patophys 1: Motor and Cerebellum

Question 1

What are the six points used to described muscle strength?

Answer 1

0 - no movement
1 - flicker or contraction
2 - motion with eliminated gravity
3 - motion against gravity
4 - motion against gravity and some resistance
5 - normal power

Question 2

Which nerve roots are involved in the following reflexes:

Triceps
Biceps
Brachioradialis
Knee
Ankle

Answer 2

Triceps: C7 - C8
Biceps, Brachioradialis: C5 - C6
Knee: L2 - L4
Ankle: S1 - S2

Question 3

Which nerve roots are involved in the following reflexes?

Abdominal
Anal Wink
Cremasteric
Plantar/babinski

Answer 3

Abdominal: T8-T12
Anal wink: S3 - S4
Cremasteric: L1 - L2
Plantar: S1 - S2

Question 4

Hyperreflexia or clonus indicate a lesion where?

Answer 4

UMN

Question 5

Hyporeflexia / Arefkexia indicate a lesion where?(4)

Answer 5

LMN
polyneuropathy
muscle pathology
acute UMN

Question 6

The different kinds of hypertonia indicates a lesion where?

Answer 6

Spasticity - UMN
Rigidity - basal ganglia
Paratonia - frontal lobes / diffuse cerebral

Question 7

Hypotonia (flaccidity) indicates a lesion where? (6)

Answer 7

LMN
cerebellar
basal ganglia
polyneuropathies
myopathies
acute UMN

Question 8

A lesion in the cortex may produce what clinical findings?(4)

Answer 8

contralateral restricted motor deficit
aphasia
apraxia
agnosia (inabillity to process sensory information)

Question 9

A lesion in the internal capsule may produce what clinical findings? (2)

Answer 9

Contralateral severe hemiparesis (limbs and face)
contralateral hemianesthesia

supplied by MCA

Question 10

A lesion in the brainstem may produce what clinical findings?

Answer 10

tetraparesis +- sensory disturbances - CNs

contralateral hemiparesis + ipsilateral CNs

Question 11

A lesion in the spinal cord may produce what clinical findings?

Answer 11

tetraparesis, paraparesis or ipsilateral motor deficits
+ sensory disturbances nelow lesion
(ipsilateral reduced deep sens, contralateral reduced pain/temp)

Question 12

A lesion in the anterior horn cells may produce what clinical findings?

Answer 12

fasiculations, no sensory deficit

Question 13

A lesion in the anterior root may produce what clinical findings?

Answer 13

radicular distribution, no sensory loss

Question 14

A lesion in the plexus may produce what clinical findings?

Answer 14

motor + sensory deficit in the plexus` distribution

Question 15

A lesion in the peripheral nerve may produce what clinical findings?

Answer 15

motor + sensory deficits in the nerve`s distribution

Question 16

What is the role of the extrapyramidal system?(2)

Answer 16

modulation of corticospinal/ corticobrainstemspinal systems

control of tone, posture, coordination

Question 17

Name four group of symptoms from extrapyramidal lesions:

Answer 17

rigidity or decreased tone
hyper/hypo/bradykinesia
tremor/chorea/atheosis/balisimus/dystonia
Postural instability

Question 18

What are the tasks of the cerebellum?(3)

Answer 18

coordination of movement (skilled voluntary)
posture and gait
regulation of tone

Question 19

What are clinical manifestations of cerebellar lesions?(6)

Answer 19

Decreased muscle tone
incoordination (ataxia)
intention tremor
equilibrium/gait disturbances
dysarthria
Nystagmus

Question 20

Nystagmus, gait ataxia and head and trunk titubation(staggering/stumbling) suggests a lesion where ?

Answer 20

Cerebellum - midline

Question 21

Isolated gait ataxia suggests a lesion where in the cerebellum?

Answer 21

Superior vermis

Question 22

Nystagmus, dysarthria, ipsilateral hypotonia, limb ataxia, failing to ipsilateral side - suggests a lesion where?

Answer 22

Cerebellum - hemisphere

Question 23

Symmetric wide based gait suggests a lesion where?(3)

Answer 23

posterior columns, cerebellum, bihemispheric (apraxia)

Question 24

Symmetric - narrow based gait suggests a lesion where?(2)

Answer 24

spastic - bilateral UMN

Festinating (parkinsonian) - basal ganglia (subst. nigra)

Question 25

Assymetric gait suggests a lesion where?(4)

Answer 25

hip pathology
hemiplegic - UMN
Foot drop - peroneal nerve
antalgic - foot, leg pain