Approaches to Patient with CNS Disorders

Question 1

Define “Praxis”

Answer 1

The engaging, applying, exercising, realising, and practising of ideas

Question 2

Inhibition of inappropriate behaviour is controlled by what area of the brain?

Answer 2

Frontal lobe

Question 3

What are some symptoms of Frontal Lobe dementia?

Answer 3

• Disinhibited behaviour
• Bladder dysfunction
• Gait apraxia (magnetic gait)

Question 4

Saccadic movements are controlled by what?

Answer 4

Frontal lobe / Frontal eye fields

Question 5

Where are the legs of a human tropographically represented on the cerebrum?

Answer 5

Medial aspect of the brain

Question 6

Where is the face / arms of a human topographically represented on the cerebrum?

Answer 6

Lateral aspect of the brain

Question 7

What is an Upper Motor Neuron defined as?

Answer 7

Neurons above the level of the anterior horn cells

Question 8

What is a Lower Motor Neuron defined as?

Answer 8

Neurons below the level of the anterior horn cells

Question 9

Give examples of symptoms of a LMN lesion

Answer 9

• Flaccidity
• Hypotonic
• Hyporeflexic
• Babinski -ve

Question 10

Give examples of symptoms of a UMN lesion

Answer 10

• Spasticity
• Hypertonic
• Hyperreflexic
• Babinski +ve

Question 11

What is the name for the Descending motor neuron tract? How many neurones does this pathway have?

Answer 11

Corticospinal Tract, 2

Question 12

A lesion in the right motor cortex will cause what motor symptoms?

Answer 12

Left sided (contralateral) upper motor neuron weakness

Question 13

A lesion in the right cranial nerve nuclei will cause what motor symptoms?

Answer 13

Right sided (ipsilateral) lower motor neuron weakness

Question 14

A lesion in the right side of the spinal cord will cause what motor symptoms?

Answer 14

Right sided (ipsilateral) Upper Motor Neuron weakness

Is above anterior horn cell, so UMN

Question 15

A stroke affecting the Left middle cerebral artery will cause what motor symptoms?

Answer 15

Right sided (contralateral) Upper Motor Neuron weakness

Question 16

A lesion in the right parietal cortex, internal capsule or thalamus will give rise to what sensory symptoms?

Answer 16

Left sided (contralateral) sensory deficit

Question 17

A lesion in the left half of the spinal cord will give rise to what sensory symptoms?

Answer 17

Right sided (contralateral) sensory anterior column loss below level of lesion and left sided (ipsilateral) posterior column loss

Anterior column = decussates
Posterior column = does not decussate

Question 18

Are Cranial nerves UMN or LMNs?

Answer 18

LMNs

Question 19

Cerebellar lesions cause what sided lesions?

Answer 19

Ipsilateral (same side)

Question 20

What are 7 features of Cerebellar dysfunction?

Answer 20

V: Vertigo
A: Ataxia
N: Nystagmus
I: Intention Tremor
S: Slurred Staccato
H: Hypotonia
D: Dysmetria

Question 21

If there was an Oculomotor (CN III) lesion, what would you see in a patient?

Answer 21

• Eyes are down and out
• Dilated pupil (parasympathetic nerve)
• Ptosis

Question 22

What is Horner’s Syndrome caused by?

Answer 22

Sympathetic nerve supply is damaged

Question 23

How is Horner’s Syndrome characterised?

Answer 23

• Ptosis
• Anhidrosis (reduced sweating)
• Enopthalmos
• Miosis (constriction)

Question 24

An Upper Motor Neuron lesion such as a stroke has what affect on the face?

Answer 24

Contralateral face weakness, sparing the forehead