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36 Cards in this Set
- Front
- Back
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apraxia
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loss of the ability to execute or carry out learned purposeful movements, despite having the desire and the physical ability to perform the movements.
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agnosia
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the inability to identify objects, people, etc
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Bell's palsy involves muscles innervated by what nerve?
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CN VII
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What kind of neurons does the ventral horn contains?
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motor
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What kind of neurons does the dorsal horn control?
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sensory
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Motor Systems composed of?
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1) Upper Motorneuron
2) Lower Motorneuron |
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Where are the bodies of the upper motor neurons found?
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1) Red nucleus
2) Reticular Formation 3) Lateral Vestibular Nuclei of the brain stem. 4) Cerebral Cortex (Most Important) |
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What tract are the upper motor neurons run in?
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Corticospinal Tract
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Decorticate rigiditiy is caused by?
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Lesions above the midbrain
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A lesion below the midbrain causes what type of rigidity?
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Decerebrate Rigidity
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What reflexes are lost in an Upper Motorneuron Lesion?
Reversal of Reflexes |
1) Babinski Reflex (extension instead of flexion)
2) Abdominal Reflex Lost 3) Cremasteric Reflex Lost |
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How do you determine a lesion to the Dorsal Column?
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Loss of Joint sensation
- vibratory - pressure sensation - two-point discrimination - loss of the ability to identify characteristics of an object |
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What is asterognosis?
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Identify:
- shape - size - consistency - form of an object using the sense of TOUCH |
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How do you diagnose Dorsal Column Pathway lesion?
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ask patient to close his eyes and place feet together
- positive if patient sways - if patient sways with eyes open then the lesion/damage is at the cerebellum and not dorsal column |
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What is another name for the Anterolateral System?
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Spinothalamic Tract System
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What does the Anterolateral System sense?
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- pain
- temperature - crude touch sensations |
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What three parts make the Brainstem?
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1) midbrain
2) pons 3) medulla |
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What cranial nerves arise from the midbrain?
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1) oculomotor III
2) trochlear IV 3 and 4 |
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What cranial nerves enter or exit the pons?
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V, VI, VII, VIII
5-8 |
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What three cranial nerves enter or exit from the medulla?
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IX, X, XII
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What muscles does the spinal accesory nerve innervate?
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1) sternocleidomastoid
2) trapezius |
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Alpha 1 receptors are located on
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Vascular smooth muscle (vasoconstriction) and hepatocytes
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S/S of Bell's palsy
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Loss of taste, hyperacusis, increased or decreased tearing.
There is acute onset of unilateral facial weakness/paralysis. Both upper and lower parts of the face are affected. |
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Differential diagnosis for facial nerve palsy
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Trauma (e.g., temporal bone, forceps delivery) * Lyme disease * Tumor (acoustic neuroma, cholesteatoma, neurofibroma) * Guillain-Barré syndrome (palsy is usually bilateral) * Herpes zoster |
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Guillain-Barré Syndrome clinical features
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Abrupt onset with rapidly ascending weakness/paralysis of all four extremities; frequently progresses to involve respiratory, facial, and bulbar muscles o Usually symmetric (but not always) o Weakness may be mild or severe. o Weakness usually progresses from distal to central muscles. o If generalized paralysis is present, it can lead to respiratory arrest. * Extremities may be painful, but sensory loss is not typical. * Sphincter control and mentation are typically spared. * Autonomic features (e.g., arrhythmias, tachycardia, postural hypotension) are dangerous complications. |
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Guillain-Barré Syndrome diagnosis
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CSF analysis—elevated protein, but normal cell count * Electrodiagnostic studies—decreased motor nerve conduction velocity |
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Treatment of Guillain-Barré Syndrome
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1. hospitalize - watch respiratory status, may need intubation
2. # Administer IV immunoglobulin if the patient has significant weakness. If progression continues, plasmapheresis may reduce severity of disease. #3 Do not give steroids. They are usually harmful and never helpful in Guillain-Barré syndrome. |
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what Autoimmune disorder— Autoantibodies are directed against the nicotinic acetylcholine receptors of the neuromuscular junction, which leads to a reduced postsynaptic response to acetylcholine and results in significant muscle fatigue.
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Myasthenia gravis
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peak incidence of myasthenia gravis
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women is age 20 to 30; in men, 50 to 70. It is more common in women.
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Treatment of myasthenia gravis
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The mainstay of therapy is administration of a cholinesterase inhibitor, such as pyridostigmine, which produces a transient improvement in strength. * Thymectomy often leads to improvement of symptoms. * Corticosteroids, immunosuppressive agents, IV immunoglobulin, and plasmapheresis are effective in patients with refractory disease. |
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other name for Tic Douloureux
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trigeminal neuralgia
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Clinical features of trigeminal neuralgia
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Brief (seconds to minutes) but frequent attacks of severe, lancinating facial pain * Involves the jaw, lips, gums, and maxillary area (ophthalmic division is less commonly affected) * Recurrent attacks may continue for weeks at a time. * No motor or sensory paralysis |
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major risk factors for stroke
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Smoking, HTN, hypercholesterolemia, oral contraceptives, heavy EtOH use, AIDS, diabetes, elevated blood homocysteine levels
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Hemorrhagic strokes are usually secondary to?
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HTN
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Strokes involving the anterior choroidal, anterior cerebral, or middle cerebral arteries are associated wiht hemispheric s/s or?
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aphasia, apraxia, hemiparesis, hemisensory losses, visual field defects.
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Strokes involving the posterior circulation (vertebral and basilar arteries), show evidence of brainstem dysfunction such as?
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coma, drop attacks, vertigo, nausea, vomiting, ataxia
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