Page: 12-13 (Central Nervous System)

Question 1

_____: associated with two-point discrimination, vibration, and joint position sense?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

Answer 1

c.) Corticospinal (aka: “Pyramidal”)

Question 2

_____: associated with pain and temperature?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

Answer 2

a.) Lateral spinothalamic

Question 3

_____: associated with crude light touch?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

Answer 3

b.) Anterior spinothalmic

Question 4

_____: associated with UMNL?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Ventral corticospinal
d. ) Lateral corticospinal

Answer 4

c.) Ventral corticospinal

Question 5

_____: associated with Labyrinthitis and Benign Positional Vertigo?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

Answer 5

d.) Vestibulospinal

Question 6

_____: associated with Syringomyelia?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

Answer 6

a.) Lateral spinothalamic

Question 7

_____: refers to a pathological longitudinal cyst of the central canal of the spinal cord causing a loss of pain and temperature over the shoulders and back in a cape like distribution?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

Answer 7

c.) Syringomyelia

Question 8

_____: refers to a non-progressive motor disorder of the cerebral cortex due to anoxia to the brain prenatally or during birth trauma causing Athetosis/Choreiform movements?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

Answer 8

d.) Cerebral palsy

MC symptom = Athetosis: a symptom characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, arms, legs, neck and tongue.

Question 9

_____: refers to a disease in Females 20-40 y/o, which causes demyelination of the CNS. Patient experiences periods of exacerbations and remissions, as well as Scanning speech, Intention tremors, and Nystagmus. Worse when moving from a cold to warm environment?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

Answer 9

b.) Multiple sclerosis

• BOTH sensory and motor tracts are affected.
• Oligodendrocytes, are responsible for myelination in CNS.
• Ortho’s: (+) Lhermitte’s Test
• Diagnosed: MRI, Proteins in CSF fluid

Question 10

_____: refers to an autoimmune disease in Females 20-40 y/o, in which the body makes antibodies against the acetylcholine receptors. Weakness in cranial nerves then proximal muscles affected. Early signs: Ptosis, Diplopia, Dysarthria, and Fatigue of muscles (especially following exercise)?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

Answer 10

a.) Myasthenia gravis

• MC in Females, 20-40 y/o
• Diagnosed via ACHr(+) and Tensilon Test and treated with Cholinesterase inhibiting drugs.

Question 11

_____: affects the corticospinal tract and anterior horn, usually begins in the hands/feet of Males over 40 y/o and life expectancy is short?

a. ) Tabes dorsalis
b. ) Gullain-Barre syndrome
c. ) Amyotrophic lateral sclerosis
d. ) Posterolateral sclerosis

Answer 11

c.) Amyotrophic lateral sclerosis (aka: “Lou Gehrig’s Disease”)

• Fasciculations are present as well as spasticity and increased DTR’s. LMNL in the arms and UMNL in the legs.
• DDX: Lateral canal stenosis

Question 12

_____: refers to inflammatory polyneuropathy of the PNS linked to recent immunizations or seen after recent FLU infection. Pt presents with ascending paralysis (Beginning in the Legs) and sensory symptoms?

a. ) Tabes dorsalis
b. ) Gullain-Barre syndrome
c. ) Amyotrophic lateral sclerosis
d. ) Posterolateral sclerosis

Answer 12

b.) Gullain-Barre syndrome

Question 13

_____: refers to degeneration of the posterior columns and the corticospinal tracts as a result of a B12 deficiency (pernicious anemia). Neurological symptoms are irreversible. Patient has a glove and stocking paresthesia?

a. ) Tabes dorsalis
b. ) Gullain-Barre syndrome
c. ) Amyotrophic lateral sclerosis
d. ) Posterolateral sclerosis

Answer 13

d. ) Posterolateral sclerosis (aka: “Combined Systems Disease”)
- Ortho’s:(+) Schilling test

Question 14

_____: refers to a chronic progressive condition associated with loss of dopamine in the substantial nigra causing basal ganglionic dysfunction. Extrapyramidal tract involvement. Gradual onset over age 50?

a. ) Muscular dystrophy
b. ) Charcot Marie Tooth disease
c. ) Parkinson’s disease
d. ) Brown sequard

Answer 14

c.) Parkinson’s disease (aka: “Paralysis Agitans”)

Question 15

_____: refers to a sex linked recessive disorder in boys ages 3-7 y/o. Pt has proximal muscle weakness causing a Waddling gait; Gower’s sign, Psuedohypertrophy of the calves, Toe walking, and HYPERlordosis?

a. ) Muscular dystrophy
b. ) Charcot Marie Tooth disease
c. ) Parkinson’s disease
d. ) Brown sequard

Answer 15

a. ) Muscular dystrophy (aka: “Erb Duchenne”)

- Large increase in CPK (CK-MM); decreased creatine

Question 16

_____: refers to a hereditary condition that affects both motor and sensory nerves. A typical feature includes weakness of the foot and lower leg muscles which may result in foot drop and a high-steppage gait with frequent tripping or falls?

a. ) Muscular dystrophy
b. ) Charcot Marie Tooth disease
c. ) Parkinson’s disease
d. ) Brown sequard

Answer 16

b.) Charcot Marie Tooth disease

Question 17

_____: refers to mental deterioration (cortical degeneration), amnesia?

a. ) Paralysis agitans
b. ) Parkinson’s disease
c. ) Alzheimer’s
d. ) Huntington’s chorea

Answer 17

c. ) Alzheimer’s

- Most definitive dx: Autopsy

Question 18

_____: refers to a neurodegenerative genetic disorder, which affects muscle coordination; cognitive decline and dementia. MC onset 35-44 y/o?

a. ) Paralysis agitans
b. ) Parkinson’s disease
c. ) Alzheimer’s
d. ) Huntington’s chorea

Answer 18

d.) Huntington’s chorea

Question 19

Diagnosed via Tensilon Test and treated with Cholinesterase inhibiting drugs?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

Answer 19

a.) Myasthenia gravis

Question 20

Which of the following orthopedic test are positive for Multiple Sclerosis?

a. ) Soto hall
b. ) Schilling test
c. ) Brudzinski
d. ) Lhermitte’s

Answer 20

d.) Lhermitte’s

Question 21

Which of the following orthopedic test are positive for Posterolateral Sclerosis?

a. ) Soto hall
b. ) Schilling test
c. ) Brudzinski
d. ) Lhermitte’s

Answer 21

b.) Schilling test

Question 22

Which of the following is associated with Charcot’s Triad: Scanning speech, Intention tremors, Nystagmus (SIN)?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

Answer 22

b.) Multiple sclerosis

Question 23

Which of the following tracks is associated with Parkinson’s Disease?

a. ) Corticospinal
b. ) Lateral spinothalmic
c. ) Reticulospinal
d. ) Extrapyramidal

Answer 23

d.) Extrapyramidal

Question 24

What condition causes a loss of pain and temperature over the shoulders and back in a cape like distribution?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

Answer 24

c.) Syringomyelia

Question 25

What condition is associated with Charcot’s triad?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

Answer 25

b.) Multiple sclerosis

Charcot’s triad: Scanning speech, Intention tremors, Nystagmus

Question 26

What is the most common symptom in a patient with Cerebral palsy?

a. ) Scissor gait
b. ) Spastic paralysis
c. ) Athetoid
d. ) Choreiform movements

Answer 26

c.) Athetoid

Question 27

What’s the best way to diagnose a patient with Alzheimer’s?

Answer 27

autopsy

Question 28

What is the average age for onset of Huntington’s Chorea?

Answer 28

35-44 years old

Question 29

Cerebral palsy is most commonly caused by what?

Answer 29

birth trauma

Question 30

This condition has a gradual onset over the age of 50. Causing a patient to present with Bradykinesia, Festinating gait, Cogwheel/lead pipe rigidity, Resting tremors, Mask like face, and a Forward stooped posture?

Answer 30

Parkinson’s disease (aka: Paralysis agitans)

Question 31

What is the case management for a patient with Parkinson’s disease?

Answer 31

• GABA
• Modify home to decrease falls
• Encourage continuation of ADL

Question 32

This condition is commonly seen after a recent flu infection, which causes ascending paralysis and sensory symptoms. Can become a medical emergency if it reaches the diaphragm?

Answer 32

Gullian-Barre Syndrome