PDF - Gait / Movement

Question 1

What provides postural gait control and postural coordination?

Answer 1

1. EPS

2. Cerebellum

Question 2

What is needed to walk in dark?

Answer 2

Sensation, primarily proprioception

Question 3

What is gate apraxia?

Answer 3

Have all capabilities needed to walk but cannot walk when asked to do so

Question 4

What is romberg sign?

Answer 4

Can stand readily with feet together but will sway when eyes are closed
- Proprioception not in tact

Question 5

What is issue if patient has to spread feet to keep balance?

Answer 5

Cerebellar issue

Question 6

What is broad based ataxic gait, when is it seen?

Answer 6

1. Have to spread feet for balance
2. Worse on heel toe / straight line
   - Can be cerebellar or posterior column dysfunction

Question 7

What is hemiplegic gait?

Answer 7

1. Leg stiff and circumscribed on walking

2. Ipsilateral arm flexed arm and wrist with diminished swing

Question 8

What is tabetic gait?

Answer 8

1. Seen in tabes dorsalis
2. Foot slapping gait
3. Forcibly planting feet to floor to compensate for decreased sensation

Question 9

What is steppage gait?

Answer 9

1. Seen in foot drop / weak dorsiflexion
2. Hip lifted higher than normal to prevent tripping toes
3. Toes slowly lowered down first

Question 10

Cuase foot drop?

Answer 10

1. Peroneal nerve
   OR
2. L5 root

Question 11

What is waddling gait? When seen?

Answer 11

1. Seen in myopathies from weak hip muscles

2. Trunk lifted and bent to L when R foot raised

Question 12

Scissor gait? When seen?

Answer 12

1. Advancing limb crosses midline
2. Seen in UMN (corticospinal) lesions
3. Spastic Adductors are forcing limbs to cross

Question 13

Parkinsonian gait?

Answer 13

1. Slow, shuffling
2. Stooped
3. Lots of steps on turning
4. Decreased arm swing
   * Festination of gait: having to lean forward to start then run to catch center of gravity

Question 14

Function of cerebellum?

Answer 14

Coordinates smoothness and coordination of movements of limbs, eyes, trunk, and voice

Question 15

Weakness seen in cerebellar lesions?

Answer 15

No

Question 16

What is dysmetria?

Answer 16

Over or undershooting of target by hand / foot

Question 17

Where is lesion in cerebellum impacting voice?

Answer 17

Left hemisphere

Question 18

Which side of body do cerebellar lesions impact?

Answer 18

Ipsilateral

Question 19

Where do midline cerebellar lesions impact?

Answer 19

The trunk

Question 20

Non neuro features friedreich’s Ataxia?

Answer 20

1. Pes cavus - high arches
2. Scoliosis
3. Cardiac hypertrophy - arrhythmias

Question 21

Multiple trinucleotide repeats on chromosome 9?

Answer 21

Friedreich’s ataxia

Question 22

Type of tremor in familial essential tremor?

Answer 22

Postural: more apparent when arm held out for example

Question 23

What is athetosis?

Answer 23

Slow, writhing movements of distal limbs

Question 24

Causes choreoathetosis?

Answer 24

Lesions in caudate

- Seen in huntingtons

Question 25

Causes hemiballismus?

Answer 25

Lesion in contralateral subthalamic nucleus often from ischemic stroke

Question 26

Comorbidity tourettes?

Answer 26

ADHD

Question 27

What is myoclonus?

Answer 27

Rapid, shock live movements of limbs

- Seen in CJD or encephalopathy

Question 28

Rx essential tremor?

Answer 28

Beta blocker

Question 29

Rx dystonia?

Answer 29

1. Anticholinergics
2. Benzos
3. Botox

Question 30

Rx tix, hemiballismus, chorea athetosis?

Answer 30

1. Dopamine antagonists