Clinical Skills Yellow Questions

Question 1

What does the term fasciculation mean? Describe the physiology underlying it

Answer 1

Small, local, involuntary muscle contraction and relaxation which may be visible under the skin.
Possibly disease of motorneurones

Question 2

Suggest 2 conditions that may cause wasting of the small muscles of the hand.

Answer 2

motor neuron disease (T1)
spinal cord compression
cervical rib

Question 3

Define muscle tone.

Answer 3

Continuous and passive partial contraction of the muscles

Question 4

In what conditions might “tone” be increased or decreased?

Answer 4

HYPOTONIA
LMN disease
Traumatic brain injury

HYPERTONIA
UPM disease

Question 5

What is a deep tendon reflex ?

Answer 5

tonic contraction of the muscles in response to a stretching force, due to stimulation of muscle proprioceptors.

Question 6

In which conditions might tendon reflexes be increased? Why?

Answer 6

Upper motor neuron lesions

Question 7

Which common disease may result in impaired vibration sense?

Answer 7

Acute meningitis

Question 8

Which sensory modalities are carried in

1. the spinothalamic tract?
2. the dorsal column

Answer 8

spinothalamic tract: Pain, temperature, crude touch

dorsal column: touch, vibration, position sense, movement sense and conscious proprioception

Question 9

Define the term peripheral neuropathy.

Answer 9

“Result of damage to your peripheral nerves

Causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body.”

Question 10

Define the term “glove and stocking” pattern.

Answer 10

“Symptoms of peripheral neuropathy usually start in
the longest nerves in the body and so first affect the
feet and later the hands. “

Question 11

Define the term mononeuritis multiplex?

Answer 11

“Type of peripheral neuropathy. It happens when there is damage to two or more different nerve areas.”

Question 12

What are the features of a cerebellar syndrome?

Answer 12

Form of ataxia originating in the cerebellum

Results in loss of coordination

Question 13

Define an extrapyramidal syndrome. Give examples.

Answer 13

Any of a group of clinical disorders marked by abnormal involuntary movements, alterations in muscle tone, and postural disturbances
E.g. parkinsonism, chorea

Question 14

What is the commonest cause of tremor

1) At rest?
2) On action?

Answer 14

1) At rest: Parkinson’s

2) On action: Tumors, strokes