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57 Cards in this Set
- Front
- Back
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where are the CST and STT located in the sacral spinal cord? |
lateral |
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where are the posterior columns (V/P) located in the sacral spinal cord? |
medial |
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patient flexes neck and gets a jolt of electricity down the spine |
Lhermitte's sign: posterior column involvement |
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spinal cord lesions |
-UMN below* lesion -LMN at* lesion |
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patient has UMN findings on the Left, and loss of V/P on the Left, loss of temperature/sensation on the Right, where is the lesion? |
left spinal cord: Brown-Sequard |
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what happens to the bladder when the spinal cord is compressed above S2-S4? |
1st: flaccid atonic bladder, then changes to spastic in a few months |
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describe the atonic bladder phase |
-urethral sphincter still contracts from REFLEX, but the bladder doesn't contact -this means there's a bunch of pee left in the bladder and it becomes DISTENDED -lots of poist-void residuals* -Need Cath |
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describe the spastic bladder phase |
-INCREASED detrusor tone from uninhibited over-activation of S2-4 PARA -no you just start peeing spastically -PVRs are still increased because the detrusor muscle is over active, but not as much as in the atonic phase -still have incomplete bladder emptying -lots of UTIs :(
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what carries MOTOR, SENSORY, and SYMP fibers to external genitalia/external urethral & anal sphincter/perineum/scrotum/anus?
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pudendal nerve from S2-4 sacral plexus |
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bilateral pain and temperature loss in the arms in a "cape" |
syringomyelia: central cervical cord cavitation |
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why is it that pain and temperature are lost in a central cord cavitation? |
due to involvement of the anterior white commissure (crossing of the STT) |
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which artery is most susciptible in ANTERIOR SPINAL ARTERY occlusion? |
artery of Adamkiewicz: mid-upper thoracic cord |
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spastic weakness & loss of pain/temp but (posterior columns) V/P are OK**** |
anterior spinal artery occlusion |
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loss of ONLY V/P |
POSTERIOR spinal artery occlusion |
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"stomping gait" |
posterior spinal artery occlusion |
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skinny part of the butterfly |
POSTERIOR: PROMISE!! |
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what is HIGH in B12 deficiency? |
homocystein and methylmalonic acid |
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-megaloblastic anemia -falling (posterior columns V/P) -some UMN findings (CST) -some stocking-glove sensory deficits -cognitive changes* |
demyelination* of posterior columns* from B12 deficiency!!! |
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-falling (posterior columns V/P) -PAIN (loss of nerve roots) SYPHILLIS |
tabes dorsalis |
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what is the motor nucleus for CN 9 & 10? |
nucleus ambiguous |
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why do you get severe dysarthria/dysphagia (bulbar palsy) in ALS? |
degeneration of the nucleus ambiguous!!! |
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crossed findings |
think brainstem |
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how does lateral medullary syndrome happen? |
occlusion of the PICA |
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-IPS facial numbness**** -IPS Horner's Horner's, Nystagmus, hiccups*, decreased gag*, nystagmus, vertigo, nauseau, limb ataxia -CONT extremity numbness*** |
lateral medullary syndrome |
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why do you have hiccups, hoarseness, bad gag ? |
nucleus ambiguous |
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why do you have ataxia? |
inferior cerebellar peduncle |
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why do you have nystagmus, vertigo, N/V? |
vestibular nucleus |
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from what nerves does nucleus solitarious receive input? |
7,9,10 |
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anterior 2/3 of taste on the tongue |
7 |
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posterior tongue taste |
9 |
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lesion here results in BP instability, TACHY, and loss of taste |
nucleous solitarious |
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nucleuous involved in baroreceptor reflex |
nucleus solitarious |
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-IPS tongue weakness/atrophy (XII) -CONTRA spastic weakness (med pyramid) & loss of V/P (med lemniscus) |
medial medullary syndrome |
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which way does the tongue deviate in medial medullary syndrome? |
tongue goes AWAY FROM HEMIPLEGIA |
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lesion to medullary pyramid |
spastic weakness, mostly hand clumsiness*** |
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decerebrate posturing: powerful EXTENSION in all 4 extremities |
lesion is in midbrain/pons ABOVE lateral vestibular nucleus |
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what area makes you vomit from chemo? |
area postrema: lacks a BBB & is in the wall of the 4th ventricle of the medulla |
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1st: hearing loss, dizziness, tinnitus Then: facial weakness, loss of sensation, diminished corneal reflex |
acoustic schwanomma in cerebellopontine angle |
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3 branches of the trigeminal nerve |
-opthalmic -maxillary -mandibular |
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-opthalmic -maxillary -mandibular |
-superior orbital fissure -rotundum -ovale |
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what nucleus mediates the "jaw jerk" reflex? |
trigeminal |
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parts of the corneal reflex |
-afferent 5 -efferent 7 (b/l so both eyes should close) |
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you touch left eye cornea and only the left eye closes, is this ok? |
no, should both close. lesion is in the RIGHT 7th nerve**** |
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jaw jerk reflex |
V3 (for both) |
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touch for the tongue |
V |
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taste for the tongue |
VII and IX |
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SO4(troch), LR6 |
eveything else is 3 |
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upper and lower face weakness: Bell's palsy |
LMN lesion |
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mostly just lower face weakness only |
UMN (because upper face has b/l stim) |
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stapedius |
7 |
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tensor tympani |
5 |
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lesion of the chorda tympani |
decreased taste sensation |
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concsiousness |
reticular formation |
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serotonin |
raphe nucleus in the RAS |
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sleep induction |
RAS |
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-left eye goes in (6) -left mouth droops down (7) -contra hemiplegia (CST) |
PONS!!!! |
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cold caloric test is normal |
lesion is NOT in brainstem |
