CEREBELLUM Flashcards
A 60-year-old male presents with a wide-based and irregular gait. On examination, he demonstrates swaying even with normal stance and needs to take a wide-based stance to remain upright. Which term best describes the gait abnormality seen in this patient?
A) Appendicular ataxia
B) Truncal ataxia
C) Dyssynergia
D) Dysmetria
B) Truncal ataxia
Explanation: The patient’s wide-based and irregular gait, along with the swaying even with normal stance, suggests truncal ataxia. Truncal ataxia refers to ataxia affecting the torso and muscles closest to the body, resulting in instability of the trunk.
A 55-year-old female presents with difficulty in maintaining a continued muscle contraction. She struggles to hold objects for an extended period and often drops them suddenly. Which term best describes this coordination problem?
A) Dysdiadochokinesia
B) Isometrataxia
C) Impaired checking
D) Dyssynergia
B) Isometrataxia
Explanation: The patient’s difficulty in maintaining a continued muscle contraction and inability to hold objects for too long indicate isometrataxia. Isometrataxia refers to difficulty in maintaining a sustained muscle contraction, leading to the inability to hold objects for an extended period.
A 45-year-old male presents with a head and neck tremor characterized by continuous nodding, bobbing, or head-shaking. Which term best describes this tremor?
A) Intention tremor
B) Titubation
C) Dysmetria
D) Dysdiadochokinesia
B) Titubation
Explanation: The patient’s head and neck tremor characterized by continuous nodding, bobbing, or head-shaking is indicative of titubation. Titubation is a sign of truncal ataxia and refers to a head and neck tremor associated with cerebellar pathology.
A 50-year-old female presents with bilateral hypometria and hypermetria when reaching for objects. She often under-reaches or over-reaches when aiming for targets. Which term best describes these errors in reaching for targets?
A) Decomposition of movement
B) Dyssynergia
C) Dysmetria
D) Intention tremor
C) Dysmetria
Explanation: The patient’s errors in reaching for objects, characterized by both hypometria (under-reaching) and hypermetria (over-reaching), indicate dysmetria. Dysmetria is a common sign in cerebellar lesions and refers to difficulty in accurately judging distances during movements.
A 65-year-old male presents with jerky eye movements that become worse when he tries to follow a moving target. His eyes move in jumps and jerks instead of smooth tracking. Which term best describes this eye movement abnormality?
A) Nystagmus
B) Saccadic pursuit
C) Hypermetric saccades
D) Oscillopsia
A)
Explanation: The patient’s jerky eye movements that worsen when trying to follow a moving target suggest saccadic pt refers to the inability to smoothly track a moving target, with eyes following in jumps and jerks instead of a continuous motion.
A 50-year-old female presents with an ataxic gait, dysmetria, and dysdiadochokinesia. She also demonstrates scanning speech and has difficulty regulating tone and loudness while speaking. Which term best describes her speech pattern?
A) Ataxic dysarthria
B) Scanning speech
C) Dysmetria
D) Opsoclonus
A) Ataxic dysarthria
Explanation: The patient’s speech pattern characterized by difficulty regulating tone, loudness, pausing, and breathing during speech is consistent with ataxic dysarthria. Ataxic dysarthria refers to a typical speech pattern seen in patients with cerebellar lesions, where there is impairment in coordinating the movements necessary for clear and fluent speech.
A 55-year-old male presents with difficulty in performing rapid, alternating movements rhythmically and identically. He struggles with rhythmic hand-clapping and foot-tapping movements. Which term best describes this difficulty?
A) Dysdiadochokinesia
B) Isometrataxia
C) Decomposition of movement
D) Hypometria
A) Dysdiadochokinesia
Explanation: The patient’s difficulty in performing rapid, alternating movements rhythmically and identically, such as hand-clapping and foot-tapping, suggests dysdiadochokinesia. Dysdiadochokinesia refers to the inability to perform rapid, alternating movements smoothly and with coordination.
A 40-year-old male presents with an intention tremor that worsens as he tries to reach for a target. The tremor becomes more pronounced as he gets closer to the target. Which term best describes this tremor?
A) Titubation
B) Intention tremor
C) Pendular nystagmus
D) Downbeat nystagmus
B) Intention tremor
Explanation: The patient’s tremor that worsens as he attempts to reach for a target is indicative of an intention tremor. Intention tremor is a tremor that becomes worse during voluntary movements, particularly as the patient approaches the target.
A 30-year-old female presents with a wide-based and staggering gait. She demonstrates an irregular pattern of steps with a tendency to lose balance while walking. On examination, she shows dysdiadochokinesia and dysmetria. Which term best describes the gait abnormality seen in this patient?
A) Truncal ataxia
B) Appendicular ataxia
C) Dyssynergia
D) Dysmetria
B) Appendicular ataxia
Explanation: The patient’s wide-based and staggering gait, along with dysdiadochokinesia and dysmetria, indicates appendicular ataxia. Appendicular ataxia refers to ataxia involving the limbs and extremities rather than the trunk.
A 55-year-old male presents with unsteady gait and falls while walking. On examination, the patient is unable to maintain balance with feet together and eyes closed. Which of the following is the most likely cause of these findings?
A) Cerebellar lesion
B) Loss of proprioception
C) Sensory ataxia
D) Vestibular dysfunction
B) Loss of proprioception
Explanation: The patient’s inability to maintain balance with eyes closed suggests loss of proprioception, which is tested using the Romberg’s test. This finding indicates dysfunction in the sensory input from the lower limbs rather than cerebellar or vestibular dysfunction.
A 60-year-old female presents with slurred speech and difficulty articulating words. Upon examination, she demonstrates ataxic dysarthria. Which of the following tests is most appropriate to assess this finding?
A) Romberg’s test
B) Speech test
C) Eye movement test
D) Upper limb test
B) Speech test
Explanation: The patient’s slurred speech and difficulty articulating words indicate ataxic dysarthria. The speech test, which involves asking the patient to say specific syllables and phrases, helps evaluate the coordination and control of speech muscles, specifically for assessing dysarthria.
During an eye examination, a 45-year-old male demonstrates primary position nystagmus and gaze-evoked nystagmus at the extremes of gaze. Which of the following conditions is most likely present?
A) Cerebellar lesion
B) Vestibular dysfunction
C) Optic nerve lesion
D) Oculomotor nerve lesion
A) Cerebellar lesion
Explanation: The presence of primary position nystagmus and gaze-evoked nystagmus at the extremes of gaze suggests dysfunction in the cerebellum, which plays a significant role in coordinating eye movements.
A 50-year-old female presents with an upward drift of the right arm and pronation when her eyes are closed during the upper limb examination. Which of the following conditions is the most likely cause of these findings?
A) Cerebellar lesion
B) Vestibular dysfunction
C) Sensory ataxia
D) Cauda equina syndrome
A) Cerebellar lesion
Explanation: The upward drift of the right arm and pronation when the eyes are closed indicate a cerebellar lesion on the ipsilateral side. This finding is consistent with cerebellar ataxia, which can result from cerebellar dysfunction.
During the lower limb examination, a 55-year-old male exhibits an inability to maintain a smooth movement of the heel along the shin and shows jerky motion. Which of the following is the most likely finding?
A) Sensory ataxia
B) Cerebellar lesion
C) Spasticity
D) Weakness
A) Sensory ataxia
Explanation: The inability to maintain a smooth movement of the heel along the shin, along with jerky motion, is indicative of ataxia of the legs. In this case, sensory ataxia should be considered, which results from impaired proprioception and sensory feedback from the lower limbs.
