patophys 1: Motor and Cerebellum Flashcards
What are the six points used to described muscle strength?
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
Which nerve roots are involved in the following reflexes:
Triceps Biceps Brachioradialis Knee Ankle
Triceps: C7 - C8
Biceps, Brachioradialis: C5 - C6
Knee: L2 - L4
Ankle: S1 - S2
Which nerve roots are involved in the following reflexes?
Abdominal
Anal Wink
Cremasteric
Plantar/babinski
Abdominal: T8-T12
Anal wink: S3 - S4
Cremasteric: L1 - L2
Plantar: S1 - S2
Hyperreflexia or clonus indicate a lesion where?
UMN
Hyporeflexia / Arefkexia indicate a lesion where?(4)
LMN
polyneuropathy
muscle pathology
acute UMN
The different kinds of hypertonia indicates a lesion where?
Spasticity - UMN
Rigidity - basal ganglia
Paratonia - frontal lobes / diffuse cerebral
Hypotonia (flaccidity) indicates a lesion where? (6)
LMN cerebellar basal ganglia polyneuropathies myopathies acute UMN
A lesion in the cortex may produce what clinical findings?(4)
contralateral restricted motor deficit
aphasia
apraxia
agnosia (inabillity to process sensory information)
A lesion in the internal capsule may produce what clinical findings? (2)
Contralateral severe hemiparesis (limbs and face)
contralateral hemianesthesia
supplied by MCA
A lesion in the brainstem may produce what clinical findings?
tetraparesis +- sensory disturbances - CNs
contralateral hemiparesis + ipsilateral CNs
A lesion in the spinal cord may produce what clinical findings?
tetraparesis, paraparesis or ipsilateral motor deficits
+ sensory disturbances nelow lesion
(ipsilateral reduced deep sens, contralateral reduced pain/temp)
A lesion in the anterior horn cells may produce what clinical findings?
fasiculations, no sensory deficit
A lesion in the anterior root may produce what clinical findings?
radicular distribution, no sensory loss
A lesion in the plexus may produce what clinical findings?
motor + sensory deficit in the plexus` distribution
A lesion in the peripheral nerve may produce what clinical findings?
motor + sensory deficits in the nerve`s distribution
What is the role of the extrapyramidal system?(2)
modulation of corticospinal/ corticobrainstemspinal systems
control of tone, posture, coordination
Name four group of symptoms from extrapyramidal lesions:
rigidity or decreased tone
hyper/hypo/bradykinesia
tremor/chorea/atheosis/balisimus/dystonia
Postural instability
What are the tasks of the cerebellum?(3)
coordination of movement (skilled voluntary)
posture and gait
regulation of tone
What are clinical manifestations of cerebellar lesions?(6)
Decreased muscle tone incoordination (ataxia) intention tremor equilibrium/gait disturbances dysarthria Nystagmus
Nystagmus, gait ataxia and head and trunk titubation(staggering/stumbling) suggests a lesion where ?
Cerebellum - midline
Isolated gait ataxia suggests a lesion where in the cerebellum?
Superior vermis
Nystagmus, dysarthria, ipsilateral hypotonia, limb ataxia, failing to ipsilateral side - suggests a lesion where?
Cerebellum - hemisphere
Symmetric wide based gait suggests a lesion where?(3)
posterior columns, cerebellum, bihemispheric (apraxia)
Symmetric - narrow based gait suggests a lesion where?(2)
spastic - bilateral UMN
Festinating (parkinsonian) - basal ganglia (subst. nigra)
