Clinical Aspect of sensory and motor systems

Question 1

LMN lesion

Answer 1

anterior horn/ motor neuron (peripheral nerve lesion)

result from interruption of the final nerve pathway

Question 2

UMN lesion

Answer 2

above the anterior horns of the spinal cord (spinal cord lesion)

Question 3

LMN lesion symptoms

Answer 3

** flaccid paralysis

NO BABINSKI

** areflexia (no deep tendon reflex)

fasciculations

decreased muscle tone

** atrophy of muscle(s)

loss of voluntary movements
small area of body affected

Question 4

UMN lesion symptoms

Answer 4

** spastic paresis

** hyperreflexia

** BABINSKI SIGN PRESENT

increased muscle tone

clasp knife reflex

disuse atrophy of muscles

decreased speed of voluntary movements

large area of body affected

Question 5

Single peripheral nerve lesion

Answer 5

Sensory loss in corresponding areas of distribution

Question 6

Multiple nerve lesions (Polyneuropathy)

Answer 6

Diabetic, inflammatory, & vasculitis

Sensory deficit more marked in legs & feet in lower limb; hands in upper limb.

Question 7

Nerve root lesion (Radiculopathy)

Answer 7

Compression of single sensory nerve root

does not produce complete loss of sensation

Question 8

Lesion of sensory ganglia

Answer 8

Inflammatory, toxic, & neoplastic diseases

Loss of sensation in proximal body parts

Question 9

Lesion of spinal cord

Answer 9

• Tabetic Syndrome
• Posterior column Syndrome
• Complete Spinal Sensory Syndrome
• Brown Sequard Syndrome
• Syringomyelia Syndrome
• Anterior Spinal Artery Syndrome
• Poliomyelitis
• Amyotrophic lateral sclerosis

Question 10

Complete Spinal Sensory Syndrome

Answer 10

Bilateral lower motor neuron paralysis and muscular atrophy (damage to the neurons in the anterior gray columns)

Bilateral spastic paralysis below the level of the lesion. A bilateral Babinski sign is present (interruption of the corticospinal tracts on both sides of the cord)

Bilateral loss of all sensations below the level of the lesion (bilateral destruction of the ascending tracts in the posterior white columns)

loss of pain, temperature, and light touch sensations (section of the lateral and anterior spinothalamic tracts on both sides)

Question 11

Tabes dorsalis

Answer 11

tertiary syphilis or neurosyphilis

loss of vibration sensation, two-point discrimination, and conscious proprioception

Romberg sign

Argyll Robertson pupils

Question 12

Posterior Column Syndrome

Answer 12

Both side of dorsal column affected

Loss of sense of position & vibration

interruption to posterior spinal artery.

Question 13

Anterior Spinal Artery Syndrome

Answer 13

Bilateral lower motor neuron paralysis

Bilateral spastic paralysis below the level of the lesion

Bilateral loss of pain, temperature, and light touch sensations below the level of the lesion

Tactile discrimination and vibratory and proprioceptive sensations are preserved

Question 14

Brown Sequard Syndrome

Answer 14

Ipsilateral lower motor neuron paralysis in the segment of the lesion and muscular atrophy

Ipsilateral spastic paralysis below the level of the lesion

Spastic paralysis

Ipsilateral band of cutaneous anesthesia in the segment of the lesion

Ipsilateral loss of tactile discrimination and of vibratory and proprioceptive sensations below the level of the lesion

Contralateral loss of pain and temperature sensations below the level of the lesion

Question 15

Syringomyelic Syndrome

Answer 15

shawllike/ Cape and Shawl distribution (caused by the interruption of the lateral spinothalamic tracts as they cross the midline in the anterior gray and white commissures)

Tactile discrimination, vibratory sense, and proprioceptive sense are normal

LMN weakness

bilateral spastic paralysis of both legs

Question 16

Poliomyelitis

Answer 16

Acute viral infection of the neurons of the anterior gray columns and the motor nuclei of the cranial nerves

leads to paralysis and wasting of the muscles

Progressive infantile muscle atrophy (Werdnig Hoffmann disorder) and Juvenile Hereditary LMN disease (Kugel berg Walender disease)

Question 17

Progressive infantile muscle atrophy (Werdnig Hoffmann disorder)

Answer 17

Onset usually before 3 months, Range :0 to 6 months

Question 18

Juvenile Hereditary LMN disease (Kugel berg Walender disease)

Answer 18

Onset: Often around 18 months

Question 19

Subacute Combined Degeneration

Answer 19

deficiency of enzymes necessary for vitamin B 12 absorption

pernicious anemia

defects in both sensory and motor function

Disturbance in motor function includes upper motor neuron

Dysfunction which may include a weakness of the lower limbs and an ataxic gait

Question 20

Amyotrophic Lateral Sclerosis Lou Gehrig’s disease

Answer 20

disease confined to the corticospinal tracts and the motor neurons of the anterior gray columns of the spinal cord

progressive muscular atrophy, paresis, spasticity, BABINSKI RESPONSE and fasiculations