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final-review 16

neuro16 pathology

upper motor neuron disease is characterized by a lesion found in descending motor tracts within the cerebral motor cortex, internal capsule, brainstem or spinal cord.
Symptoms upper motor neuron disease weakness of involved muscles, hypertonicity, hyperreflexia, mild disuse atrophy, and abnormal reflexes.
where are Damaged tracts in upper motor neuron disease the lateral white column of the spinal cord.
Examples of upper motor neuron lesions include cerebral palsy, hydrocephalus, CVA, birth injuries, multiple sclerosis, and brain tumors.
upper motor neuron disease Reflexes: Hyperactive
upper motor neuron disease Atrophy: Mild from disuse
upper motor neuron disease Fasciculations: Absent
upper motor neuron disease Tone Hypertonic
lower motor neuron disease a lesion that affects nerves or their axons at or below the level of the brainstem, usually within the “final common pathway.” The ventral gray column of the spinal cord may also be affected.
Symptoms of Lower Motor Neuron Disease flaccidity or weakness of the involved muscles, decreased tone, fasciculations, muscle atrophy, and decreased or absent reflexes.
Examples of lower motor neuron lesions include poliomyelitis, tumors involving the spinal cord, trauma, infection, and muscular dystrophy.
Lower Motor Neuron Disease Reflexes: Diminished or absent
Lower Motor Neuron Disease Reflexes Atrophy: Present
Lower Motor Neuron Disease Reflexes Fasciculations: Present
Lower Motor Neuron Disease Reflexes Tone: Hypotonic to flaccid
Alzheimer's Disease Progressive neurological disorder that results in deterioration and irreversible damage within the cerebral cortex and subcortical areas of the brain
Alzheimer's Disease is initially noted by a change in higher cortical functions characterized by subtle changes in memory, impaired concentration, and difficulty with new learning
Typical course of the Alzheimer's disease averages between 7-11 years with death resulting from infection or dehydration
Amyotrophic Lateral Sclerosis Risk is higher in males than females and usually occurs between 40-70 years of age
Clinical presentation Amyotrophic Lateral Sclerosis may include both upper and lower motor neuron involvement with weakness occurring in a distal to proximal progression
Average course of the diagnosis of Amyotrophic Lateral Sclerosis is two to five years with 20-30% of patients surviving longer than five years
Central Cord Syndrome An incomplete spinal cord lesion that most often results from a cervical hyperextension injury
Clinical presentation Central Cord Syndrome involves motor loss that is greater in the upper extremities than the lower extremities
Most common incomplete spinal cord lesion accounting for approximately 30% of all incomplete forms of tetraplegia
Spastic cerebral palsy involves upper motor neuron damage; athetoid cerebral palsy involves damage to the cerebellum, cerebellar pathways or both
Clinical presentation cerebral palsy includes motor delays, abnormal muscle tone and motor control, reflex abnormalities, poor postural control, and balance impairments
Mental retardation and epilepsy are present in 50-60% of children diagnosed with cerebral palsy
Types of CVA include ischemic stroke (thrombus, embolus, lacunar) and hemorrhagic stroke (intracerebral, subdural, subarachnoid)
Left CVA may present with weakness or paralysis to the right side, impaired processing, heightened frustration, aphasia, dysphagia, and motor apraxia
Right CVA may present with weakness or paralysis to the left side, poor attention span, impaired awareness and judgment, spatial deficits, memory deficits, emotional lability, and impulsive behavior
Down Syndrome Clinical manifestations include hypotonia, flattened nasal bridge, Simian line (palmar crease), epicanthal folds, enlargement of the tongue, and developmental delay
Detection Down Syndrome occurs in approximately 60-70% of women tested that are carrying a baby with Down syndrome
Exercise is essential for a child with Down syndrome in order to avoid inactivity and obesity
Erb's Palsy Muscles affected are supplied by cervical roots C5 and C6 which result in a loss of function of the rotator cuff, deltoid, brachialis, coracobrachialis, and biceps brachii
Erb's Palsy Brachial plexus injury in a newborn usually occurs during a difficult delivery, due to a large baby, a breech presentation with a prolonged labor or with the use of forceps
Results of Erb's Palsy flaccid paralysis nicknamed the “Waiterʼs tip deformity” (characterized by a loss of shoulder function, loss of elbow flexion, loss of forearm pronation, and the hand positioned in a pinch grip manner)
Guillain-Barre Syndrome Results of motor weakness in a distal to proximal progression, sensory impairment, and possible respiratory paralysis
Etiology of Guillain-Barre Syndrome is unknown, however, it is hypothesized to be an autoimmune response to a previous respiratory infection, influenza, immunization or surgery
Majority of Guillain-Barre Syndrome patients experience full recovery, 20% have remaining neurologic deficits, and 3-5% of patients die from respiratory complications
Huntington's Disease Chronic progressive genetic disorder that is fatal within 15 to 20 years after clinical manifestation
Huntington's Disease Characterized by degeneration and atrophy of the basal ganglia (specifically the striatum) and cerebral cortex within the brain
Clinical presentation Huntington's Disease includes enlarged ventricles secondary to atrophy of the basal ganglia, mental deterioration, speech disturbances, and ataxic gait
Multiple Sclerosis Characterized by demyelination of the myelin sheaths that surround nerves within the brain and spinal cord resulting in plaque development, decreased nerve conduction velocity, and eventual failure of impulse transmission
Clinical symptoms Multiple Sclerosis may include visual problems, paresthesias, sensory changes, clumsiness, weakness, ataxia, balance dysfunction, and fatigue
Multiple Sclerosis Intervention includes regulation of activity level, relaxation and energy conservation techniques, normalization of tone, balance activities, gait training, and core stabilization
Parkinson's Disease Degenerative disorder characterized by a decrease in production of dopamine (neurotransmitter) within the corpus striatum portion of the basal ganglia
Clinical presentation Parkinson's Disease may include hypokinesia, difficulty initiating and stopping movement, festinating and shuffling gait, bradykinesia, poor posture, and “cogwheel” or “lead pipe” rigidity
Medical management Parkinson's Disease includes dopamine replacement therapy (Levodopa, Sinemet, Madopar) which is designed to minimize bradykinesia, rigidity, and tremor
Sciatica Secondary to a Herniated Disk The sciatic nerve experiences an inflammatory response and subsequent damage secondary to compression from the herniated disk
Sciatica is characterized by low back and gluteal pain that typically radiates down the back of the thigh along the sciatic nerve distribution
Sciatica Secondary to a Herniated Disk Pain will increase in a sitting position or when lifting, forward bending or twisting
Classifications of spinal bifida include occulta (incomplete fusion of the posterior vertebral arch with no neural tissue protruding), meningocele (incomplete fusion of the posterior vertebral arch with neural tissue/meninges protruding outside the neural arch), and myelomeningocele (incomplete
Spina Bifida Approximately 75% of vertebral defects are found in the lumbar/sacral region most often at L5-S1
Spina Bifida Prenatal testing of alpha-fetoprotein (AFP) in the blood will show an elevation in levels that indicate a probable neural tube defect at approximately week 16 of gestation
Spinal Cord Injury – Complete C7 Tetraplegia
Clinical presentation Spinal Cord Injury – Complete C7 Tetraplegia includes impaired cough and ability to clear secretions, altered breathing pattern, and poor endurance
Outcomes Complete C7 Tetraplegia include independence with feeding, grooming, dressing, self-range of motion, independent manual wheelchair mobility, independent transfers, and independent driving with an adapted automobile
Complete C7 Tetraplegia muscles The triceps, extensor pollicis longus and brevis, extrinsic finger extensors, and flexor carpi radialis will remain the lowest innervated muscles
Complete L3 Paraplegia Patients possess at least partial innervation of the gracilis, iliopsoas, quadratus lumborum, rectus femoris, and sartorius with full upper extremity use
Additional findings Complete L3 Paraplegia that can exist include sexual dysfunction, a nonreflexive bladder, the need for a bowel program, urinary tract infections, muscle contractures, and pressure sores
Patients with L3 paraplegia should be able to live independently with education regarding the management of their disability
Traumatic Brain Injury Occurs due to an open head injury where there is penetration through the skull or closed head injury where the brain makes contact with the skull secondary to a sudden, violent acceleration or deceleration
Brain injury may include swelling, axonal injury, hypoxia, hematoma, hemorrhage and changes in intracranial pressure
Complete L3 Paraplegia High risk groups include males between 15-24 years of age, individuals over 65 years of age, and children between 1-2 years of age
Created by: micah10
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