neuro hor fun - controlling movement

Question 1

LMN lesion

Answer 1

mostly lesion in PNS

no reflex: reflex arc broken
weakness
hypotonia
denervation - muscle wasting, fasciculations

• foot drop

Question 2

UMN lesion

Answer 2

lesion in CNS (UMN/BG/cerebellar)

modulation of reflex arc lost -> uninhibited and reinforced -> hyperreflexia (brisk reflexes) and spasticity
hypertonia
clasp knife rigidity
Babinskis sign - normal plantar reaction is going downwards

• spastic gait, hoffman reflex, clonus

Question 3

lesion in cerebral hemisphere

Answer 3

affects contralateral face, arm, leg

Question 4

lesion in brainstem

Answer 4

contralateral leg

ipsilateral face - cause cn does not decussate after the lesion

Question 5

lesion in cerebellum

Answer 5

ipsilateral ataxia (neurodegeneration)

Question 6

lesion in spinal cord (CNS)

Answer 6

affects BILATERAL sensory at level below its lesion

• has LMN lesion signs at level of injury
• has UMN lesion signs below level of injury

Question 7

spinothalamic tract

Answer 7

pain
temperature
decussate at level of spinal cord

Question 8

dorsal column medial lemniscus

Answer 8

proprioception
vibration
decussate at brain stem

Question 9

lesion in roots

Answer 9

sensory and motor distributions (dermatomes and myotomes) 
confined to single nerve roots
elbow flexion - C5/6
wrist extension - C6
Biceps and supinator jerk - C5/6

Question 10

lesion in nerve

Answer 10

absent reflexes

glove and stocking distribution

Question 11

important cord levels

Answer 11

C3,4,5 - phrenic nerve
C5-T1 - brachial plexus
L1-S4 - lumbosacral plexus
S2-S4 - anal sphincter, urinary bladder

Question 12

extrapyramidal components

Answer 12

basal ganglia - too much/little movement

cerebellum - sensitivity of movement