What is the difference between a focal, multi-focal lesion, and diffuse lesion?
Focal lesion is limited. There are specific functional defecits.
Multi-focal refers to several and nonsymmetrical.
Diffuse is bilateral and symmetrical, but doesn't cross the midline
Give an example of a focal lesion:
tumor or infarct
Give an example of a multi-focal lesion:
stroke and metastasis
Give an example of a diffuse lesion:
MS and Alzheimers
In a neurological evaluation what is acute?
Generally vascular or trauma, and is in a short time frame- hours to minutes (can last 48-72 hours)
In a neurological evaluation a tumor or degenerative disease that is gradually worsening over weeks to years is considered what?
What is subacute in a neurological evaluation?
Inflammatory- progressive over a few days
What two etiologies have a rapid onset?
- Trauma- history important, focal lesion
- Vascular Disorder- medical history, focal or multi-focal lesions
What three etiologies have a slow onset?
- Inflammation- recent medical history provides wealth of info, generally multi-focal or diffuse lesion
- Degenerative Disorders- diffuse lesions
- Neoplasm- focal lesions
What two etiologies have varying onsets?
- Immunological disorders- often slow, history and medical work-up necessary, diffuse lesions
- Toxic/Metabolic Conditions- often slow onset
Name five ways lower motor neuron syndrome can effect someone's PNS:
- flaccid paralysis (floppy muscles)
- hypotonia (decreased muscle tone)
- hypoactive reflexed (diminished or absent)
- muscle atrophy
- fibrilations (muscle will spontaneously contract)
What are the three ways motor or sensory loss can occur in the peripheral nervous system:
- segmental (myotome/dermatome)
- peripheral nerve distribution (radial nerve, ulnar, etc.)
- patterns (glove and stocking parathesia, reticular, referred)
Where could and injury causing upper motor neuron syndrome occur?
from the cortex all the way down the spinal cord
Name five problems that can occur with upper motor neuron syndrome within the CNS
- spastic paralysis
- hyperactive reflexes
- no muscle atrophy
- babinski sign present
What does a + Babinski sign show?
In a + Babinski sign the big toe extends when all of the other toes curl when a reflex hammer is rubbed on the bottom.
What are two exceptions to motor/sensory loss below the foramen magnum?
Horner's Syndrome and C2 or C3 lesions
What does bilateral cord damage cause in the spinal cord?
- UMN syndrome below the level of the injury
What does hemisection in the spinal cord cause?
disassociated sensory loss (pain loxx, discrimitive touch loss on opposite sides. your sensory loss on one side may not match the sensory loss on the other side)
What does damage to the central part of the nervous system cause?
- Ventral white commissure
- Bilateral segmental pain loss
- proximal muscle group weakness
Brainstem problems can occur from damage where?
- posterior cranial fossa
What are the 4 D's of cranial nerve involvement?
What does dysphagia cause problems with and what nerves were impacted?
- glossopharyngeal and vagus
What does dysarthria cause problems with and what nerves were impacted?
- hypoglossal, vagus, and glossopharyngeal
What does diplopia cause problems wiht and what nerves were impacted?
- double vision
- oculomotor, trochlear, and abducens
Where can damage to the cortical spine occur?
cortex --> spinal cord
What types of problems can occur from cortical spine damage?
- higher level functioning loss:
- language, vision, somatosensory, auditory, emotional, affect, motor planning, memory
What are significant factors of trauma?
- rapid onset
- focal lesion
What are significant factors of vascular disorders?
- rapid onset
- medical history
- focal or multi-focal lesions
What are significant factors of inflammation?
- slower onset
- recent medical history
- multi-focal or diffuse
What are significant factors of degenerative disorders?
What are significant factors of neoplasms?
What are significant factors of immunological disorders?
- onset varies-often slow
- history and complete medical work up important
What are significant factors of toxic/metabolic conditions?
onset varies- often slow
What does dysmetria cause?
- problems in cerebellum
- problems reacting to things
- judging distance, how much muscle contraction needed