Neuro

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Author:
jessiekate22
ID:
171293
Filename:
Neuro
Updated:
2012-09-16 19:55:00
Tags:
Neuroanatomical Localisation CNS lesions
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Info for VIVA
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  1. General issues of lesions
    • - site of lesion
    • - size/ extent of lesion
    • - pathological process
    • - potentialfor treatment/ recovery
    • - age/ neuroplasticity
    • - stage of rehabilitation: primary problems vs secondary changes
  2. How do you know if a lesion is an upper motor neuron syndrome?
    • -weakness or paralysis of movement
    • - no profound wasting- global
    • - spasticity and hyperreflexia
    • - primitive reflexes
  3. How do you know if a lesion is an lower motor neuron syndrome?
    • - weakness or paralysis of individual muscles
    • - wasting- specific mm wasting
    • - fasciculation- spontaneous firing of nerves
    • - hypotonnia and hyporelexia/areflexia
  4. What symptoms would a patient have if they have a cerebellar lesion?
    • - incoordination
    • - poor postural control
    • - ataxia
    • - vertigo¬†
    • - nystagmus (voluntary or involuntary eye movement)
    • - intention tremour- tremour when you move
    • - dysmetria- inaccuracy with reach
    • - rebound phenomenon (oppose elbow flex when you remove force and the pt will continue to contract)
    • - dysdiadokineasia- cant rapidly alt movements
    • - dysynergia- inability turn mm off/on
  5. How can you tell if a pt has a basal ganglia lesion?
    • - motor control (bradykineasia)
    • - mm tone (eg rigidity)
    • - involuntary movements (eg resting tremour, chorea (big movement), athetosis (small), hemiballisums (violent/ abrubt)
    • - NO weakness or sensory loss
  6. How can you tell if a pt has a thalamic lesion?
    • - pain direct consequence- only this type
    • - loss of sensation in the contralateral face and limbs
    • - thalamic pain/ causalgia (burning pain)
    • - emotional disturbance- hypothalamus¬†
    • - sleep/ wake cycle problems
    • Rich connections: can mimic cortical defects
  7. What are some mid brain syndromes that may occur as a result of brainstem lesion?
    • - weber's
    • - benedikt's
    • - medial pons syndrome
    • - wallenberg syndrome- most common- lesion in pons
    • - locked syndrome- upper pons/ medualla- paraplegia and face movements
    • - unilateral lesion: ipsilesional CN findings, contralateral motor and sensory signs
    • - bilateral lesions = coma and death
  8. what are the types of lesions?
    • - vascular (occlusive, haemorrhagic)
    • - traumatic (focal, diffuse) - car accident
    • - trauma (benign, malignant)
    • - infective (bacterial, viral)
    • - degenerative
    • - congenital/ developmental
    • - other eg demyelinating disease
  9. Where does the ACA feed?
    - anterior circulation feeds the optic nerves, frontal, parietal and temporal lobes
  10. where does the posterior circulation feed?
    - cerebellum, brainstem, thalamus, occipital lobe and the medial part of the temporal bone
  11. intracranical haemorrhage types?
    • - extradural haematoma- trauma- blood outside between dura and skull- #s and skull fracture
    • - subdural haematoma- can be acute or chronic- blood under dura, caused by rupture of veins in subdural space
    • Above 2 not stroke- out side of brain
    • Below- stroke
    • - intracerebral haematoma- trauma, AVM, tumour, HT
    • - subarachnoid haemorrhage- trauma, aneurysm- blood below the arachnoid in the subarachnoid space, due bleeding of vessles on surface of the brain mixes with CSF
  12. What are the different types of traumatic lesions?
    • - penertrating force: foreign object, skull #, gun shot
    • - acceleration/ deceleration: contusions and bleeds
    • - rotational: sheering/tearing of axons and blood vessels- grey and white matter moves at different speeds
    • - secondary injury: hypoxia, metabolic effets, infection, system failure

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