Clinical questions; motor control systems/lesions

Question 1

What are the three motor control systems?

Answer 1

Corticospinal system
Extrapyramidal system
Cerebellum

Question 2

On examination a patient has; a drifting of one limb downwards and medially when the hands are supposed to be outstretched. The forearm is also pronated. In which motor control system does this patient have a problem?

Answer 2

Corticospinal

Question 3

Weakness, spasticity and changes in superficial reflexes are due to problems in which motor control system?

Answer 3

Corticospinal

Question 4

Would problems in the upper motor neurones causes weakness in muscle groups or individual muscles?

Answer 4

Muscle groups

Question 5

If there is an upper motor neurone problem; will there more obviously be weakness in the extensors or flexors of the arm?

Answer 5

Extensors

Question 6

If there is an upper motor neurone problem; will there more obviously be weakness in the extensors or flexors of the leg?

Answer 6

Flexors

Question 7

Is spasticity a problem with upper or lower motor neurones?

Answer 7

Upper

Question 8

List some characteristics of muscles affected by lower motor neurone disease

Answer 8

Wasting

Fasiculations

Question 9

Are reflexes increased or decreased in lower motor neurone lesions?

Answer 9

Decreased

Question 10

A patients walks with a broad based gait. Where is there most likely to be a problem?

Answer 10

cerebellum

Question 11

A patient has truncal ataxia - she has difficult standing as well as sitting in a chair. Where is the problem?

Answer 11

The vermis of the cerebellum

Question 12

Cerebellar disease affecting the right cerebellar hemisphere would cause the patient to veer towards which side of the body?

Answer 12

Right

Question 13

In what disease is there degeneration of the caudate nucleus?

Answer 13

Huntingtons disease

Question 14

A patient presents with pain in the right ear and her mouth is sagging on the right hand side.

Answer 14

Bells Palsy.

Question 15

What is Bells Palsy?

Answer 15

Lower motor neurone lesion affecting the facial nerve. All the muscles on one half of the face are affected and there may be loss of taste sensation of the anterior 2/3rds of the tongue.

Question 16

62 year old lady presents with a stiff spastic tongue and donald duck like speech. On examination she has a brisk jaw jerk and was prone to laughing inappropriately.

Answer 16

Pseudobulbar palsy. Upper motor neurone lesions of the lower cranial nuclei. MND can be associated with emotional lability.