Pattern Recognition and (Very) Basic Anatomy Flashcards
Muscle wasting is a ____ motor neuron sign
Lower
Increased muscle tone is a ____ motor neuron sign
Upper
Pathological reflexes is a ____ motor neuron sign
Upper
Normal or decreased muscle tone is a ____ motor neuron sign
Lower
Decreased or absent superficial reflexes is a ____ motor neuron sign
Upper
Increased deep tendon reflexes (hyperreflexia) is a ____ motor neuron sign
Upper
A central pattern of sensory loss is a ____ motor neuron sign
Upper
Fasciculation is a ____ motor neuron sign
Lower
A generalized or predominantly proximal/distal/focal weakness distribution is a ____ motor neuron sign
Lower
Peripheral nerve/root or glove and stocking distribution of sensory loss is a ____ motor neuron sign
Lower
A corticospinal distribution (weak extensors in the arm, weak flexors in the legs) or hemiparesis or quadriparesis or monoparesis or faciobrachial weakness distribution is a ____ motor neuron sign
Upper
Spastic gait is a ____ motor neuron sign
Upper
Slowed movements is a ____ motor neuron sign
Upper
A resting tremor (present when the subject is relaxed, and decreasing on maintaining a posture or during movement) is found classically in which condition?
Parkinson’s disease
A postural/action tremor (present on maintaining a posture and during movement, but disappearing at rest) is found in which conditions?
Drugs, anxiety, thyrotoxicosis etc
An intention tremor (present only toward the end of a movement to a target, causing overshoot) is present in which conditions?
Cerebellar disease
Pathological increased tone is split into spasticity and rigidity. Which of these is associated with UMN lesions
Spasticity - velocity dependent and usually associated with an UMN distribution of weakness and brisk tendon reflexes and sometimes clonus
Pathological increased tone is split into spasticity and rigidity. Which of these is associated with extrapyramidal conditions affecting basal ganglia (eg Parkinson’s)
Rigidity - not velocity dependent and not usually associated weakness or change in tendon reflexes. Can have a “cog-wheel” or “lead-pipe” quality
A spastic gait (asymmetric foot dragging) is caused by what?
Upper motor neurone lesions
A Parkinsonian gait (small shuffling steps) is caused by what?
Basal ganglia pathology
An ataxic gait (widebased & unsteady) is caused by what?
- Cerebellar disease
- Hydrocephalus
- Propriocetive loss (Neuropathy/myelophathy)
A bilateral high stepping gait is caused by what?
Peripheral neuropathy
Dystonia (continuous spasms and muscle contractions), akathisia (may manifest as motor restlessness),[1] parkinsonism (characteristic symptoms such as rigidity), bradykinesia (slowness of movement), tremor, and tardive dyskinesia (irregular, jerky movements) are all examples of what kind of symptoms?
Extrapyramidal symptoms
The dermatome that covers the ear and back of the head is supplied by_____?
C2
The dermatome that covers part of the lower arm and the thumb is supplied by_____?
C6
The dermatome that is at the umbilicus is supplied by_____?
T10
The dermatome that covers the shoulder is supplied by_____?
C5
The dermatome that covers the upper anterior thigh is supplied by_____?
L2
The dermatome that covers the heel is supplied by_____?
S1
The dermatome that is just above the hip girdle is supplied by_____?
T12
The dermatome that covers the posterior thigh is supplied by_____?
S2
The dermatome that covers the neck is supplied by_____?
C3
The dermatome that covers the the middle finger is supplied by_____?
C7
The dermatome that covers the lower part of the upper anterior thigh and inside the knee is supplied by_____?
L3
The dermatome that covers the space between the neck and the shoulder is supplied by_____?
C4
The dermatome that covers the buttocks is supplied by_____?
S3
The dermatome that covers the ring and little fingers and part of the lower arm is supplied by_____?
C8
The dermatome that covers the nipple is supplied by_____?
T4
The dermatome that covers the knee and part of anterior lower leg is supplied by_____?
L4
The 2 dermatomes that supply the skin of the genitals are supplied by_____?
S2, 3
The dermatome that is at the level of the xiphoid process is supplied by_____?
T6
The dermatome that covers part of the anterior lower leg, the foot and all toes but the pinky tow is supplied by_____?
L5
Bulbar palsies are caused by a ____ lesion
LMN
Pseudobulbar palsies are caused by a ____ lesion
UMN
The biceps reflex is supplied by which 2 spinal and 1 named nerves?
C5/6 and musculocutaneous
The triceps reflex is supplied by which 2 spinal and 1 named nerves?
C7/8 and radial
The patellar reflex is supplied by which 2 spinal nerves?
L3/4
The ankle reflex is supplied by which 2 spinal nerves?
S1/2
DANISH stands for what in the cerebellar examination?
D - dysdiadochokinesis (difficulty performing quick and alternating movements) A - ataxia N - nystagmus I - intention tremor S - scanning dysarthria H - heel-shin test positivity
CN I is what type of nerve?
Special sensory
CN II is what type of nerve?
Special sensory
CN III is what type of nerve?
Motor
CN IV is what type of nerve?
Motor
CN V is what type of nerve?
Both
CN VI is what type of nerve?
Motor
CN VII is what type of nerve?
Both (inc. special sensory to anterior 2/3 of tongue)
CN VIII is what type of nerve?
Sensory
CN IX is what type of nerve?
Both (inc. special sensory to posterior 1/3 of tongue)
CN X is what type of nerve?
Both
CN XI is what type of nerve?
Motor
CN XII is what type of nerve?
Motor
CN I controls what?
Sense of smell
CN II controls what?
- Visual acuity
- Sensory part of pupillary reflex
- Accommodation reflex
CN III controls what?
- Eye movements
- Eyelid elevation
- Pupillary reflex (motor part)
CN IV controls what?
Eye movements (Lateral Rectus)
CN V controls what?
- Facial sensation
- Sensation to anterior 2/3 of tongue
- Corneal reflex (sensory part)
- Mastication
CN VI controls what?
Eye movements (Superior Oblique)
CN VII controls what?
- Facial expression
- Taste to anterior 2/3 of tongue
- Corneal reflex (motor part)
- Innervation to submandibular and sublingual glands
CN VIII controls what?
- Hearing
- Balance
CN IX controls what?
- Sensation + taste to posterior 1/3 of tongue
- Gag reflex/swallowing (sensory part)
- Innervates parotid gland
CN X controls what?
- Gag reflex/swallowing (motor part)
- Speech (articulation)
CN XI controls what?
- Shoulder movement
- Head rotation
CN XII controls what?
- Tongue movement
- Speech (articulation)
Excitatory synapses use which neurotransmitter?
Glutamate
Inhibatory synapses use which neurotransmitter?
GABA and glycine
The dorsal column medial leminscal (DCML) pathway does what?
Senses discriminatory touch, pressure, vibration, conscious proprioception
The spinothalamic tract (STT) does what?
Senses pain, thermosensation, crude touch, itch, tickle
Which of the somatic sensory pathways crosses to the contralateral side?
The spinothalamic tract
Are the dorsal columns in the anterior or posterior of the spinal cord?
Posterior
Where is the somatosensory cortex found in the brain?
Post central gyrus of the parietal cortex immediately posterior to the central sulcus
The corticospinal tract/pyramidal tract does what?
Controls primary motor activity
Apetitive and approach system is controlled by which neurotransmitter?
Dopamine
Aversive and defensive system is controlled by which neurotransmitter?
Serotonin
Where is Wernicke’s area?
In the temporal lobe of the dominant hemisphere
Where is Broca’s area?
The frontal lobe of the dominant hemisphere
Hoffman’s sign is what?
Flexion of ipsilateral thumb elicited by flicking the nail of the middle finger (shows problem in corticospinal tract)
Babinski’s sign is what?
An extension of the hallux (upwards response) during plantar reflex testing (indicates an UMN lesion)
Lhermitte’s sign is what?
An uncomfortable “electrical” sensation that runs through the back and into the limbs (suggests a lesion or compression of the upper cervical spinal cord or lower brainstem)
Gower’s sign is what?
Patient that has to use their hands and arms to “walk” up their own body from a squatting position
Pronator drift is what?
Arms held out, palms up for ten seconds. weak arm drops and pronates (turns palm down). Tests for lesions on one side of the brain affecting arms – upper motor neuron sign
What does the 4AT primarily test for
Rapid dementia screening
Problems in the cervical spine can cause both upper and lower motor neuron signs. True or false.
True - can be UMN if central
Problems in the thoracic spine can cause both upper and lower motor neuron signs. True or false.
True - can be UMN if central
Problems in the thoracic spine can cause both upper and lower motor neuron signs. True or false.
False - only LMN signs and only legs can be involved
What are fasciculations?
A brief spontaneous contraction affecting a small number of muscle fibres, often causing a flicker of movement under the skin (LMN sign)
What is clonus?
Rhythmic contraction of a muscle group elicited by a rapid passive stretch of it (UMN sign)