Week 11b: Disorders of Motor Function

Question 1

Which type of motor neuron lesion?

• paralysis affects movement rather than muscle
• muscle wasting is only from disuse
• spasticity of “clasping knife” type
• muscles are hypertonic

Answer 1

upper motor neuron lesion

Question 2

Which type of motor neuron lesion?

• individual muscle or group of muscles affected
• muscle wasting is pronounced
• Flacidity
• muscles are hypotonic

Answer 2

lower motor neuron lesion

Question 3

What is characterized by a reduction in the diameter of the muscle fibres because of a loss of protein filaments

Answer 3

muscle atrophy

Question 4

Disuse atrophy

Answer 4

result of a normally innervated muscle not being used for long periods. The cells shrink but do not die

Question 5

progressive deterioration of skeletal muscles because of mixed muscle cell hypertrophy, atrophy and necrosis

Answer 5

muscular dystrophy

Question 6

Muscular dystrophy probably does not involve?

Answer 6

the nervous system

Question 7

pseudohypertophy

Answer 7

when fat and connective tissue replaces the muscle fibres which increases muscle size and results in muscular weakness

Question 8

growers sign is associated with?

Answer 8

Duchenne muscular dystrophy

Question 9

signs of muscle weakness associated with Duchenne muscular dystrophy become evident…?

Answer 9

beginning at 2-3 years, when frequent falling occurs

Question 10

respiratory muscle involvement in Duchenne muscular dystrophy

Answer 10

results in a weak and ineffective cough and frequent respiratory infections

Question 11

a disorder of transmission at the neuromuscular junction that affects communication between the motor neuron and the innervated muscle cell

Answer 11

myasthenia gravis

Question 12

an autoimmune disease caused by antibody mediated loss of acetylcholine receptors in the neuromuscular junction

Answer 12

myasthenia gravis

Question 13

what is the first noticeable sign of myasthenia gravis?

Answer 13

weakness of the eye muscles

Question 14

other possible first symptoms of myasthenia gravis?

Answer 14

• slurred speech

- difficult swallowing

Question 15

other symptoms of myasthenia gravis that are variable in type and severity

Answer 15

• ptosis
• diplopia
• unstable or waddling gait
• change in facial expression
• difficulty in swallowing
• impaired speech (dysarthria)
• weakness in arms, hands, fingers, legs and neck

Question 16

myasthenia crisis

Answer 16

worsening of muscle weakness, resulting in respiratory failure that requires intubation and mechanical ventilation

Question 17

the tension test assesses for?

Answer 17

myasthenia gravis

Question 18

what is important to have ready when administering the tension test?

Answer 18

atropine in case of bradycardia

Question 19

treatments of myasthenia gravis

Answer 19

• cholinesterase inhibitors
• corticosteroids
• immunosuppressants
• plasmapheresis
• IVIg
• monoclonal antibody
• thymectomy

Question 20

Characteristics of disorders of the basal ganglia

Answer 20

• involuntary movements
• alterations in muscle tone
• disturbances in body posture

Question 21

a degenerative disorder of basal ganglia function that results in variable combinations of tremor, rigidity and bradykinesia

Answer 21

PKD

Question 22

progressive destruction of the dopamine nigrostriatal pathway with subsequent reduction in striatal concentrations of dopamine

Answer 22

PKD

Question 23

Dopamine deficiency in the basal ganglia associated with motor impairment

Answer 23

PKD

Question 24

PKD results in difficulty…?

Answer 24

initiating and controlling movements

Question 25

permanent destruction of the myelin sheath of the CNS

Answer 25

MS

Question 26

Symptoms as MS progresses

Answer 26

paralysis, vision loss and diminished brain function

Question 27

a progressive motor disorder affecting upper motor neurons and lower motor neurons

Answer 27

MS

Question 28

MS disease susceptibility is linked to…?

Answer 28

the HLA locus on chromosome 6

Question 29

first stage of MS

Answer 29

inflammation and small lesions due to antibody-antigen reactions

Question 30

second stage of MS

Answer 30

due to demyelination and gliosis (scar tissue) which slows, blocks or distorts transmission impulses

Question 31

a disease that is more common in males, and is a degenerative disorder that involves UMN and LMN and progressive muscle wasting

Answer 31

ALS

Question 32

temporary loss or depression of all or most spinal reflex activity below the level of injury

Answer 32

spinal shock

Question 33

what is a possible complication of spinal shock?

Answer 33

hypotension due to the lack of sympathetic tone

Question 34

example of a drug that is a dopamine precursor for PKD

Answer 34

levodopa

Question 35

example of a drug that is a dopamine receptor agonist for PKD

Answer 35

mirapex

Question 36

example of a maoi for PKD

Answer 36

selegiline

Question 37

example of a drug that promotes the release of dopamine for PKD

Answer 37

amantadine and COMT inhibitors

Question 38

example of drugs that decrease the effect of Ach for PKD?

Answer 38

benztropine and diphenhydramine

Question 39

adverse effects of sinemet

Answer 39

• orthostatic hypotension
• nausea, vomiting, dysphagia, anorexia, flatulence
• involuntary choreifrom movements
• headaches, anxiety, depression, agitation, insomnia

Question 40

adverse effects related to anticholinergic meds

Answer 40

• sedation, confusion
• constipation
• nausea and vomiting
• blurred vision, dilated pupils
• dry mouth, dry skin
• urinary retention