chapter 27-28-29 Flashcards
Below are listed some clinically important nerve root levels. For the following muscles, select the root which is most responsible for its innervation. A. C3 B. C4 C. C5 D. C6 E C7 F. L3 G. L4 H. L5 I. S1 Tibialis anterior.
G
Below are listed some clinically important nerve root levels. For the following muscles, select the root which is most responsible for its innervation. A. C3 B. C4 C. C5 D. C6 E C7 F. L3 G. L4 H. L5 I. S1 Deltoid.
c
Below are listed some clinically important nerve root levels. For the following muscles, select the root which is most responsible for its innervation. A. C3 B. C4 C. C5 D. C6 E C7 F. L3 G. L4 H. L5 I. S1 Gastrocnemius.
i
Below are listed some clinically important nerve root levels. For the following muscles, select the root which is most responsible for its innervation. A. C3 B. C4 C. C5 D. C6 E C7 F. L3 G. L4 H. L5 I. S1 Brachioradialis.
d
Which of the following statements regarding dennatomal sensory innervation are true?
1. Digit 5 of the hand is supplied by C8
2. In the upper chest, the C4 and T2 dermatomes are contiguous
3. The nipple is at the T4 level
4. The umbilicus is at the Tl 0 level
Select: A = 1,2, 3. B = 1, 3. C = 2. 4. D = 4 only. E = All
e
A lesion of the L2 nerve root would be expected to produce which of the following
1. Sensory loss in the upper thigh
2. Weakness of knee extension
3. Weakness of hip flexion
4. Loss or diminution of knee reflex
Select A = 1.2.3. B= 1, 3. C = 2 4. D = 4 only, E = All
b
Anterior spinal artery syndrome is associated with which of the following findings?
1. Dysfunction of autonomic pathways
2. Dysfunction of the spinothalamic tracts
3. Dysfunction of the corticospinal tracts
4. Dysfunction of the do^ai columns
Select: A - 1, 2. 3. B - 3. 3. C = 2. 4 D = 4 only. E - All
a
Which of the following symptoms may develop due to a lesion at the foramen magnum?
1. Occipital pain
2. Downbeat nystagmus
3. Spastic weakness
4. Lower motor neuron weakness of the anus
Select: A = 1. 2. 3. B = 1, 3. C = 2. 4. D = 4 oniy. E - All
d
Which of the following clinical features suggest conus medullaris lesion rather than cauda
equina lession?
1. Mild symmetric weakness
2. Lack of sphincter disturbance
3. Sudden onset
4. Severe bilateral pain
Select: A = 1, 2, 3. B = i, 3. C = 2 4. D =4 only. E = All
b
A 36-year-old black male is evaluated for weakness and is found on routine evaluation to
have a CK of 480 U/L. Which of the following clinical formulations is most likely ?
A. The CK is elevated sufficiently that the differential diagnosis would have to include
inflammatory myopathy, muscular dystrophy, and other myopathies
B. The CK is abnormal, but the low level of increase would be consistent with nonmyopathic
conditions incjuding denervation and even minor muscle trauma unrelated to the weakness
C. The CK is norma! for age and race, and therefore is not supportive of a primary muscle
disorder
c
Clinical assessment of patients being treated for inflammatory myopathy is key. but which
of the following laboratory tests is best for following patients during the treatment
regimen?
A. CK
B. EMG
C. Muscle biopsy
D. None of these are helpful
a
The following questions concern a single patient. Select the best answer for each question on the
basis of the information provided, not using information from the subsequent questions.
A 27-year-old female present for evaluation of diffuse weakness and is found on examination to
have weakness most prominent in the cekoid. biceps, quadriceps, and iliopsoas. Distal muscles
are judged to have normal strength. CK is mildly increased. EMG shows some short-duration
polyphasic potentials in the right deltoid and biceps, with some longer-duration polyphasic
potentials in the light quadriceps.What is the best clmicai formulation for the information provided?
A. The patient most likely has a myopathy
B. The patient most likely has a neuropathy with the CK increase being due to partial
denervation
C. The patient has mixed myopathic and neuropathic findings which indicates a multisystem
disease with both neuronal and muscle involvement
a
The following questions concern a single patient. Select the best answer for each question on the
basis of the information provided, not using information from the subsequent questions.
A 27-year-old female present for evaluation of diffuse weakness and is found on examination to
have weakness most prominent in the cekoid. biceps, quadriceps, and iliopsoas. Distal muscles
are judged to have normal strength. CK is mildly increased. EMG shows some short-duration
polyphasic potentials in the right deltoid and biceps, with some longer-duration polyphasic
potentials in the light quadriceps.
Muscle biopsy is performed to help with the diagnosis. Which muscle would be the best to sample ? A. Left quadriceps B. Right quadriceps C. Pvight deltoid D.Left gastrocnemius
a
The following questions concern a single patient. Select the best answer for each question on the
basis of the information provided, not using information from the subsequent questions.
A 27-year-old female present for evaluation of diffuse weakness and is found on examination to
have weakness most prominent in the cekoid. biceps, quadriceps, and iliopsoas. Distal muscles
are judged to have normal strength. CK is mildly increased. EMG shows some short-duration
polyphasic potentials in the right deltoid and biceps, with some longer-duration polyphasic
potentials in the light quadriceps.
Muscle biopsy is performed and shows inflammatory reaction with scattered fiber necrosis.
Perifascicular atrophy is not seen. Which is the most likely diagnosis?
A. Polymyositis
B. Dennalomyosuis
C. Limb girdle dystrophy
D. Motor neuron disease
a
Which of the following neuromuscular disorders is least likely to give fluctuating
weakness, as opposed to constant (static) weakness?
A. Myasthenia gravis
B. Lambert-Eaton myasthenic syndrome
C. Periodic paralysis
D. ALS
d
