NM Diff Dx CNS Disorders

Question 1

Cerebral cortex/corticospinal tracts:

Disorder:

Answer 1

Stroke

Question 2

Cerebral cortex/corticospinal tracts:

Sensation:

Answer 2

Impaired/absent

Depending on lesion location; C/L sensory loss

Question 3

Cerebral cortex/corticospinal tracts:

Tone:

Answer 3

Hypertonic/spasticity;
Class-knife phenomena
Spasticity is velocity dependent
With cerebral shock… may see initial flaccidity

Question 4

Cerebral cortex/corticospinal tracts:

Reflexes

Answer 4

Increased- hyperreflexia

Question 5

Cerebral cortex/corticospinal tracts:

Strength

Answer 5

C/L weakness or paralysis: hemiplegia

Question 6

Cerebral cortex/corticospinal tracts:

Bulk:

Answer 6

Normal: acute

Disuse atrophy: chronic

Question 7

Cerebral cortex/corticospinal tracts:

Involuntary movements

Answer 7

Spasm

Question 8

Cerebral cortex/corticospinal tracts:

Voluntary movements

Answer 8

Dyssynergic: Abnormal timing, co-activation, activation, fatigability

Question 9

Cerebral cortex/corticospinal tracts:

Postural:

Answer 9

Impaired or absent

Depends on lesion location

Question 10

Cerebral cortex/corticospinal tracts:

Gait

Answer 10

Impaired: gait deficits due to abn synergies, spasticity, timing deficits

Question 11

Basal ganglia: Subcortical gray:

Disorder:

Answer 11

Parkinsonism

Question 12

Basal ganglia: Subcortical gray:

Sensation

Answer 12

Not affected

Question 13

Basal ganglia: Subcortical gray:

Tone

Answer 13

Leadpipe rigidity: uniform increased resistance to movement
Cogwheel rigidity: ratchet-like resistance to movement
Rigidity is NOT velocity dependent

Question 14

Basal ganglia: Subcortical gray:

Reflexes

Answer 14

Normal
Or
May be decreased- hyporeflexia

Question 15

Basal ganglia: Subcortical gray:

Strength

Answer 15

Slowness of movement

Question 16

Basal ganglia: Subcortical gray:

Bulk

Answer 16

Normal or

Disuse atrophy

Question 17

Basal ganglia: Subcortical gray:

Involuntary movements:

Answer 17

Resting tremor

Question 18

Basal ganglia: Subcortical gray:

Voluntary movements

Answer 18

Bradykinesia/akinensia: slowness, lack of spontaneous and automatic movements

Question 19

Basal ganglia: Subcortical gray:

Postural

Answer 19

Impaired: stooped

Question 20

Basal ganglia: Subcortical gray:

Gait

Answer 20

Impaired: shuffling, destinations

Question 21

Cerebellum:

Disorder

Answer 21

Cerebellar lesion: tumor, stroke

Question 22

Cerebellum:

Sensation

Answer 22

Not affected

Question 23

Cerebellum:

Tone

Answer 23

Normal or

May be decreased

Question 24

Cerebellum:

Reflexes

Answer 24

Normal or may be decreased/hyporeflexia

Question 25

Cerebellum:

Strength

Answer 25

Normal or weak: Asthenia

Question 26

Cerebellum:

Bulk

Answer 26

Normal

Question 27

Cerebellum:

Involuntary movements

Answer 27

None

Question 28

Cerebellum:

Voluntary movements

Answer 28

Ataxia: intention tremor
Dysdiadochokinesia
Dysmetria
Dyssynergia
Nystagmus

Question 29

Cerebellum:

Gait

Answer 29

Impaired: ataxia gait deficits
Wide BOS
Unsteady

Question 30

Spinal cord:

Disorder

Answer 30

SCI: trauma, complete, incomplete

Question 31

Spinal cord:

Sensation:

Answer 31

Impaired or absent below level of lesion

Question 32

Spinal cord:

Tone

Answer 32

Hypertonic/spasticity below the level of the lesion

Initial flaccidity due to spinal shock

Question 33

Spinal cord:

Reflexes

Answer 33

Increased/hyperreflexia

Question 34

Spinal cord:

Strength

Answer 34

Impaired or absent below the level of the lesion
Paraplegia or tetraplegia (quadriplegia)

Side note: Tetraplegia occurs in all 4 extremities and trunk from injury between C1-C8
Paraplegia occurs between T1 and T12/L1 and involves both LE and trunk

Question 35

Spinal cord:

Bulk

Answer 35

Disuse atrophy

Question 36

Spinal cord:

Involuntary movements:

Answer 36

Spasms

Question 37

Spinal cord:

Voluntary movement

Answer 37

Intact: above level of lesion

Question 38

Spinal cord:

Postural

Answer 38

Impaired below level of lesion

Question 39

Spinal cord:

Gait

Answer 39

Impaired or absent: depends on level of lesion