Term
| Patient presents with a transverse lesion of the entire cord (transverse cord section) what is lost, be specific? |
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Definition
Bilateral loss from the point of the lesion and below.
Loss of touch, pressure, vibration, proprioception, 2 point descrimination (medial lemniscus)
Loss of Pain and temperature (spinal thalamic tract)
loss of voluntary motor (cortical spinal) |
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Term
| Patient presents with ipsilateral voluntary motor loss, ipsilateral loss of touch/pressure/vibration and contralateral deficit of pain and temperature. which syndrome is this most reminiscent of? |
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Definition
brown sequard syndrome
compression or lesion of one half of the spinal cord |
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Term
| Patient presents with a capelike loss of pain and temperature sensation along the back of both arms, what might be the cause? |
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Definition
syringomyelia
cyst formation on the spinal cord usually occurs at the level of C5, most commonly bilateral deficit of pain and temperature along the dermatome which is affected. since it most commonly occurs at the level of C5, it looks like a "cape" |
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Term
| describe freidrichs ataxia |
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Definition
| an autosomal recessive disorder causing degeneration of spinal cord white matter, often affects dorsal column and clarks nucleus also corticospinal tract bilateral deficits with touch, pressure, vibration adn voluntary motor |
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Term
| which tracts are involved with central cord syndrome? |
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Definition
medial lemniscus,
corticospinal,
spinalthalamic
there is some sacral sparing so many times areas of hte body supplied by sacral dermatomes still maintain sensation |
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Term
| what tracts are affect with posterior cord syndrome? |
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Definition
| medial lemniscus, deficit of touch/pressure/ vibration/proprioception |
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Term
| what tracts are affected in anterior cord syndrome? |
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Definition
| corticospinal tract, spinal thalamic tract |
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Term
| patient presents with B12 deficiency, bilateral spastic paralysis, bilateral loss of proprioception and descriminitiave touch |
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Definition
subacute combined degeneration....
degeneration of posterior and lateral columns of spinal cord
seen with B12 deficiency, nutritional problem |
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Term
| Amyotropic lateral sclerosis |
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Definition
UMN and LMN disease. Presents with both flacid paralysis, at the level of hte lesion and spastic paralysis below the lesion
Involves the fatal degeneration of neurons and patient cannot control voluntary movement |
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Term
| Patient presents with sensory loss, tabetic gait and incontinence...what could be the reason |
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Definition
tabes dorsalis, neurosyphallis
destroys large diameter of hte dorsal rootfibers and DRG, usualy lumbarsacral |
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Term
| Patient presents with an eye that is down and out, and dilated, what could be the reason? |
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Definition
Occulomotor nerve palsy
Causing paralysis to all the eye muscles with the exeception of superior oblique and lateral rectus. Because those two muscles are still in tact that explains the "down and out" placement of the eye. This is caused by damage to the oculomotor nerve complex/oculomotor nucleus. Because the complex also contains edinger westphal nucleus which sends parasympathetic fibers to the eye for constriction, the eye is then dilated |
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Term
| patient presents with vertical diplopia and hypertropia, medial rotation of the eye, what could be the cause |
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Definition
Superior oblique muscle which is innervated by the trochlear nerve
This is the most commonly injured cranial nerve in head trauma |
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Term
| patient presents with horizontal diplopia and estropia (where one or both eyes are pointed inward) what could be the preoblem? |
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Definition
| Abducens nerve palsy... eye canot abduct normally, as |
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Term
| patient presents with sharp sudden pain in the face triggered by touching of the skin, what might cause this? |
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Definition
trigeminal neuralgia
Think: V1, V2, and V3 all provide sensory innervation to the face. V2 is the most likely cause then V3 then V1
The cause is unknown but could be blood vessel compression of the nerve.
Treatment: move blood vessel or remove part of the sensory root |
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Term
| Patient presents with paralesis of facial muscles on the right side of the face. (ipsilateral upper and lower facial assymetry) |
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Definition
| Bells palsy, which occurs due to either lesion at facial nucleus or the peripheral nerve of VII typically lesion occurs at or beyond the stylomastoid foramen |
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Term
| Uvula is innervated by which nerve? |
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Definition
| Vegus, CNX, BE fibers from nucleus ambiguus |
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Term
| What results in a lesion to nucleus ambiguus |
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Definition
Nucleus ambiguus sends fibers to innervate the larynx, pharynx, and palate (uvula). A lesion to nucleus ambiguus would most likely involve CNX, as it sends BE fibers to those structures to provide motor innervation. If it was lesioned then this can be seen dignostically by looking at the uvula (which normally should sit centered) but in this case will deviate opposite to the side with the lesion, since the intact muscles pull it to the intact side.
Note: glossopharyngeal sends sensory innervation to these structures via nucleus ambiguss via BE fibers.
Spinal accessory nerve, cranial root allows CNX to send its fibers along its track to these structures. |
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Term
| Patient presents with the tongue deviated to the left side, what could this imply? |
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Definition
well we know that CN XII (hypoglossal nerve) supplies motor innervation to the tongue.
1. this could involve a lesion to CNXII on the left side or the left hypoglossal nucleus, since the tongue will deviate ipsilaterally due to the action of hte unimpaired genioglossus muscle.
2. This could involve a lesion on the right side of the tract from the cortext to the hypoglossal nucleus |
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Term
| lesion to posterior spinal artery |
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Definition
| will affect medial lemniscus |
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Term
| Lesion to anterior spinal artery at the level of the spinal cord |
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Definition
| will bilaterally affect spinalthalamic and corticospinal tracts |
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Term
| A lesion to this artery will disturb blood supply to the optic nerve and orbit |
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Definition
opthalmic artery
branch of the internal carotid |
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Term
| A lesion to this artery will prevent blood supply to the optic tract, some choroid plexus, part of hte cerebral peduncle, portions of the hypothalamus, thalamus and hippocampus |
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Definition
| anterior choroidal artery |
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Term
| occlusion to which artery would cause contralateral motor and somatosensory deficit to the body above the knees? |
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Definition
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Term
| Occlusion of what artery will cause contralateral voluntary motor and somatosensory deficit below the knee (lower limb) |
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Definition
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Term
| describe medial medullary syndrome |
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Definition
1. occlusion of the anterior spinal artery at the level of the medulla
2. will affect: corticospinal tract, medial lemniscus, and hypoglossal nucleus
also called: inferior alternating syndrome |
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Term
| Describe lateral medullary syndrome (wallenbergs syndrome) |
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Definition
Occlusion of PICA or Vertebral artery
affects:
inferior cerebellar peduncle
spinalthalamic tract
sympathetic fibers (hornors syndrome PAM is Horny)
Nucleus ambiguus
nucleus solitarious (taste) |
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Term
| Occlusion of AICA affects 5 different things, what are they |
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Definition
1. middle cerebral peduncle
2. vestibular nuclei
3. spinal V nucleus and tract
4. spinalthalamic tract
5. descending sympathetic fibers |
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Term
| Patient presents with unilateral damage to the ventral region of the midbrain as their is superior alternating hemipalegia (ipsilateral oculomotor nerve palsy and contralateral hemipalegia), occlusion of what artery might cause this |
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Definition
occlusion of the posterior cerebral/basilar arteries
= Webers syndrome or Superior alternating syndrome |
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Term
| Patient presents with intense aching burning pain in their head combined with hemianestheia and sensory ataxia |
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Definition
thalamic syndrome.
almost always includes damage to vpl and vpm. May be accompanied with paralysis. |
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