1
Q
pain that is resistant or refractory to treatment
A
Intractable pain
2
Q
absence of pain in response to stimulation which would normally be painful
A
Analgesia
3
Q
Continuous, slow, wormlike movement of the limb, face or body
A
Athetosis
4
Q
brief, rapid, jerky purposeless movement
A
Chorea
5
Q
a physical loss of function, eg. walking
A
Disability
6
Q
the degree of disadvantage that disability puts you into, in daily life
A
Handicap
7
Q
a diagrammatic representation of both sensory and motor innervations of the body in the brain
A
Homunculus
8
Q
Inflammation of a nerve or nerves
A
neuritis
9
Q
the perception of pain
A
nociception
10
Q
a group of nerve cell bodies in the central nervous system
A
nucleus
11
Q
weakness or incomplete loss of movement
A
paresis
12
Q
weakness on one side of the body
A
hemiparesis
13
Q
an abnormal sensation such as pins and needles or burning
A
paresthesia
14
Q
LMN lesion result in flaccid
A
Paralysis
15
Q
both limbs on one side
A
hemi
16
Q
one side
A
hemiplegia
17
Q
Lower motor neuron lesion
A
- Peripheral nerve injury
- Hyporeflexia - decreased deep tendon reflexes (DTR)
- Muscle atrophy and wasting due to loss of spinal reflexes [stretch reflex]
- Muscle flaccidity and decreased muscle tone [flaccid paralysis]
18
Q
[UMN] Upper Motor Neuron Lesion
A
- Central nervous system injury
- Hyperreflexia - increased DTR
- Spasticity and increased muscle tone [spastic paralysis]
19
Q
Spina Bifida
A
- Meningomyelocele is the most common
- Paralysis usually affects the bladder and rectal function, eventually leading to severely damaged kidneys.
20
Q
Syringomyelia
A
- A cape-like sensory deficit over the shoulders and back is common.
- Possible cause of disruption of sympatric activity to the eye.
21
Q
Arnold-Chiari [Chiari] Malformations
A
Type II -in an infant or child, congenital
22
Q
Congenital Hydrocephalus “Water on the brain”
A
-Results from impaired reabsorption of CSF from the arachnoid villi into the venous system, e.g. malformation, scarring from infection [meningitis] [Obstruction to CSF occurs OUTSIDE the ventricular system] - communicating
23
Q
Non-communicating
A
-Due to blockage in the ventricular system whereby CSF cannot reach the arachnoid villi, e.g. malformation, tumour, inflammation [Obstruction to CSF occurs INSIDE the ventricular system]
24
Q
Cerebral Palsy
A
There are 4 main groups:
1) Spastic Most common (70%), UMN involvement in cortex
2) Dyskinetic [Athetoid], involves the basal ganglia (20%) , Athetosis: slow writhing movements of the extremities. Chorea: quick, jerky, purposeless movements may also occur
3) Ataxic 5% , Affects cerebellum
4) Mixed 13%
25
Traumatic Injury
Concussion -Some people have concussions and don't realize it. Produces no obvious bruising of the brain.
26
Hematomas
2 types - Epidural & Subdural
27
Epidural Hematoma
- Occur between the inner skull bones and the Dura.
- Arterial: high pressure bleed, Middle meningeal arteries
- Middle meningeal artery affected
28
Subdural Hematoma
- Massive brain trauma
| - A subdural hematoma develops between the Dura and the arachnoid space.
29
Acute Subdural Hematoma
-Abrupt but slower onset
30
Chronic Subdural Hematoma
- Subdural hematomas can also occur after a very minor head injury, especially in the elderly. In the elderly, the veins are often already stretched because of brain atrophy.
- May be confused with dementia in elderly
31
Subarachnoid Hemorrhage
- The most common cause of any form of subarachnoid hemorrhage is trauma.(cranial trauma)
- Headache- described as "one of the worst-ever experiences" Caused Seizure
32
Cerebral Contusion (Coup-Contre-Coup)
- An injury to the head causes the brain to bounce against the rigid bone of the skull
- The head from a motor vehicle crash, headache and dizziness are common
33
Spinal Cord Injury
-The spinal cord runs from the foramen magnum to L1 or L2. The cord extends as the cauda equina [horses tail] and then
34
Brown-Séquard syndrome
[ipsilateral motor control], there is a loss of motor function, pro-prioception, vibration, and light touch. Contralaterally (opposite side of injury) [contralateral temperature sensation], there is a loss of pain, temperature and deep touch sensations.
35
Most common causes of spinal cord injury are:
- Motor vehicle accidents. 50 percent of new spinal cord injuries each year.
- Falls. Spinal cord injury after age 65 is often caused by a fall. Overall, falls make up approximately 24%.
36
Arteriovenous Malformations
These are the most common of congenital malformations
37
Aneurysms
- An aneurysm is a ballooning of the artery due to weakness of the wall and intravascular pressure.
- Causes can be: developmental, atherosclerosis, hypertension, trauma.
38
1. Berry Aneurysm
- At the Circle of Willis, most commonly involves the middle cerebral artery
- rupture results in subarachnoid hemorrhage, with 35% mortality during initial phase
- the enlargement of the aneurysm may com
39
2. Aortic Aneurysms:
2 types - Thoracic or Abdominal
40
Thoracic
can produce chronic hoarseness and difficulty swallowing [dysphagia]
41
Abdominal
- severe low back pain
42
3. Dissecting Aneurysm
-Aneurysm Treatment: surgical clipping or patch repair of the artery, or coil-induced clotting of the aneurysm [neurosurgery: craniotomy and clipping of aneurysm]
43
two main types of strokes
ischemic and Hemorrhagic strokes
44
Ischemic strokes
are caused by an interruption of blood flow in a cerebral vessel and are the most common type of stroke accounting for 70 - 80% of strokes. They are typically caused by cerebral thrombosis due to arteriosclerosis or embolism (e.g. atrial fibrillation).
45
Hemorrhagic strokes
are caused by bleeding into brain tissue. This type of stroke usually is from a blood vessel rupture by hypertension, aneurysm, arteriovenous malformation or head injuries. Hemorrhagic strokes have a much higher fatality rate than ischemic strokes.
46
Meningitis
is an inflammation of the membranes (meninges) surrounding your brain and spinal cord, usually due to the spread of an infection
47
Bacterial Meningitis
Streptococcus pneumoniae (pneumococcus). This bacterium is the most common cause of bacterial meningitis. It more commonly causes pneumonia, or ear, or sinus infections.
48
Meningococcal meningitis
It affects mainly teenagers and young adults and may cause local epidemics in college dormitories, boarding schools and military bases.
49
Viral Meningitis
-Symptoms: High fever, severe headache, stiff cervical muscles
50
Encephalitis
-Caused by Herpes viruses, arboviruses transmitted by mosquitoes, ticks and other insects [about 5 types],
Rabies transmitted through animal bites. In unusual cases, severe S+S would include stupor
51
Lyme Disease
- Caused by the bacterium Borrelia burgdorferi. Certain ticks carry these bacteria.
- There may be a "bulls eye" rash,[ erythema migrans] a flat or slightly raised red spot at the site of the tick bite.
52
Reye’s Syndrome
-Aspirin has been linked with Reye's syndrome.
53
Guillain-Barre Syndrome [Acute Idiopathic Polyneuritis]
- A disorder in which the body's immune system attacks part of the PNS Idiopathic, Possibly auto-immune
- Usually follows a respiratory or GI infection [66%]
- Symmetrical weakness, tingling and decreased deep tendon reflexes [extrenities]
- Moves proximally from legs to trunk and arms [progressive ascending (musles weakness) paralysis]
54
Poliomyelitis & Post-Polio Syndrome
10-40 years after polio virus infection
- Polio virus targets intestinal mucosa first and after infects the anterior horn cells
- Polio is eradicated in Canada due to vaccinations but is still seen in certain regions in the world
- Resembles flu
55
Tension [Tension-Type Headache]
-Most common headache, caused by grinding your teeth, poor posture, from stress
56
Migraine
Caused by vasoconstriction of cerebral blood vessels, blind spots (scotomas)
57
Cluster Headaches
at night, Males more than females, unilateral, Severe pain in eye or temple region
58
Sinus Headaches:
often aggravated by forward bending
59
Chemical
Hormone, hunger (low sugar), hangover, rebound (too much pain medication)
60
Thunderclap Headaches
Bleeding between the brain and membranes covering the brain
61
Parkinson's Disease
- Degenerative disease of the substantia nigra cells (a decrease in dopamine)
- Dopamine helps the basal ganglia to maintain balance, posture and co-ordination (agonists vs. antagonists)
- Causes can include environmental, genetics, head trauma (boxer's), drug-induced (reversible)
- Bradykinesia: difficulty in initiating or sustaining movement (loss in the ability to control body movement)
- Shuffling or festinating gait , stopped posture, change in thinking ability
62
Huntington's Chorea
- Rare genetic disorder
- Dementia
- Choreiform movements (irregular, spasmodic, involuntary movements)
- Due to degeneration of basal ganglia
63
Multiple Sclerosis
- The further away from the equator, the higher the incidence
- Auto-immune
- Myelin and/or oligodendrocytes damaged by immune response
- Environment: further from equator=higher incidence
- Patchy inflammation, sclerosis and plaques in CNS
- fatigue if it is too warm, keep treatment room cool due to fatigue with higher temps.
64
Dementia
A deterioration in cognitive/intellectual function.
65
Alzheimer Disease
-Neuro-fibrillary tangles - tau proteins degenerate[ widespread neurofibrillary tangles composed of abnormal proteins],
66
Wernicke-Korsakoff Syndrome
-The condition is due to a B1 (thiamine) deficiency
67
Creutzfeldt-Jakob disease
[change rapidly progressive dementia due to neuronal degeneration ataxia like Alzheimers]
68
Trigeminal Neuralgia
(Tic Douloureux)
- It is triggered by benign stimuli such as brushing teeth, drinking, eating, talking or even wind.
- Trigeminal neuralgia is thought to be caused by pressure on the nerve by a blood vessel although it can occur along with other conditions such as multiple sclerosis.
69
Bell’s Palsy
- Bell's palsy is a form of temporary facial paralysis, resulting from damage or trauma, to one of the two facial nerves.
- Rarely it can be bilateral.
- Weakness or paralysis of region supplied by facial nerve(CN7)
- Lower motor neuron injury, flaccid, paralysis, drooping eyelid, corner of the month
- Moist heat, acupuncture
70
Horner's Syndrome
- Constricted pupil [miosis]
- Drooping eyelid [ptosis]
- Lack of face sweating [anhydrosis]
Pathology 5 final review
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