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Summary of Lesion Patterns Flashcards

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1
Q

Characteristics signs and symptoms of Cerebrun

A

a combination of UMN signs and disturbed cognitive function of mood

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2
Q

Consciousness is housed in the cortex of the _______

A

cerebrum

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3
Q

Stroke is a problem in the area of…..

A

Cerebrum

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4
Q

Alzheimer’s disease is a problem in the area of….

A

cerebrum

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5
Q

CJD disease is a problem in the area of….

A

cerebrum

- spongiform encephalopathy / prion disorder

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6
Q

Characteristic signs and symptoms of Basal Nuclei

A

mainly extrapyramidal motor signs: bradykinesia, akinesia, pill-rolling tremor, resting tremor, stooped posture, myerson’s sign, choreiform movement signs

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7
Q

The patient who suffers from basal nuclei disease only can…..

A

understand you, they can attempt to do what you ask….. they will have trouble DOING things

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8
Q

Parkinsons is a problem with

A

Substantia nigra (basal nuclei)

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9
Q

Name the basal nuclei

A

Caudate, putamen, Globus pallidus, substantia nigra, subthalamic nuclei

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10
Q

Huntington’s disease is a problem with the

A

caudate nucleus

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11
Q

Characteristic signs and symptoms of Cerebellum damage include

A
  • combination of ataxia and dystaxia
  • –swaying when standing with a narrow base, vertigo, nystagmus, hypotonia, decomposition of movement
  • General weakness and fatigue (think MS)
  • recent evidence shows cerebellum contributes to cognition and affective state
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12
Q

MS is a problem with the

A

Cerebellum

- predilection for demyelinating the dorsal spinocerebellar tract

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13
Q

Brainstem signs and symptoms

A
  • high incidence of cranial nerve problems with crossed pattern involvement (the face on the lesion side and the body on the opposite side)
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14
Q

Weber syndrome

  • location in BS
  • CN #
  • info
A
  • Midbrain
  • ipsilateral CN III palsy and contralateral hemiparesis/hemiplegia
  • stroke: paramedian branches of posterior cerebral artery
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15
Q

Medial Pontine Syndrome

  • location in BS
  • CN #
  • info
A
  • Pons
  • Ipsilateral CN VI palsy and contralateral hemiparesis/hemiplegia
  • stroke: paramedian branches of the basilar artery
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16
Q

Lateral medullary syndrome

  • location in BS
  • info
A
  • medulla
  • contralateral PTLT loss with ipsilateral cranial nerve palsies
  • especially ipsilateral loss of PTLT of the face

-AKA Wallenberg syndrome, PICA stroke

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17
Q

Characteristics of a spinal cord injury (myelopathy)

A
  • sensory disturbance below the level of the lesion (paint and temp would be lost contralaterally, and touch/CP would be lost ipsilaterally
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18
Q

Characteristics of a spinal cord injury (myelopathy)

A
  • sensory disturbance below the level of the lesion (paint and temp would be lost contralaterally, and touch/CP would be lost ipsilaterally
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19
Q

At the level of Myelopathy, _____ lesion signs are apparent

A

LMN

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20
Q

Below the level of myelopathy, _____ lesion signs are apparent

A

UMN

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21
Q

After myelopathy, superficial reflexes are ____

A

decreased

-abdominal, cremasteric, anal

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22
Q

Expansile lesions will typically produce ……

A

upper extremity weakness that gradually descends to the trunk and lower extremity

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23
Q

Hemisection of the cord is also called

Study These Flashcards
A

Brown Sequard Syndrome

24
Q

An example of an expansive lesion is a

25
Examples of compressive lesions are
cervical disc herniation, central cord syndrome
26
What is a congenital malformation causing myelopathy
syringomeylia
27
Compressive lesions will typically produce.....
an ascending pattern of motor weakness
28
What is a congenital malformation causing myelopathy
syringomyelia
29
Compressive lesions will typically produce.....
an ascending pattern of motor weakness
30
T/F a lower extremity neurological examination may reveal signs of cervical spine involvement
True | - perform a complete upper and lower extremity exam
31
Central cord syndrome
- often caused by serious flexion/extension injuries - has similar SSX with syringomyelia - -bilateral loss of PTLT at the levels of the cord affected by the lesion
32
Posterior Cord Syndrome
- stroke/damage to the posterior spinal artery - the PSA only perfuses the DWC, so the only loss is bilateral conscious touch and proprioception - (could be confused with tabes dorsalis)
33
Anterior cord syndrome
- stroke/damage to the anterior spinal artery - the ASA perfuses all of the cord except for the DWC - loss includes bilateral paralysis and bilateral loss of PTLT
34
Anterior horn cell/ Lateral sclerosis (ALS) | - if truly just the GSE is affected (POLIO), then only _____ signs will appear
LMN | -weakness, flaccid paralysis
35
If lateral sclerosis (ALS), then signs will include
- a combination of UMN and LMN S/SX | - LMN signs will predominate eventually
36
_____ + _____ (motor loss/atrophy) commonly occur in LMN lesions
Fasciculations + weakness
37
ALS includes only _____ signs
MOTOR; both upper and lower motor neuron signs
38
In polio, there are only ______ deficits
LMN
39
In Guillian-Barre syndrome....
complete PNS demyelination; therefore both motor and sensory signs, but only LMN
40
Erb/ Erb-Duchene Palsy
- brachial plexus upper trunk - weakness if C5-6 innervated muscles (deltoid, biceps, rhomboids, supra and infraspinatus, wrist extensors - hyporeflexia - finger and hang movements are relatively spared - common MOI: traction on an infants shoulder during delivery; motorcycle accidents
41
Klumpke's palsy
- brachial plexus lower trunk injury - weakness in C8-T1 innervated muscles (hand and finger weakness, atrophy of hypothenar muscles, sensory loss on the ulnar aspect of the hand & forearm, and hyporeflexia) - common causes: upward traction (such as grabbing a branch during a fall from a tree) and pancoast syndrome (atypical lung tumor)
42
In Klumpke's, If the T1 nerve root is damaged proximal to the sympathetic trunk, there also may be an associated.....
Horner's syndrome
43
TOS
- compression of the brachial plexus - most often weakness/atrophy of C8 and T1 innervated muscles and sensory loss (C8 + T1) - must be DDX from lower trunk injury/neuritis, nerve root lesions and peripheral n. lesions - orthos: adsons, costoclaviclar, wrights
44
MCC of TOS is
postural alterations
45
Signs and symptoms in lumbosacral plexus includes
- L1 - S4 innervated muscles | - corresponding sensory deficit and hyporeflexia
46
MC compression of lumbosacral roots (S1) is:
By disc material (L5-S1) and osteophytes - other causes include compression of the sciatic nerve by the piriformis m.
47
Spinal nerve root symptoms
- pain and numbness following a related dermatome pattern (mainly distal pain) - hypesthesia (decreased sensation) of a related dermatome - weakness often associated with low back or neck pain - atrophy is a late sign - hyporeflexia or areflexia - corresponding nerve root tension signs and symptoms
48
Common causes of spinal nerve root problems:
- disc herniation | - osteophytes
49
Peripheral nerve signs and symptoms:
- sensory complaints following a CUTANEOUS pattern - weakness associated with a particular muscle or a group of muscles innervated by the specific peripheral nerve - atrophy is possible - normal reflexes are typical - corresponding nerve tenderness (tinsel’s sign present)
50
Common cause of peripheral nerve signs and symptoms?
Nerve compression/entrapment
51
Myo-neural Junction signs and symptoms:
- usually more apparent with muscles supplied by cranial nerves - repeated contraction causes progressive weakness; rest is helpful
52
Examples of neuromuscular junction (myo-neural junction) disorders:
- myasthenia Travis - botulism - tetanus
53
Myopathy (proximal muscular problem) signs and symptoms:
- proximal weakness first - no sensory findings - reflexes may be normal
54
Myopathy examples
- typical of muscular dystrophy - myasthenia gravis - inflammatory disorders of muscle
55
Systemic conditions signs and symptoms
- Distribution of paresthesia/pain/weakness involves multiple peripheral nerves (peripheral neuropathy; mononeuritis multiplex) or is atypical - other associated symptoms = weight change, fatigue, poly-phagia/Uria/dypsia, skin change - family history or past/current history of the particular disorder
56
Examples of systemic conditions
- cases of peripheral neuropathy (caused by (for example) diabetes, alcoholism, pernicious anemia) may demonstrate Achilles hypo or areflexia upon exam - metabolic storage conditions, enzyme deficiencies, and other genetic problems may affect the nervous system as well as other organ systems

NDX (2 decks)

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