Neuro - Exam 5 - Part 3

Front 1

contralateral hemiparesis indicates what kind of lesion?

Back 1

UMN lesion of corticospinal tract

Front 2

UMN lesions above the _____ cause contralateral deficits

Back 2

UMN lesions above the MEDULLA cause contralateral deficits

Front 3

UMN lesions at ______ levels cause ipsilateral deficits

Back 3

UMN lesions at SPINAL CORD levels cause ipsilateral deficits

Front 4

Describe the period of shock associated with UMN lesions

Back 4

immediately after lesions occur

transient hypotonia & hyporeflexia with paralysis/paresis

Front 5

Paresis of limb muscles in UMN lesions is more marked in which muscle groups?

Back 5

upper limb extensors

lower limb flexors

Front 6

the hyperreflexia seen in UMN lesions is caused by what?

Back 6

destruction of the corticoreticulospinal inhibitory influence

Front 7

Ventral root spinal cord lesions

deficits (in general)

Back 7

LMN lesion findings

Front 8

Ventral root spinal cord lesions at C8-L2

Back 8

sympathetic deficits:

flushed skin (loss of cutaneous vasoconstriction)
dry skin (loss of sweating)
skin does not blanch on exposure to cold

Front 9

Ventral root spinal cord lesions at C8-T2

Back 9

general sympathetic deficits +

Horner's syndrome

Front 10

Horner's syndrome

Back 10

ventral root spinal cord lesion between C8-T2

ptosis
miosis
anhydrosis
facial flush

Front 11

ventral root lesion between S2-S4

Back 11

parsympathetic deficits

bowel paralysis
motor paralytic bladder
erectile dysfuction if roots lesioned bilaterally

Front 12

5 signs of dorsal root spinal cord lesions

Back 12

hypotonia
hyporeflexia
anesthesia
atrophic skin changes
if roots lesioned bilaterally: sensory paralytic bladder & fecal incontinence

Front 13

In dorsal root lesions, hypotonia and hyporeflexia are caused by?

Back 13

sensory limb (Ia) defect

Front 14

describe atrophic skin changes

Back 14

skin is thin, shiny, ulcerated

Front 15

sensory paralytic bladder/bowel

Back 15

bladder overflow incontinence

constipation with fecal incontinence

Front 16

motor findings in complete spinal cord transection

Back 16

paralysis in withdrawal (flexion) posture below the level of the lesion

(because motor neurons influenced only by dorsal root afferents, which are predominantly withdrawal)

--> ipsilateral spastic hemiplegia

Front 17

sensory findings in complete cord transection

Back 17

ipsilateral loss of MVP below level of lesion

contralteral loss of ALS beginning about one segment below the lesion

Front 18

Brown-Sequard Syndrome

Back 18

complete (ventral & dorsal) hemisection of the spinal cord

result from traumatic insult or from presssure from extramedullary tumor

Front 19

effective LMNs of sympathetic outflow from the spinal cord

Back 19

sympathetic preganglionic neurons

in intermediolateral column (IML): C8 - L2

Front 20

Ispilateral Horner's syndrome

etiology

Back 20

lesions of preganglionic sympathetic axons as they ascend the cervical sympathetic chain

Front 21

What happens with sympathetic axon lesions above the superior cervical ganglion

Back 21

external carotid plexus: anhydrosis and flushing of the infraorbital portion of the face

internal carotid plexus: ptosis, miosis, sweating and flushing of SUPRAorbital face

Front 22

Deficits associated with

lesions of IML column and outflow at T11-L2

Back 22

interfere with ejaculation and tone of involuntary sphincter of the bladder

Front 23

neurons of IML column are under the higher level control of...

Back 23

uncrossed fibers from the hypothalamus

that relay down through the reticular formation

concentrated in the lateral funiculus

Front 24

contralateral lower facial weakness

lesion:

Back 24

UMN lesion to CN VII

Front 25

contralateral tongue weakness

protruded tongue deviates AWAY from side of lesion

Back 25

UMN lesion to CN XII

Front 26

protruded tongue deviates TOWARD weak side

Back 26

LMN lesion to CN XII

Front 27

SCM weakness

weakness turning head

Back 27

weakness turning head AWAY from side of lesion

UMN & LMN CN XII lesions both IPSILATERAL

Front 28

entire face weak

Back 28

ipsilateral LMN CN VII lesion

Front 29

What nerves/nuclei are in MIDBRAIN?

Back 29

CN III

CN IV

Front 30

What nerves/nuclei are in ROSTRAL PONS?

Back 30

CN V

Front 31

What nerves/nuclei are in CAUDAL PONS?

Back 31

CN VI (medial) & abducens nucleus

CN VII (lateral) & facial motor nucleus

Front 32

What nerves/nuclei are in MEDULLA

Back 32

CN XII

nucleus ambiguus

Front 33

caudal ventromedial medulla lesion

structures involved
clinical signs

Back 33

caudal ventromedial medulla lesion

pyramid
medial lemniscus

contralateral hemiparesis - UMN corticospinal lesion

contralateral loss of position of vibratory sense - medial lemniscus

Front 34

if you lesion dorsal columns, deficits are ____lateral

Back 34

IPSILATERAL

Front 35

if you lesion medial lemniscus deficits are ____lateral

Back 35

CONTRALATERAL

Front 36

caudal ventromedial medulla lesion

etiology

Back 36

thrombosis of branch of anterior spinal artery (ASA)

Front 37

rostral ventromedial medulla lesion, aka:

Back 37

inferior alternating hemiplegia

Front 38

rostral ventromedial medulla lesion

structures involved
clinical signs

Back 38

contralateral hemiparesis - UMN corticospinal (pyramid)
rostral ventromedial medulla lesion:

contralateral loss of MVP - medial lemniscus

ipsilateral paralysis of tongue - roots/nucleus of CN XII

Front 39

inferior alternating hemiplegia

etiology

Back 39

thrombosis of branch of anterior spinal artery

Front 40

lateral medulla lesions, aka:

Back 40

Wallenberg's syndrome

Front 41

Wallenberg's syndrome

signs and symptoms

Back 41

contralateral loss of pain/temp/sensation on body

ipsilateral losso of pain/temp on face
dysphagia & dysphonia - ipsilateral loss of gag reflex
tachycardia
Horner's syndrome
ipsilateral ataxia of limbs
ipsilateral deafness & tinnitus
nystagmus, N/V, vertigo
ipsilateral loss of taste

Front 42

one-sided loss of pain & temp on body

lesion:

Back 42

contralateral ALS (corticothalamic) above upper cervical cord

Front 43

one-sided loss of pain & temp on face

lesion

Back 43

ipsilateral CN V or trigeminal nucleus

Front 44

dysphagia & dysphonia
one sided loss of gag reflex
tachycardia

lesion:

Back 44

ipsilateral -
vagus nerve
dorsal vagal nucleus
nucleus ambiguus

Front 45

Horner's syndrome

lesion

Back 45

descending sympathetic fibers C8-T2

Front 46

one-sided ataxia of limbs

Back 46

ipsilateral cerebellum

Front 47

one-sided deafness & tinnitus

Back 47

ipsialateral cochlear nucleus

Front 48

nystagmus, N/V, vertigo

Back 48

vestibular system

Front 49

one-sided loss of taste; vomting (?)

Back 49

ipsilateral solitary nucleus

Front 50

Wallenberg's syndrome

structures involved

Back 50

lateral spinothalamic tract (ALS)
spinal tract and nucleus of CN V
nucleus ambiguus
descending central sympathetics
inferior cerebellar peduncle
cochlear nuclei
inferior & medial vestibular nuclei
solitary nucleus

Front 51

Wallenberg's syndrome

etiology

Back 51

thrombosis of PICA or vertebral artery

Front 52

caudal ventrolateral pons syndrome, aka:

Back 52

facial hemiplegia alternans
millard-Guber

Front 53

caudal ventrolateral pons lesion

clinical signs
structures involved

Back 53

contralateral hemiparesis - UMNs of corticospinal tract

ipsilateral facial nerve signs - facial nerve root

Front 54

caudal ventrolateral pons lesion

etiology

Back 54

neoplasm

Front 55

rostral ventrolmedial pons lesion, aka:

Back 55

abducens hemiplegia alterans

Front 56

rostral ventromedial pons

clinical signs
structures involved

Back 56

contralateral hemiparesis - corticospinal tract

internal strabismus & paralysis of abduction of the eye - ipsilateral abducens nerve root or nucleus (LMN)

Front 57

rostral ventrolateral pons lesion

clinical signs
structures

Back 57

contralateral hemiparesis - corticospinal tract

trigeminal nerve signs - ipsilateral trigeminal nerve root

Front 58

rostral pontine tegmentum lesion

clinical signs
structures

Back 58

loss of MVP - contralateral medial lemniscus

loss cutaneous sensation - contralateral ALS

trigeminal nerve signs - ipsilateral trigeminal nerve root

Horner's syndrome - descending sympathetics

Front 59

cadual pontine tegmentum lesion

structures affected

Back 59

medial lemniscus

spinothalamic tract

facial or abducens nuclei/roots

CN V

vestibular nuclei

descending sympathetics

Front 60

anterior internuclear opthalmoplegia

Back 60

interruption of fibers that connect the nerves of extraocular eye movement

i.e.: ascending medial longitudingal fasciculus

Front 61

anterior internuclear opthalmoplegia

clinical signs

Back 61

paralysis of eye adduction

intact adduction on convergence

nystagmus of abducting eye(s)

Front 62

anterior internuclear opthalmoplegia

etiology

Back 62

MS

Front 63

ventral pons lesion, aka:

Back 63

locked-in syndrome

Front 64

ventral pons syndrome

clinical signs
structures involved

Back 64

quadriplegia - corticospinal tracts

bilateral facial, largyngeal and lingual paralysis - corticobulbar tracts

eyes are able to move - b/c medial longitudinal fasciculus is still intact

Front 65

lateral midbrain tegmentum

structures involved

Back 65

medial lemniscus
spinothalamic tracts
ventral trigeminothalamic tract

Front 66

central midbrain tegmentum lesion

clinical signs
structures involved

Back 66

contralateral hemichora (intention tremor) - red nucleus

paralysis of vertical & medial eye movements, papillary dilation, loss of light reflex, ptosis and external stabismus (all ipsilateral) - oculomotor rootlets

contralateral loss MVP - medial lemniscus

Front 67

signs of CN III lesion

Back 67

paralysis of vertical & medial eye movements

papillary dilation

ptosis

loss of light reflex

external stabismus

Front 68

ventromedial midbrain lesion, aka:

Back 68

Weber's syndrome

Front 69

ventromedial midbrain

clinical signs
structures involved

Back 69

oculomotor nerve signs - ipsilateral CN III rootlets

one-sided hemiparesis - contralteral corticospinal tract

one-sided lower facial weakness - contralateral corticobulbar fibers

Front 70

Weber's syndrome

etiology

Back 70

aneurysim of posterior communicating artery

Front 71

superior colliculus lesion, aka:

Back 71

Parinaud's syndrome

Front 72

Parinaud's syndrome

clinical signs
symptoms

Back 72

paralysis of upward gaze - rostral/corticotectal fibers

loss of papillary light reflex - pretectum

paralysis of downward tracking eye movements - caudo-lateral corticotectal fibers

Front 73

superior colliculus syndrome

etiology

Back 73

pinealoma

Front 74

Thalamic syndrome

aka:
description
etiology

Back 74

Dejerine-Roussy Syndrome

intractable, perisistent pain - usually poorly localized

usu. results from occlusion of thalamogeniculate branch of posterior cerebral artery

Front 75

Thalamic syndrome

deficits
associated structures

Back 75

contralateral hemihypalgeisa & intense pain - thalamic VPL

contralateral hemiparesis, Babinski, hyperreflexia - corticospinal fibers in posterior of internal capsule

homonymous hemianopsia - lateral geniculate nucleus (LGN)

Front 76

Lesion of posterior limb of internal capsule

deficit
associated structure

Back 76

contralateral hemiparesis, Babinski - corticospinal fibers in internal capsule

paralysis of lower facial muscles & paresis of tongue - contralateral corticobulbar fibers (genu & posterior limb)

dimunition/loss of pain/temp & MVP in body and face - interrruption of thalamocoritical fibers from VPM/VPL to somatosensory cortex

Front 77

blockage of the middle cerebral artery (MCA) leads to deficits in...

Back 77

vision
hearing
speech

Front 78

blockage of the anterior cerebral artery (ACA) leads to deficits in...

Back 78

lower limb motor ability

Front 79

blockage of the posterior cerebral artery (PCA) leads to deficits in...

Back 79

visual cortex

Front 80

What is usually spared in a middle cerebral artery occlusion (stroke)?

Back 80

lower limb

exception: when posterior limb of internal capsule is involved

Front 81

proximal MCA occlusion

deficit
associated structure

Back 81

hemiplegia of lower face, trunk, upper and lower limbs, Babinski - contralateral somatomotor cortex & internal capsule (corticospinal & corticobulbar fibers)

contralateral hemianesthesia of face, trunk, limbs - somatosensory cortex & thalamocortical fibers from VPM/VML in internal capsule

homonymous hemianopsia - geniculocalcarine fibers looping through temporal and parietal lobes (LGN --> 1* visual cortex)

Front 82

DO CASES CP. 459 - 61

Back 82

DO CASES CP. 459 - 61

Front 83

Hypertonia in upper limb flexors is a symptom of a lesion in the

Back 83

corticoreticulospinal pathway

Front 84

Which secretory circumventricular organ is involved in osmotic regulation of vasopressin secretion?

Back 84

neurohypophysis

Front 85

Growth hormone-releasing hormone neurosecretory neurons are located in which of the following hypothalamic nuclei?

Back 85

arcuate nucleus

Front 86

Which nucleus is the major coordinating center for autonomic visceromotor reflex responses?

Back 86

nucleus solitarius

Front 87

Which nucleus is the major center for integration of visceromotor, somatomotor, and behavioral responses to thirst?

Back 87

medial preoptic nucleus

Front 88

chiasmatic lesions most commonly present as

Back 88

right homonymous hemianopia

Front 89

Medial preoptic nucleus

functions

Back 89

* urinary bladder contraction
* Decreased heart rate
* Decreased blood pressure

Front 90

Supraoptic nucleus

Back 90

* oxytocin release
* vasopressin release

Front 91

Paraventricular nucleus

Back 91

oxytocin release
vasopressin release

Front 92

Anterior hypothalamic nucleus

Back 92

* thermoregulation
* panting
* sweating
* thyrotropin inhibition

Front 93

Suprachiasmatic nucleus

Back 93

* vasopressin release
* Circadian rhythms

Front 94

Lateral nucleus

Back 94

* thirst and hunger

Front 95

Ventromedial nucleus

region
function

Back 95

tuberal region

satiety
neuroendocrine control

Front 96

Arcuate nucleus

Back 96

* GnRH release
* feeding
* Dopamine
* GHRH

Front 97

Lateral nucleus

Back 97

thirst and feeding

Front 98

Mammillary nuclei

Back 98

memory

Front 99

Posterior nucleus

Back 99

* Increase blood pressure
* pupillary dilation
* shivering