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Neurological conditions - intro

Morgan Morgan Medicine, Surgery & Radiology University Inglés 25 fichas

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  1. 1Sensory assessment (8) L, P, D, T, V, S, T, SLight touch
    Pressure
    Deep pain
    Temperature
    Vibration
    Sharp – Blunt perception
    Two point discrimination
    Stereogenesis
  2. 2Motor assessment (6) G, M, M, M, P, RGait analysis
    Muscle tone
    Muscle bulk
    Muscle strength
    Plantar response
    Reflexes
  3. 3Autonomic assessment (3)Skin Texture
    Skin Temperature – warm red skin – absence of vasoconstriction
    Other associated autonomic complications – bowel, bladder, sexual dysfunction
  4. 4Upper Motor Neurone Lesion - definition“An injury to or lesion in the brain or spinal cord that causes damage to the cell bodies, axons, or both of the upper motor neurons, which extend from the cerebral centres to the cells in the spinal column”
  5. 5Lower Motor Neurone Lesion - definitionParalysis resulting from an injury or lesion that damages the cell bodies or axons, or both, of the lower motor neurons, which are located in the anterior horn cells of the spinal cord and the spinal and peripheral nerves
  6. 6Upper Motor Neurone Lesions - features of (6) H, S, R, P, I, CHypertonic
    Spastic paralysis
    Reduced power
    Plantar response – +ve Babinski
    Increased reflexes
    Clonus
  7. 7Hypertonicis an increased tension of the muscles, meaning the muscle tone is abnormally rigid, hampering proper movement.
  8. 8Spastic paralysisA chronic pathological condition in which the muscles are affected by persistent spasms and exaggerated tendon reflexes because of damage to the central nervous system.
  9. 9Plantar response – +ve BabinskiTest the plantar response by scraping an object across the sole of the foot beginning from the heel, moving forward toward the small toe, and then arcing medially toward the big toe. The normal response is downward contraction of the toes. The abnormal response, called Babinski's sign, is characterized by an upgoing big toe and fanning outward of the other toes. In some patients the toes are "silent," moving neither up nor down. If the toes are downgoing on one side and silent on the other, the silent side is considered abnormal. The presence of Babinski's sign is always abnormal in adults, but it is often present in infants, up to the age of about 1 year.
  10. 10Clonusa continuous rhythmic reflex tremor initiated by the spinal cord below an area of spinal cord injury, set in motion by reflex testing
    ankle clonus , foot clonus a series of abnormal reflex movements of the foot, induced by sudden dorsiflexion, causing alternate contraction and relaxation of the triceps surae muscle.
  11. 11Lower Motor Lesion features (6) H, F, R, L, F, FHypotonic
    Flacid Paralysis
    Reduced power
    Loss of reflexes
    Fascicullations
    Fibrillations
  12. 12Hypotonic?Having less than normal tone or tension, as of muscles or arteries.
  13. 13Flaccid paralysis?The weakening or the loss of muscle tone.
  14. 14FascicullationsMuscle twitches
  15. 15Fibrillationsis the rapid, irregular, and unsynchronized contraction of muscle fibers
  16. 16Conditions associated with UMNL Signs (Examples) 10Cerebral palsy
    CVA
    Brain Injury
    Fredreich’s ataxia
    Spinal injury
    Brain or spinal injury
    Motor neurone disease
    Vitamin B12 deficiency
    Multiple Sclerosis
    Syringomyelia (later stages)
    HMSN
  17. 17Conditions associated with LMNL Signs (Examples) 8Poliomyelitis
    Injury to lower motor neurone and/or peripheral nerve
    Motor Neurone Disease
    Syringomyelia
    Vitamin B12 deficiency
    Cord compression
    Spina Bifida
    HMSN
  18. 18Peripheral Neuropathy - 3 classifications?Polyneuropathy, Mononeuropathy and Focal neuropathy
  19. 19PolyneuropathySeveral classifications
    Anatomic
    Clinical Pattern
    Affections of sensory involvement
    Affections of motor involvement
    Hereditary sensory neuropathies
    Hereditary motor and sensory neuropathies
    Aetiology
  20. 20Aetiological Classifications 6 HIMITOMetabolic: Diabetic, alcoholic
    Hereditary: HMSN, Amyloidosis
    Toxic: Biological, Lead, Mercury
    Ischaemic: Necrotising angiitis
    Inflammatory: Guillian Barre Syndrome
    Other: Carcinoma, leprosy, herpes zoster
  21. 21Mononeuropathy - main factor? 4 othersMain factor – trauma
    Physical
    Thermal
    Electrical
    Radiation
    Systemic disease may predispose
    Vascular lesions
    Neoplasia
    Granulomatous lesions
  22. 22Classification of Nerve Injuries 3Class 1 - Neuropraxia
    Class 2 – Axonotmeses
    Class 3 – Neurotmesis
  23. 23Class 1 - NeuropraxiaCompression injuries, transient loss of sensation/function. Lasting several days – weeks. Demyelisation followed by remylination.
    Usually no lasting clinical damage
  24. 24Class 2 – AxonotmesesCrush, severe compression, degeneration of the axon – regeneration of axon – realignment of axon.
    Likely sensory and motor defects distal to site
  25. 25Class 3 – Neurotmesisaxons and connective tissue lacerated, ends not realligned.
    Severe sensory, motor and autonomic defects

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University Medicine, Surgery & Radiology Fichas sobre Neurological conditions - intro, creado por Morgan Morgan el 27/12/2014.
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Morgan Morgan
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