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Motor Unit Pathologies
Yates Lecture 2/15
89
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Graduate
03/01/2011

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Term
Name 2 pathologies that occur due to injury to the neuronal cell body
Definition
Poliomyelitis
ALS
Term
Moves retrogradely from the GI tract to the cell body of the neuron to attack it.
Definition
Poliomyelitis
Term
A viral infection that attacks the cell bodies of alpha motor neurons in the spinal cord.
Definition
Poliomyelitis
Term
Where does the polio virus enter the body?
Definition
GI Tract
Term
This virus travels up the neuronal axon to the cell body where it interrupts synthesis of neuronal proteins in favor of synthesis of viral proteins.
Definition
Poliomyelitis
Term
Can poliomyelitis result in paralyis?
Definition
yes
Term
Paralysis caused by this pathology develops 2-5 days post onset of illness or may be delayed as long as 2-3 weeks.
Definition
Poliomyelitis
Term
The degree of involvement of this pathology is proportional to the number of motor neurons destroyed.
Definition
Poliomyelitis
Term
May occur within 30-40 years following the intial disease of polio.
Definition
Post Polio Syndrome
Term
A slowly progressive weakness in previously affected muscles.
Definition
Post polio syndrome
Term
Also known as Lou Gehrig's disease
Definition
ALS
Term
Name a pathology that occurs because of an injury to action potential conductance mechanism
Definition
Tetrodotoxin
Term
Produced by puffer fish in their ovaries and liver. Puffer fish is a delicacy in Japan.
Definition
Tetrodotoxin
Term
This pathology causes blockage of the voltage gated Na+ channels in the neuronal cell membrane so they cannot open.
Definition
Tetrodotoxin
Term
Causes a failure of action potential with resultant paralysis. Patient can die from respiratory paralysis.
Definition
Tetrodotoxin
Term
Name 3 pathologies that occur from injuries to synaptic terminals.
Definition
Alpha-latrotoxin
Botulism Toxin
Tetanus Toxin
Term
Produced by black widow spiders
Definition
Alpha-latrotoxin
Term
Stimulates excessive release of ACh at the neuromuscular junction
Definition
Alpha-latrotoxin
Term
Is alpha-latrotoxin typically fatal?
Definition
no
Term
Causes severe local cramps followed by paralysis secondary to ACh depletion.
Definition
Alpha-latrotoxin
Term
A very powerful toxin that is produced by anaerboic bacterium.
Definition
Botulinum Toxin
Term
Can occur from incompletely sterilized canned foods or inhalation of spores.
Definition
Botulinum Toxin
Term
A systemic problem if ingested or inhaled. Fine locally.
Definition
Botulinum Toxin
Term
The most powerful biological poison known. Fatal in very small quantities.
Definition
Botulinum Toxin
Term
This pathology blocks the release of ACh with resultant paralysis. Patient will die quickly of respiratory failure.
Definition
Botulinum Toxin
Term
A patient can benefit from this with injection with a few muscles. Dosage depends on the weight of the patient. Useful in CP patients.
Definition
Botulinum Toxin
Term
Inject __ into spastic agonist muscles to allow for development of full range of motion in joint and allow stregthening of the antagonist.
Definition
Botox
Term
You inject specific muscles with this for a functional outcome.
Definition
Botox
Term
Produced by anaerobic bacterium in contaminated puncture wounds
Definition
Tetanus Toxin
Term
The tetanus toxin is carried to the spinal cord by __ transport up neuronal axons.
Definition
Retrograde
Term
Binds to axonal terminals of glycine-secreting inhibitory neurons.
Definition
Tetanus Toxin
Term
Prevents the release of glycine, causing unopposed excitatory input to motor neurons and uncontrolled muscle contraction.
Definition
Tetanus Toxin
Term
This is found in fertilized soil or soil contaminated by human or animal waste. The onset of symptoms are 3 days to 3 weeks following injury.
Definition
Tetanus Toxin
Term
What is the mortality rate of tetanus toxin
Definition
50%
Term
How can you prevent tetanus toxin?
Definition
Tetanus Vaccine
Term
Symptoms include asphasia, lock jaw, and spasm of facial neck muscles.
Definition
Tetanus Toxin
Term
An autoimmune disorder whose etiology is unknown.
Definition
Myasthenia Gravis
Term
Antibodies produced against own ACh receptors which then block the receptors, resulting in muscle weakness.
Definition
Myasthenia Gravis
Term
Causes decreased number of junctional folds which results in decreased ACh receptors.
Definition
Myasthenia Gravis
Term
With this pathology you can have normal activation of a muscle will experience weakness over time. Muscles will have difficulty with fast repetition.
Definition
Myastenia Gravis
Term
This pathology has decreased number of ACh receptors, sparse, shallow junctional folds, widening of synaptic space.
Definition
Myasthenia Gravis
Term
Patient with this pathology initially presents with weakness of ocular muscles (ptosis and diplopia); oropharyngeal weakness (dysarthria, dysphagia) and limb and neck weakness.
Definition
Myasthenia Gravis
Term
Drooping of eyelid
Definition
Ptosis
Term
Double vision
Definition
Diplopia
Term
Difficulty speaking
Definition
dysarthria
Term
Difficulty Swallowing
Definition
Dysphagia
Term
Weakness with this pathology can be resolved by administeration of cholinesterase blockers such as neostigmine or edrophonium
Definition
Myasthenia Gravis
Term
AChesterase breaks down ACh to reuse it. So if you use a cholinesterase blocker this will inhibit the breakdown and allow for ACh to hang out in the neuromuscular junction longer. What is the problem with this?
Definition
Receptors may become desensitized
Term
The most common X-linked disorder known. The incidence is 1:3500 live births
Definition
DMD (Duchenne Muscular Dystrophy)
Term
What is the lifespan of a person with DMD?
Definition
Late teens to early twenties
Term
What is muscle destruction in DMD due to?
Definition
abnormal or missing dystrophin (protein) and its effect at the muscle cell membrane
Term
What are PT goals with a patient with DMD?
Definition
Prevention of contractures and preserevations of mobility
Term
Poisons Schwann cells and causes demyelination fo nerve fibers and loss of nerve function.
Definition
Diptheria toxin and Lead
Term
An autoimmune disorder preceeded by a viral illness such as mono or flu
Definition
Guillian-barre Syndrome
Term
Peripheral polyneuropathy. Segmental demyelination of peripheral nerves including cranial nerves.
Definition
Guillian-Barre
Term
Causes symmetric limb weakness progressing to paralysis. May or may not experience sensory loss.
Definition
Guillian Barre
Term
Recovery for this pathology can take weeks to months. Two thirds can make a full recovery.
Definition
Guillian Barre
Term
How is cognitive function in a patient with Guillian Barre?
Definition
Intact
Term
A pathology that is more common in females usually between the ages of 20-40
Definition
MS (Multiple Sclerosis)
Term
Multiple areas of demyelination and sclerosis in the CNS. Unknown etiology, but believed to be a combination of environmental and genetic
Definition
MS
Term
A viral infection and autoimmune disorder are the two most common causes of pathogenesis for this.
Definition
MS
Term
Symptoms of this pathology very according to location and number of lesions. The disease is characterized by exacerbations and remissions.
Definition
MS
Term
An inflammatory response
Definition
Exacerbation
Term
Decreased edema and pain making the patient feel better.
Definition
Remission
Term
This pathology takes a variable and unpredicable course. It has multiple areas of demyelination. There is no functional return or repair.
Definition
MS
Term
What are the 3 traumatic injuries to axons and their myelin sheaths that were discussed?
Definition
Neuropraxia
Axonotmesis
Neurotmesis
Term
How are peripheral nerve injuries classified?
Definition
by their severity of lesion
Term
This peripheral nerve injury results in a temporary slowing or loss of axonal conduction.
Definition
Neuropraxia
Term
This peripheral nerve injury does not have any disruption to the axon or axonal degeneration.
Definition
Neuropraxia
Term
This peripheral nerve injury is usually caused by compression, stretching, or inflammation and a full recovery is expected.
Definition
Neuropraxia
Term
This peripheral nerve injury results in disruption of the axon continuity but no damage to the connective tissue that surrounds the axons.
Definition
Axonotmesis
Term
This peripheral nerve injury may be due to subsequent degeneration of distal axonal segments.
Definition
Axonotmesis
Term
This peripheral nerve injury presents with distal weakness and or sensory loss. It takes time to recover depending on severity and length of the nerve.
Definition
Axonotmesis
Term
Denervation of this peripheral nerve injury may be partial or complete.
Definition
Axonotmesis
Term
What is the peripheral receptor of the Deep Tendon Reflex?
Definition
Muscle Spindle
Term
This peripheral nerve injury is caused by axonal disuption and damage to the connective tissue that surrounds the nerve. Must be surgically repaired.
Definition
Neurotmesis
Term
This peripheral nerve injury results in degeneration of distal axonal segments, distal weakness and or sensory loss due to the complete transection of the nerve.
Definition
Neurotmesis
Term
Will a patient with Neurotmesis likely have a full recovery?
Definition
NO
Term
The process of axonal degeneration and secondary myelin degeneration following axonotmesis or neurotmesis.
Definition
Wallerian Degeneration
Term
This is where the axon degenerates since it is no longer supported by the neuronal cell body. Then the myelin sheath degenerates. Then macrophages arrive to ingest and remove the dead myelin and axonal fragments.
Definition
Wallerian Degeneration
Term
How long does wallerian degeneration take?
Definition
Many weeks
Term
How long does wallerian degeneration take?
Definition
Many weeks
Term
Where the nucleus moves to the periphery and there is a loss of nissl substance.
Definition
wallerian degeneration
Term
Where do you primarily see axonal degeneration?
Definition
PNS
Term
Central Chromatolysis of neuronal cell body
Definition
1. cell body swells
2. nissl substance disappears
3. altered metabolism to support regeneration of severed axon
Term
If the nerve sheath is intact, axonal sprouts will grow along it to target organ at an average rate of what?
Definition
1 mm/day
Term
In axonal regeneration, what is it that sprouts new axons?
Definition
axonal stump
Term
Can oligodendrocytes in the CNS regenerate?
Definition
No
Term
Can Schwann cells in the PNS regenerate?
Definition
Yes
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