Neuromuscular I
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33 terms
Terms | Definitions |
|---|---|
 Sx include: ataxic limb movements, Intention tremor, irregular oscillatory voluntary movements. Dysdiadokinesia, Dysmetria, Dyssynergia. ie. MS | Cerebellar Disease of the Pontocerebellum/Neocerebellum |
| Sx include: Hypotonia, truncal ataxia: disequilibrium, static postural tremor, inc. sway, wide BOS, high guard arm position. Posture worse with eyes closed, narrow BOS (Rhomberg, Sharpened Romberg). Ataxic gait; unsteady, inc falls, uneven dec. step length, inc. step width. ie. alcoholic cerebellar disease, Fredrich's ataxia. | Cerebellar Disease of the Spinocerebellum/ Paleocerebellum |
| Sx include: ipsilateral sx: Contralat sx: ocular dysmetria, poor eye pursuit, dysf. VOR, impaired eye-hand coordination, Gait /trunk ataxia Little chance in tone/dyssynergia of extremity mvmts. (vertigo, nystagmus, unsteady gait.) | Cerebellar Disease of the Vestibulocerebellum/Archicerebellum |
| 3 Types of Traumatic Nerve Injuries | Neurapraxia, Axonotmesis, Neurotmesis |
| Neurapraxia Class I | transient loss of function (conduction block ischemia) may be rapidly reversed or persist a few wks. ie. compression |
| Axonotmesis Class II | loss of function Wallerian degeneration distal to lesion; no disruption of endoneurium. (regen. distal to site is possible) ie. crush injury |
| Neurotmesis Class III | cutting of nerve severance of all structures, complete loss of function. Reinnervation typically fails with out surgical intervention. |
| Myopathy | inflammation of muscle, disease of muscle. sx: Proximal muscle weakness ie. MD |
| Radiculopathy | nerve rts, DDD, herniated disc, diabetes, spur, infection-trauma. |
| Mononeuropathy | single n. due to physical injury, prolonged pressure |
| Neuropathies | Sensory neuropathy(peripheral neuropathy) Polyneuropathy Charcots jt |
| Peripheral Neuropathy (Sensory) | most common is DM neuropathy |
| Polyneuropathy | symmetrical, Bilat, (related to glucose control), tingling in ft, dec sensation, affects LEGS > ARMS, and DISTAL> PROXIMAL. |
| Charcots jt neuropathy | affects jt, ft mostly, also compression of cranial autonomic neuropathies, Sx: DISTAL weakness of extremities |
| Asthenia | generalized weakness, F to G muscle grades. |
| Medial Medullary Syndrome | Sx include: ipsilat paralysis of tongue, contralat-paralysis of arm, leg, with impaired sensation. |
| Medial Inferior Pontine Syndrome (branch of basiliar artery) | ipsilat-cerebellar (nystagmus, ataxia, paralysis of conjugate gaze to SIDE OF LESION, diplopia. Central-hemiparesis, impaired sensation |
| Lateral inferior pontine Syndrome: AICA | ipsilat sx: cerebellar facial paralysis, conjugate gaze to SIDE OF LESION. deafness, tinnitus, impaired facial sensation Contralat sx: pain & temp 1/2 body |
| Lateral Medullary Syndrome (Wallenburgs) | ipsilat sx: ataxia, vertigo, nystagmus. Horners Syn: miosis, ptosis, dec sweating. Dysphagia, impaired speech, dec gag reflex Sensory loss; ipsilat arm, trunk, leg Contralat: loss pain& temp 1/2 body |
| Lacunar Stroke | occlusion of vessels of MCA or circle of Willis (branches) or vertebral art. and branches. |
| Vertebral Basiliar Artery Syndrome | Locked in syndrome Bilat corticospinal tracts; vertigo, ataxia, dysarthria (corticobulbar tracts) hemiplegia, tetraplegia, LOC, CN 6 VI (Abducens) |
| Posterior Cerebral Artery | Supplies; midbrain, temp lobe, post 1/3 cortex. Thalamic syndrome; pain and loss of sensation in face, arms, or legs. Involuntary mvmts- athetosis, chorea, hemiballismus Contralat hemiparesis Webers syndrome-oculomotor n. palsy, contralat hemiparesis Central sensory loss Central homonymous hemianopsia Visual sx-miosis, ptosis, dec. papillary light reflex. |
| Anterior Cerebral Artery (ACA) | supplies 2/3 of medial cerebral cortex Contralat sensory, hemiparesis LE>UE |
| Middle Cerebral Artery (MCA) | supplies lateral cerebral cortex, basal ganglia, large portions of internal capsule. Contralat- sensory loss, hemiparesis UE> LE Motor speech- Broca's Perceptual dysf. Homonymous Hemianopsia Loss of conjugate gaze on OPPOSITE side Sensory ataxia (parietal lobe) |
| Most common type of CVA | CVA of Middle Cerebral Artery (MCA) |
| Souques phenomenon | Raising involved UE above 100 deg with elbow extension will produce extension and abduction of fingers. |
| Raimistes phenomenon | involved LE will ABD/ADD with applied resistance to uninvolved LE in the same direction. |
| Homolateral Synkinesis | flex pattern of involved UE, facilitates flexion of involved LE. |
| Opisthotonos | prolonged severe spasm of m. causing hd, neck, heels to arch backwards. Arms/hands held rigidly flexed, Seen in severe meningitis, tetanus, epilepsy, strychnine poisoning. |
| Ideomotor apraxia | pt cannot perform task on command but can do task when left on own. |
| Ideational apraxia | pt cannot perform task at ALL, either on command or on own. |
| Agnosia | inability to recognize familiar obj w/one sensory modality while retaining ability to recognize the same obj. w/ other sensory modalities. |
| Apraxia | inability to perform voluntary learned mvmts w/loss of some conceptual/motor system. |
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