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TRACT LESIONS

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nibbs06's version from 2018-09-08 00:20

PATHOPHYS OF TRACT-LESIONS

Question Answer
FLOPPY BABYWERDING-HOFFMAN DISEASE – AUTOSOMAL RECESSIVE DAMAGE OF VENTRAL MOTOR HORN W/ LMN SIGNS
POLIOMYELITISPOLIO INFECTION – DAMAGE OF VENTRAL MOTOR HORN W/ LMN SIGNS
AMYOTROPHIC LATERAL SCLEROSISBILATERAL DEGENERATION OF UMN & LMN VIA PROGRESSIVE ATROPHY/DEGENERATION OF CST(UMN) + VENTRAL MOTOR HORN(LMN SIGNS)
FRIEDRICH ATAXIAAUTOSOMAL RECESSIVE TRINUCLEOTIDE-REPEAT (GAA) DISORDER OF IRON-BINDING FRATAXIN GENE THAT CAUSES MITOCHONDRIAL IMPAIRMENT/ACCUMULATION OF IRON LEADING TO FREE-RADICAL DAMAGE (VIA FENTON-RXN) THAT CAUSES DEGENERATION OF MULTIPLE SPINAL TRACTS
HORNERSDISRUPTION OF THE SYMPATHETIC SUPERIOR CERVICAL GANGLIA
CENTRAL HORNERSLESION OF DESCENDING HYPOTHALAMIC FIBERS (N1/PREGANG SYMP-FIBERS; THALAMUS -> S.C) @ BRAINSTEM OR CERVICAL SPINAL CORD LEVELS
PERIPHERAL HORNERSLESION/COMPRESSION OF T1(N2) NERVE
PAINFUL PERIPHERAL HORNERSLESION OF POST-GANG FIBERS(N3) OF THE EXITING SUPERIOR CERVICAL GANG THAT FORM CAROTID PLEXUS
BROWN-SEQUARD SYNDROMEHEMISECTION THAT LESIONS ALL 3 S.C SYSTEMS
SYRINGOMYELIACYSTIC DEGEN OF S.C @ VENTRAL HORN OF C8-T1 NEAR ANT-WHITE COMMISSURE OF STT (COMMONLY IN LOWER CERVICAL SC/ENLARGEMENT)
ANTERIOR SPINAL ARTERY OCCLUSIONINTERRUPTION/OCCLUSION OF THE DOMINANT BLOOD SUPPLY OF THE VENTROLATERAL SPINAL CORD (USUALLY @ MID-THORACIC LEVELS) CAUSING ISCHEMIA OR INFARCTION IN THE ANTERIOR 2/3 OF S.C
TABES DORSALISTERTIARY-SYPHILIS(TREPONEMA PALLIDUM) INFECTION CAUSING DEMYELINATION/DEGENERATOIN OF DORSAL COLUMNS + ROOTS (Ia-TO CLARKE’S NUC -> CEREBELLUM VIA SPINOCEREBELLAR TRACT)
SUBACUTE COMBINED DEGENERATION(SCD)VIT B12 DEFICIENCY + PERNICIOUS/MEGALOBLASTIC ANEMIA - BILATERAL DEMYELINATION OF DORSAL COLUMN TRACT, SPINOCEREBELLAR TRACT & CST IN THE UPPER THORACIC OR LOWER CERVICAL CORD
MULTIPLE SCLEROSISMOST COMMON AUTOIMMUNE DEMYLINATING DISEASE OF CNS - DESTRUCTION OF MYELINATED AXONS IN A TRACT (MLF) & OLIGODENDROCYTES
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PATHO-SYMTPOMS OF TRACT LESIONS

Question Answer
LMN SIGNS(4)SPASTIC WEAKNESS W/ ATROPHY + FASICULATIONS(MUSCLE TWITCHING) W/ DECREASED TONE + FLACCID PARALYSIS W/ AREFLEXIA + NEG BABINSKI (“EVERYTHING LOWERED” – LESS MUSCLE MASS, TONE, REFLEXES & DOWNWARD/LOWERED TOES)
UMN SIGNS(4)WEAKNESS W/ NO ATROPHY + INCREASED TONE + SPASTIC PARALYSIS W/ CLASP-KNIFE SPASTICITY + (+)BABINSKI
DEGENERATION OF VENTRAL/ANTERIOR HORNLMN SIGNS(5)-FLACCID PARALYSIS W/ ATROPHY + WEAKNESS W/ DECREASED TONE + FASICULATIONS + AREFLEXIA + (-)BABINSKI
DEGENERATION OF LATERAL CSTUMN SIGNS (3)-SPASTIC PARALYSIS + HYPERREFLEXIA W/ INCREASED TONE & (+)BABINSKI
WERDING-HOFFMAN DISEASE (5)LMN SIGNS (5)-FLACCID PARALYSIS W/ ATROPHY + WEAKNESS W/ DECREASED TONE + FASICULATIONS + AREFLEXIA + NEG BABINSKI
ALS (2SX & LOCATION)UMN SIGNS IN LL (SPASTIC PARALYSIS + HYPERREFLEXIA W/ INCREASED TONE & +BABINSKI) + LMN SIGNS IN UL (FLACCID PARALYSIS W/ ATROPHY + WEAKNESS W/ DECREASED TONE + FASICULATIONS + AREFLEXIA + NEG BABINSKI)
BROWN-SEQUARD SYNDROME (3)P/T LOSS & UMN-SIGNS IPSI & @ LESION + MVP LOSS & SPASTIC WEAKNESS(UMN) IPSI & BELOW LESION + P/T CONTRALAT & 1-2SEG’S BELOW LESION
FRIEDRICH ATAXIA (6)KYPHOSCOLIOSIS @ CHILDHOOD + STAGGERING/ATAXIC GAIT (CEREBELLAR DEGENERATION) + FREQUENT FALLING + HYPERTROPHIC CARDIOMYOPATHY + DIABETES + LOSS OF ALL TRACT FUNCTION (MVP, P/T & MOTOR)
(GENERAL) HORNER’S SYNDROME(3+CN’S)SX ALWAYS IPSILATERAL(“PAM-OSIS)-PTOSIS(CN3)/ANHYDROSIS(CN7)/MIOSIS(CN3)
CENTRAL HORNERS (1)CONTRALATERAL LOSS OF P/T 1-2 SEGMENTS BELOW LESION (BRAINSTEM OR S.C)
SYRINGOMYELIA(4/8)BILATERAL LOSS OF P/T IN “CAPE-LIKE” FASHION IN UL @/OR 1-2SEGS BELOW LESION + LMN DISORDERS(WEAKNESS W/ ATROPHY + MUSCLE TWITCH W/ DECREASED TONE + FLACCID PARALYSIS W/ AREFLEXIA + (-)BABINSKI) + HORNERS SYNDROME(EXPANSION @ T1- “PAM-osis” Ptosis(cn3), Anhydrosis(cn7), Miosis(cn3)) + SEEN W/ ARNOLD CHIARI-1
ANTERIOR SPINAL ARTERY OCCLUSION(4)DIFFERENTIAL TO ALS SX’S IS SPASTIC BLADDER. BILATERAL LOSS OF P/T BELOW INFARCT + BILATERAL SPASTIC WEAKNESS (BILAT CST + LMN LESION) W/OUT ATAXIA + ORTHOSTATIC HYPOTENSION IF @ MID-THORACIC LEVELS (AFFECTS DESCENDING HYPOTHALAMIC TRACTS)
TABES DORSALIS (6)PROGRESSIVE SENSORY ATAXIA W/ ROMBERG SIGN (IMPAIRED PROPRIOCEPTION/POOR COORDINATION) + CHARCOT(PAINFUL) JOINTS(DEMYELIN OF ANT LAT TRACT; P/T DORSAL ROOTS) + ARGYLL ROBERTSON PUPILS(CN3) + LOSS OF REFLEX-RESPONSE(LMN) + PARESTHESIA(ALTERED VIBRATORY SENSE) + POLYURIA(DEMYELIN OF BLADDER-AXONS ABOVE SACRAL LEVEL)
SUBACUTE COMBINED DEGENERATION(SCD) (3)ATAXIC GAIT(SPINOCEREBELLAR TRACT) + BILATERAL SPASTIC WEAKNESS(BILAT CST + LMN LESION) + IMPAIRED POSITION SENSE/ALTERED VIBRATION AKA PARESTHESIA(BILATERAL LOSS OF DORSAL COLUMN)
MULTIPLE SCLEROSIS (7)NEURO DEFICITS COME & GO (TIME) + ASSYMETRICAL SX’S (SPACE) + VERTIGO(CN-8) + SCANNING SPEECH(BRAINSTEM) + INTERNUCLEAR OPHTHALMOPLEGIA(MLF) + OPTIC NEURITIS(CN-1*) + HEMIPARESIS OR UNILAT LOSS OF SENSATION OR WEAKNESS + BOWL/BLADDER/SEX DYSFUNCTION (AUTONOMIC)
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