Midterm 1

Question 1

Define hemisensory neglect

Answer 1

Inability of a person to process and perceive stimuli on 1 side of the body/environment

Dysfxn of the CONTRAlateral parietal lobe (sensory cortex)

Question 2

List the “Pure Patches” with a sensory exam

Answer 2

C5
C6
C7
L4
L5
S1

Question 3

What is astereognosis a disease of?

Answer 3

Dorsal Column

Question 4

What is astereognosis?

Answer 4

Loss of vibration sense, proprioception, pressure sensation/deep touch

Question 5

What is graphesthesia?

Answer 5

Ability to recognize letters or numbers being traced on the skin

Question 6

What type of lesion causes agraphesthesia?

Answer 6

Contralateral parietal lobe affecting the association centre

Question 7

What are secondary sensory modalities we use?

Answer 7

Stereognosis
Graphesthesia
2 point discrimination

Question 8

T/F DTRs are a voluntary reaction of a muscle to being stretched by percussion of the tendon

Answer 8

False! Theyr’e involuntary

Question 9

T/F DTRS have a sensory and motor component

Answer 9

True! Motor integrity is usually what is being tested though

Question 10

T/F A grade of 3+ for a DTR of the biceps tendon is always considered pathologic

Answer 10

False

Grades of 1+, 2+ and 3+ are not normal nor pathologic

Question 11

T/F A common cause of hyporeflexia is operator error

Answer 11

True

Question 12

What do LMN lesions present with?

Answer 12

Hyporeflexia
Flaccid paresis (specific muscles)
Fasciculations
Marked atrophy

Question 13

Another term for a grade 4+ DTR is?

Answer 13

Clonus (rhythmic oscillations b/w flexion and extension)

UMN lesion!

Question 14

Patient present with the ability to feel the rough surface of sandpaper but cannot identify that it is sandpaper (lacks ability to associate). What would you suspect?

Answer 14

Middle Cerebral Artery Stroke

Question 15

Which DTR is always abnormal?

Answer 15

Clonus

Question 16

T/F Asymmetry of reflexes is often more important than overall tonus

Answer 16

True!

Question 17

T/F Absence of one or both reflexes can never be attributed to age

Answer 17

False! Age can be a huge factor

Question 18

Which nerve root does the biceps tendon reflex test?

Answer 18

C5

Question 19

Which nerve root does Brachioradialis tendon test?

Answer 19

C6

Question 20

Which nerve root does triceps tendon DTR test?

Answer 20

C7

Question 21

T/F It is always necessary to test DTRs bilaterally?

Answer 21

True

Question 22

What is the afferent/efferent nerve associated with biceps tendon DTR?

Answer 22

Musculocutaneous

Question 23

What is the afferent/efferent nerve associated with brachioradialis DTR?

Answer 23

Radial nerve

Question 24

Which afferent/efferent nerve is associated with triceps DTR?

Answer 24

Radial nerve

Question 25

Which nerve root is associated with the patellar tendon DTR?

Answer 25

L4

Question 26

Which nerve root does medial hamstring tendon DTR test?

Answer 26

L5

Question 27

Which nerve root does Achilles tendon DTR test?

Answer 27

S1

Question 28

What is the afferent/efferent nerve associated with patellar DTR?

Answer 28

Femoral nerve

Question 29

What is the afferent/efferent nerve associated with Medial Hamstring DTR?

Answer 29

Sciatic nerve

Question 30

Which afferent/efferent nerve is the achilles tendon DTR associated with?

Answer 30

Tibial nerve

Question 31

What is the motor exam looking for?

Answer 31

Motor neuron disease/lesion Radiculopathies Peripheral neuropathy weakness

Question 32

T/F Paralysis is the loss of voluntary movement which may be accompanied by sensory loss

Answer 32

True

Question 33

Patient presents with no tremors upon resting but when they go to scratch their leg, their hand begins to shake. Which type of tremor is it?

Answer 33

Kinetic tremor

Question 34

Patient presents with no additional movements during rest but when they reach for a glass, their hand begins to shake. The shaking gets worse as they get closer to the glass. Which type of tremor is this?

Answer 34

Kinetic tremor that is also intentional

Question 35

What is dysmetria?

Answer 35

Past-pointing, seen with ipsilateral lesion of the cerebellar hemisphere Finger-nose testing will demonstrate even mild limb ataxia

Question 36

What tests can you use to test ipsilateral lesions of the cerebellar hemisphere?

Answer 36

Heel to Shin | Finger-nose tests

Question 37

What is truncal ataxia indicative of?

Answer 37

Midline cerebellar lesion

Question 38

Name a few things characteristic of a Parkinsonian Gait

Answer 38

Pt walks w/forward flexion First step retardation/apraxia Propulsion required to start gait Marche a petit pas (march of little steps) Festination (pt picks up speed as they move) Difficulty stopping movement because of speed Lack of arm movement during gait