Movement CPC

Question 1

Understand the neuro exam of coord and gait

Answer 1

1) mental status
2) reflexes
3) sensory
4) Cranial nerves
5) coordination

Question 2

Testing aspects of coordination 
- Rapid speech
lalalalala
pappapa
cacacaca

Answer 2

CN 12
CN 7
CN 10

Question 3

different ways to examine tremor

Answer 3

while at rest
holding arms up against gravity
touch finger to nose and extend all the way

Question 4

how to test rapid alternating movements

Answer 4

flip hands over and over

Question 5

how to test precision hand movements

Answer 5

tap index and thumb then diff fingers

Question 6

how to test drift
if pronator drift, means…

if drifts out then ….

Answer 6

close eyes and pretend holding pizza box in front of you

pronator drift = pyramidal tract dysfunction
if drift out = cerebellar dysfunction

make head move side to side for subtle drift

Question 7

different movement tests

Answer 7

heel shin –> toes

foot rapid alternating movements (tap toes on examiner hands and toe to examiner finger)

Question 8

check reflexes

Answer 8

make fist
push against resistance
then remove to see antagonist

Question 9

how to check rebound

how to check romberg

how to check pull test

Answer 9

rebound = elevate, you pull down, leg go and see arms bounce up

romberg = close eyes and arm by side to see if arms swaying
(cerebellar problem)

pull = pull patient back and see how many step back they make

Question 10

different kinds of gait

Answer 10

1) tandem
2) forced = walk on toes, heel, outside feet
3) casual = length, posture, tempo

Question 11

how to check different gaits

1) neuropathic
2) hemiplegic
3) diplegic
4) L5 radiculopathy
5) choreiform gait
6) waddling/trendelenberg

Answer 11

1) neuropathic = periph nerve disease, high gait
2) hemiplegic = UMN lesion on one side , arm tuck, spasticity
3) diplegic = LMN&raquo_space; UMN problem, swinging gait on both sides, adducted kenes
4) L5 radiculopathy = neuropathy
5) choreiform gait = foot drop and step
6) waddling/trendelenberg

Question 12

Features of dementing disease

Answer 12

1) impaired language
2) impaired long term memory
3) impaired planning, behavior, judgment
4) impaired short term memories

Question 13

features of movement disorder
basal ganglia

vs cerebellar

Answer 13

basal ganglia
= resting tremor,
= hypokinesis = bradykinesis and rigidity
= hyperkineiss = chorea, athetosis, akathesia

cerebellum
= HANDS tremor

Question 14

how is PSP and Alzheimer’s similar and diff

Answer 14

both tauopathies
PSP = movement
alzheimer = dementing

Question 15

how is parkinson’s similar and diff from lewy body

Answer 15

both synucleinopathies
parkinson’s = movement
diffuse lewy body = demeting

Question 16

recognize that various disease processes affect specific neuroanatomic site manifest similarly

Answer 16

substantia nigra
affected in 
1) parkinson's
2) multiple system atrophy
3) PSP
4) corticobasal degeneration

all present with parkinsonian like symptoms

Question 17

Key histologic hallmarks of the “synucleinopathies”:

1. Parkinson disease

Answer 17

1) lewy bodies
2) lewy neuritis (protein around neurons)
3) subst nigra degeneration with few neurons + gliosis

Question 18

Key histologic hallmarks of the “synucleinopathies”:

2. Multiple System Atrophy

Answer 18

1) glial cytoplasmic inclusions
2) axonal and neuronal inclusions
3) gliosis and glial scars
4) diffuse degeneration of brainstem, putamen

Question 19

extrapyramidal signs

basal ganglia vs cerebellar disorders

Answer 19

a