Exam 1: Motor system examination

Question 1

Where are the voluntary motor impulses located in the brain?

Answer 1

in the cerebral motor cortex, located primarily in the motor cortex of the frontal lobe on the pre central gyrus

Question 2

What is the mapped out presentation of the motor cortex called?

Answer 2

motor homunclulus

Question 3

What are the three areas of muscle integrity that are assessed for the purposes of neurological evaluation?

Answer 3

strength, tone, and volume

Question 4

What is muscle twitch (discrete and palpable contractions)?

Answer 4

Muscle fasciulation

Question 5

Fasculations are due to denervated muscle fibers. T/F

Answer 5

True

Question 6

If fasciculations are not seen by the naked eye by can be demonstrated electromyographically, what are they called?

Answer 6

fibrillations

Question 7

What is the force exerted in changing positions?

Answer 7

kinetic

Question 8

What is the force exerted in resulting movement?

Answer 8

static

Question 9

Antigravity muscles, those that hold the body the in quadruped position, up against gravity, are not stronger than their antagonists. T/F

Answer 9

False. They ARE stronger

Question 10

What part of the muscle strength grading systems is complete paralysis?

Answer 10

0/5

Question 11

What part of the muscle strength grading system is a twitch of movement (0-10% of normal movement)?

Answer 11

1/5

Question 12

What part of the muscle strength grading system is a moderate to severe paresis (active movement is gravity is eliminated) and 11-25% of normal movement?

Answer 12

2/5

Question 13

What part of the muscle strength grading system is a moderate paresis (active movement against gravity) and 23-50% of normal movement?

Answer 13

3/5

Question 14

What part of the muscle strength grading system is mild paresis (active movement against gravity and resistance) and 51-75% of normal movement?

Answer 14

4/5

Question 15

What part of the muscle strength grading system is normal (76-100%)?

Answer 15

5/5

Question 16

What is the segmental innervation and peripheral nerve for supraspinatus?

Answer 16

S: C(4)-5-6 (primarily 5)
P: suprascapular

Question 17

What is the segmental innervation and peripheral nerve for the deltoid?

Answer 17

S: C5/6 (primarily 5)
P: axillary

Question 18

What is the segmental innervation and peripheral nerve for the biceps?

Answer 18

S: C5/6 (primarily 5)
P: musculocutaneous

Question 19

What is the segmental innervation and peripheral nerve for the brachioradialis?

Answer 19

S: C5/6 (primarily 5)
P: radial

Question 20

What is the segmental innervation and peripheral nerve for wrist extension?

Answer 20

S: C6/7/8 (primarily 6)
P: radial

Question 21

What is the segmental innervation and peripheral nerve for the triceps?

Answer 21

S: C6/7/8 (T1) (primarily 7)
P: Radial

Question 22

What is the segmental innervation and peripheral nerve for wrist flexion?

Answer 22

S: C6/7/8 (T1) (primarily 7)
P: Median/ulnar

Question 23

What is the segmental innervation and peripheral nerve for finger extension?

Answer 23

S: C6/7/8 (primarily 7)
P: radial

Question 24

What is the segmental innervation and peripheral nerve for finger flexion?

Answer 24

S: C7/8, T1 (primarily 8)
P: median/ulnar

Question 25

What is the segmental innervation and peripheral nerve for finger abduction?

Answer 25

S: C8/T1 (primarily T1) P: ulnar

Question 26

What is the segmental innervation and peripheral nerve for finger adduction?

Answer 26

S: C8-T1 (primarily T1) P: Ulnar

Question 27

If muscle tone is increased, what could that suggest?

Answer 27

UMNL

Question 28

If muscle tone is decreased, what could that suggest?

Answer 28

LMNL

Question 29

What is an increased muscular resistance felt by the examiner during quick joint movement, which then quickly fades away?

Answer 29

Spasticity

Question 30

What is clasped knife?

Answer 30

tension at first, followed by a decrease in that tension as the joint is opened (spasticity)

Question 31

What is spasticity associated with?

Answer 31

cortical or pyramidal pathway lesion (UMNL)

Question 32

What is an involuntary muscular resistance felt when moving a resisting joint and persists as the joint is moved through its entire ROM?

Answer 32

rigidity | "Gooseneck rigidity"

Question 33

What is rigidity associated with?

Answer 33

lesions of extrapyramidal pathways (UMNL)

Question 34

What is hypotonia usually indicative of?

Answer 34

neurological damage at the level of there reflex arc (LMNL)

Question 35

Cerebellar disease DOES NOT cause diffused hypotonia. T/F

Answer 35

FALSE. It can

Question 36

What is something that may occur following acute, sever UMN damage in either the brain of spinal cord?

Answer 36

neural shock

Question 37

Neural shock is not related to vascular shock. T/F

Answer 37

True

Question 38

What is loss of normal neurological function is like reductions in tone, stretch reflexes, strength and volume?

Answer 38

Deficit phenomenon

Question 39

What do lower motor neurons produce?

Answer 39

Deficit phenomenon

Question 40

What are exaggerations or perversions of normal neurological functions and are due to a loss of cortical inhibition?

Answer 40

Release phenomenon

Question 41

Hyper-refelxia, hypertonia, and pathological reflexes would be an example what type of phenomenon?

Answer 41

Release phenomenon

Question 42

What are UMNL indicative of?

Answer 42

release phenomenon

Question 43

Explain tone or tonis.

Answer 43

- reflex phenomenon - afferent and efferent components - gamma efferents stimulates intramural fibers of muscle spindles and afferent impulses go to anterior horn of spinal cord to initiate contraction by relfex action of alpha motor neurons

Question 44

What is the segmental innervation and peripheral nerve for the biceps reflex?

Answer 44

S: C5/6 (primarily C5) P: Músculocutaneous

Question 45

What is the segmental innervation and peripheral nerve for the brachioradialis reflex?

Answer 45

S: C5/6 (primarily 6) P: radial

Question 46

What is the segmental innervation and peripheral nerve for the triceps reflex?

Answer 46

S: C6/7/8 T1 (primarily 7) P: radial

Question 47

What is the segmental innervation and peripheral nerve for finger flexion reflex?

Answer 47

S: C7/8, T1 (primly 8) P: median, ulnar

Question 48

What is the reflex grading system called?

Answer 48

wexler scale

Question 49

What does a 0 on the reflex grading system mean?

Answer 49

absent with reinforcement

Question 50

What does a +1 on the reflex grading system mean?

Answer 50

hypoactive with reinforcement

Question 51

What does a +2 on the reflex grading system mean?

Answer 51

normal (may use sluggish or brisk)

Question 52

What does a +3 on the reflex grading system mean?

Answer 52

hyperactive

Question 53

What does a +4 on the reflex grading system mean?

Answer 53

hyperactive with transient or sustained clonus

Question 54

What is the method of jendrassik?

Answer 54

distracting the patient while performing the reflex, such as clinching fists or flexing toes