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Board Prep > Module 3 UMN and LMN > Flashcards

Module 3 UMN and LMN Flashcards

1
Q

What is the locations and structures involved in UMN lesion?

A

central nervous system cortex, brain stem, corticospinal tracts, spinal cord

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2
Q

UMN diagnosis/pathology

A

stroke, traumatic brain injury, spinal cord injury

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3
Q

UMN tone

A

increased: hypertonia velocity dependent

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4
Q

UMN reflexes

A

increased: hyperreflexia, clonus
Exaggerated cutaneous and autonomic reflexes, +Babinski

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5
Q

UMN involuntary movements

A

muscles spasms: flexor or extensor

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6
Q

UMN strength

A

Weakness or paralysis ipsilateral stroke) or bilateral (SCI)
Corticospinal: contralateral if above decussation in medulla; ipsilateral if below distribution: nerve focal

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7
Q

UMN muscle bulk

A

Disuse atrophy: variable widespread distribution. especially of antigravity muscles

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8
Q

UMN voluntary movements

A

impaired or absent: dyssynergic patterns, obligatory mass synergies

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9
Q

LMN location and involved structures

A

cranial nerve nuclei/nerves
Spinal cord: anterior horn cell, spinal roots
peripheral nerve

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10
Q

LMN diagnosis/pathology

A

Polio, Guillain-Barre
Peripheral nerve injury
Peripheral neuropath
Radiculopathy

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11
Q

LMN tone

A

decreased or absent: hypotonia, flaccidity
not velocity dependent

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12
Q

LMN Reflexes

A

decreased or absent: hyporeflexia
cutaneous reflexes decreased or absent

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13
Q

LMN involuntary movement

A

with denervation: fasciculations

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14
Q

LMN strength

A

Ipsilateral weakness or paralysis
Limited distribution: segmental or focal pattern, root-innervated pattern

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15
Q

LMN muscle bulk

A

neurogenic atrophy: rapid, focal distribution, severe wasting

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16
Q

LMN Voluntary Movements

A

Weak or absent if nerve interrupted

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17
Q

Cerebral Cortex Corticospinal tracts diagnosis/pathology

A

stroke

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18
Q

Cerebral cortex corticospinal tract sensation

A

impaired or absent: depends on lesion location; contralateral sensory loss

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19
Q

cerebral cortex corticospinal tracts tone

A

hypertonia/spasticity velocity-dependent; clasp-knife
initial flaccidity: cerebral shock

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20
Q

Cerebral cortex corticospinal tracts reflexes

A

hyperreflexia

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21
Q

Cerebral cortex corticospinal tracts strength

A

Contralateral weakness or paralysis: hemiplegia or hemiparesis
Disuse weakness in chronic state

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22
Q

Cerebral cortex corticospinal tracts muscle bulk

A

normal during acute stage; disuse atrophy in chronic stage

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23
Q

Cerebral cortex corticospinal tract involuntary movement

A

Spasms

24
Q

Cerebral cortex corticospinal tracts voluntary movement

A

Dyssynergic: abnormal timing, co-activation, fatigability

25
Q

Cerebral cortex corticospinal tract postural control

A

impaired or absent, depends on lesion location
impaired balance

26
Q

Cerebral cortex Corticospinal tracts Gait

A

impaired: gait deficits due to abnormal weakness, synergies, spasticity, timing deficits

27
Q

Basal ganglia diagnosis/pathology

A

Parkinson’s disease

28
Q

Basal ganglia sensation

A

not affected

29
Q

Basal ganglia tone

A

lead-pike rigidity: increased uniform resistance
Cogwheel rigidity: increased, ratchet-like resistance

30
Q

Basal ganglia reflexes

A

normal or may be decreased

31
Q

Basal ganglia strength

A

Disuse weakness in chronic stage

32
Q

Basal ganglia muscle bulk

A

normal or disuse atrophy

33
Q

Basal ganglia involuntary movements

A

resting tremor

34
Q

Basal ganglia voluntary movements

A

bradykinesia: slowness of movement
Akinesia: absence of movement

35
Q

Basal ganglia postural control

A

Impaired: stooped (flexed)
Impaired balance

36
Q

Basal ganglia gait

A

Impaired: shuffling, festinating gait

37
Q

Cerebellum diagnosis/pathology

A

tumor, stroke

38
Q

Cerebellum sensation

A

not affected

39
Q

Cerebellum tone

A

Normal or may be decreased

40
Q

Cerebellum reflexes

A

Normal or weak: asthenia

41
Q

Cerebellum muscle bulk

A

Normal

42
Q

Cerebellum involuntary movements

A

none

43
Q

Cerebellum voluntary movements

A

Ataxia: intention tremor dysdiadokinesia dysmetria dyssynergia nystagmus

44
Q

Cerebellum postural control

A

Impaired: truncal axtaxia
impaired balance

45
Q

Cerebellum gait

A

Impaired: ataxic gait deficits, wide-based, unsteady

46
Q

SC diagnosis/pathology

A

trauma, tumor, vascular insult: complete, incomplete SCI

47
Q

SC sensation

A

Impaired or absent below the level of lesion

48
Q

SC tone

A

hypertonia/spasticity below the level of the lesion
Initial flaccidity: spinal shock

49
Q

SC reflexes

A

Hyperreflexia

50
Q

SC strength

A

Impaired or absent below the of the lesion: paraplegia or paraparesis; tetraplegia or tetraparesis

51
Q

SC muscle bulk

A

disuse atrophy

52
Q

SC involuntary movements

A

spasms

53
Q

SC voluntary movements

A

Above level lesion: intact
Below level of lesion: impaired or absent

54
Q

SC postural control

A

impaired below level of lesion
impaired balance

55
Q

SC gait

A

impaired or absent: depends on level of lesion

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