Neurology - An Introduction to lower motor neuron disorders Flashcards
increased tone, reflexes and plantar responses indicates what
a.upper motor neurone lesion
b.lower motor neurone lesion
a.upper motor neurone lesion
wasting, decreased tone, reflexes and plantar decrease indicates what
a.upper motor neurone lesion
b.lower motor neurone lesion
b.lower motor neurone lesion
possible sites of pathology of LMN weakness
anterior horn cell
nerve root - radiculopathy
peripheral nerve - neuropathy
neuromuscular junction
muscle fibres - myopathy
painless and progressive weakness and wasting indicates a disorder of what
a. anterior horn cell
b. nerve root - radiculopathy
c. peripheral nerve - neuropathy
d. neuromuscular junction
e. muscle fibres - myopathy
a. anterior horn cell
motor horn
which of these conditions is an example of anterior horn cell disorder
a.motor neurone disease
b.myasthenia gravis
c.eaton lambert
d.multiple sclerosis
e. stroke
a.motor neurone disease
in motor neurone disease there are….
a.only upper motor neurone signs
b.only lower motor neurone signs
c.upper and lower motor neurone signs
c.upper and lower motor neurone signs
patient with painless progressive weakness and wasting , increased tone and decreased reflexes , normal eye movements and normal sensation indicates what
a.motor neurone disease
b.myasthenia gravis
c.eaton lambert
d.multiple sclerosis
e. stroke
a.motor neurone disease
spinal muscular atrophy is a disorder of what
a. anterior horn cell
b. nerve root - radiculopathy
c. peripheral nerve - neuropathy
d. neuromuscular junction
e. muscle fibres - myopathy
a. anterior horn cell
mechanical compression of a nerve root leads to what
a. anterior horn cell disorders
b. radiculopathy
c. neuropathy
d. neuromuscular junction disorder
e. myopathy
b. radiculopathy
patient with pain weakness and sensory loss . the weakness is confined to one myotone and the sensory loss is confined to one dermatome and reflex loss at the nerve root level indicates what
a. anterior horn cell disorders
b. radiculopathy
c. neuropathy
d. neuromuscular junction disorder
e. myopathy
b. radiculopathy
loss of the bicep jerk reflex, accompanied by pain, sensory loss of one dermatome and weakness of one myotome indicates radiculopathy at which level
a.c3
b.c4
c.c5
d.c6
c.7
c.c5
mainly radiculopathy occurs in which roots
a.cervical and thoracic
b.thoracic and lumbar
c.lumbar and sacral
d.cervical and lumbar
d.cervical and lumbar
which nerve root is responsible for elbow flexion
a.c5
b.c6
c.c7
d.c8
e.t1
a.c5
which nerve root is responsible for wrist extension
a.c5
b.c6
c.c7
d.c8
e.t1
b.c6
which nerve root is responsible for wrist flexion and finger extension
a.c5
b.c6
c.c7
d.c8
e.t1
c.c7
which nerve root is responsible for finger abduction
a.c5
b.c6
c.c7
d.c8
e.t1
e.t1
what nerve root is responsible for knee flexion and big toe extension
a.t1
b.l2
c.l3
d.l4
e.l5
e.l5
what nerve root is responsible for knee extension
a.t1
b.l2
c.l3
d.l4
e.l5
c.l3
d.l4
what nerve root is responsible for big toe flexion
a.t1
b.l2
c.l3
d.l4
e.l5
f.s1
f.s1
which nerve root is responsible for the biceps reflex
a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1
a.c5
which nerve root is responsible for the brachioradialis reflex
a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1
b.c6
which nerve root is responsible for the triceps reflex
a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1
c.c7
which nerve root is responsible for the quadriceps reflex
a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1
d.l3.l4
diffuse disorder of peripheral nerves
polyneuropathy
single peripheral nerve disorder
mononeuropathy
disorder of several individual nerves
mononeuropathy multiplex
which nerves are affected first in polyneuropathies
a.proximal
b.distal
b.distal
polyneuropathies have weakness +/- sensory loss starting distally in which pattern
a.asymetrical
b.one sided only
c.symmetrical
c.symmetrical
in polyneuropathies reflexes are abscent …….
a.late
b.early
b.early
pes cavus is seen in what
a.mononeuropathies
b.mononeuropathies multiplex
c.polyneuropathies
c.polyneuropathies
mononeuropathies are often…
a.idiopathic
b.idiosyncratic
c.compressive/ traumatic
c.compressive/ traumatic
foot drop is caused by palsy of which nerve
a.median nerve
b.radial nerve
c.ulnar
d.common peroneal nerve
d.common peroneal nerve
fatiguability is the hallmark of which disorder
a. anterior horn cell disorders
b. radiculopathy
c. neuropathy
d. neuromuscular junction disorder
e. myopathy
d. neuromuscular junction disorder
which muscles are commonly involved in neuromuscular junction disorders
a.intraocular
b.extraoccular
c. facial
d.cardiac
b.extraoccular
opthalmoplegia, ptosis, diplopia
opthalmoplegia, ptosis and diplopia followed by problems with chewing , swallowing and nasal sounding speech are seen in which conditions
a. anterior horn cell disorders
b. radiculopathy
c. neuropathy
d. neuromuscular junction disorder
e. myopathy
d. neuromuscular junction disorder
what is the most common neuromuscular junction disorder
a.eaton lambert
b.myasthenia gravis
c. motor neurone disease
d.multiple sclerosis
e.parkinsons
b.myasthenia gravis
proximal, symmetrical weakness with sparing of reflexes until late indicates what
a. anterior horn cell disorders
b. radiculopathy
c. neuropathy
d. neuromuscular junction disorder
e. myopathy
e. myopathy
weakness distribution - asymetric
reflexes- lost or increased
wasting - early
other- mixed upper and lower mn signs
a.anterior horn cell disorder
b.nerve root disorder
c.peripheral nerve disorder
d.neuromuscular junction disorder
e.myopathy
a.anterior horn cell disorder
weakness in one myotome
reflexes- lost at lesion
wasting- no
other - dermatomal sensory loss
a.anterior horn cell disorder
b.nerve root disorder
c.peripheral nerve disorder
d.neuromuscular junction disorder
e.myopathy
b.nerve root disorder
weakness distal and symmetrical
reflexes- lost early
wasting- early
other - distal sensory loss
a.anterior horn cell disorder
b.nerve root disorder
c.peripheral nerve disorder
d.neuromuscular junction disorder
e.myopathy
c.peripheral nerve disorder
weakness proximal, fatiguable
reflexes- normal
wasting- no
other - extraocular and bulbar muscle involvement
a.anterior horn cell disorder
b.nerve root disorder
c.peripheral nerve disorder
d.neuromuscular junction disorder
e.myopathy
d.neuromuscular junction disorder
weakness - proximal and symmetrical
reflexes- normal
wasting- late
other -
a.anterior horn cell disorder
b.nerve root disorder
c.peripheral nerve disorder
d.neuromuscular junction disorder
e.myopathy
e.myopathy
stairs/ hair brushing difficulties indicates weakness where
a.proximal
b.distal
a.proximal
tripping/ difficulty opening jars difficulties indicates weakness where
a.proximal
b.distal
b.distal
weakness coming on over years indicates what cause
a.genetic
b.inflammatory
a.genetic
there is no pain in which conditions
a.nmj/ mnd
b.radiculopathies
a.nmj/ mnd
PAIN ESP. IN RADICULOPATHIES
symptoms of respiratory muscle weakness
lethargy
nausea
early morning headache
scapular winging is seen in
a.anterior horn cell disorder
b.nerve root disorder
c.peripheral nerve disorder
d.neuromuscular junction disorder
e.myopathy
e.myopathy
spontaneous firing of a single motor unit (motor nerve and group of muscles it innervates)
fasciculations
indicates active denervation and reinnervation
what should be tested in all patients with neuromuscular weakness
a.crp
b. ccp
d.anti transglutaminase
e.creatine kinase
e.creatine kinase
which enzyme is primarily found in skeletal /cardiac muscle and increases after high intensity excercise
a.crp
b. ccp
d.anti transglutaminase
e.creatine kinase
e.creatine kinase
increase of creatine kinase >10,000 indicates what
rhabdomyolysis
muscular dystrophy
which test gives info about how the nerve conducts the motor response
a.nerve conduction
b.electromyography
a.nerve conduction
which test gives info about damage to muscle as a result of myopathy or denervation
a.nerve conduction
b.electromyography
b.electromyography
what type of muscle is best for a muscle biopsy
a.weak
b.strong
c.atrophied
a.weak
