integrative spinal cord/brain stem - neuroanatomy

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  • Right Horners Syndrome-Where can the lesion(s) be?

  • Representative of Case History #2Guillain-Barr Syndrome (GBS)

    acute inflammatory demyelinating polyneuropathy disorder of the peripheral nervesattack of the myelin sheath of nerves by antibodies or white blood cellsrapid onset of ascending paralysisbegins with weakness and/or abnormal sensations of the legs and armsbreathing muscles may be so weakenedfollowing gastrointestinal or respiratory viral infectionspalpitations (sensation of feeling heartbeat), difficulty beginning to urinate, incomplete bladder emptying, incontinence (leaking of urine), constipation, and muscle contractions

  • Representative of Case History #1

    DUCHENNES MUSCULAR DYSTROPHY

    Gowers Signmarked enlargement of calveshyperlordosoisdecreased tendon reflexesnormal sensation

  • in A, patient is attempting to raise eyelids as high as possible

    In B, same patient has had an iv injection of Tensilon, an acetylcholinsterase inhibitor. Eyelids go higher for a while

    ABRepresentative of Case History #2

    MYASTHENIA GRAVIS

  • Note relationships of cranial nerves to major vessels and think about the effects of aneurisms!!!!

  • Lateral MedullarySyndrome (Wallenbergs)

    Think of the neurological deficits!! This is one of your Case Vignettes!!!

    What side is the lesion on?

    Remember, the lesion is bigger than the white area.

  • Why are the spinal nerves smaller (shrunken) on the right cord??? Is there both upper and lower motor neuron disease? Is this also called Lou Gehrig Disease? Are there fasciculations? Representative of Case History #5Amytropic Lateral Sclerosis

  • Schwannoma of right CN VIII-You have a similar Case VignetteWhat are some of the neurological deficits?

  • Parkinsons Disease! Which brain has the least number of nigra cells containing melanin pigment?

  • What are the big white bundlessurrounding the 4th ventricle?The melanin containing black spots is/are the locus coeruleus (contains nor-epi cells). We cover it in the third module.

    What pathways are affected by the lesion? Does it looks like level 7 without the myelin stained??

  • Schwannoma of CN VIII. What problem(s) will this person have? This is similar to one of your Case Vignettes!! What side is the lesion one??

  • Bells Palsey. What side is affected?

    Can she wrinkle her forehead on the right?

  • Central VIIPeripheral VII

  • Ectropion-drooping lower lid Lagophthalmos-inability to close upper lid What CNs are involved in the corneal reflex?

  • Could the lesion be in cortex, midbrain, pons, or medulla?,

  • Where is the lesion????????

  • Where could the lesion be??

    Medulla?Pons?Midbrain?Cortex?

    Which side??

  • Inability to abduct the left eye!

    Where could the lesion be???

  • Lid down and eye rotated down and out!Where could the lesion be??

  • Left head tilt (not rotation!!)!Where could the lesion be??

  • Right eye cant go all the way down (ventral) and in (adduction); look at right eye in lower right frame)!!