Nerve tracts & lesions

Question 1

Glove & stocking sensory loss?

Answer 1

Implies length dependent neuropathy

Question 2

Dermatomal sensory loss?

Answer 2

Can point towards mono neuropathy, radicular or plexus lesion

Question 3

Sensory level

Answer 3

Implies a spinal cord lesion

Question 4

Hemianaesthesia

Answer 4

Suggests contralateral cerebral lesion, or with no other signs of a non- organic disorder

Question 5

Dissociated sensory loss?

Answer 5

With lost spinothalamic (temp/ pain) but preserved dorsal column (vibration, light touch, proprioception) suggests hemicord damage

Question 6

Hemicord damage?

Answer 6

Anterior spinal artery
Brown Sequard syndrome
Syringomyelia

Question 7

Dysfunction of basal ganglia?

Answer 7

EXTRAPYRAMIDAL
Hyperkinetic MD
Hypokinetic

Question 8

Hyperkinetic Movement disorders?

Answer 8

Dystonia
Tics
Myoclonus
Chorea
Tremor

Question 9

Hypokinetic ?

Answer 9

Rigidity & bradykinesia

Parkinsonism

Question 10

Corticospinal/ pyramidal tract dysfunction

Answer 10

Pyramidal/ UMN features

• Pyramidal weakness
• Spasticity

Question 11

Pyramidal weakness?

Answer 11

Weakness of upper limb extensors, lower limb flexors.

Question 12

Cerebellar signs/ co-ordination?

Answer 12

Broad based and unsteady gait
Intention tremor/ ataxia
Dysdiadochokinesis
Nystagmus & dysarthria

Question 13

Dysdiadochokinesis?

Answer 13

Clumsy fast alternating movements

Question 14

Extrapyramidal symptoms/ Parkinsonism?

Answer 14

Motor symptoms
Bradykinesia, rigidity, resting tremor, impaired gait & posture
Hypomimia
Hypophonia
reduced arm swing, stooped posture, small steps
Impaired postural reflexes
Asymmetry in PD, symmetry in drug induced or atypical PD

Question 15

Is spinothalamic tract ascending or descending?

Answer 15

Ascending

Question 16

Function of anterior spinothalamic tract?

Answer 16

Sensory, crude (light) touch & pressure

Question 17

Function of lateral spinothalamic tract?

Answer 17

Sensory, pain and temp

Question 18

Is spinocerebellar tracts ascending or descending?

Answer 18

Ascending

Question 19

Function of spinocerebellar tracts>

Answer 19

Carry unconscious proprioceptive information

Transmit info from muscles to cerebellum

Question 20

How many pathways in spinocerebellar tracts?

Answer 20

4

Question 21

Posterior spinocerebellar tract?

Answer 21

Carries proprioceptive information from lower limbs to ipsilateral cerebellum

Question 22

Dorsal column/ medial lemniscal pathway?

Answer 22

Ascending
Fine touch and conscious proprioception (particularly from the upper limb)
Fibers cross in medulla!!!

Question 23

Where do pyramidal tracts originate?

Answer 23

Cerebral cortex

Question 24

What are pyramidal tracts responsible for?

Answer 24

Carry motor fibres to spinal cord & brainstem

Voluntary control of musculature of body and face

Question 25

Extrapyramidal tracts origin?

Answer 25

Brian stem

Question 26

What are extrapyramidal tracts responsible for?

Answer 26

Carry motor fibres to spinal cord | Involuntary and automatic control of all musculaturee (tone, balance, posture, locomotion)

Question 27

Are there synapses within the descending pathways?

Answer 27

NO

Question 28

At the end of descending pathways, what do they synapse with?

Answer 28

A lower motor neurone

Question 29

What are neurones within descending motor system classed as?

Answer 29

Upper motor neurones

Question 30

Where are cell bodies and axons of descending neurones found?

Answer 30

Cell body - cerebral cortex or brainstem | Axons - remain in CNS

Question 31

Functions of pyramidal tracts?

Answer 31

Voluntary control of muscles of body and face

Question 32

What are the pyramidal tracts?

Answer 32

Corticospinal | Corticobulbar

Question 33

Corticospinal?

Answer 33

Supplies musculature of the body

Question 34

Corticobulbar?

Answer 34

Supplies musculature of head and neck

Question 35

Extrapyramidal tracts type and origin?

Answer 35

Descending | Brainstem

Question 36

What are extrapyramidal tracts responsible for?

Answer 36

Motor fibres to spinal cord | Involuntary and automatic control of musculature (tone, balance, posture, locomotion)

Question 37

How many extrapyramidal tracts?

Answer 37

4

Question 38

Name the 4 extrapyramidal tracts?

Answer 38

Vestibulospinal Tracts Reticulospinal Tracts Rubrospinal Tracts Tectospinal Tracts

Question 39

Which extrapyramidal tracts desiccate and provide contralateral innervation?

Answer 39

Rubrospinal and tectospinal

Question 40

Which extrapyramidal tracts do not desiccate and provide ipsilateral innervation?

Answer 40

Vestibulospinal and reticulospinal

Question 41

Shoulder abduction? | Muscle, nerve, root

Answer 41

Deltoid Axillary C5

Question 42

Elbow extension? | Muscle, nerve, root

Answer 42

Triceps Radial C7

Question 43

Finger extension? | Muscle, nerve, root

Answer 43

Extensor digitorum Posterior interosseous (branch of radial) C7

Question 44

Index finger abduction? | Muscle, nerve, root

Answer 44

First dorsal interosseous Ulnar T1

Question 45

Knee flexion? | Muscle, nerve, root

Answer 45

Hamstrings Sciatic S1

Question 46

Ankle dorsiflexion? | Muscle, nerve, root

Answer 46

Peroneal Common perineal and sciatic L4, L5

Question 47

Great toe dorsiflexion? | Muscle, nerve, root

Answer 47

Extensor hallucis longus Common perineal L5

Question 48

Root innervation/ deep tendon reflex of ankle?

Answer 48

S1, S2

Question 49

Root innervation/ deep tendon reflex of knee?

Answer 49

L3, L4

Question 50

Root innervation/ deep tendon reflex of biceps?

Answer 50

C5, C6

Question 51

Root innervation/ deep tendon reflex of triceps?

Answer 51

C7, C8