Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

T2 - Phase 3 - Brain, Mind, and Behavior > BMB 2 - Neuromuscular Disorders > Flashcards

BMB 2 - Neuromuscular Disorders Flashcards

You may prefer our related Brainscape-certified flashcards:
The Brain flashcards
1
Q

Define paresis.

A

Weakness of voluntary movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define fasciculation.

A

Muscle twitch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the major signs of an upper motor neuron injury?

A

Spastic paresis, increased reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the major signs of a lower motor neuron injury?

A

Flaccid paresis, decreased reflexes, fasciculations and fibrillations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What term refers to injury to nerve myelin which spares the axon itself?

A

Neurapraxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What term refers specifically to axonal damage?

A

Axonotmesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What term refers to nerve injury that also extends to the surrounding connective tissue?

A

Neurotmesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

State whether the following nerve fiber is large or small, myelinated or unmyelinated, and also state the function: A-alpha

A

Large

Myelinated

Proprioception / vibratory sensation / motor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

State whether the following nerve fiber is large or small, myelinated or unmyelinated, and also state the function: A-beta

A

Large

Myelinated

Proprioception / vibratory sensation / motor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

State whether the following nerve fiber is large or small, myelinated or unmyelinated, and also state the function: A-gamma

A

Medium

Myelinated

Motor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

State whether the following nerve fiber is large or small, myelinated or unmyelinated, and also state the function: A-delta

A

Small

Myelinated

Pain / temperature / autonomics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

State whether the following nerve fiber is large or small, myelinated or unmyelinated, and also state the function: C-fibers

A

Small

Unmyelinated

Pain / temperature / autonomics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe type 1 muscle fibers in terms of twitch speed, duration and intensity of use, and fatigue rate.

A

Slow-twitch, endurance / low fatigue rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe type 2A muscle fibers in terms of twitch speed, duration and intensity of use, and fatigue rate.

A

Fast-twitch, moderate duration and intensity of use, moderate fatigue rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe type 2B muscle fibers in terms of twitch speed, duration and intensity of use, and fatigue rate.

A

Fast-twitch, short duration and high intensity of use, quick fatigue rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which muscle fiber type is slow-twitch?

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which muscle fiber type is fast-twitch but still oxidative?

A

2A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which muscle fiber type is glycolytic?

A

2B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name the dermatome found at the following locations:

Bottom of the neck –

Nipples –

Umbilicus –

Inguinal area –

Knees –

A

Name the dermatome found at the following locations:

Bottom of the neck – C4

Nipples – T4

Umbilicus – T10

Inguinal area – L1

Knees – L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name the dermatome found at the following locations:

Thumb –

Middle finger –

Pinky and ring finger –

A

Name the dermatome found at the following locations:

Thumb – C6

Middle finger – C7

Pinky and ring finger – C8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name the dermatome found at the following locations:

Great toe –

Middle three toes –

Pinky toe–

A

Name the dermatome found at the following locations:

Great toe – L4

Middle three toes – L5

Pinky toe – S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which nerve roots are tested using the triceps reflex?

A

C7, C8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which nerve roots are tested using the biceps reflex?

A

C5, C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which nerve roots are tested using the brachioradialis reflex?

A

C5, C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which nerve roots are tested using the patellar reflex?

A

L3, L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which nerve roots are tested using the achilles reflex?

A

S1, S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which nerve is tested using the jaw jerk / masseter reflex?

A

CN V3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

True/False.

The Babinski reflex is a polysynaptic motor reflex.

A

False.

The Babinski reflex is a polysynaptic cutaneous reflex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How does one elicit a Babinski reflex?

A

Drag sensation along lateral foot and then across the ball of the foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is a normal Babinski reflex in an adult?

A

Toes curl downwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is an abnormal Babinski reflex in an adult (or most individuals over ~15 months)?

A

Toes curl upwards and fan out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

An upward Babinski reflex in an adult suggest what?

A

UMN damage of the corticospinal tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the normal motor function of the median nerve in relations to the hand?

A

Innervation of the abductor policis brevis and opponens policis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

A patient experiences a tingling sensation in their hand when you tap on their median nerve. This is known as the ________ sign.

A

A patient experiences a tingling sensation in their hand when you tap on their median nerve. This is known as the Tinel sign.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

If you can recreate a patient’s median nerve -related symptoms by flexing their wrist to 90° for one minute, this is known as a positive _________ test.

A

If you can recreate a patient’s median nerve -related symptoms by flexing their wrist to 90° for one minute, this is known as a positive Phalen test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What might be indicated by numbness in the thumb area and an associated more proximal motor weakness in the biceps, deltoids, and forearm?

A

C6 lesion

(The C6 dermatome and myotome are both affected in this example.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

A patient is unable to extend her 2nd and 3rd digits. What is the cause?

A

Distal median n. injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

A patient is unable to flex her 2nd and 3rd digits. What is the cause?

A

Proximal median n. injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

A patient is unable to extend her 4th and 5th digits. What is the cause?

A

Distal ulnar n. injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

A patient is unable to flex her 4th and 5th digits. What is the cause?

A

Proximal­ ulnar n. injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

________ tunnel neuropathies affect branches of the median nerve, while ________ tunnel neuropathies affect branches of the ulnar nerve.

A

Carpal** tunnel neuropathies affect branches of the median nerve, while **cubital tunnel neuropathies affect branches of the ulnar nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Ulnar neuropathies typically result in what sort of sensory and motor deficits?

A

Sensory changes in the hand only;

motor dysfunction in hand intrinsics (as well as some wrist/finger flexors)

(NOTE: C8 radiculopathies will be similar but also involve sensory loss of the forearm.)

43
Q

Describe ‘Saturday night palsy.’

A

AKA radial palsy – loss of wrist/finger extension; loss of sensation to volar thumb and index finger

44
Q

Where is the fibular nerve commonly compressed?

A

The fibular head

45
Q

What is the fibular palsy presentation?

A

Flaccid foot drop (steppage gait), tendency to inversion

(NOTE: L5 radiculopathies will be similar but also involve gluteal weakness.)

46
Q

What term refers to Herpes Zoster in the V1 distribution, resulting in blindness?

A

Herpes Zoster ophthalmicus

47
Q

What eponymous term refers to Herpes Zoster + a facial palsy + lesions in the ear canal?

A

Ramsay Hunt syndrome (think Herpes zoster + Bell’s palsy)

(NOTE: treatment includes acyclovir and gabapentin)

48
Q

Bell’s palsy is an idiopathic lesion of which nerve?

A

CN VII

49
Q

Bell’s palsy is characterized by an inability to fully __________ the eye.

A

Bell’s palsy is characterized by an inability to fully close the eye.

50
Q

Following a bicycle injury, a patient presents with an internally rotated arm and a flexed, pronated wrist. What is the eponymous term given to this condition?

A

Erb’s palsy

51
Q

Erb’s palsy occurs due to a lesion in what?

A

The upper trunk of the brachial plexus (C5, C6)

52
Q

Following a climbing injury, a patient presents with a claw-like hand affecting all the fingers. What is the eponymous term given to this condition?

A

Klumpke’s palsy

(NOTE: the elbow may be flexed and supinated as well if the C7 root is involved.)

53
Q

Klumpke’s palsy occurs due to a lesion in what?

A

The lower trunk of the brachial plexus (C8, T1)

54
Q

Upon pushing against the wall with their hands, a patient presents with a posteriorly protruding scapula. What nerve is injured and what nerve roots feed this nerve?

A

Long thoracic nerve

C5, C6, C7

55
Q

Which muscle(s) lose innervation in lesions to the long thoracic nerve (resulting in a winged scapula)?

A

Serratus anterior

56
Q

A suprascapular nerve palsy often leads to weakness in what two motions of the upper extremity?

A

Abduction;

external rotation

57
Q

What is the cause of the loss of abduction and loss of external rotation seen in a suprascapular nerve palsy?

A

Loss of innervation of the supraspinatus and infraspinatus due to suprascapular n. impingement at thesuprascapular notch

58
Q

Diabetic neuropathy typically affects which neurons more, sensory or motor?

A

Sensory

59
Q

Diabetic neuropathy typically affects which tissue more, the axons or the myelin sheaths?

A

The axons

60
Q

What are the main presenting features of diabetic neuropathy?

A

Foot ulcers, ascending numbness (starting in the toes), paresthesias

(NOTE: can also cause sweating and decreased GI mobility)

61
Q

A patient with uncontrolled type II diabetes mellitus presents with proximal muscle weakness and pain in his hip and thigh. He reports that the pain started gradually and has improved over time. What is the diagnosis?

A

Diabetic amyotrophy

(an asymmetric, inflammatory motor neuropathy of the lumbosacral plexus)

62
Q

True/False.

Hyperuremia, alcohol use, and thyroid disorders are all associated with the development of neuropathies.

A

True.

Hyperuremia is associated with sensorimotor issues; alcohol abuse is associated more with sensory issues (pain > numbness) than motor; etc.

63
Q

Chemotherapy is associated with neuropathies, especially if containing __________.

A

Chemotherapy is associated with neuropathies, especially if containing platinum.

64
Q

What is the classic presentation of lead poisoning -induced neuropathy?

A

Abdominal pain, wrist/foot drop, etc.

65
Q

How do the neuropathies associated with vitamin B12 and/or copper deficiencies present?

A

Vibratory and sensory deficits

(subacute combined degeneration)

66
Q

True/False.

Zinc deficiency can be caused by an excess in copper intake.

A

False.

Copper deficiency can be caused by an excess in zinc intake.

67
Q

Monoclonal gammopathy of undetermined significance is associated with anti-MAG antibodies that can cause what sort of neuropathy?

A

Distal sensory demyelination

68
Q

What disorder results due to an inherited misfolding of a vitamin A carrier, causing buildup of the carrier protein in body tissues?

A

Hereditary transthyretin amyloidosis

69
Q

A teenage patient presents with high arches, hammer toes, and ‘champagne bottle’ legs. She reports having had balance issues and gait problems her entire life. What is the likely diagnosis?

A

Charcot-Marie-Tooth disorder

70
Q

What is Charcot-Marie-Tooth disorder?

A

A demyelinating disease resulting in sensorimotor deficits

71
Q

What is the most common gene involved in inheritance of Charcot-Marie-Tooth disorder?

A

CMT1A

(NOTE: PMP22 is the most common duplication)

72
Q

30% of cases of Guillain-Barré syndrome cases are preceeded by infection with ______________, and another 10% of cases are preceded by _____________,

A

30% of cases of Guillain-Barré syndrome cases are preceeded by infection with Campylobacter jejuni, and another 10% of cases are preceded by CMV.

73
Q

The influenza vaccine typically carries about a ____-case-per-1,000,000-vaccines-administered risk of triggering an episode of Guillain-Barré syndrome.

A

The influenza vaccine typically carries about a 1-case-per-1,000,000-vaccines-administered risk of triggering an episode of Guillain-Barré syndrome.

74
Q

Name the most common subtype of Guillain-Barré syndrome in North America and Europe.

A

Acute inflammatory demyelinating polyneuropathy

75
Q

True/False.

Guillain-Barré syndrome is purely a disease of ascending motor deficit due to demyelination.

A

False.

Guillain-Barré syndrome is a disease of ascending motor deficits and sensory loss due to demyelination.

76
Q

The pathogenesis of Guillain-Barré syndrome is thought to be one of ___________ ___________.

A

The pathogenesis of Guillain-Barré syndrome is thought to be one of molecular** **mimicry.

77
Q

Why may patients with Guillain-Barré syndrome require hospitalization?

A

To maintain respiration

78
Q

Describe the likely lumbar puncture results in a patient with Guillain-Barré syndrome.

A

Elevated protein

(with < 10 WBCs / mm3)

79
Q

How is Guillain-Barré managed?

A

IV Ig + plasmapheresis

80
Q

Which demyelinating disorder is characterized by both proximal and distal muscle weakness that arises over a period of weeks, months, or even years?

A

Chronic inflammatory demyelinating neuropathy

(NOTE: there are variants that are purely sensory, only distal, multifocal motor and sensory, etc.)

81
Q

What is the POEMS form of demyelination disorder?

A

Polyneuropathy

Organomegaly

Endocrinopathy

M-protein

Skin changes

82
Q

Describe the basic end result of amyotrophic lateral sclerosis.

A

UMN and LMN damage

83
Q

How does ALS typically present?

A

Mixed reflexes, spasticity, atrophy fasciculations;

bilateral tongue fasciculations;

jaw jerk reflex

84
Q

You are presented with an infant who is increasingly ‘floppy’ and atonic. You rule out botulism and suspect what etiology?

A

A defect in the SMN1 gene (spinal muscular dystrophy)

85
Q

Duchenne muscular dystrophy is caused by what structural etiology?

A

An absence of dystrophin

86
Q

Becker muscular dystrophy is caused by what structural etiology?

A

A less functional form of dystrophin

87
Q

What is the most common form of adult-onset muscular dystrophy? What is the etiology?

A

Myotonic dystrophy;

  • CTG* repeats in the DM1 and DMPK genes
  • (NOTE: shows anticipation)*
88
Q

How does myotonic dystrophy present?

A

An adult developing myotonia (contracted muscles), atrophy of facial and temporal muscles, cardiac conduction blocks, cataracts, cognitive impairment

89
Q

Most channelopathies present as what two forms?

A
  1. Periodic paralysis
  2. Myotonic
90
Q

How do most channelopathies present? How are most managed?

A

Periodic paralysis;

correction of the metabolic disturbance

91
Q

Which channelopathy mutation results in hyperkalemia and can be eased through a high-carb diet (which leads to increased insulin release, driving potassium into the intracellular space)?

A

SCN4A

92
Q

Which channelopathy mutation results in hypokalemia?

A

CACNA15

93
Q

Which channelopathy mutation is especially associated with thyrotoxicity?

A

KCNJ18

94
Q

How do individuals with nondystrophic channelopathies typically appear?

A

Hypertrophic build, bulky jaws

(often heat- and/or cold-sensitive)

95
Q

Name two forms of nondystrophic channelopathy.

A

Myotonia congenita (CLCN1);

paramyotonia congenita (SCN4A)

96
Q

How are nondystrophic channelopathies typically treated?

A

Mexiletine or procainamide

97
Q

A patient with fibromyalgia and uncontrolled diabetes presents with complaints that her ‘legs aren’t working right’ and her balance is off. What do you suspect?

A

Diabetic neuropathy

98
Q

A diabetic patient presents with a painful, weak hip. What do you suspect?

A

Diabetic amyopathy

99
Q

A patient presents with leg weakness one week after food poisoning.

What do you do next?

A

Send her to the ER for workup of Guillain-Barré syndrome

100
Q

A patient presents with difficulty moving her arms over the past few months. What neuropathies do you most suspect?

A

Myasthenia gravis,

cervical myopathy

101
Q

A patient presents with increasing issues with her balance. She is only taking over-the-counter supplements to prevent COVID infection. What do you suspect?

A

Zinc toxicity

(and subsequent subacute combined degeneration)

102
Q

Charcot-Marie-Tooth disease mostly affects what portion of the body?

A

The feet

103
Q

A patient presents with complaints that one of his legs has been dragging and he’s been choking on steak and hard bread over the past month.

What are you most concerned this might be?

A

Amyotrophic lateral sclerosis

T2 - Phase 3 - Brain, Mind, and Behavior (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions