Ch 6 Neurologic Exam Part II

Question 1

Define akinesia

Answer 1

lack of movement

Question 2

Define athetosis

Answer 2

slow, continuous, involuntary writhing movement that prevents maintenance of a stable posture

Question 3

Define chorea

Answer 3

irregularly timed excessive jerky movements

Question 4

Define ballismus

Answer 4

extreme choreiform movement

Question 5

What are tone abnormalities

Answer 5

resistance to passive stretching of a joint.

Question 6

What are upper motor neurons? (UMN)

Answer 6

They include projections from the cortex to spinal cord (corticospinal tract) including the part that crosses in the medulla (pyramidal tract)

Question 7

What are lower motor neurons? (LMN)

Answer 7

They include projections from the brainstem and spinal cord, via motor nerves to innervate skeletal muscle

Question 8

Hyperreflexia and increased tone are indicative of what type of lesions

Answer 8

Upper motor neuron lesions (UMN)

Question 9

atrophy, fasiculations, hyporeflexia can be indicative of what type of lesions?

Answer 9

Lower motor neuron lesions (LMN)

Question 10

Pronator drift reflects problems in which area?

Answer 10

Upper motor neurons

Question 11

Stereognosis

Answer 11

the ability to perceive and recognize the form of an object in the absence of visual and auditory information

Question 12

graphesthesia

Answer 12

the ability to recognize writing on the skin purely by the sensation of touch

Question 13

Gait abnormalities can be described in which 5 ways?

Answer 13

spastic
scissored
steppage
parkinsonian
ataxic

Question 14

Spastic gait

Answer 14

spastic hemiparesis

when affected leg swings in arc motion

Question 15

Scissored gait

Answer 15

corticospinal dysfunction

gait appears stiff and thigh crosses over in front of the other thigh

Question 16

steppage gait

Answer 16

when a foot or both feet are weak, resulting in foot drop

Question 17

parkinsonian gait

Answer 17

short shuffling steps
person has difficulty starting or stopping
stooped over, arm swing reduced

Question 18

ataxic gait

Answer 18

unsteady, wide based gait
hard to turn
cerebellar dysfunction

Question 19

What is dysmetria? Where is the dysfunction located in the brain?

Answer 19

touching nose and examiner’s finger

ipsilateral cerebellar hemispheric dysfunction

Question 20

What is dysdiadocholinesia?

Where is the dysfunction located in the brain?

Answer 20

switching hand movements facing up to palm facing down

ipsilateral cerebellar hemispheric dysfunction

Question 21

heel shin test assesses what

Answer 21

cerebellar functions in lower extremity

Question 22

Romberg test

Answer 22

stand with feet together, eyes closed

Question 23

romberg sign

Answer 23

unsteadiness within several seconds of closing eyes
suggests poor proprioception
dysfunction in posterior column of spinal cord
Vitamin b12 deficiency

Question 24

What do deep tendon reflexes evaluate?

Answer 24

evaluate afferent and efferent functioning

Question 25

How is DTR assessed

Answer 25

single brisk tap from reflex hammer on skin of tendon

Question 26

DTR increased reflexes (hyperactive)

Answer 26

corticospinal dysfunction

Question 27

DTR decreased reflexes (hypoactive)

Answer 27

peripheral nerves or nerve roots dysfunction

Question 28

dysfunction of corticospinal tracts can lead to what? seen in what condition

Answer 28

``` ipsilateral paralysis (inability to move) paresis (decreased motor strength) hypertonia (increased tone) long tract signs seen in normal pressure hydrocephalus ```

Question 29

long tract signs mean?

Answer 29

symptoms that are attributable to the involvement of the long fiber tracts in the spinal cord. signs related to UMN lesions

Question 30

example of long tract signs

Answer 30

e.g. spasticity, hyperreflexia, and abnormal reflexes such as Babinski or Hoffman's sign

Question 31

Babinski sign can indicate what condition

Answer 31

corticospinal system dysfunction | UMN dysfunction

Question 32

Define blown pupil

Answer 32

pupil that is dilated and unresponsive to changes in light

Question 33

What is Babinski sign

Answer 33

fanning of toes and upward flexion of big toe (extensor plantar response)

Question 34

Define bilateral temporal hemianopsia

Answer 34

loss of visual temporal fields due to a abnormality in optic chiasm

Question 35

Clonus

Answer 35

repetitive, involuntary vibratory movement

Question 36

Diplopia

Answer 36

experience of double vision

Question 37

hemianopsia

Answer 37

loss of visual hemifield

Question 38

homonymous

Answer 38

on the same side

Question 39

Lower motor neuron

Answer 39

Motor neuron that originate in the anterior horn of spinal cord / brainstem and project to skeletal muscles

Question 40

Nystagmus

Answer 40

rapid involuntary eye movement | can be lateral, vertical, rotational or mixed

Question 41

Proprioception

Answer 41

perception of one's body position in space (based on sensory input from muscles and tendons)

Question 42

Quandrantopsia

Answer 42

loss of one quadrant of visual field

Question 43

Spasticity

Answer 43

increased muscle tone or increased resistance to stretching

Question 44

Upper motor neuron

Answer 44

neurons that originate from the cerebral primary motor cortex (precentral gyrus) or from certain brainstem nuclei

Question 45

Vestibular

Answer 45

sense of balance

Question 46

Pyramidal Tract

Answer 46

- divides into corticospinal and corticobulbar tract - part of the UMN system - system of efferent nerve fibers - originate in the cerebral cortex and carry signals from the cerebral cortex to brainstem or spinal cord - responsible for voluntary control of body and face muscle

Question 47

Corticobulbar tract

Answer 47

motor cortex to cranial nerve | controls voluntary movement of the muscles of the face, head and neck

Question 48

Extrapyramidal tract

Answer 48

- originate in the brain stem - carrying motor fibers to the spinal cord - responsible for the involuntary and automatic control of muscle tone, balance, posture and locomotion

Question 49

Corticospinal tract

Answer 49

motor cortex to LMN in spinal cord | controls voluntary movement of the muscles of the limbs and trunk