Neurological Disorders and Lesions

All

Long

I-Parkinson Sx(Amimia/Micrgraphia)(dementia/hyperkinesia)II-2nd Park(Neuroleptic)(CO/Arteriscleoris/encephlaiits)III-Syringomyelia(Sensory loss/Wasting/Long tract/Autonomiv)IV-Tx of M Gravis(Ach(-)(CSD)(Plasmophoresis)(thymectomy)V-Foot Drop(L5...)VI-Open Depressed ScullVII-Cerebral artery aneurysm!(gigantic,sacular)VIII-Sterotactic Techniques used for:^^glioblastoma Histology-Lumbar vertebral Fractures:-Sx provoked by brain tumour!-Multifocal Tumours:-Dx for Cerebral artery aneurysm-Cerebral artery naeurysm Clipped by:

-CN 9+10 Dx:-Lesion CN 5(sensory nuclei)-CN 9 lesion!-Malingnant brain glioma

***T/F:

-CS tract(NOT ) onl from Frontal-BS lesion--->controlateral hemiparesis(T)-Bilateral amr paralysis, Central cord(T)-controlateral Focal Weakness(NOT) by Midbrain lesion-Mediatl long fascili(NOT) Conjugate Gaze!-Early sign of optic chiams is(NOT) bitemptal hjemiponia(F)-heavy myeline fibes...(F)-Occulomaotor pathway ecassate at MB+ pons(T)-Dystonia/dyarthia (NOT) only local significance)-occipital lobe lesion(T) caues homonymous hemianopia!(T)-The hallmark (T)-i mpaired rapid (F)-when wallowing (T)-reflexes are icnreased(F)-Positive ramberg(F)-inability to imitate(T)-severe motor restless(t)-asymmetic(T)-complete destruction (F)-Tonic downward

***MCQ

I--Dysmetria---->inability to stop directed movement on Time-Dyssynergia---->Loss of Precis muscle coarporation-|Dysadiokinea--->(-) of Rapid alt movement-Intension tremor---------->in Directed movementsII--Metabolic-->no neuro Sign , No Meningeal Signs!-Cerebral abscess-->Caom + Focal sign-subarachnoid------> No Focal But meningeal signs present!III--M Gravis--------->worsen After Phyical Acticity!-spinal muscular trophy------------->Radicular Pain-Hereditary Myotonia---------------->impoves after physcial acitivty!-Hereditory motor+ snesory neuropathyy--------->Foot deformity\-Acute dmeyelinating Neuropthy----------------> fibrilltion of tongue!IV-Cyanosis-->Tonic/ClonicAbsanese---->short last arrestAutomatism---->Short partial siezurefoot deformity!---->Hereditoary motorV-Multiple sclerosis-------------->Myelin sheath of Various Fibers and Trats!-ALS---------------->Motor nuclei and Pyramidal Tract-Myastheisa Gravis------------>Neuromuscular synpase-Huntington------------>basal Ganglia-Syringmyelia------------>Posterior horn+ SCVI-MS---->Myulinsheth +tractALS--->Motor+PyramidalSynring---->posterior HornsMMyastr---->neurmusclarHunitgnhon-->Basal gangliaVII-Epidemic ecnephlisi-->Occulomotor!PKD-->AcheokinesiaMS-->optic diskSynrin-->SensationVIII-Radial-->benedictulnar-->clawmedian-->MonkeyPenus-->Horse Gait

***HX:

Where-WhatComplainHxSomaticScalesDxTimeModeDurationCourse-Progression-Pain-Previous Tx!

-Let patient Talk-Watch out for Sx-Sort Sx change-How Sx started1-Watch pts stand & Walk(Romberg+Heel&Toe)2-inspect limbs (trophic changes + Ulcers)3-Look @ postural tremor4-Pseduoathetosis5-Palpate nerves6-note weakness7-Tendon Reflex8-Sensory testing-B12-Urine-CSF-EMG-XRAY

***Lesion:

Cerebrum:BS-SC-Cognitive impairment-unilateral weakness+sense abnormality-Visual field abN-Movement Abnormalities(chorea/tremor)-Isolated CN-Crossed Weakness-Back=Pain +tender-weaknes sparing head-Mixed UM+ LMN-Sphincter(-)

Spina root:Peripheral NerveNeurmuscular:-Radiating Limb Pain-Loss of Reflex-Mid distal Limb-Loss of reflex-Bilateral weakness(Ptosis/Diplopia/)-increasing wekaness of exertion(MG)-Sparing sensation

UMNLMN-Spastic-Hperreflexlia-Hypertonic(Decerebratio)(decortication)-Fasulation(-)-Babinski(+)-Atrophy-Flacid-Hyporeflexia-Hypotonic-Wasting-Fascilulation(+)-Babinski(-)

***Visual Fields:

-Retina(ipsilated)-Optic nerve=Ipsilateral blindness-Center Chiasm=Bitemporal hemianopia-Side chiasm=unilateral , Nasal Hemianopia-Optic tract=Contro.ateral , Homonymous heminoiopia(MCA)-geniculocalcrine nuclei=Controlateraltel , ... With Macular sparing(PCA

***Ataxia

CerebellarSensory-Wide-Heel shine Abnormal-Unsteady turns-narrow-Heelshin +/-Slow Velocity

***Romberg(+)= Joint position!--------------->Posterior COlumn Lesions!+peripheral Neuropathy!***unsteadiness=Unabe o stand still:---------->Cerebellar--------->Central+ peripheral vestibular syndrome!*** Coma Glasgow Score!!:(EXAM Answer 4)Eyes(4)Verbal (5)Motor(6)1=Closed Eyes2=Open to pain3=Open to Verbal4-Open Spontanous!1=No verbals2=Incomprehensible3=inapprotriate word4=Confused5=Oriented1=No Motor2=extersionon pain3=Fleion on pain4-withdraw from pain5-localize pain6-Obeys command!SCORE 2 Motor= DECERBRATion(Abnormal Extension)(Midbrain + pons))Score 3 Motor=Deconticate( Abnormal Felxion)(Cerebral hemispheres)y3(Dead)<-------8(comatose)----->15(Healthy)

***Aphasias:

-Loss of language function due to some kind of brain damage!(ussually the left Side)-Wenicke=Comprehesion!-Broaca=For speech generation(motor)-Arcuate fasculi= connectionI-Broca (motor)II-Wernicke:(sensory)III-Conduction(Fluent aphasia!-Compreehsion(+)-Response(-)=Bad output!(defect in expression)(Non fluent)-Comprehesion(-)-Response(+)(Fluent+nonsensical)(speaks to much)-Arcuate fasiculi damage!-repetion(-)-Comprhesion(+)-ResponsE(+)-agraphsia=inaiblity to write-alexia=Inabilty to Read/recod words!The pts understand but cannot express with correct set of words!

** TENS (I and CI)

I

-Before+after operation-Painful various joint-Carpel tunnel syndrome-Reduce headache-cancer painCI-Cardiostimulro-Pain > origin-mental illness-OH overdose-Bone fracture

***FES:

I(+)metabilic acitityReduce Muscle Hypotrophy-(+) Muscle strnegth-(+) ROM-(-) spacitictyCI-(+)sensitivity-Pts >38C-bleeding-TB-Malignant Tumour-Epilepsy-Pacemaker-aRR