Neurological Examation of Limbs

Question 1

What did Brown-Séquard give his name to?

Answer 1

The syndrome of cord hemisection

Question 2

What may a patient with a stroke affecting the right middle cerebral artery have? (4)

Answer 2

left sided hemi-paresis
left sided numbness
left sensory neglect
left hemianopia

Question 3

When you are examining the power of left elbow flexion, what are you testing (apart from motor planning and the right motor cortex)? (2)
What tract? What nerve roots?

Answer 3

Consciousness
Language reception

Right corticospinal tract
C5&6 roots

Question 4

Is descending control negative or positive overall?

Answer 4

Negative

Question 5

Upper motor neuron lesions cause weakness due to loss of descending control of what type of neurons?

Answer 5

α-motor neurons

Question 6

Lower motor neuron weakness is due to loss of…?

Answer 6

Alpha motor neurons, motor axons or muscles

Question 7

What are you looking for on inspection? (4)

Answer 7

Fasciculation
Muscle wasting
Spontaneous movement
Scars

Question 8

What are fasciculations a sign of?

Answer 8

Ongoing damage to LMNs

Question 9

What is ‘tone’?

Is it increased in UMN or LMN lesions?

Answer 9

The global muscle activity at rest, or resistance to passive movement
UMN lesions

Question 10

In UMN lesions, which two actions are relatively spared?

Answer 10

Upper limb flexion and lower limb extension

Question 11

What is quadraparesis?

Answer 11

Weakness below the level of the cervical cord

Question 12

What is paraparesis?

Answer 12

Weakness below the level of the thoracic cord

Question 13

What spinal levels control the diaphragm?

Answer 13

C3, C4, C5

Question 14

What spinal levels control the bladder and anal sphincters?

Answer 14

S2, S3, S4

Question 15

How is power graded? What does a score of __ mean?
5?
3?
0?

Answer 15

MRC grading
5 Normal
3 Able to overcome gravity
0 No movement

Question 16

What type of reflexes are tendon reflexes?

In UMN lesions are they exaggerated or diminished?

Answer 16

Monosynaptic

Exaggerated

Question 17

What levels control the following reflexes?
Biceps
Supinator
Triceps
Patellar
Ankle

Answer 17

C5/6
C6
C7/8
L3/4
S1

Question 18

When testing for coordination, what are you trying to reveal?

Answer 18

An ipsilateral cerebellar hemispheric lesion

Question 19

What does dysdiadochokinesia mean?

Answer 19

Impairment of the ability to perform rapidly alternating movements

Question 20

What pattern of sensory deficit is seen in peripheral neuropathy?

Answer 20

Glove and stocking

Question 21

What pattern of sensory deficit is seen in spinal cord lesions?

Answer 21

Loss below a sensory level

Question 22

Dorsal column is for… (3)

Answer 22

Proprioception
Vibration
Light touch

Question 23

Spinothalamic tract is for… (2)

Answer 23

Pain

Temperature

Question 24

Carpal tunnel syndrome causes numbness in which digits?

Answer 24

edian nerve lesion at the wrist

Radial 3½ digits

Question 25

Carpal tunnel syndrome causes weakness in…?

Answer 25

Abductor pollicis brevis

Question 26

Which nerve lesion causes carpal tunnel syndrome?

Answer 26

Median nerve (at the wrist)

Question 27

Which nerve lesion causes cubital tunnel syndrome?

Answer 27

Ulnar nerve (at the elbow)

Question 28

Cubital tunnel syndrome causes numbness in which digits?

Answer 28

Ulnar 1½ digits

Question 29

Which muscles are weak in cubital tunnel syndrome?

Answer 29

Interossei (notably 1st dorsal) and hypothenar muscles