Tuesday [18/4/23] Flashcards
(36 cards)
what are lower motor neurone lesions?
lesions anywhere from the anterior horn of the spinal cord, peripheral nerve, NMJ, or muscle. This causes hyporeflexia, flaccid paralysis, atrophy
difference between UMN lesions and LMN lesions
difference between LMN and UMN is flaccid paralysis - paraylsis accompanied by loss muscle tone. Contrast to UMN lesion which often presents with spastic paralysis and severe hypertonia
What are the most common causes of LMN lesion? [4]
The most common causes of lower motor neuron injuries are trauma to peripheral nerves that serve the axons, and viruses that selectively attack ventral horn cells. Disuse atrophy of the muscle occurs i.e., shrinkage of muscle fibre finally replaced by fibrous tissue (fibrous muscle) Other causes include Guillain–Barré syndrome, West Nile fever, C. botulism, polio, and cauda equina syndrome; another common cause of lower motor neuron degeneration is amyotrophic lateral sclerosis.
Pathway and function of corticospinal tract
corticospinal tract from the motor cortex to lower motor neurons in the ventral horn of the spinal cord The major function of this pathway is fine voluntary motor control of the limbs. The pathway also controls voluntary body posture adjustments.
Colliculospinal tract pathway and function
corticospinal tract from the motor cortex to lower motor neurons in the ventral horn of the spinal cord The major function of this pathway is fine voluntary motor control of the limbs. The pathway also controls voluntary body posture adjustments.
corticobulbar tract from the motor cortex to several nuclei in the pons and medulla oblongata Involved in control of facial and jaw musculature, swallowing and tongue movements.
rubrospinal tract pathway and function
colliculospinal tract (tectospinal tract) from the superior colliculus to lower motor neurons Involved in involuntary adjustment of head position in response to visual information.
vesticulospinal tract pathway and function
from vestibular nuclei, which processes stimuli from semicircular canals It is responsible for adjusting posture to maintain balance.
reticulospinal tract pathway and function
from reticular formation. Regulates various involuntary motor activities and assists in balance.
Sx of UMN lesions
Symptoms can include muscle weakness, decreased motor control including a loss of the ability to perform fine movements, increased vigor (and decreased threshold) of spinal reflexes including spasticity, clonus (involuntary, successive cycles of contraction/relaxation of a muscle), and an extensor plantar response known as the Babinski sign
When can UMN lesions arise? [1]
Such lesions can arise as a result of stroke, multiple sclerosis, spinal cord injury or other acquired brain injury.
what are extrapyramidal SE
It involves repetitive, involuntary facial movements, such as tongue twisting, chewing motions and lip smacking, cheek puffing, and grimacing. You might also experience changes in gait, jerky limb movements, or shrugging
when do extrapyramidal SE usually occur for patient of antipsychotics? [2]
You might also experience changes in gait, jerky limb movements, or shrugging. It usually doesn’t develop until you’ve been taking the drug for six months or longer
Mx of IECOPD
antibiotics, nebulisers, chest physio, 88-92% oxygen, corticosteroids, respriatory swab
what is a comminuted fracture?
bone breaks several places
transverse fracture
A transverse fracture is when the fracture line is perpendicular to the shaft (long part) of the bone.
oblique fracture
An oblique fracture is when the break is on an angle through the bone
stress vs pathological fracture
A pathologic fracture is caused by a disease that weakens the bone
A stress fracture is a hairline crack
Sx and Sx of secondary hyperparathyroidism
Bone and joint pain are common, as are limb deformities. The elevated PTH has also pleiotropic effects on the blood, immune system, and neurological system
secondary hyperparathyroidism
higher blood phosphorus, kidneys cannot make active vitamin D, lower calcium levels. Usually seen in cases CKD or defective calcium receptors on the surface parathyroid glands.
what is GBS? [1]
rapid-onset muscle weakness
what is GBS? [1]
rapid-onset muscle weakness damaging the peripheral nervous system
why can GBS be serious? [1]
During the acute phase, the disorder can be life-threatening, with about 15% of people developing weakness of the breathing muscles and, therefore, requiring mechanical ventilation
in those with severe weakness, what should be given
In those with severe weakness, prompt treatment with intravenous immunoglobulins or plasmapheresis, together with supportive care, will lead to good recovery in the majority of cases
What is transverse myleitis?
Transverse myelitis is a rare neurological condition. It’s caused by inflammation (swelling) of the spinal cord. The swelling damages the nerves and can leave permanent scars or lesions. The scars or lesions interrupt the communication between the nerves in the spinal cord and the rest of the body.
