motor neurone

Question 1

UMN lesion

Answer 1

Cerebral hemispheres, cerebellum, brainstem, spinal cord

Question 2

LMN lesion

Answer 2

Anterior horn cell, motor nerve roots, peripheral motor nerves

Question 3

3

UMN tone

Answer 3

increased spasticity or rigidity +/- ankle clonus
hyperreflexia

Question 4

LMN tone

Answer 4

Decreased (hypotonia, flaccid) or normal

Question 5

UMN power

Answer 5

Reduced with pyramidal pattern of weakness (extensors weaker than flexors in arms, and vice versa in legs)

Question 6

LMN power

Answer 6

Reduced in distribution of affected motor root/nerve

Question 7

UMN reflexes

Answer 7

Exaggerated or brisk (hyperreflexia)

Question 8

LMN reflexes

Answer 8

Reduced or absent (hyporeflexia or areflexia)

Question 9

UMN plantar reflex

Answer 9

Upgoing/extensor (Babinski positive)

Question 10

LMN plantar reflex

Answer 10

Normal (downgoing/flexor) or no movement

Question 11

UMN eg conditions

Answer 11

• Ischaemic or haemorrhagic stroke (including brainstem strokes)
• Amyotrophic lateral sclerosis
• Multiple sclerosis

Question 12

LMN eg conditions

Answer 12

• Peripheral nerve trauma/compression
• Spinal muscular atrophy
• Amyotrophic lateral sclerosis
• Guillain-Barré syndrome
• Poliomyelitis

Question 13

n2 p6

UMN syndrome positive/negative

Answer 13

negative
- weakness
- decreased motor control

positive
- hypertonus/ spasticity
- hyperreflexia (increased tendon reflexes)
- co-activation
- spasms
- clonus
- associated reactions

Question 14

UMN syndrome secondary adaptive changes

Answer 14

• increased resistance to passive movement
• intrinsic biomechanical stiffness
• contractures