neuro16 pathology
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| 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.
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| Symptoms upper motor neuron disease | weakness of involved muscles, hypertonicity, hyperreflexia, mild disuse atrophy, and abnormal reflexes.
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| where are Damaged tracts in upper motor neuron disease | the lateral white column of the spinal cord.
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| Examples of upper motor neuron lesions include | cerebral palsy, hydrocephalus, CVA, birth injuries, multiple sclerosis, and brain tumors.
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| upper motor neuron disease Reflexes: | Hyperactive
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| upper motor neuron disease Atrophy: | Mild from disuse
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| upper motor neuron disease Fasciculations: | Absent
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| upper motor neuron disease Tone | Hypertonic
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| 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.
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| Symptoms of Lower Motor Neuron Disease | flaccidity or weakness of the involved muscles, decreased tone, fasciculations, muscle atrophy, and decreased or absent reflexes.
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| Examples of lower motor neuron lesions include | poliomyelitis, tumors involving the spinal cord, trauma, infection, and muscular dystrophy.
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| Lower Motor Neuron Disease Reflexes: | Diminished or absent
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| Lower Motor Neuron Disease Reflexes Atrophy: | Present
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| Lower Motor Neuron Disease Reflexes Fasciculations: | Present
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| Lower Motor Neuron Disease Reflexes Tone: | Hypotonic to flaccid
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| Alzheimer's Disease | Progressive neurological disorder that results in deterioration and irreversible damage within the cerebral cortex and subcortical areas of the brain
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| 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
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| Typical course of the Alzheimer's disease | averages between 7-11 years with death resulting from infection or dehydration
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| Amyotrophic Lateral Sclerosis Risk is higher in | males than females and usually occurs between 40-70 years of age
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| Clinical presentation Amyotrophic Lateral Sclerosis may include | both upper and lower motor neuron involvement with weakness occurring in a distal to proximal progression
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| Average course of the diagnosis of Amyotrophic Lateral Sclerosis is | two to five years with 20-30% of patients surviving longer than five years
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| Central Cord Syndrome | An incomplete spinal cord lesion that most often results from a cervical hyperextension injury
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| Clinical presentation Central Cord Syndrome involves | motor loss that is greater in the upper extremities than the lower extremities
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| Most common incomplete spinal cord lesion accounting for approximately | 30% of all incomplete forms of tetraplegia
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| Spastic cerebral palsy involves | upper motor neuron damage; athetoid cerebral palsy involves damage to the cerebellum, cerebellar pathways or both
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| Clinical presentation cerebral palsy includes | motor delays, abnormal muscle tone and motor control, reflex abnormalities, poor postural control, and balance impairments
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| Mental retardation and epilepsy are present in 50-60% of children diagnosed with | cerebral palsy
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| Types of CVA include | ischemic stroke (thrombus, embolus, lacunar) and hemorrhagic stroke (intracerebral, subdural, subarachnoid)
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| Left CVA may present with | weakness or paralysis to the right side, impaired processing, heightened frustration, aphasia, dysphagia, and motor apraxia
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| 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
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| Down Syndrome Clinical manifestations include | hypotonia, flattened nasal bridge, Simian line (palmar crease), epicanthal folds, enlargement of the tongue, and developmental delay
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| Detection Down Syndrome occurs in approximately | 60-70% of women tested that are carrying a baby with Down syndrome
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| Exercise is essential for a child with Down syndrome in order to | avoid inactivity and obesity
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| 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
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| 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
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| 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)
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| Guillain-Barre Syndrome | Results of motor weakness in a distal to proximal progression, sensory impairment, and possible respiratory paralysis
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| 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
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| Majority of Guillain-Barre Syndrome patients experience | full recovery, 20% have remaining neurologic deficits, and 3-5% of patients die from respiratory complications
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| Huntington's Disease | Chronic progressive genetic disorder that is fatal within 15 to 20 years after clinical manifestation
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| Huntington's Disease Characterized by | degeneration and atrophy of the basal ganglia (specifically the striatum) and cerebral cortex within the brain
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| Clinical presentation Huntington's Disease includes | enlarged ventricles secondary to atrophy of the basal ganglia, mental deterioration, speech disturbances, and ataxic gait
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| 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
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| Clinical symptoms Multiple Sclerosis may include | visual problems, paresthesias, sensory changes, clumsiness, weakness, ataxia, balance dysfunction, and fatigue
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| Multiple Sclerosis Intervention includes | regulation of activity level, relaxation and energy conservation techniques, normalization of tone, balance activities, gait training, and core stabilization
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| Parkinson's Disease | Degenerative disorder characterized by a decrease in production of dopamine (neurotransmitter) within the corpus striatum portion of the basal ganglia
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| 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
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| Medical management Parkinson's Disease includes | dopamine replacement therapy (Levodopa, Sinemet, Madopar) which is designed to minimize bradykinesia, rigidity, and tremor
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| Sciatica Secondary to a Herniated Disk | The sciatic nerve experiences an inflammatory response and subsequent damage secondary to compression from the herniated disk
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| Sciatica is characterized by | low back and gluteal pain that typically radiates down the back of the thigh along the sciatic nerve distribution
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| Sciatica Secondary to a Herniated Disk Pain will increase in | a sitting position or when lifting, forward bending or twisting
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| 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
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| Spina Bifida | Approximately 75% of vertebral defects are found in the lumbar/sacral region most often at L5-S1
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| 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
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| Spinal Cord Injury – | Complete C7 Tetraplegia
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| Clinical presentation Spinal Cord Injury | – Complete C7 Tetraplegia includes impaired cough and ability to clear secretions, altered breathing pattern, and poor endurance
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| 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
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| Complete C7 Tetraplegia muscles | The triceps, extensor pollicis longus and brevis, extrinsic finger extensors, and flexor carpi radialis will remain the lowest innervated muscles
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| Complete L3 Paraplegia Patients possess at least partial innervation of | the gracilis, iliopsoas, quadratus lumborum, rectus femoris, and sartorius with full upper extremity use
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| 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
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| Patients with L3 paraplegia should be able to | live independently with education regarding the management of their disability
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| 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
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| Brain injury may include | swelling, axonal injury, hypoxia, hematoma, hemorrhage and changes in intracranial pressure
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| 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
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