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Neurology 1 > Neurology - Impairment of Motor Control - Clinical Signs and Patterns > Flashcards

Neurology - Impairment of Motor Control - Clinical Signs and Patterns Flashcards

1
Q

which part of the frontal lobe is made up of large pyrimidal neurons that travel down the spinal cord and synapse with motor neurons

a.primary motor cortex
b.premotor cortex
c.prefrontal and orbitofrontal

A

a.primary motor cortex

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2
Q

which part of the frontal lobe organises and sequences movements

a.primary motor cortex
b.premotor cortex
c.prefrontal and orbitofrontal

A

b.premotor cortex

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3
Q

which part of the frontal lobe is responsible for abstract planning and telling the premotor cortex the steps required to reach a goal

a.primary motor cortex
b.premotor cortex
c.prefrontal and orbitofrontal

A

c.prefrontal and orbitofrontal

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4
Q

descending motor pathway

A

primary motor cortex
internal capsule
cerebellar peduncles in pons
cross at level of medulla to form lateral corticospinal tracts
synapse with lower motor neurons
neuromuscular junction
muscle

primary motor cortex
internal capsulse
cerebellar peduncles in pons
cross over at level of medulla to form corticospinal tracts
synapse with lower motor neurons
neuromuscular junction
muscle

primary motor cortex
internal capsule
cerebellar peduncles in pons
cross over at level of medulla to form corticospinal tracts
synapse with lower motor neurons
neuromuscular junction
muscle

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5
Q

the cell body of lower motor neurons is located within which structure

a.dorsal horn
b.ventral horn

A

b.ventral horn

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6
Q

which type of motor neurons are responsible for voluntary muscle contraction and the myostatic stretch reflex

a.a motor neurons
b.y motor neurons

A

a.a motor neurons

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7
Q

which type of motor neurons are responsible for regulating muscle tone and maintaining proprioception

a.a motor neurons
b.y motor neurons

A

b.y motor neurons

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8
Q

the cortex exerts …………. signals over both the spinal neurons and brainstem motor areas

a.exitatory
b.inhibitory

A

b.inhibitory

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9
Q

to ensure postural stability when pulling on a handle contraction of the gastrocnmius happens ……………….. contraction of the biceps

a.before
b.after

A

a.before

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10
Q

weakness of the legs

a.paraparesis
b.paraplegia
c.paraesthesia
d.quadraparesis
e.hemiparesis

A

a.paraparesis

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11
Q

complete weakness of the legs

a.paraparesis
b.paraplegia
c.paraesthesia
d.quadraparesis
e.hemiparesis

A

b.paraplegia

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12
Q

abnormal sensation

a.paraparesis
b.paraplegia
c.paraesthesia
d.quadraparesis
e.hemiparesis

A

c.paraesthesia

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13
Q

weakness of the arms and legs

a.paraparesis
b.paraplegia
c.paraesthesia
d.quadraparesis
e.hemiparesis

A

d.quadraparesis

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14
Q

weakness of half of the body

a.paraparesis
b.paraplegia
c.paraesthesia
d.quadraparesis
e.hemiparesis

A

e.hemiparesis

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15
Q

myelo -

A

of the spinal cord

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16
Q

radiculo -

A

of the nerve roots

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17
Q

lack of coordination of limb movements and or gait

a.paraparesis
b.paraplegia
c.paraesthesia
d.quadraparesis
e.ataxia

A

e.ataxia

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18
Q

contralateral (to the lesion) hemiplegia (paralysis of one side of the body ) and pattern of flexed upper limbs and extended lower limbs indicates brain damage where ?

a.above medulla
b.below medulla
c.peripheral nervous system
d.basal ganglia
e.cerebellum

A

a.above medulla

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19
Q

damage below the medulla results in a spinal cord syndrome. quadriplegia suggests damage to which part of the spinal cord

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

A

a.cervical

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20
Q

paraplegia (paralysis of the legs) indicates damage below the medulla to which section of the spinal cord

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

A

b.thoracic or c,lumbar

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21
Q

hemisection of the spinal cord results in which spinal cord syndrome

a.guillian barre
b.eaton lambert
c.cushings
d,waterhouse friedrickson
e.brown sequard

A

e.brown sequard

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22
Q

in brown sequard syndrome weakness /paralysis occurs ………….. to the lesion

a.contralaterally
b.ipsilaterally

A

b.ipsilaterally

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23
Q

in brown sequard syndrome loss of pai and temperature sensation occurs ………….. to the lesion

a.contralaterally
b.ipsilaterally

A

a.contralaterally

24
Q

UMN lesion results in …………… of the stretch reflex

a.hyperexcitability
b.hypoexcitability

A

a.hyperexcitability

loss of inhibitory control
eg clasp knife

25
Q

increased tone, clonus , hyperreflexia and the babinski sign indicate what

a.UMN lesion
b.LMN lesion
c.cerebellar damage
d.basal ganglia damage

A

a.UMN lesion

26
Q

spastic paraparesis of all 4 limbs indicates the lesion must be above..

a.c6
b.c5
c.c4
d.c3
e.c2

A

b.c5

27
Q

what does a complete lesion cause

A

complete paralysis below lesion
loss of sensory modalities below lesion
loss of bowel, bladder and sexual function

28
Q

if there is spastic paraparesis in legs but arms are normal the lesion must be below

a.c5
b.c6
c.c7
d.t1
e.t2

A

d.t1

29
Q

lesions of the thoracic / lumbar spinal cord are often ………… causing bilateral leg weakness , impaired sensory function and defective bowel, bladder and sexual function

a.complete
b.incomplete

A

b.incomplete

30
Q

conditions with UMN signs

A

brain tumour
ischaemic stroke
intracranial haemorrhage
MS
spinal cord stenosis
prolapsed disc

31
Q

damage to the motor neuron in the anterior horn of the spinal cord is classed as a

a.UMN lesion
b.LMN lesions

A

b.LMN lesions

32
Q

muscle wasting, flaccid tone, fasciculations and waddling gait indicate which type of lesion

a.UMN
b.LMN
c.cerebellar lesion
d. basal ganglia lesion

A

b.LMN

33
Q

distal and ascending (from legs to torso to arms ) flaccid areflexic paraplegia is seen in which syndrome

a.guillian barre
b.eaton lambert
c.cushings
d,waterhouse friedrickson
e.brown sequard

A

a.guillian barre

34
Q

in which syndrome does the immune syste attack nerve cells leading to ascending flassid areflexic paraplegia

a.guillian barre
b.eaton lambert
c.cushings
d,waterhouse friedrickson
e.brown sequard

A

a.guillian barre

35
Q

proximal weakness leading to difficulty rising, walking up stairs and washing hair can be caused by what

a.brown sequard syndrome
b.guillian barre syndrome
c.plexopathy, radiculopathy , muscular dystrophies
d.focal/widespread neuropathy
e.myasthenia gravis

A

c.plexopathy, radiculopathy , muscular dystrophies

36
Q

distal weakness eg difficulty with fine tasks eg writing and phone can be caused by

a.brown sequard syndrome
b.guillian barre syndrome
c.plexopathy, radiculopathy , muscular dystrophies
d.focal/widespread neuropathy
e.myasthenia gravis

A

d.focal/widespread neuropathy

37
Q

fatiguable weakness (worse with repeated effort/ at the end of the day more so in neck and eyes indicates what

a.brown sequard syndrome
b.guillian barre syndrome
c.plexopathy, radiculopathy , muscular dystrophies
d.focal/widespread neuropathy
e.myasthenia gravis

A

e.myasthenia gravis

38
Q

patient with foot drop ( unable to dorsiflex the foot and floppy at ankle ) may be due to wasting of which muscle if long standing

a.tibialis anterior
b.fibularis anterior
c.fibularis posterior
d. tibialis posterior

A

a.tibialis anterior

39
Q

which of these is NOT a lesion location indicated in foot drop

a.deep/ common peroneal nerve
b.sciatic nerve
c.lumbosacral plexus
d.L5 nerve root
e,T1 nerve root

A

d.L5 nerve root

40
Q

a lesion in which of these nerve root can cause foot drop

a.L1
b.L2
c.L3
d.L4
e.L5

A

e.L5

41
Q

if wrist drop is chronic is may be due to wasting of which muscle

a.biceps brachii
b.brachioradialis
c.triceps

A

c.triceps

42
Q

wrist drop may be due to a lesion on which nerve

a. median
b.musculocutaneous
c.axillary
d.radial
e. ulnar

A

d.radial

43
Q

wrist drop can be seen in which of these conditions

a.brown sequard syndrome
b.guillian barre syndrome
c. Motor neurone disease
d.focal/widespread neuropathy
e.myasthenia gravis

A

c. Motor neurone disease

44
Q

combination of upper and lower motor neurone signs eg fasciculations, atrophy , brisk reflexes and extensor plantar response indicates which condition

a.brown sequard syndrome
b.guillian barre syndrome
c. Motor neurone disease
d.focal/widespread neuropathy
e.myasthenia gravis

A

c. Motor neurone disease

damage to anterior horn in spinal cord

45
Q

what do the basal ganglia do

(striatum - caudate and putamen, globus pallidus , subthalmic nucleus, substantia nigra)

A

give fluidity to movement
sequencing and control of movement

46
Q

hypokinesis, bradykinesia, lead pipe stiffness and resting tremor indicate which condition

a.brown sequard syndrome
b.guillian barre syndrome
c. Motor neurone disease
d.parkinsons
e.myasthenia gravis

A

d.parkinsons

47
Q

in which of these conditions is there gradual degeneration of the striatum leading to chorea, tremor most obvious in hands when doing tasks eg writing , ballism , dystonia

a.brown sequard syndrome
b.guillian barre syndrome
c. Motor neurone disease
d.parkinsons
e.myasthenia gravis
f.huntingtons

A

f.huntingtons

48
Q

what is the role of the cerebellum

A

coordinates agonist and antagonist muscle activity in learned movements

49
Q

nystagmus , dysarthia , intention tremor and a wide based unsteady gait indicates dysfunction where?

a/UMN
b.LMN
c. basal ganglia
d.cerebellum

A

d.cerebellum

50
Q

A 36 year old man attends the Emergency Department with a 10 day history of progressive patchy loss of sensation over his legs and lower abdomen. He reports difficulty passing urine. He has acute urinary retention, mild weakness in his legs, a mid-thoracic sensory level and brisk reflexes in his legs.
* What investigation will be the most helpful?

a) Electromyography of lower limbs
b) MRI of spine
c) Nerve conduction studies of lower limbs
d) Urinalysis
e) Visual evoked potentials

A

b) MRI of spine

brisk reflexes = UMN
brain or spinal cord?
both legs involved, urinary dysfunction, sensory level

51
Q

is myasthenia gravis upper or lower motor neurone syndrome

a.upper
b.lower

A

b.lower

droopy eyelids
double vision
difficulty making facial expressions
difficulty swallowing
slurred speech
SOB
fatiguiable weakness

52
Q

what is the first line drug for myasthenia gravis

a.pyridostigmine
b.prednisolone
c. nimodipine
d.immunosurpressants

A

a.pyridostigmine

only works to reduce muscle weakness for few hours so has to be taken multiple times daily

53
Q

what is the main side effect of pyridostigmine

a.GI upset (diarrhoea and stomach pain)
b.agranulocytosis
c. itching skin
d.nightmares

A

a.GI upset (diarrhoea and stomach pain)

54
Q

what is given in hospital if a person with myasthenia gravis is having difficulty swallowing or breathing

a.pyridostigmine
b.prednisolone
c. nimodipine
d.immunosurpressants

A

b.prednisolone

55
Q

what is a side effect of prednisolone (steroid)

a.weight gain
b.weight loss
c. Gi upset
d.pupil constriction

A

a.weight gain

Neurology 1 (44 decks)

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