Term
|
Definition
Located in the spinal cord
myelinated axons |
|
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Term
|
Definition
Located in the spinal cord
exclusively ascending pathways |
|
|
Term
|
Definition
Located in the spinal cord
bidirectional pathways |
|
|
Term
| anterior column funiculus- |
|
Definition
Located in the spinal cord
primarily descending pathways |
|
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Term
|
Definition
Located in the spinal cord
pain and temperature fibers cross midline here |
|
|
Term
|
Definition
Located in the spinal cord
neurons that have primarily a sensory role |
|
|
Term
|
Definition
Located in the spinal cord
neurons that have primarily a motor role |
|
|
Term
| intermediate gray and intermediate horn- |
|
Definition
Located in the spinal cord
neurons of the sympathetic nervous system |
|
|
Term
| anterior median and lateral fissure- |
|
Definition
Located in the spinal cord
AMF is home to the anterior spinal a. |
|
|
Term
| posterior median and intermediate sulcus- |
|
Definition
Located in the spinal cord
posterior median and intermediate sulcus- |
|
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Term
|
Definition
Located in the spinal cord
sensory information gain accès to SC |
|
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Term
|
Definition
motor and autonomic fibers to periphery
Located in the spinal cord |
|
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Term
|
Definition
Located in the spinal cord
sensory fibers from the periphery |
|
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Term
|
Definition
Located in the spinal cord
sensory neurons |
|
|
Term
| white pre-ganglionic ramus- |
|
Definition
Located in the spinal cord
short, presynaptic sympathetic fibers |
|
|
Term
| gray post-ganglionic ramus- |
|
Definition
Located in the spinal cord
long, postsynaptic sympathetic fibers |
|
|
Term
| posterior ramus of spinal nerve- |
|
Definition
| mixed nerve to skin and muscles of backLocated in the spinal cord |
|
|
Term
| anterior ramus of spinal nerve |
|
Definition
Located in the spinal cord
mixed nerve to skin and muscles of remainder of body |
|
|
Term
| cervical enlargement (C5-T1)- |
|
Definition
Located in the spinal cord
innervation to the arms |
|
|
Term
| lumbar enlargement (L1-S2)- |
|
Definition
Located in the spinal cord
innervations to the legs |
|
|
Term
| lumbar enlargement (L1-S2)- |
|
Definition
Located in the spinal cord
innervations to the legs |
|
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Term
|
Definition
Located in the spinal cord
tapered end of spinal cord |
|
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Term
|
Definition
Located in the spinal cord
fixes the spinal cord distally to the coccyx |
|
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Term
|
Definition
Located in the spinal cord
very long spinal roots after L2 level |
|
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Term
|
Definition
Located in the spinal cord
innermost meningeal layer |
|
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Term
|
Definition
Located in the spinal cord
intermediate meningeal layer |
|
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Term
|
Definition
Located in the spinal cord
outermost meningeal layer |
|
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Term
|
Definition
Located in the spinal cord
pial extensions that anchor the cord laterally |
|
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Term
|
Definition
Located in the spinal cord
pathway for sensation of light touch and vibration from below T7 |
|
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Term
|
Definition
Located in the spinal cord
pathway for sensation of light touch and vibration from above T7 |
|
|
Term
| 4 components of the Brain stem |
|
Definition
Medulla
Pons
Mid-Brain
Cerebellum |
|
|
Term
| pyramids and pyramidal decussation- |
|
Definition
Found in the Medulla
descending motor pathway and site of motor fiber crossing |
|
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Term
|
Definition
Found in the Medulla
motor nuclei that connects with cerebellum |
|
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Term
|
Definition
Found in the Medulla
indicates location of nucleus associated with sensation of light touch and proprioception from below T7 |
|
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Term
|
Definition
Found in the Medulla
indicates location of nucleus associated with sensation of light touch and proprioception from above T7 |
|
|
Term
| inferior cerebellar peduncle- |
|
Definition
Found in the Medulla
major pathway of sensory input from spinal cord to cerebellum |
|
|
Term
| foramen luschka and magendie |
|
Definition
Found in the Medulla
- passageway for CSF to flow out of brain |
|
|
Term
|
Definition
Glossopharyngeal Nerve IX
Vagus Nerve X
Spinal accessory nerve XI
Hypoglossal nerve XII |
|
|
Term
|
Definition
Found on the Pons
home of basilar artery |
|
|
Term
| middle cerebellar peduncle (brachium pontis)- |
|
Definition
Found on the Pons
major pathway for motor information from cerebral cortex to cerebellum |
|
|
Term
|
Definition
Trigeminal nerve V
abducens nerve VI
Facial nerve VII
Vestibular cochlear nerve VIII |
|
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Term
|
Definition
Found on the Mid-brain
continuation of medullary pyramid/ descending motor pathways |
|
|
Term
|
Definition
Found on the Mid-brain
major production site of dopamine |
|
|
Term
|
Definition
Found on the Mid-brain
motor nucleus that connects to upper extremity flexors |
|
|
Term
|
Definition
Found on the Mid-brain
connects the third and fourth ventricles |
|
|
Term
|
Definition
Found on the Mid-brain
integration of visual information |
|
|
Term
|
Definition
Found on the Mid-brain
integration of auditory information |
|
|
Term
| superior cerebellar peduncle |
|
Definition
Found on the Mid-brain
major efferent pathway from cerebellum to cerebral cortex |
|
|
Term
| superior medullary velum- |
|
Definition
Found on the Mid-brain
the roof of the fourth ventricle |
|
|
Term
| CN found on the Mid-brain |
|
Definition
oculomotor nerve III
trochlear nerve IV |
|
|
Term
|
Definition
anterior lobe
posterior lobe
primary fissure
posterolateral fissure
floccular nodular lobe
vermis and para-vermis
lateral hemisphere |
|
|
Term
| 4 parts of the Diencephalon |
|
Definition
Thalamus
Hypothalamus
Subthalamus |
|
|
Term
|
Definition
Found on the Thalamus
non-functional anatomical landmark that indicates the fusion of the two thalami |
|
|
Term
| septum pellucidum and third ventricle |
|
Definition
|
|
Term
| medial and lateral geniculate bodies |
|
Definition
Found on the Thalmus
relay station for auditory (medial) and visual (lateral) information |
|
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Term
|
Definition
|
|
Term
| infundibulum and pituitary- |
|
Definition
Found on the Hypothalamus
major site of hormone production |
|
|
Term
|
Definition
Found on the Hypothalums
limbic site that helps with formation of memories as well as integration of smell with memories |
|
|
Term
|
Definition
Found on the Hypothalamus
part of the limbic system, pathway that connects the hippocampus to the mammillary bodies |
|
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Term
|
Definition
| part of the basal ganglia, has a role in motor refinement |
|
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Term
|
Definition
Epithalamus
producer of melatonin, has role in regulating sleep/ wake cycles |
|
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Term
|
Definition
Epithalamus
interhemispheric communication, role in bilateral pupillary light reflex |
|
|
Term
| Telencephalon lateral sulcus |
|
Definition
|
|
Term
| Telencephalon central sulcus |
|
Definition
| separates frontal and parietal lobes |
|
|
Term
| Telencephalon calcarine sulcus |
|
Definition
| medial part of occipital lobe |
|
|
Term
| Telencephalon parieto-occipital notch and fissure |
|
Definition
| divides occipital and parietal lobes |
|
|
Term
| Telencephalon longitudinal fissure |
|
Definition
| separates the two hemispheres |
|
|
Term
|
Definition
(parahippocampal, uncus, and cingulate gyrus)
a. hippocampus deep to parahippocampal
b. amygdala deep to uncus |
|
|
Term
| corpus callosum and anterior commissure |
|
Definition
|
|
Term
|
Definition
| minor pathway into and out of cerebral cortex |
|
|
Term
|
Definition
putamen
globus pallidus
caudate nucleus |
|
|
Term
|
Definition
| dura structure that separates the two hemispheres |
|
|
Term
|
Definition
| dura structure that separates occipital lobe from cerebellum |
|
|
Term
| Recognize these structures |
|
Definition
3. dura matter
4. arachnoid and arachnoid granulations
5. sub-arachnoid space
6. superior sagittal sinus
7. inferior sagittal sinus
8. straight sinus
9. transverse sinus
10. sigmoid sinus
11. confluence of sinuses
12. cavernous sinus
13. two lateral ventricles
14. interventricular foramen (foramen of monroe)
15. choroid plexus |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| (internal carotid and sympathetics) |
|
|
Term
|
Definition
| (middle meningeal artery) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| (venous drainage, CNs IX, X, XI) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Branches of the vertebral artery |
|
Definition
a. anterior spinal artery
b. posterior inferior cerebellar artery
c. posterior spinal artery |
|
|
Term
|
Definition
a. labyrinthine artery (internal auditory)
b. anterior inferior cerebellar artery
c. superior cerebellar artery
d. posterior cerebral artery
e. pontine artery |
|
|
Term
| branches of internal carotid |
|
Definition
. internal carotid artery
2. ophthalmic artery
3. middle cerebral artery
4. anterior cerebral artery
5. posterior communicating artery
6. anterior communicating artery
7. anterior choroidal artery |
|
|
Term
|
Definition
Respond as long as the stimulus is present.
Example: muscle stretch |
|
|
Term
|
Definition
Respond initially to the stimulus. If stimulus remains constant, the receptor will stop transmitting.
Example: wrist watch |
|
|
Term
| Speed of transmission is determined by: |
|
Definition
Axon diameter
Axon myelination
Number of synapses – lesser synapses = faster |
|
|
Term
| Where are the majority of cell receptors located? Body and Head |
|
Definition
Body - dorsal root ganglion
Head - cranial nerve ganglia |
|
|
Term
| Structure of a peripheral sensory nerve |
|
Definition
Distal axons conduct messages from receptor to the cell body
Proximal axons project from the cell body into the spinal cord or brainstem, some proximal axons extend all the up into the medulla. |
|
|
Term
|
Definition
area of skin innervated by a single afferent neuron
smaller distally and larger proximally |
|
|
Term
| Fine touch receptor types |
|
Definition
| Meissner's corpucels - light touch and vibration Merkel's disks, pressure Hair folicles Subcutaneous - ruffini and pacinian corpuscles stretch and light touch A-betta afferents |
|
|
Term
|
Definition
| free endings, tickle and scratch |
|
|
Term
| What type of afferent fiber are involved in muscle spindles |
|
Definition
|
|
Term
| Tonic stretch noted by what type effect pathway |
|
Definition
|
|
Term
|
Definition
| maintain the sensitivity of intrafusal fibers |
|
|
Term
|
Definition
| transmit information about light touch and vibration |
|
|
Term
|
Definition
| transmit införmation about pain and temperature |
|
|
Term
| Dorsal Column/Medial Lemniscus System (DCML) from periphery to Medulla, |
|
Definition
| - Primary neuron is stimulated, goes up the distal axon to the dorsal root ganglion, where the cell body resides, - then the signal goes to the proximal axon into the spinal cord through the dorsal root to the dorsal column where it travel Ipsilateraly up the spinal cord, - Lower extremity neurons are in the fasciculus gracilis, Upper extremity neurons are in the fascicles cuneatus, - Synapse in the medulla at the nucleus gracilis, nucleus cuneatus |
|
|
Term
| Second order neuron in the DCML pathway |
|
Definition
Cell body the second order neuron is in the ispilateral medulla, (nucleus gracilis and cutaneous)
Crosses over quickly after synapse to contralateral side as internal arcuate fibers,
They ascend to the thalamus as the medial lemniscus,
Second neuron end the Ventral posterior lateral nucleus (VPL) |
|
|
Term
| Third Order neuron of DCML |
|
Definition
| Start at the VPL of the thalamus going to the cortex. Travel through the internal capsule |
|
|
Term
| Sensory information from the face goes through what nerve |
|
Definition
|
|
Term
| First order neuron in face sensation |
|
Definition
Their cell body reside in the trigeminal ganglion, the proximal neuron ends at the pons in the trigeminal main sensory nucleus.
On the ipsilateral side |
|
|
Term
| second order neuron of facial light touch sensation |
|
Definition
Cell body found in the trigeminal main sensory nucleus in the pons, immediately cross midline, called trigeminal lemniscus and end in the ventral posteromedial (VPM) nucleus of the thalamus.
Third-order axons continue to the cerebral cortex |
|
|
Term
|
Definition
| map of the body in the cortex |
|
|
Term
|
Definition
Cold - A-delta fiber
Hot C-delta fiber
First order goes to dorsal horn and synapse with with the second order
2nd order cross midline, then goes up the spinal cord to the VPL nucleus of the nucleus of the thalamus. Third order goes from the the thalamus to the sensory cortex |
|
|
Term
|
Definition
spinothalamic pain
first order- brings information into the dorsal horn through dorsalateral tract (lissauer's maginal) of the spinal cord
2nd order crosses midline at the anterior commissure and goes up the spinal cord up the Lateral thalamus
3rd order starts at the VPL thalamus to the cerebral cortex
A-delta fibers |
|
|
Term
| A lesion in the VPL nucleus |
|
Definition
| interrupts the pain pathway to the cortex, causing inability to localize painful stimuli feeling the affective (emotional) aspects of pain |
|
|
Term
| DCML vs Spinothalamic System |
|
Definition
spino - ascends contra laterally in the spinal cord
Dorsal - crosses in the medulla
both crosses at the 2nd order
both 2nd order ends at VPL nucleus of the thalamus to th |
|
|
Term
|
Definition
1st order - enter the pons travel down to the the medulla and upper cervical cord in the descending tract of the trigeminal nerve before synapsing in the spinal cord
Second fiber crosses the midlne and ascend in the trigeminal lemniscus to the VPM nucleus of the thalamus |
|
|
Term
| What is located in the Dorsal root ganglia? |
|
Definition
cell bodies of peripheral sensory neurons
no synapse occurs in the DRG |
|
|
Term
|
Definition
mediated by free nerve endings
percieve crudely localized touch, pressure and sensation of tinkle and itch |
|
|
Term
|
Definition
| Area of skin innervated by all axons found within a single DRG. |
|
|
Term
| Peripheral Nerve Distribution: |
|
Definition
| Peripheral nerves are made up of axons from multiple DRGs, therefore, the distribution will be different. |
|
|
Term
| Golgi tendon organs is transmitted by what type of neuron |
|
Definition
|
|
Term
| In sensory pathways where does the second order neuron cell body reside? |
|
Definition
in the medulla
Nucleus gracilis
Nucleus cuneatus |
|
|
Term
| Where are the cell bodies of 3rd oder neurons in the sensory pathway |
|
Definition
Thalamus
Relay to the cortex |
|
|
Term
| Where are the cell bodies of the 3rd order neuron located in the DCML |
|
Definition
| Ventral posterior lateral of the Thalamus |
|
|
Term
| Where do 1st order enter the spinal cord for the spinothalamic tract |
|
Definition
|
|
Term
| Spinomesencephalic (spino midbrain) Tract: |
|
Definition
Carries nociceptive info to superior colliculus and PAG (peri aqueductal gray).
Involved in orienting head to source of noxious input as well as activating descending pain control systems. |
|
|
Term
|
Definition
Reticular formation is neural network in the brainstem that controls arousal, attention and sleep/wake cycles.
Severe pain commands attention and disrupts sleep.
Control our back ground system |
|
|
Term
|
Definition
| Involves emotional response to injury or pain. |
|
|
Term
| Trigeminal sensory neurons |
|
Definition
The majority of the first order neurons are found in the Trigeminal ganglion (equivalent to the DRG).
The second order neurons are found in one of the sensory nuclei associated with the trigeminal nerve.
The third order neurons are located in the VPM nucleus of the thalamus. |
|
|
Term
| Facial Pain, Crude Touch and Temperature |
|
Definition
First order neurons found in the trigeminal ganglion.
Central processes enter the brainstem and descend within the spinal trigeminal tract.
Synapse with second order neurons in the ipsilateral spinal trigeminal nucleus.
Fibers cross, ascend in the ventral trigemino-thalamic tract to synapse in the VPM. |
|
|
Term
|
Definition
4 of them,
LE pathways: Dorsal Spinocerebellar Tract (DSCT), Ventral Spinocerebellar Tract (VSCT)
UE:: cuneocerebellar tract and rostral spino-cerebellar tract relay
, enter ascend and end up on the same side, right half of cerebellar, go into inferior cerebellar peduncle, where they travel lower half of the spinal cord, |
|
|
Term
|
Definition
Test: Alternate unilateral and bilateral stimuli
Interpretation:when you touch both bilaterally you can’t feel one side, but you can feel both sides unilaterally |
|
|
Term
| Complete Somatosensory Examination: Graphesthesia |
|
Definition
Test: What letter am I tracing on your hand?
Interpretation: Intact vs supra-thalamic lesion |
|
|
Term
| Complete Somatosensory Examination: Stereognosis |
|
Definition
Test: Place a common object in the pt’s hand
Interpretation: Normal- able to ID the object.
Abnormal: Lesion in contralateral association areas. |
|
|
Term
| Complete Somatosensory Examination: Sharp vs Dull |
|
Definition
Test: Use paperclip- randomly alternate between pointy end and blunt end.
Interpretation: Able to differentiate between two stimuli.
PNL= no detection
ALS lesion= cannot differentiate |
|
|
Term
| Electrodiagnostic Studies |
|
Definition
Nerve Conduction Studies (NCS)
Only tests peripheral nerves
Somatosensory Evoked Potentials (SEP)
Tests both PNS and CNS
Typically not performed by PTs |
|
|
Term
|
Definition
Caused by lesions in peripheral sensory nerves, DRG, dorsal columns or medial lemnisci.
Romberg test can distinguish between sensory and cerebellar ataxia. How?
People with sensory ataxia can do pretty well with reliable visual cues. |
|
|
Term
| Demyelination affects proprioception and vibratory senses more severely. Why? |
|
Definition
| more myelinated, first ones to go |
|
|
Term
| Brainstem Lesions affect sensory |
|
Definition
| Sensory signals from the body and face cross midline at various levels of the brainstem. Therefore, brainstem lesions will cause a mix of ipsilateral and contralateral deficits. All tracts have crossed by the time we get to the upper midbrain- therefore all sensory loss will be contralateral. |
|
|
Term
| Cerebral Lesions: Thalamus |
|
Definition
Lesions of the VPL result in decreased somatosensation from conralateral body.
What about sensation from the face? |
|
|
Term
| Cerebral Lesions: Somatosensory Cortex |
|
Definition
Contralateral loss of discriminative sensations.
Crude awareness of sensation may be present at thalamic level. |
|
|
Term
|
Definition
anticipatory use of sensory information preceeding a movement
Hamstring firing in advance of taking a step post ACL repair |
|
|
Term
|
Definition
| use of sensory information during or after a movement to improve accuracy |
|
|
Term
|
Definition
Decision - anterior portion of frontal lobe
Planning - fontal lobe
Control centers - basal ganglia and cerebellum
Action - Motor neuron + spinal interneurons |
|
|
Term
| Where are the cell bodies of lower motor neurons? |
|
Definition
| anterior horn of the spinal cord |
|
|
Term
| Organization of the Anterior horn |
|
Definition
Anterior - extensors
Posterior - flexors
Medial - proximal muscles
lateral - distal muscles |
|
|
Term
|
Definition
| Muscle contraction following brief stretch (think DTR) |
|
|
Term
|
Definition
Refers to response that lasts as long as the stretch stimulus is applied.
Example of clonus
Injury of damage to the CNS |
|
|
Term
| Medial Upper Motor Neurons |
|
Definition
| Signal LMN that innervate posture/ girdle muscles (antigravity muscles) |
|
|
Term
|
Definition
| Signal LMN that serve fine/distal movements. (upper-lower extremity neural highways) |
|
|
Term
| Nonspecific Upper Motor Neurons |
|
Definition
| Synapse throughout ventral horn and contribute to background activity and facilitate local reflex arcs (emotional motor) |
|
|
Term
| 4 major upper motor neurons highways |
|
Definition
-Tectospinal *** (posterior midbrain)
-Reticulospinal (nebulas
-Medial and lateral vestibulospinal (vestibular system Pons and medulla)
-Medial corticospinal (cortex) |
|
|
Term
|
Definition
| Orients head towards a visual or auditory stimulus |
|
|
Term
|
Definition
| Afferents from vestibular organs. Project to Bilateral cervical and thoracic mm, for proximal , goes to upper thoracic |
|
|
Term
|
Definition
| Afferents from vestibular organs. Facilitate ipsilateral extensors and inhibit ipsilateral flexors. Project throughout length of spinal cord. Antigravity, extremity extensors |
|
|
Term
|
Definition
| From cortex to ipsilateral cervical and thoracic LMNs. Controls neck, shoulder and trunk muscles |
|
|
Term
| Where do motor tracts that control posture and proximal limb movements begin? |
|
Definition
- Start in the Brain stem (x MCST, start in cortex)
- bi , ipsi, contra, lateral
- With the lesion of the brain one side, trunk gets milder deficits than limbs, because of these redundant pathways |
|
|
Term
|
Definition
Control limb flexion and fine movements.
Two tracts control movements of the limbs:
-Lateral Corticospinal Tract
-Rubrospinal Tract
One series of tracts controls facial muscles:
-Corticobulbar (Corticobrainstem)Tract go to cranial nerves |
|
|
Term
|
Definition
Originates in primary motor, premotor and supplemental motor cortex.
Goes down the lateral finiculus, distal control, cross overa at the decusation of the pyramids at the bottom of the medulla |
|
|
Term
|
Definition
| Rubro means red, - originates in the red nucleus of the midbrain |
|
|
Term
|
Definition
Two bilateral nuclei (locus ceruleus, raphe nucleus) enhance the activity of LMNs and spinal interneurons.
These tracts (ceruleospinal and raphespinal) are not related to specific movements and have been called part of the emotional motor system.
Examples: wall climbing and postural sway on platform. |
|
|
Term
|
Definition
Partial loss of voluntary contraction.
Hemi: Half the body
Para: Below the arms
Tetra: All extremities
LMN lesions cause paralysis as there is nothing else talking to the muscle
UMN lesions typically cause paresis as some tracts may still be intact |
|
|
Term
| Decerebrate vs Decorticate Rigidity |
|
Definition
If I damage the cortical brain and all is left is lower midbrain, all I can do is extension because of medial projecting tracts (Decerebral)
If red nucleus is concerved (rubrospinal stract), UE flexion starts becoming more noticeable (Decorticate)
Decerebratte – pointing down to the cerebellum
Decorticate – pointing up to the cortical |
|
|
Term
| Loss of Fractionated Movement |
|
Definition
Inability to activate muscle independent of other muscles.
Interruption of LCST (boss man)
Movements are awkward and inefficient |
|
|
Term
| UMN Syndromes: Abnormal Cutaneous Reflexes |
|
Definition
Babinski sign: Normal in infants younger than 7 months secondary to absence of myelin in LCST.
Indicates damage in corticopsinal tracts via mechanisms that are poorly understood.
Muscle stretch hyper-reflexia: Loss of descending presynaptic inhibition
Clonus: Lack of UMN influence over spinal interneurons. |
|
|
Term
|
Definition
Tone: Resistance to stretch in resting muscles
Following chronic UMN lesion, hypertonia (unusually strong resistance to stretch) is present.
Acute UMN lesion may present with hypotonia.
As cerebral/ spinal shock resolve, LMN and interneurons resume activity but without UMN influence. |
|
|
Term
|
Definition
Poorly used term as research and clinical definitions vary.
Research: Increase in muscle tone due to hyperexcitability of tonic stretch reflex
Clinical: Much broader: Includes entire UMN syndrome of paresis, muscle hyperstiffness, co-contraction and hyperreflexia |
|
|
Term
|
Definition
Complete SCI: loss of all descending neuronal control.
Incomplete- presentation is variable depending on location and extent. |
|
|
Term
| Parts of the Basal Ganglia |
|
Definition
| Caudate, Putamen, Globus Pallidus, Subthalmic Nucleus, Substantia Nigra |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the major output structures of the Basal Ganglia |
|
Definition
Striatum communicates with Globus Pallidus interns and Substntia Ngria Reticularis
This action is inhibitory |
|
|
Term
| Direct Pathway of the Basal Ganglia |
|
Definition
give distal control over proximal
The motor thalamus, is our thermostat (controlled by output is determining proximal input |
|
|
Term
| substantia nigra compacta |
|
Definition
(home of domamine), basal ganglia doesn’t work without dopamine,
Dopamine helps drive distal control at the expense of practical control
Without dopamine, parkinstons |
|
|
Term
| Dopamine on the Basal ganglia |
|
Definition
| Dopamine facilitates the direct pathway and inhibits the indirect pathway. In each case, the net effect is enhancement of motor cortex output. |
|
|
Term
| Thalamus involvement in hypokinetic and hyperkinetic movement |
|
Definition
Hypokinetic: Excessive inhibition of motor thalamus
Hyperkinetic: Insufficient inhibition of motor thalamus |
|
|
Term
| Parkinson’s Disease symptoms and signs |
|
Definition
| Rigidity, hypokinesia, Resting tremor(hyper movement), shuffling gait, freezing, visuoperceptive deficits, postural instability, and dementia |
|
|
Term
| Substangtia nigra compact produces what? |
|
Definition
|
|
Term
| Parkinson's Disease effects BG output |
|
Definition
Inhibits Motor Thalamus, which limits stimulation of motor cortex and corticospinal tracts, limits LMNs tracts
Increased stimulation of RST and VST tracts leading to Postural and Girdle tracts |
|
|
Term
| Progresive supranuclear palsy |
|
Definition
| Caused by loss of descending neurons that synapse on cranial nerve nuclei that control eye movements. |
|
|
Term
| Progressive supranuclear palsy signs and symptoms |
|
Definition
Early onset of gait instability (backwards falls)
Axial rigidity
Freezing of gait
Depression, psychosis, rage attacks
Gaze palsy (eyes can’t move) |
|
|
Term
| General input into the Cerebellum |
|
Definition
Intended informtion - from the Motor cortex, through the Pons
Interneuron excitability through the spinal interneurons - Ventral spinocerebellar tract VSPT, Rostral spinocerebellar Tract
Actual movement proprioceptors - DSCT Dorsal spinocerebellar tract, CST |
|
|
Term
| Part of the Cerebellum that receives information |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Vermis and paranormal action |
|
Definition
proximal control
Major outputs to the vestibular organs and reticular formation.
Controls and adjusts antigravity postural corrections and postural muscle tone |
|
|
Term
|
Definition
|
|
Term
| vestibulocerebellum controls |
|
Definition
|
|
Term
|
Definition
|
|
Term
| cerebrocerebellum controls |
|
Definition
|
|
Term
| Inferior Cerebellar Penduncles |
|
Definition
Afferents from the spinal cord and brainstem
- knowledge of actual movement - proprioceptors |
|
|
Term
| Middle cerelebellar penducles |
|
Definition
| Afferents from the pontine nuclei of the contralateral side, Intentions of movement from the cerebrum |
|
|
Term
| Superior Cerebellar Peduncles |
|
Definition
Major efferents from the cerebellum
going out of the cerebellum |
|
|
Term
| lateral hemispheres of the cerebellum |
|
Definition
are involved in planning movements.
Particularly learned, skillful movements that become more automatic and precise with practice. |
|
|
Term
| Destruction of one half of the cerebellum lead to |
|
Definition
|
|
Term
| Intermediate zone of the cerebellum |
|
Definition
Can influence LMN vis CST and RuST
Compares actual movements with intended movements |
|
|
Term
| Damage to the midline of the cerebellum |
|
Definition
| causes postural instability |
|
|
Term
| lateral damage to the cerebellum |
|
Definition
|
|
Term
| Flocculonodular damage of the Cerebellum |
|
Definition
|
|
Term
| Midline Damange, cerebellum causes and effects |
|
Definition
Malnutrition associated with alcoholism causes degeneration of cerebellar cortex that starts in midline of anterior lobe (anterior lobe syndrome).
The anterior lobe occupies a large part of vermis and paravermis
Gait is broad based and stiff with marked postural instability |
|
|
Term
| Lateral Damege of the cerebellum signs and symptoms |
|
Definition
Lateral hemispheres make up majority of cerebellum.
Most frequently damaged portion of cerebellum
Results in alterations in muscle tone (hypotonia), reflexes (hyporeflexia) and voluntary movements (dysmetria, dysdiadochokinesia).
All deficits are ipsilateral to lesion |
|
|
Term
|
Definition
| inaccurate movement, (distance, direction, force), picking up a cup (too short, miss the cup, too much force) |
|
|
Term
| Damage to Floculonodular Lobe |
|
Definition
Affects eye movements
Medulloblastomas are most common cause of damage
Loss of equilibrium and postural control
Difficulty with eye pursuits, maintaining eccentric gaze, making voluntary accurate eye movements. |
|
|
Term
| Where is the primary control of posture |
|
Definition
|
|
Term
| Ambulating is primarily controlled by |
|
Definition
| brainstem and spinal cord regions |
|
|
Term
| reaching and grasping are controlled |
|
Definition
|
|
Term
|
Definition
Provides orientation (adjustment of body and head to vertical) and balance (ability to maintain COM over BOS)
Achieved by central commands directing LMNs
Central commands include: TST, MRST, VST, MCST. |
|
|
Term
| Postural control Parkinson's Disease |
|
Definition
| Flexed posture, lack of protective reactions and weak anticipatory postural adjustments |
|
|
Term
| Ambulation cerebral cortex effects |
|
Definition
| goal orientation and control of ankle movements |
|
|
Term
|
Definition
|
|
Term
| Ambulaiton cerebellum effects |
|
Definition
| Timing, coordination and error correction |
|
|
Term
| Ambulation Brainstem Descending Tracts |
|
Definition
| Adjusts strength of muscular contractions |
|
|
Term
| Spinal Cord effect of Ambulation |
|
Definition
| Controls pattern of muscle activation |
|
|
Term
| How do afferent pathways of the ANS enter the CNS |
|
Definition
Into the spinal cord via the dorsal roots
Into the brainstem via CN VII, IX and X |
|
|
Term
| Where do visceral information converge in the CNS? |
|
Definition
Solitary Nucleus in the Medulla
From here, information is routed to visceral control centers in the Pons, Medulla and to modulatory areas in the Hypothalamus, Thalamus and Limbic system |
|
|
Term
| ANS synapse in the spinal cord |
|
Definition
visceral afferents entering the spinal cord synapse with efferents (autonomic reflexes) and with neurons that ascend to regions of the brainstem, hypothalamus and thalamus.
Visceral nociceptive information additionally connect with:
Somatosensory pain efferents (referred pain)
Somatic efferents (muscle guarding) |
|
|
Term
| what is the role of the medulla and pons in the ANS |
|
Definition
| - Regulation of heart rate, respiration, vasoconstriction/vasodilation |
|
|
Term
| Role of hypothalamus in ANS |
|
Definition
| Control homeostasis by influencing caridorespiratory, metabolic, water reabsorption and digestive activity |
|
|
Term
|
Definition
Information reaching thalamus is projected mainly to limbic areas to produce:
Increased HR with anxiety, blushing with embarrassment, crying |
|
|
Term
| How many neurons are present in efferent ANS pathways |
|
Definition
2-neuron chain
The primary neuron lives in the CNS (presynaptic or preganglionic)
The secondary neuron is the periphery (Postsynaptic or postganglionic) |
|
|
Term
| What is location of primary neurons in the Sympathetic system |
|
Definition
| lateral horns of T1-L2 (spinal cord) thoracolumbar system |
|
|
Term
| Where does the sympathetic system innervate |
|
Definition
| adrenal medulla, vasculature, sweat glands, erector hair cells, viscera |
|
|
Term
| Sympathetic efferent to the adrenal medulla |
|
Definition
| Primary neuron is directly connected to the medulla causing a release of the epinephrine directly into the blood stream |
|
|
Term
| Symphathetic efferents to the face, limbs, body wall, heart, and lungs |
|
Definition
| Primary neuron synapse in the parabertebral chain then a secondary neuron goes to the specific tissue |
|
|
Term
| Sympathetic efferents to the abdominal and pelvic viscera |
|
Definition
| travel to through paravertebral chain without synapsing, they travel with the splanchnic nerves, and synapse in the pre vertebral ganglia |
|
|
Term
| FUNCTIONS OF SYMPATHETIC SYSTEM |
|
Definition
Prime job is to maintain optimal blood supply to the organs
Sympathetic activity causes vasoconstriction- decreasing blood flow
Think about fear-
Vasoconstriction in skin and gut increases blood flow to active muscles
Blood glucose increases, bronchi and coronary vessels dilate, BP and HR increase, digestion is halted |
|
|
Term
| REGULATION OF BLOOD FLOW IN SKELETAL MUSCLE |
|
Definition
Skeletal muscle veins and venules allow blood to pool during relaxation
If pooling is not prevented when a person stands, BP will drop (syncope)
Normally, the pooling is prevented by contraction of the vessels prior to standing
Accomplished by systemic release of norepinephrine |
|
|
Term
| Additional action sympathetic control in the head |
|
Definition
In addition; pupil dilation, elevation of upper eyelid, production of thick saliva (cotton mouth)
Levator palpebrae superioris contains both smooth muscle and skeletal muscle |
|
|
Term
| Parasympathetic efferent neuron chain |
|
Definition
Neuron 1- contained within the CNS (CN III, VII, IX, X and S2-4)
Neuron 2- in a peripheral ganglion located near the target tissue |
|
|
Term
|
Definition
| pupil constriction and lens thickening |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Heart, lungs and upper GI system |
|
|
Term
|
Definition
| lower GI, pelvic and perineal viscera |
|
|
Term
| Does the PNS innervate the limbs or body wall |
|
Definition
no
the Sympathetic does though |
|
|
Term
|
Definition
- Interruption of sympathetic pathways to the head
- lesion of the descending sympathetic signals, upper thoracic spine, vertical sympathetic chaing
- Ptosis, myosis, anhydrosis
Myosis – size of the pupil, cant dilate
Anhydrosis – lack of sweating |
|
|
Term
| Severing a peripheral nerve, ANS implication |
|
Definition
Severing a peripheral nerve interrupts sympathetic efferents, causing loss of vascular control, temperature regulation, sweating in the region supplied.
These may lead to trophic changes in the skin |
|
|
Term
| Brainstem injury ANS implications |
|
Definition
May interfere with descending control of heart rate, blood pressure and respiration.
May also interfere with CN nuclei affecting pupil size, tear production, mucus production, salivation or regulation of thoracic and abdominal viscera |
|
|
Term
| Cerebral damage: ANS implications |
|
Definition
| Damage to certain parts of the hypothalamus can disrupt homeostasis with consequent metabolic and behavioral dysfunctions |
|
|
Term
| Neural Tube Formation (18-26 days) |
|
Definition
Nervous system begins as a longitudinal thickening of the ectoderm called the neural plate.
The plate begins to fold, creating the neural groove.
When the ends of the fold touch, the neural tube forms.
The groove zips closed leaving openings at each end (medial to lateral). |
|
|
Term
|
Definition
Cells adjacent to the neural tube separate from the tube to form neural crest cells.
Neural crest cells creates clusters are outside the tube – part of our peripheral nervous system |
|
|
Term
| When does the neural tube close |
|
Definition
|
|
Term
| gray and white matter formation |
|
Definition
The tube differentiates into two concentric rings.
The mantle layer (inner wall) will become gray matter.
The outer marginal layer will develop into white matter. |
|
|
Term
|
Definition
| adjacent tissue to the neural tube that is divided into spherical clusters |
|
|
Term
|
Definition
| Becomes skull and vertebrae |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Therefore, myotome has two meanings: |
|
Definition
| An embryologic section of the somite. Post-embryonic stage: a group of muscles that are innervated by a segmental spinal nerve. |
|
|
Term
| the dorsal section of the neural tube |
|
Definition
is the association (alar) plate
neurons here will become sensory neurons |
|
|
Term
| Basal plate of the neural tube |
|
Definition
| Neurons whose cells bodies are in the basal plate become motor neurons which innervate skeletal muscle and interneurons. |
|
|
Term
|
Definition
The neural crest separates into two columns, one on each side of the tube.
The columns break into segments that correspond to the dermal areas of the neighboring somite.
These neural crest cells will become peripheral sensory neurons, myelinating cells, autonomic neurons and endocrine organs. |
|
|
Term
| peripheral sensory nerve development |
|
Definition
| The cells that become peripheral sensory nerves grow two processes; one connects to the spinal cord and the other innervates the region of the somite that will become the dermis. |
|
|
Term
| Spinal column development |
|
Definition
Until the 3rd month, spinal cord segments are adjacent to corresponding vertebrae and the spinal nerves project laterally.
As the fetus matures, the spinal column grows faster than the spinal cord.
The adult spinal cord ends at the L2/L3 vertebral level.
Within the adult spinal cord, the neural tube cavity persists as the central canal. |
|
|
Term
| Following closure of the superior neuropore, the brain region of the tube expands to form three enlargments. |
|
Definition
- Forebrain
- Midbrain
- Hindbrain |
|
|
Term
|
Definition
The forebrain continues to develop rapidly and will begin to fold in on itself thereby burying many nuclear structures:
Thalamus
Hypothalamus
Basal Nuclei |
|
|
Term
| Epithelial cell development |
|
Definition
Epithelial cells that line the neural tube will differentiate into neurons and glial cells.
These cells migrate into their final positions via multiple methods.
Once in the final position, the cells will differentiate into a specific type of cell, depending on its location.
Therefore, daughter cells of a specific mother cell may assume very different functions based on their final location. |
|
|
Term
| Cellular processes (growth cone) |
|
Definition
Cellular processes (growth cone) grow out from the neuron which slowly samples the cellular environment along the way.
The growth cone continuously samples other neurons and chemical signals until it finds a region that has compatible growth cone characteristics. |
|
|
Term
| When the growth cone has found chemical signals that it likes |
|
Definition
synapses begin to form between the neuron and its target.
By the fourth month, axons undergo a process called myelination.
This process will continue until the third year of life. |
|
|
Term
| Oligodendrocytes and Schwann: Cellular-Level Development |
|
Definition
Oligodendrocytes in the CNS are able to myelinate several different axons.
Schwann cells in the PNS can only myelinate a single axon. |
|
|
Term
|
Definition
Myelination occurs at different rates.
Motor neurons in the spinal cord are myelinated by 1 month after birth.
However, the cortical neurons that extend down to reach the spinal cord may not be myelinated until age 2.
Implications of perinatal nerve injury? – you wont see the injury, and can go undetectad for a couple of years because no CNS control yet, grow into their defecits |
|
|
Term
| when is the cps most susceptible to major malformation |
|
Definition
The CNS is most susceptible to major malformations between day 14 and week 20.
After this period, growth and remodeling continue.
However, insults cause functional disturbances and/ or minor malformations. |
|
|
Term
|
Definition
Anencephaly occurs when the cranial end of the neural tube fails to close and the forebrain does not develop.
The skull fails to close over the top of the brain.
Not compatible with life. |
|
|
Term
| Arnold-Chiari malformations. |
|
Definition
Developmental malformations of the hindbrain include Arnold-Chiari malformations.
The inferior cerebellum and medulla are elongated and protrude into the foramen magnum.
The deformity is associated with enlarged cranium 2° to CSF blockage. |
|
|
Term
| Arnold-Chiari malformations. symptoms and problems |
|
Definition
Problems may include: tongue and facial weakness, deafness, weakness of lateral eye movements and coordination of movements due to cerebellar and cranial nerve involvement.
May require surgical enlargement of foramen magnum. |
|
|
Term
|
Definition
Failure of the inferior neuropore to close results in spina bifida.
Developing vertebrae do not close around the incomplete neural tube.
Associated with maternal nutritional deficits.(folic acid) |
|
|
Term
|
Definition
| neural tissue does not protrude and function is usually normal. |
|
|
Term
|
Definition
| Meninges protrude and spinal cord function may be impaired. Mild deficits de to a slight defecits of the cord |
|
|
Term
|
Definition
Neural tissue protrudes and involves varying degrees of lower extremity and bowel/ bladder dysfunction.
Similar to a L4 spinal cord injury |
|
|
Term
| Fetal Alcohol Syndrome (FAS) |
|
Definition
results in impaired nervous system development, growth deficiencies and facial abnormalities.
Cognitive impairments are typical.
Children will have abnormally small heads and eyes will be very far apart.
Behavioral issues are prevelant. |
|
|
Term
|
Definition
Cocaine can easily cross the placenta and remains in the fetal blood stream for prolonged periods secondary to immaturity of metabolic and excretory processes.
Results in impaired nervous system development. |
|
|
Term
|
Definition
CP is a movement and postural disorder caused by permanent and non-progressive damage to the developing brain.
Caused by diminished oxygen delivery to the developing brain. |
|
|
Term
|
Definition
Damaged neurons around the ventricles.
Muscle shortening often results in toe walking and scissor gait patterns. |
|
|
Term
|
Definition
Neuronal damage in the basal nuclei. hyperkinetic
Results in slow, writhing movements of the trunk or extremities. |
|
|
Term
|
Definition
Damage in the developing cerebellum.
Results in incoordination, weakness and shaking during voluntary movements.
Cognitive, somatosensory, visual, auditory and speech problems are also frequently seen in all types of CP. |
|
|
Term
| What do the posterior rami innervate |
|
Definition
| deep back muscles and overlying skin |
|
|
Term
| Anterior rami innervates.. |
|
Definition
| skeletal, muscular and cutaneous areas of the limbs and anterior lateral trunk |
|
|
Term
|
Definition
surrounds individual axons
Surrounds individual fibers
If intact following injury, may help guide nerve fiber during regrowth |
|
|
Term
|
Definition
bounds axons into groups of fascicles
Thin layer of concentrically arranged collagen
Forms a blood-nerve barrier
Continues as the capsule of some endings (Pacinian corpuscles, spindles, GTO)
However, at NMJ, perineurium is deficient, allowing endoneurial space around the nerve to communicate with extracellular space
Certain toxins and viruses gain access to the nervous system here |
|
|
Term
|
Definition
encloses the entire nerve trunk
Loose CT surrounding each peripheral nerve
Forms substantial covering over nerve trunk then thins to incomplete layer at terminal end
Responsible for the tensile strength of the nerve
Continuous centrally with Dura mater |
|
|
Term
| What insulates axons from each other |
|
Definition
| Within the nerve, axons are insulated from each other by endoneurium and a myelin sheath (Schwann cells) |
|
|
Term
| Efferent large myelinated |
|
Definition
name: Aa
innervates: Extrafusal muscle fibers |
|
|
Term
|
Definition
NameL A-gamma
Intrafusal muscle fibers |
|
|
Term
|
Definition
name: B
Presynaptic autonomic |
|
|
Term
|
Definition
|
|
Term
| Afferent large myelinated |
|
Definition
name: Ia, Ib, II
Spindle, GTO, touch and pressure |
|
|
Term
| Afferent small myelinated |
|
Definition
name A-delta
Pain, temp, visceral receptors |
|
|
Term
|
Definition
Name C
Pain, temp, visceral receptors |
|
|
Term
|
Definition
Anterior rami of C1-4
Found deep to SCM
Provides sensation from posterior scalp to clavicle, innervates anterior neck muscles and diaphragm |
|
|
Term
|
Definition
Anterior rami of C5-T1
Emerges between Anterior and Middle Scalene, passes deep to clavicle to enter axilla
Provides sensation and motor to entire UE |
|
|
Term
|
Definition
Anterior rami of L1-4
Forms within Psoas Major
Provides sensation and motor to entire anterior and medial thigh |
|
|
Term
|
Definition
Movement improves health of nerve by promoting blood flow and the flow of axoplasm
Fascicles glide within the nerve and nerves glide relative to other structures
In the absence of movement, axoplasm thickens and becomes more resistant to flow (anterograde and retrograde transport)
Nerves elongate with the support of CT and axonal folding |
|
|
Term
|
Definition
Nerve-muscle synapse requires only depolarization of the motor axon, releasing ACh (always excitatory) which binds with receptors on muscle membrane.
No summation is required and no inhibition is possible.
In normal motor unit, every depolarization of the motor axon releases sufficient ACh to initiate AP in the muscle
Even when LMN is inactive, it spontaneously releases minute amounts of ACh causing mini end-plate potentials (needed for muscle health) |
|
|
Term
| Sensory changes post PN dysfunction |
|
Definition
| Sensory changes (decreased or absent) or abnormal sensations (hyperalgesia, dysesthesia, paresthesia) |
|
|
Term
| Autonomic changes post-dysfunction of PN |
|
Definition
| may include lack of sweating, loss of sympathetic control of smooth muscle in arteries (edema). If many nerves included- impotence, difficulty regulating BP, HR, B/B function |
|
|
Term
|
Definition
| Motor changes may lead to paresis or paralysis. Denervated muscle EMG activity may show fibrillation after 1 week post injury |
|
|
Term
| Denervation: Trophic Changes |
|
Definition
Muscle atrophy, skin becomes shiny, nails become brittle and subcutaneous tissue thickens.
Ulceration and poor healing of wounds is common as is neurogenic joint dysfunction 2/2 blood supply changes, loss of sensation and lack of movement |
|
|
Term
|
Definition
Caused by trauma,
myelination
Recovery: complete and rapid by remylination |
|
|
Term
|
Definition
usual cause: trauma
axonal damage
recovery: slow, by regrowth of axons. But gooth |
|
|
Term
|
Definition
trauma, axon and myelin damage
Slow, with poor results secondary to inappropriate reinnervation |
|
|
Term
|
Definition
causes: DM, blood vessel inflammation
pathology: Iscemia of neuron
Recovery: Slow, by regrowth of axons. Usually good |
|
|
Term
|
Definition
cause: DM, autoimmune syndrome (GBS) or genetic
Metabolic or inflammary pathology
recovery Variable |
|
|
Term
|
Definition
Traumatic injury including repetitive stimuli, prolonged compression or stretch, wounds:
Traumatic myelinopathy
Traumatic axonopathy
Severance |
|
|
Term
|
Definition
Loss of myelin limited to site of injury
Involves large-diameter axons leading to motor, light touch/ proprioceptive, phasic stretch deficits and neuropathic pain
Autonomic function typically sparred (C fibers, don’t have mylein anywhere)
Axons are NOT damaged
Recovery is typically complete and rapid |
|
|
Term
| Progressive monoaxonal damage |
|
Definition
1) Repeated mechanical Stimulation
2) Decresed epineural blood flow/axonal transport
3) Edema of endo/epineurium (also causes 2)
4) Thickening of epi/perineurium
5) Myelin Damage
6) Development of entropic foci
7) REpeted stimulation of nociceptors (cause by 4)
8) Sensitization of nociceptors
9) Excessive sensitivity to mechanical and chemical stimuli |
|
|
Term
|
Definition
| unmyelination causes adjacent unwanted stimuli because of touching |
|
|
Term
| Myelin damage progression |
|
Definition
1) axonal damage
2) Decreased NCV
3) Impairered light touch, proprioception (also results from 4)
4) Decreased amplitude of nerve conduction potentials (caused by 1) |
|
|
Term
| common compression of median nerve |
|
Definition
| (Pronator Teres (syndrom), Carpal Tunnel) |
|
|
Term
| Ulnar nerve compression sites |
|
Definition
| (Cubital tunnel, Guyon’s canal) |
|
|
Term
| Radial nerve compression site |
|
Definition
|
|
Term
| Common fibular compression |
|
Definition
|
|
Term
Pronator Teres Syndrome.
muscles affected |
|
Definition
Compression of Anterior Interosseous Nerve:
FPL, FDP (Index finger), Pronator Quadratus |
|
|
Term
|
Definition
| atrophy and sensory changes to the medial part of the hand |
|
|
Term
|
Definition
Ulna nerve
Handlebar Paslsy |
|
|
Term
|
Definition
sleeping on an IR humerus
saturday night palsy |
|
|
Term
|
Definition
| Radial nerve compression in the axial region |
|
|
Term
|
Definition
Maybe cause by casting or bracing
Common fibular nerve,
DF and Eversion defecits |
|
|
Term
|
Definition
Disrupts axons and wallerian degeneration occurs distal to lesion
Typically occur from crushing injuries
Affects all sizes of axons: reflexes, somatosensation, motor function lost
Myelin and CT remains intact so regeneration and retargeting are possible
Axon regrowth at rate of 1mm/day |
|
|
Term
|
Definition
Excessive stretch or laceration leading to axon and CT destruction
Axons in proximal stump begin to sprout
If the 2 ends miraculously meet, there may be some restoration of function, not guranteed |
|
|
Term
|
Definition
Two or more nerves in different body parts.
Typically caused by DM or vasculitis.
Random, asymmetric presentation |
|
|
Term
|
Definition
Symmetric involvement of sensory, motor and autonomic fibers
Distal to proximal progression (stocking & glove)
May occur 2/2 poor axonal transport or demyelination
Causes are toxic, metabolic or autoimmune
Etoh, DM and autoimmune diseases
Socking & glove – start at the feet and hands and may progress proximal |
|
|
Term
|
Definition
Axon and myelin damage with sensation most affected
Impaired vibratory sensation typically the first sign
Decreased autonomic function, muscle weakness and loss of pain often lead to Charcot deformity |
|
|
Term
|
Definition
Greater sensory involvement with greater paresis proximally
Very rapid onset
Autoimmune disorder |
|
|
Term
| Charcot-Marie-Tooth Disease |
|
Definition
AKA: Hereditary Motor and Sensory Neuropathy (HSMN)
Paresis of muscles distal to knee- foot drop and steppage gait
Progresses to involve muscles of the hands
Genetic mutations affecting structure and function of peripheral axons and myelin |
|
|
Term
|
Definition
Autoimmune disorder damaging ACh receptors at NMJ
Circulating antibodies competitively bind to the ACh receptors- ACh has no where to go.
Repeated contractions leads to easy muscular fatigue
Treated with acetylcholinesterase inhibitors |
|
|
Term
|
Definition
Interference with ACh release from motor axon leading to acute, progressive weakness
Sensation remains intact
Botox is used therapeutically to manage spasticity to weaker overactive muscles |
|
|
Term
|
Definition
Disorders intrinsic to muscles
The nervous system is healthy and intact- sensory and autonomic functions are normal
Coordination, muscle tone and reflexes are unaffected until atrophy becomes too severe
Major myopathy is Muscular Dystrophy |
|
|
Term
|
Definition
Duchennes MD is most common
Typically occurs in boys vs girls
An inherited condition leading to random muscle fiber degeneration
Motor units are now much smaller than normal leading to decreased force production |
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Term
| Electrodiagnostic Studies can be used to differentiate the following |
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Definition
| Myelinopathy (slowed velocities) vs axonopathy (decreased amplitudes and possibly decreased velocity) UMN lesions (normal NCS) vs LMN lesions (abnormal NCS) Mononeuropathy vs polyneuropathy Local block (only at a specific site) vs wallerian degeneration (entire exam distal to lesion) |
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Term
| PNS vs CNS: Distribution of s/s |
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Definition
PNS - peripheral nerve pattern
CNS - Dermtomal or mytomal pattern (spinal cord) |
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Term
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Definition
PNS: Slowed or blocked conduction, decreased amplitude
CNS: Normal |
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Term
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Definition
PNS: Hypotonia if LMN involved
CNS: Hypertonina if UMN involved |
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Term
| Muscle atrophy: CNS vs PNS |
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Definition
PNS: rapid atrophy indicates denervation
CNS: Progresses slowly |
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Term
| Phasic stretch reflexes CNS vs PNS |
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Definition
PNS: Reduced or absent
CNS: Hyperactive or normal |
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Term
| Praspinal Sensation or Motor |
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Definition
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Term
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Definition
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Term
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Definition
mm: Coracobrachialis, Biceps Brachii, Brachialis
skin: lateral forearm |
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Term
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Definition
mm: pronator teres, FCR, Palmaris longus,
anterior interosseus: FDS, FDP (radial side), FPL, Pronator Quadratus,
Median: APB, FPB, Opponents Pollicis, Lumbricals 1,2
Snsation: medial hand palmar side, tips of thumb, index and ring dorsal side |
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Term
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Definition
mm: FCU, FDP (ulnar side) ADM, ODM, FDM, All interossei, Lumbricals 3,4, Add Policis, Palmaris Brevis
Sensation: lateral hand dorsal and ventral |
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Term
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Definition
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Term
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Definition
Triceps, Brachioradialis, ECRL, ECRB, Supinator, APL, EPB, Extensor Indices
EPL, ECU, EDM, ED, Anconeus
Sesation, posterior arm, dorsal lateral hand |
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Term
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Definition
Psoas Major
Iliacus
Pectineus
Sartorius
Vastus Lateralis
Rectus Femoris
Vastus Intermedius
Vastus Medialis
sensation quad midial shin |
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Term
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Definition
Biceps (short head)
Fibularis Longus
Fibularis Brevis
Tibialis Anterior
EDL
EHL
Fibularis Tertius
Extensor Hallicis
EDB
lateral calf, dorsal foot |
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Term
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Definition
Obturator Externus
Adductor Magnus
Adductor Brevis
Adductor Longus
Gracilis
Skin: medial thigh |
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Term
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Definition
Biceps (long head)
Semitendinosus
Semimembranosus
Adductor Magnus
Plantaris
Gastrocnemius
Popliteus
Soleus
FHL
FDB
Tibialis Posterior
Most foot intrinsics
Posterior latareal calf, plantar foot |
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