UMN vs LMN Injury, Movement Disorder Terms, D1/D2 patterns

Question 1

What is the difference between Upper Motor Neuron and Lower Motor Neuron Disease in regards to:

Reflexes

Answer 1

UMN: Hyperactive
LMN: Diminished or Absent

Question 2

What is the difference between Upper Motor Neuron and Lower Motor Neuron Disease in regards to:

Atrophy

Answer 2

UMN: Mild to Disuse
LMN: Present

Question 3

What is the difference between Upper Motor Neuron and Lower Motor Neuron Disease in regards to:

Fasciculations

Answer 3

UMN: Absent
LMN: Present

Question 4

What is the difference between Upper Motor Neuron and Lower Motor Neuron Disease in regards to:

Tone

Answer 4

UMN: Hypertonic
LMN: Hypotonic to Flaccid

Question 5

What is Akinesia?

Answer 5

Inability to initiate movement (Parkinson’s Disease)

Question 6

What is Ataxia?

Answer 6

Inability to perform coordinated movements

Question 7

What is Athetosis?

Answer 7

SLOW twisting and writhing

Question 8

What is Bradykinesia?

Answer 8

Slow movements

Question 9

What is Chorea?

Answer 9

Movements that are sudden, random and involuntary

Question 10

What is the Clasp-Knife Response?

Answer 10

Greater resistance at the beginning of ROM than at the end in a hypertonic joint

Question 11

What is Clonus?

Answer 11

Involuntary alternating spasmodic contraction of muscle from quick stretch reflex (UMN lesion)

Question 12

What is Cogwheel Rigidity?

Answer 12

Resistance to movement has a phasic quality (Parkinson’s Disease)

Question 13

What is dysdiadochokinesia?

Answer 13

Inability to perform RAPIDLY alternating movements

Question 14

What is Dysmetria?

Answer 14

Inability to control range of movement and force of muscular activity

Question 15

What is Dystonia?

Answer 15

Like athetois, however, larger axial muscle involvement rather than appendicular muscles

Question 16

What are Fasciculations?

Answer 16

Muscular twitch caused by random discharge of a LMN and it’s muscle fibers (LMN Disease)

Question 17

What is Lead Pipe Rigidity?

Answer 17

Form of rigidity where there is uniform & constant resistance to ROM (Basal Ganglia Lesion)

Question 18

What is Rigidity?

Answer 18

State of severe hypertonicity where a sustained muscle contraction does not allow for any movement at a specific joint

Question 19

What is a Tremor?

Answer 19

Involuntary, rhythmic, oscillatory movements (Basal Ganglia Lesion)

Question 20

What is a Resting Tremor?

Answer 20

Observable at rest. May or may not disappear with movement.

Question 21

What is a Postural Tremor?

Answer 21

Observed during voluntary contraction to maintain posture (ex: hyperthyroidism, fatigue, & anxiety)

Question 22

What is an Intension (Kinetic) Tremor?

Answer 22

Absent at rest
Observable with activity -> increase at target approaches
(ex: MS)

Question 23

What is the D1 Pattern for the Upper Extremity?

Answer 23

Bowling
Flexion: up and in
Extension: down and back

Question 24

What is the D2 Pattern for the Upper Extremity?

Answer 24

Sword & Pizza
Flexion: Pizza
Extension: Sword

Question 25

What is the D1 Pattern for the Lower Extremity?

Answer 25

Flexion: FABER (figure 4)
Extension: extend & point toe out

Question 26

What is the D2 Pattern for the Lower Extremity?

Answer 26

Flexion: FADIR
Extension: extend & point toe in