Approaches to Patients with CNS Disorders II

Question 1

Where would a LMN lesion affect? Give some examples

Answer 1

• Anterior Horn Cell
• Nerve root
• Brachial / Lumbosacral Plexus
• Specific Nerve / Branch
• NMJ
• Muscle Disorder
• Peripheral Neuopathy

Question 2

What is Dorsal Interossei muscle in the hand ennervated by?

Answer 2

Ulnar nerve

Question 3

Cogwheel rigidity is synonymous with which condition?

Answer 3

Parkinson’s Disease

Question 4

What are the two types of Abnormal Posturing?

Answer 4

• Decerebrate posturing

- Decorticate posturing

Question 5

What are the characteristics of Decerebrate posturing?

Answer 5

Extension of upper limbs, extended elbows

Question 6

What are the characteristics of Decorticate posturing?

Answer 6

Flexion of upper limbs, elbows bent inwards into chest

Question 7

What is the cause of Decerebrate posturing?

Answer 7

Lesion below the red nucleus

Question 8

What is the cause of Decorticate posturing

Answer 8

Lesion above the red nucleus

Question 9

Describe Grades 0-5 of Motor Power

Answer 9

0 = No movement
1 = Flicker of movement
2 = Movement with gravity removed
3 = Movement against gravity
4 = Movement against resistance
5 = Normal power

Question 10

In Primary Lateral Sclerosis, what kind of lesions occur? UMN or LMN?

Answer 10

UMN signs

Question 11

In Spinal muscle atrophy what kind of lesions occur? UMN or LMN?

Answer 11

LMN signs

Question 12

In Amyotrophic Lateral Schlerosisi, what kind of lesions occur? UMN or LMN?

Answer 12

UMN and LMN signs

Question 13

What are the two dorsal columns of the spinal cord called?

Answer 13

Fasciculus Gracilis

Fasciculus Cuneatus

Question 14

How is the descending Corticospinal tract topographically represented in the Spinal cord?

Answer 14

Lateral aspect: Sacral tracts

Medial aspect: Cervical tracts

Question 15

How is the Anterior Spinothalamic tract topographically represented in the Spinal cord?

Answer 15

Lateral aspect: Sacral tracts

Medial aspect: Cervical tracts

Question 16

How is the Posterior Spinothalamic tract topographically represented in the Spinal cord?

Answer 16

Lateral aspect: Cervical tracts

Medial aspect: Sacral tracts

Question 17

If you had lateral compression of the spinal cord, what motor symptoms would occur?

Answer 17

UMN signs in the lower limbs

Question 18

Lesions in the anterior Spinothalamic tract would cause what symptoms?

Answer 18

Contralateral loss of temperature and pain sensation

Question 19

Lesions in the posterior Spinothalamic tract would cause what symptoms?

Answer 19

Ipsilateral loss of propioception

Question 20

A cervical disc prolapse would cause what motor symptoms?

Answer 20

LMN ipsilateral symptoms at level of spinal cord

UMN ipsilateral symptoms below the spinal cord

Question 21

What is Brown Sequard Syndrome caused by?

Answer 21

Hemispinal cord lesion

Question 22

What are the symptoms of Brown Sequard syndrome?

Answer 22

Paralysis and loss of Propioception on ipsilateral side of lesion

Loss of temperature and pain sensation on contralateral side of lesion

Question 23

What does the Romberg’s test assess?

Answer 23

Balance

Question 24

What is a TIA defined as?

Answer 24

Episode of impaired cerebral circulation leading to reversible neurological deficit (Lasting less than 24 hours)

Question 25

What are the two broad types of Stroke?

Answer 25

Ischaemic stroke

Haemorrhagic stroke

Question 26

State 3 types of Ischaemic stroke

Answer 26

Thrombo-embolic
Embolic
Lacunar

Question 27

Ataxia is caused by a lesion occurring where?

Answer 27

Cerebellar lesion

Question 28

Lhermitte’s phenomenon is caused by what?

Answer 28

Compression of upper cervical spinal cord

Question 29

Painful loss of vision in the right eye would suggest what neurological condition?

Answer 29

Optic neuritis