PDX: Motor Systems

Question 1

What are characteristics associated with Upper Motor Neuron Lesions (UMNL)?

Answer 1

• Weakness or paralysis
• Spasticity
• Increased tendon reflexes
• Extensor Babinski response (positive)
• Loss of abdominal reflexes
• Little if any muscle atrophy

Question 2

What are characteristics associated with Lower Motor Neuron Lesions (UMNL)?

Answer 2

• Weakness or paralysis
• Wasting and fasciculations of involved muscles
• Hypotonia
• Decreased tendon reflexes
• Normal abdominal and plantar reflexes
• Normal Babinski response

Question 3

What nerve roots are associated with the biceps and brachioradialis reflexes?

Answer 3

C5 & C6

Question 4

What nerve roots are associated with the triceps reflex?

Answer 4

C6 & C7 (maybe C8)

Question 5

What nerve roots are associated with the patellar reflex?

Answer 5

L3 & L4

Question 6

What nerve roots are associated with the achilles reflex?

Answer 6

S1

Question 7

What should you look at while doing a reflex test?

Answer 7

Look at the muscle and make sure that you’re seeing it flex, don’t look at where the hammer is hitting.

Question 8

What is a positive babinski?

Answer 8

Toes curl upward

Question 9

What does the hemiplegic gait look like?

Answer 9

• Hand may or may not be flexed up (depending on severity)
• Cutting pyramid tract on left side causes right side symptoms
• Have foot drop (circumlocution, weakness in one leg)
• May be caused by stroke/lesion in the contralateral pyramids

Question 10

What does the Parkinson’s gait look like?

Answer 10

• Every joint is bent
• Haunched back
• Small steps taken
• Shakiness

Question 11

What does a cerebellar gait look like?

Answer 11

• Broad stance
• Fall toward side of illness
• Trunk may sway when they’re asked to stand still
• Tabulation (standing in place & rotating in circle)

Question 12

What does the Romberg test do?

Answer 12

Tests proprioception, not cerebellar function!

Question 13

What does a “stomping gait” look like?

Answer 13

• More prominent in the dark (proprioception)

- Lifting up foot high and stomping it down

Question 14

What does a diplegic gait look like?

Answer 14

• Cerebral palsy gait
• Almost seem to be walking on tiptoes
• Arm flexed
• Like hemiplegic except with both legs impaired

Question 15

What does the myopathy gait look like?

Answer 15

• Waddle
• Lift up leg, and hip falls/swings in
• Patients lean on their trunk and use that for support

Question 16

What does neuropathic gait look like?

Answer 16

• Gait with high stepping
• Steppage/equine gait
• Can’t dorsiflex the foot because it is weak

Question 17

What does the choreiform gait look like?

Answer 17

• Many involuntary movements
• Patient is already making many odd movements while sitting
• Ex: Huntington’s Korea (very rare)