Neurology - An Introduction to lower motor neuron disorders Flashcards

1
Q

increased tone, reflexes and plantar responses indicates what

a.upper motor neurone lesion
b.lower motor neurone lesion

A

a.upper motor neurone lesion

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2
Q

wasting, decreased tone, reflexes and plantar decrease indicates what

a.upper motor neurone lesion
b.lower motor neurone lesion

A

b.lower motor neurone lesion

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3
Q

possible sites of pathology of LMN weakness

A

anterior horn cell
nerve root - radiculopathy
peripheral nerve - neuropathy
neuromuscular junction
muscle fibres - myopathy

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4
Q

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

a. anterior horn cell
motor horn

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5
Q

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

a.motor neurone disease

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6
Q

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

A

c.upper and lower motor neurone signs

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7
Q

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

a.motor neurone disease

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8
Q

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

a. anterior horn cell

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9
Q

mechanical compression of a nerve root leads to what

a. anterior horn cell disorders
b. radiculopathy
c. neuropathy
d. neuromuscular junction disorder
e. myopathy

A

b. radiculopathy

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10
Q

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

A

b. radiculopathy

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11
Q

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

A

c.c5

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12
Q

mainly radiculopathy occurs in which roots

a.cervical and thoracic
b.thoracic and lumbar
c.lumbar and sacral
d.cervical and lumbar

A

d.cervical and lumbar

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13
Q

which nerve root is responsible for elbow flexion

a.c5
b.c6
c.c7
d.c8
e.t1

A

a.c5

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14
Q

which nerve root is responsible for wrist extension

a.c5
b.c6
c.c7
d.c8
e.t1

A

b.c6

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15
Q

which nerve root is responsible for wrist flexion and finger extension

a.c5
b.c6
c.c7
d.c8
e.t1

A

c.c7

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16
Q

which nerve root is responsible for finger abduction
a.c5
b.c6
c.c7
d.c8
e.t1

A

e.t1

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17
Q

what nerve root is responsible for knee flexion and big toe extension

a.t1
b.l2
c.l3
d.l4
e.l5

A

e.l5

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18
Q

what nerve root is responsible for knee extension

a.t1
b.l2
c.l3
d.l4
e.l5

A

c.l3
d.l4

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19
Q

what nerve root is responsible for big toe flexion

a.t1
b.l2
c.l3
d.l4
e.l5
f.s1

A

f.s1

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20
Q

which nerve root is responsible for the biceps reflex

a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1

A

a.c5

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21
Q

which nerve root is responsible for the brachioradialis reflex

a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1

A

b.c6

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22
Q

which nerve root is responsible for the triceps reflex

a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1

A

c.c7

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23
Q

which nerve root is responsible for the quadriceps reflex

a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1

A

d.l3.l4

24
Q

diffuse disorder of peripheral nerves

A

polyneuropathy

25
Q

single peripheral nerve disorder

A

mononeuropathy

26
Q

disorder of several individual nerves

A

mononeuropathy multiplex

27
Q

which nerves are affected first in polyneuropathies

a.proximal
b.distal

A

b.distal

28
Q

polyneuropathies have weakness +/- sensory loss starting distally in which pattern

a.asymetrical
b.one sided only
c.symmetrical

A

c.symmetrical

29
Q

in polyneuropathies reflexes are abscent …….

a.late
b.early

A

b.early

30
Q

pes cavus is seen in what

a.mononeuropathies
b.mononeuropathies multiplex
c.polyneuropathies

A

c.polyneuropathies

31
Q

mononeuropathies are often…

a.idiopathic
b.idiosyncratic
c.compressive/ traumatic

A

c.compressive/ traumatic

32
Q

foot drop is caused by palsy of which nerve

a.median nerve
b.radial nerve
c.ulnar
d.common peroneal nerve

A

d.common peroneal nerve

33
Q

fatiguability is the hallmark of which disorder

a. anterior horn cell disorders
b. radiculopathy
c. neuropathy
d. neuromuscular junction disorder
e. myopathy

A

d. neuromuscular junction disorder

34
Q

which muscles are commonly involved in neuromuscular junction disorders

a.intraocular
b.extraoccular
c. facial
d.cardiac

A

b.extraoccular

opthalmoplegia, ptosis, diplopia

35
Q

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

A

d. neuromuscular junction disorder

36
Q

what is the most common neuromuscular junction disorder

a.eaton lambert
b.myasthenia gravis
c. motor neurone disease
d.multiple sclerosis
e.parkinsons

A

b.myasthenia gravis

37
Q

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

A

e. myopathy

38
Q

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

a.anterior horn cell disorder

39
Q

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

A

b.nerve root disorder

40
Q

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

A

c.peripheral nerve disorder

41
Q

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

A

d.neuromuscular junction disorder

42
Q

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

A

e.myopathy

43
Q

stairs/ hair brushing difficulties indicates weakness where

a.proximal
b.distal

A

a.proximal

44
Q

tripping/ difficulty opening jars difficulties indicates weakness where

a.proximal
b.distal

A

b.distal

45
Q

weakness coming on over years indicates what cause

a.genetic
b.inflammatory

A

a.genetic

46
Q

there is no pain in which conditions

a.nmj/ mnd
b.radiculopathies

A

a.nmj/ mnd

PAIN ESP. IN RADICULOPATHIES

47
Q

symptoms of respiratory muscle weakness

A

lethargy
nausea
early morning headache

48
Q

scapular winging is seen in

a.anterior horn cell disorder
b.nerve root disorder
c.peripheral nerve disorder
d.neuromuscular junction disorder
e.myopathy

A

e.myopathy

49
Q

spontaneous firing of a single motor unit (motor nerve and group of muscles it innervates)

A

fasciculations

indicates active denervation and reinnervation

50
Q

what should be tested in all patients with neuromuscular weakness

a.crp
b. ccp
d.anti transglutaminase
e.creatine kinase

A

e.creatine kinase

51
Q

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

A

e.creatine kinase

52
Q

increase of creatine kinase >10,000 indicates what

A

rhabdomyolysis
muscular dystrophy

53
Q

which test gives info about how the nerve conducts the motor response

a.nerve conduction
b.electromyography

A

a.nerve conduction

54
Q

which test gives info about damage to muscle as a result of myopathy or denervation

a.nerve conduction
b.electromyography

A

b.electromyography

55
Q

what type of muscle is best for a muscle biopsy

a.weak
b.strong
c.atrophied

A

a.weak