect motor pathways

19

damage to a Brainstem-spinal pathways at the level of the medulla wiill cause

problems with movement on the opposite side of the body

20

damage to a Brainstem-spinal pathways at the level of the spinal caord wiill cause

problems with mvoement on the same side of the body