Exam 1: Motor system examination Flashcards

1
Q

Where are the voluntary motor impulses located in the brain?

A

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

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2
Q

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

A

motor homunclulus

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3
Q

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

A

strength, tone, and volume

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4
Q

What is muscle twitch (discrete and palpable contractions)?

A

Muscle fasciulation

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5
Q

Fasculations are due to denervated muscle fibers. T/F

A

True

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6
Q

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

A

fibrillations

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7
Q

What is the force exerted in changing positions?

A

kinetic

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8
Q

What is the force exerted in resulting movement?

A

static

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9
Q

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

A

False. They ARE stronger

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10
Q

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

A

0/5

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11
Q

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

A

1/5

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12
Q

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?

A

2/5

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13
Q

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

A

3/5

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14
Q

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

A

4/5

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15
Q

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

A

5/5

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16
Q

What is the segmental innervation and peripheral nerve for supraspinatus?

A

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

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17
Q

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

A

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

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18
Q

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

A

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

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19
Q

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

A

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

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20
Q

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

A

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

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21
Q

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

A

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

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22
Q

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

A

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

23
Q

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

A

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

24
Q

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

A

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

25
Q

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

A

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

26
Q

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

A

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

27
Q

If muscle tone is increased, what could that suggest?

A

UMNL

28
Q

If muscle tone is decreased, what could that suggest?

A

LMNL

29
Q

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

A

Spasticity

30
Q

What is clasped knife?

A

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

31
Q

What is spasticity associated with?

A

cortical or pyramidal pathway lesion (UMNL)

32
Q

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

A

rigidity

“Gooseneck rigidity”

33
Q

What is rigidity associated with?

A

lesions of extrapyramidal pathways (UMNL)

34
Q

What is hypotonia usually indicative of?

A

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

35
Q

Cerebellar disease DOES NOT cause diffused hypotonia. T/F

A

FALSE. It can

36
Q

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

A

neural shock

37
Q

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

A

True

38
Q

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

A

Deficit phenomenon

39
Q

What do lower motor neurons produce?

A

Deficit phenomenon

40
Q

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

A

Release phenomenon

41
Q

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

A

Release phenomenon

42
Q

What are UMNL indicative of?

A

release phenomenon

43
Q

Explain tone or tonis.

A
  • 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
44
Q

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

A

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

45
Q

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

A

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

46
Q

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

A

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

47
Q

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

A

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

48
Q

What is the reflex grading system called?

A

wexler scale

49
Q

What does a 0 on the reflex grading system mean?

A

absent with reinforcement

50
Q

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

A

hypoactive with reinforcement

51
Q

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

A

normal (may use sluggish or brisk)

52
Q

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

A

hyperactive

53
Q

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

A

hyperactive with transient or sustained clonus

54
Q

What is the method of jendrassik?

A

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