Neurologic Causes of Weakness and Paralysis

Question 1

a reduction in the power exerted by muscle

Answer 1

weakness

Question 2

inability to sustain performance of an activity that should be normal for a person of same age, sex, and size

Answer 2

fatigability

Question 3

prevents adequate feedback information

Answer 3

proprioceptive sensory loss

Question 4

increased time for full power to be exerted

Answer 4

bradykinesia

Question 5

disorder of planning and initiating a skilled/learned mov’t

Answer 5

apraxia

Question 6

weakness so severe that muscle can’t be contracted at all

Answer 6

paralysis

Question 7

less severe weakness

Answer 7

paresis

Question 8

refers to one half of body

Answer 8

“hemi-“

Question 9

both legs

Answer 9

“para-“

Question 10

four limbs

Answer 10

“quadri-“

Question 11

myopathic weakness is marked in

Answer 11

proximal muscles

Question 12

no specific pattern

Answer 12

neuromuscular junction weakness

Question 13

resistance of a muscle to passive stretch

Answer 13

tone

Question 14

increase in tone associated with disease of UMN

Answer 14

spasticity

Question 15

velocity-dependent, sudden release after reaching maximum “clasp-knife”

Answer 15

spasticity

Question 16

hypertonia that is present throughout the range of motion
lead-pipe or plastic stiffness
affects flexors and extensors equally

Answer 16

rigidity

Question 17

has a cogwheel quality that is enhanced by voluntary mov’t of contralateral limb
seen in extrapyramidal symptoms

Answer 17

rigidity

Question 18

increased tone that varies irregularly; from disease of frontal lobes

Answer 18

paratonia or gegenhalten

Question 19

decreased tone

Answer 19

flaccidity

Question 20

weakness with decreased tone or normal tone occurs with disorders of what

Answer 20

motor units

Question 21

refers to a single lower motor neuron and all the muscle fibers it innervates

Answer 21

motor unit

Question 22

muscle bulk is generally not affected by

Answer 22

UMN lesions

Question 23

atrophy is conspicuous in what lesion

Answer 23

LMN lesions

Question 24

muscle stretch reflexes are increased when?

Answer 24

UMN

Question 25

hyperreflexia in UMN lesions is usually accompanied by

Answer 25

loss of cutaneous reflexees

Question 26

tendon reflexes are ____ in myopathic weakness except in advances stages

Answer 26

preserved

Question 27

in this neuromuscular junction disorder, reflex responses are enhanced by previous voluntary activity (low to high)

Answer 27

Lambert-Eaton myasthenic syndrome

Question 28

in this neuromuscular junction disorder, reflex responses are depressed by previous voluntary activity (high to low)

Answer 28

myasthenia gravis

Question 29

neuropathic (LMN) vs myopathic

distal weakness

Answer 29

neuropathic (LMN)

Question 30

neuropathic (LMN) vs myopathic

symmetric proximal weakness

Answer 30

myopathic

Question 31

visible or palpable twitch and early atrophy indicates what lesion

Answer 31

neuropathic (LMN)

Question 32

hemiparesis

Answer 32

brain CT or MRI

Question 33

paraparesis

Answer 33

UMN - cerebral signs?
yes, CT scan (if none, spinal MRI)
no, spinal MRI (if none, myelogram/brain MRI)

LMN - EMG and NCS

Question 34

quadriparesis

Answer 34

if alert, UMN (spinal MRI) 
or LMN (EMG and NCS)

if not, CT scan or MRI

Question 35

monoparesis

Answer 35

UMN (brain CT or MRI)

LMN (EMG and NCS)

Question 36

distal, proximal, rectricted weakness

Answer 36

EMG and NCS

Question 37

electromyography (EMG) and nerve conduction studies (NCS)

Answer 37

UMN pattern -> spinal MRI
LMN pattern -> anterior horn, root, or peripheral nerve disease
myopathic -> muscle or neuromuscular disease