Y6 Rev Neuro

Question 1

Where can the tendon reflex arc be broken?

Answer 1

Stretch Receptor
Afferent Pathway
Spinal Cord
Efferent Pathway
Muscle Contraction

Therefore sensory + motor sign

Question 2

What can lead to abnormal tone?

Answer 2

Reduced: LMN, myopathy, cerebellar

Pyramidal/Spasticity: clasp knife, velocity dependent, directional given away by posture

Extrapyramidal/Rigidity: lead pipe + palpable tremor = cog wheel

Question 3

What can help you elicit cog wheel rigidity?

Answer 3

Froment Manoeuvre

Question 4

Where is the lesion if the pt has normal hand function denoted by their lace up shoes but a scissoring gait?

Answer 4

T2-12

Question 5

What should you look for if the pt has bilateral high stepping gait?

Answer 5

Pes Cavus

Question 6

What would a motor and sensory peripheral neuropathy gait look like?

Answer 6

Foot Drop + Stamp

Question 7

What is dystonia?

Answer 7

Abnormal interaction b/w agonist and antagonist eg writers cramp and spasmodic torticolis

Question 8

What should you look for when testing shoulder aBduction?

Answer 8

The speed at which they raise their arms and to what height

Question 9

How do you test power grip?

Answer 9

By pulling it apart w your own NOT by asking them to squeeze your fingers

Question 10

How do you test the motor function of the ulnar nerve?

Answer 10

Stabilise, Observe, Feel

Place their hand on the couch/in yours, do each index/little in turn, apply resistance and feel the muscle bulk w other hand ie first dorsal interosseous/hypothenar eminence

Question 11

What should you do if there is marked weakness in knee extension/flexion?

Answer 11

Swing their knee out and see if they can slide their foot up and down the couch

Question 12

What are the additional UMN reflexes?

Answer 12

Finger Jerks
Hoffman Sign
Crossed Adductors
Absent Abdo Reflexes

Question 13

What is coordination testing?

Answer 13

Finger nose/heel shin - intention tremor and dysmetria

Hand flip/foot tap - break in rhythm (PD) and dysdiadochokinesia (MS)

Question 14

How is the SCM innervated?

Answer 14

Ipsilaterally

Question 15

How can you exacerbate the signs on PD?

Answer 15

Rigidity: coactivate the contralateral limb by producing voluntary action

Bradykinesia: use big pincers/foot taps and observe for fading out and decline in amplitude

Tremor: place hands on their lap palms down and ask them to recite the mnths backwards w their eyes closed

Question 16

What is the MRC scale of grading muscle power?

Answer 16

0: None
1: Flicker
2: Along
3: Gravity
4: +/-Weak
5: Normal