PRELIMS: Reviewer [2] Flashcards by appyiiii <3

A patient demonstrates difficulty maintaining balance on an unstable surface during the CTSIB. Which muscle group is most likely to compensate during forward sway?
A) Gastrocnemius
B) Quadriceps
C) Abdominals
D) Hip flexors

Hip flexors

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Which finding during motor function testing would most strongly suggest a lesion in the anterior horn cells?
a. Intention tremor and dysmetria

b. Muscle fasciculations and atrophy

c. Hyperreflexia and clonus

d. Spasticity and rigidity

b. Muscle fasciculations and atrophy

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A patient with diabetic neuropathy exhibits significant instability in the CTSIB condition 4 (eyes open on a foam surface). What does this indicate about their balance strategy?
a.Over-reliance on somatosensory inputs
b.Poor proprioceptive feedback
c.Dependence on visual inputs
d.Impaired vestibular function

b.Poor proprioceptive feedback

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Which assessment finding would most likely indicate impaired anticipatory postural control?
a. Difficulty maintaining balance on an unstable surface
b. Excessive sway during quiet standing
c. Instability when catching a weighted ball
d. Reduced reach distance in the Functional Reach Test

d. Reduced reach distance in the Functional Reach Test

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Which system is primarily responsible for detecting the body’s position and motion in relation to the support surface?
a.Visual system
b.Motor system
c.Vestibular system
d.Somatosensory system

d.Somatosensory system

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During the Sensory Organization Test (SOT), what does a low equilibrium score in conditions 5 and 6 indicate?
a. Visual dependency
b. Cognitive impairment
c. Vestibular dysfunction
d. Somatosensory dependency

c. Vestibular dysfunction

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During a sensory examination, a patient is unable to perceive light touch on the dorsum of the hand but reports exaggerated pain when the same area is lightly pricked. This presentation is most consistent with:
a. Hyperesthesia
b. Hypoesthesia
c. Allodynia
d. Paresthesia

Allodynia

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Which subtype of Guillain-Barré Syndrome is characterized by the triad of ataxia, areflexia, and ophthalmoplegia?

Miller Fisher syndrome

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What type of cancer is most commonly associated with Lambert-Eaton Myasthenic Syndrome?
a. Colon cancer
b. Prostate cancer
c. Breast cancer
d. Small cell lung cancer

d. Small cell lung cancer

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During motor function assessment, what would a positive Babinski sign indicate?
a. Basal ganglia impairment
b. Upper motor neuron lesion
c. Cerebellar dysfunction
d. Lower motor neuron lesion

b. Upper motor neuron lesion

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In the context of coordination assessment, what does dyssynergia refer to?
a. Inability to perform movements as a single, coordinated action
b. Smooth, fluid movement patterns
c. Tremors during rest
d. Hypertonic muscle activity

a. Inability to perform movements as a single, coordinated action

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Which clinical sign is least likely to be present in a patient with basal ganglia dysfunction?
a. Rigidity
b. Resting tremor
c. Bradykinesia
d. Dysmetria

d. Dysmetria

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Which of the following is most indicative of cerebellar dysfunction during a motor examination?
a. Hypotonia
b. Dysmetria
c. Resting tremor
d. Spasticity

b. Dysmetria

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Which subtype of Guillain-Barré Syndrome is most likely to be diagnosed in a patient with severe sensory involvement and rapid progression to quadriparesis?
a. Acute inflammatory demyelinating polyneuropathy (AIDP)
b. Acute motor axonal neuropathy (AMAN)
c. Acute motor-sensory axonal neuropathy (AMSAN)
d. Miller Fisher syndrome

Acute motor-sensory axonal neuropathy (AMSAN)

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Which of the following is NOT a characteristic finding in Guillain-Barré Syndrome?
a. Progressive symmetrical weakness
b. Hyperreflexia
c. Hyporeflexia or areflexia
d. Sensory abnormalities may or may not be present

b. Hyperreflexia

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What does affective lability in a patient suggest during a mental status examination?
a. Rapid and unpredictable changes in mood and emotions
b. Difficulty in interpreting sensory stimuli
c. A tendency to maintain a flat affect
d. Consistent emotional responses to external stimuli

a. Rapid and unpredictable changes in mood and emotions

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What is the primary pathophysiological mechanism in Myasthenia Gravis?

Antibody-mediated destruction of acetylcholine receptors at the neuromuscular junction

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Which of the following conditions is most likely associated with left-side hemispatial neglect?
a. Lesion in the right parietal lobe
b. Damage to the right frontal cortex
c. Damage to the left temporal lobe
d. Lesion in the left angular gyrus

a. Lesion in the right parietal lobe

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In the context of the Clinical Test of Sensory Interaction and Balance (CTSIB), what instability would you expect in a visually dependent patient?
a. Instability only on firm surfaces
b. Instability in conditions with altered somatosensory input
c. Instability in conditions with removed or altered visual input
d. Instability when both visual and vestibular inputs are intact

d. Instability when both visual and vestibular inputs are intact

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Which of the following is considered a major factor contributing to the development of Post-Polio Syndrome?
a. High levels of stress during the initial polio infection
b. Aging and increased metabolic demands on motor units
c. Genetic predisposition
d. Consistent physical activity

b. Aging and increased metabolic demands on motor units

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Which of the following is a key diagnostic criterion for Post-Polio Syndrome?
a. Muscle biopsy showing active inflammation
b. Rapid onset of muscle weakness
c. Progressive new muscle weakness after years of stability
d. Elevated creatine kinase levels

c. Progressive new muscle weakness after years of stability

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What is the primary purpose of using a tuning fork in the assessment of sensory function?
a. To determine the level of tactile discrimination
b. To test auditory acuity
c. To evaluate vibratory sensation
d. To assess proprioceptive function

c. To evaluate vibratory sensation

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What does a positive Romberg test indicate about the integrity of the sensory systems involved in balance?
a. Visual system impairment
b. Somatosensory hyperactivity
c. Proprioceptive deficits
d. Vestibular system dysfunction

c. Proprioceptive deficits

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During sensory testing, a patient consistently fails to recognize that their hand is being touched when the other hand is touched simultaneously. This phenomenon is known as:

Extinction

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What is the hallmark feature of Myasthenia Gravis on repetitive nerve stimulation (RNS) testing? a. Decremental decrease in amplitude with repeated stimulation b. Irregular amplitude response with stimulation c. No change in amplitude with stimulation d. Incremental increase in amplitude with stimulation

a. Decremental decrease in amplitude with repeated stimulation

Which thymic abnormality is frequently associated with Myasthenia Gravis? a. Thymic aplasia b. Thymic carcinoma c. Thymoma or thymic hyperplasia d. Thymic cyst

c. Thymoma or thymic hyperplasia

Which of the following is a characteristic feature of dystonia observed during motor function assessment? a. Sudden, jerky movements b. Sustained muscle contractions c. Rhythmic, oscillatory movements d. Involuntary, twisting movements

b. Sustained muscle contractions

Which feature distinguishes Post-Polio Syndrome from amyotrophic lateral sclerosis (ALS)? a. Muscle atrophy b. Respiratory involvement c. Progressive muscle weakness d. Presence of upper motor neuron signs in ALS

d. Presence of upper motor neuron signs in ALS

Which of the following is a hallmark clinical feature of ALS? a. Spasticity and muscle atrophy b. Fluctuating muscle strength c. Persistent headaches d. Widespread sensory loss

a. Spasticity and muscle atrophy

Which coordination test would best assess a patient’s ability to perform sequential finger movements rapidly? a. Finger tapping test b. Heel-to-shin test c. Finger-to-nose test d. Tandem gait test

a. Finger tapping test

Post-Polio Syndrome is thought to result from the progressive deterioration of which cells? a. Oligodendrocytes b. Schwann cells c. Anterior horn cells d. Upper motor neurons

c. Anterior horn cells

What is the primary difference between intention tremor and resting tremor in terms of their association with specific neurological structures? a. Both tremors are associated with cerebellar dysfunction b. Intention tremor is associated with cerebellar lesions, while resting tremor is linked to basal ganglia pathology c.Intention tremor occurs at rest, while resting tremor appears during movement d. Resting tremor is associated with spinal cord lesions, while intention tremor is linked to cortical dysfunction

b. Intention tremor is associated with cerebellar lesions, while resting tremor is linked to basal ganglia pathology

A patient with ideomotor apraxia is most likely to demonstrate which of the following behaviors? a. Inability to imitate a sequence of gestures on command but can perform them automatically b. Inability to recognize familiar faces despite normal vision c. Inability to recall recent events but retains remote memories d. Inability to imitate a sequence of gestures on command but can perform them automatically Difficulty understanding spoken language despite intact hearing

Inability to imitate a sequence of gestures on command but can perform them automatically

What is the most likely effect of a lesion in the cerebellar hemispheres on fine motor coordination? a. Loss of proprioception in the contralateral limbs b. Hypertonia in the affected limbs c. Impaired coordination of ipsilateral limb movements d. Dysphagia and speech difficulties

c. Impaired coordination of ipsilateral limb movements

Which of the following is a typical early clinical manifestation of ALS? a. Visual disturbances b. Hyperreflexia with spasticity c. Symmetrical sensory loss d. Asymmetric limb weakness and muscle atrophy

d. Asymmetric limb weakness and muscle atrophy

What does the presence of hyperreflexia and spasticity indicate in ALS? a. Sensory nerve involvement b. Peripheral nerve involvement c. Upper motor neuron degeneration d. Lower motor neuron damage

c. Upper motor neuron degeneration

Which assessment would be most appropriate for detecting subtle signs of neglect syndrome in a patient? a. The Galveston Orientation and Amnesia Test b. The Glasgow Coma Scale c. The line bisection test d. The Mini-Mental State Examination

c. The line bisection test

During an assessment using the Functional Reach Test, what does a reduced reach distance indicate about a patient's balance? a. Improved dynamic balance b. Decreased limits of stability c. Good anticipatory postural control d. Enhanced proprioceptive function

b. Decreased limits of stability

Which clinical feature is typically the first to be affected in Guillain-Barré Syndrome? a. Cranial nerve function b. Reflexes c. Limb weakness d. Sensory function

c. Limb weakness

In a patient with multiple sclerosis, why might you observe a discrepancy between sensory testing results in the lower extremities compared to the upper extremities? a. Lesions affecting different parts of the spinal cord b. Peripheral nerve involvement in the upper extremities only c. Variability in the thickness of myelin sheaths d. Differences in nerve conduction velocity between the extremities

a. Lesions affecting different parts of the spinal cord

Which sensory deficit would most likely be observed in a patient with a lesion affecting the spinothalamic tract? a. Loss of fine touch and vibration sense b. Loss of stereognosis and graphesthesia c. Loss of pain and temperature sensation d. Loss of proprioception and kinesthesia

c. Loss of pain and temperature sensation

Which clinical sign is least likely to be observed in a patient with a lower motor neuron lesion? a. Muscle atrophy b. Decreased reflexes c. Fasciculations d. Hypertonia

d. Hypertonia

Which test is most appropriate to assess the function of the lateral corticospinal tract? a. Evaluating postural stability and balance b. Measuring fine motor skills and dexterity c. Testing proprioception and vibration sense d. Assessment of muscle tone

b. Measuring fine motor skills and dexterity

How does the presence of anosognosia complicate the assessment of a patient's mental status? a. It increases the likelihood of the patient exaggerating symptoms b. It results in the patient showing hyper-awareness of their environment c. It causes the patient to overestimate their cognitive abilities d. It leads to the patient denying the existence of their neurological deficits

d. It leads to the patient denying the existence of their neurological deficits

In assessing a patient with suspected cerebellar damage, which of the following would most likely indicate an impairment in timing and sequencing of movements? a. Difficulty performing heel-to-shin movements smoothly b. Inability to maintain posture during standing c. Rapid, involuntary movements of the limbs d. Muscle rigidity and resistance to passive movement

Difficulty performing heel-to-shin movements smoothly

What would be the most likely result of a lesion in the vermis of the cerebellum on a patient’s postural stability? a. Increased postural sway, particularly during standing with eyes closed b. Difficulty initiating voluntary movements c. Loss of proprioception in the lower limbs d. Inability to perform rapid alternating movements

a. Increased postural sway, particularly during standing with eyes closed

What is the primary distinction between a hallucination and an illusion as assessed in a mental status examination? a. Hallucinations are always auditory, illusions are always visual b. Illusions are false perceptions of real stimuli, hallucinations occur without external stimuli c. Hallucinations involve external stimuli, illusions do not d. Illusions occur in healthy individuals, while hallucinations are indicative of psychiatric disorders

b. Illusions are false perceptions of real stimuli, hallucinations occur without external stimuli

ALS primarily affects which part of the nervous system? a. Autonomic nervous system, affecting visceral function b. Cerebellar pathways, impacting coordination c. Central nervous system, specifically motor neurons d. Peripheral nervous system, including sensory nerves

c. Central nervous system, specifically motor neurons

Which feature is most characteristic of ataxia due to cerebellar dysfunction during a gait assessment? a. A wide-based gait with irregular steps b. A shuffling gait with short steps c. A forward-leaning posture with a festinating gait d. Stiff, spastic movements with scissoring of the legs

a. A wide-based gait with irregular steps

What type of neuropathy is primarily indicated by an abrupt onset of motor weakness and acute flaccid paralysis, with normal sensory examination findings? a. Acute motor-sensory axonal neuropathy b. Acute inflammatory demyelinating polyneuropathy c. Acute motor axonal neuropathy d. Miller Fisher syndrome

a. Acute motor-sensory axonal neuropathy

During motor function assessment, a patient exhibits hemiballismus. Which part of the brain is most likely affected? a. Subthalamic nucleus b. Primary motor cortex c. Thalamus d. Cerebellum

a. Subthalamic nucleus

What is a hallmark finding in LEMS on repetitive nerve stimulation (RNS) testing? a. No change in amplitude with repeated stimulation b. Incremental increase in amplitude after brief exercise c. Decremental decrease in amplitude with repeated stimulation d. Irregular amplitude response with stimulation

b. Incremental increase in amplitude after brief exercise

How would you assess a patient for agnosia during a mental status examination? a. By observing their response to emotional stimuli b. By testing their ability to recognize and interpret sensory stimuli they previously understood c. By asking them to follow multi-step verbal commands d. By evaluating their ability to complete complex motor tasks

b. By testing their ability to recognize and interpret sensory stimuli they previously understood

During the CTSIB, a patient exhibits significant instability when standing on foam with eyes closed. What does this suggest about their sensory dependency? a. Somatosensory dependency b. Visual dependency c. Vestibular dependency d. Mixed sensory dependency

b. Visual dependency

Which of the following signs is most characteristic of an upper motor neuron (UMN) lesion? a. Flaccid paralysis b. Spasticity c. Muscle atrophy d. Fasciculations

b. Spasticity

Which of the following tests would best identify a patient’s deficits in executive function? a. Observing the patient’s ability to complete a sequential motor task b. Asking the patient to spell “world” backward c. Evaluating the patient’s response to a verbal memory task d. Testing the patient’s ability to identify common objects

a. Observing the patient’s ability to complete a sequential motor task

What does the presence of clonus during a motor assessment suggest? a. Lower motor neuron damage b. Normal reflex activity c. Upper motor neuron damage d. Peripheral nerve lesion

c. Upper motor neuron damage

Which of the following balance strategies is least likely to be used during slow, controlled movements on a stable surface? a. Reaching strategy b. Hip strategy c. Ankle strategy d. Stepping strategy

b. Hip strategy

Which clinical finding would most likely suggest a lesion in the dorsal column-medial lemniscal pathway during a sensory examination? a. Impaired proprioception and vibration sense b. Decreased perception of crude touch and pressure c. Enhanced sensitivity to light touch and temperature d. Loss of pain and temperature sensation

a. Impaired proprioception and vibration sense

Which of the following scenarios best demonstrates a patient's intact sensorium? a. A patient who is aware of their surroundings and can plan appropriately for the future based on current events b. A patient who immediately responds to external stimuli but shows signs of affective blunting c. A patient who can recite the months backward but struggles with remembering what they ate for breakfast d.A patient who correctly identifies a figure drawn on their palm with eyes closed but fails to recall the president’s name

a. A patient who is aware of their surroundings and can plan appropriately for the future based on current events

Which strategy would a patient likely use if their center of mass (COM) moves beyond the base of support (BOS) during a perturbation? a. Reaching strategy b. Ankle strategy c. Stepping strategy d. Hip strategy

c. Stepping strategy

In the assessment of kinesthesia, which observation most accurately indicates a deficit in proprioceptive function? a. The patient cannot discriminate between different textures b. The patient reports delayed sensation during a pinprick test c. The patient misinterprets temperature sensations as painful d. The patient fails to identify the direction of passive joint movement

d. The patient fails to identify the direction of passive joint movement

Which motor function impairment is most closely associated with damage to the lateral vestibulospinal tract? a. Inability to maintain postural balance b. Decreased muscle tone in the limbs c. Loss of fine motor control d. Impaired reflexive movements

a. Inability to maintain postural balance

How does the hip strategy differ from the ankle strategy in maintaining balance on an unstable surface? a. The hip strategy involves movements primarily at the trunk and hips b. The hip strategy uses larger, slower movements c. The ankle strategy engages the hip flexors primarily d. The hip strategy is used more frequently on stable surfaces

a. The hip strategy involves movements primarily at the trunk and hips

Which clinical finding is most indicative of Post-Polio Syndrome during a physical examination? a. Muscle weakness that is asymmetrical and progressive b. Loss of sensation in the affected limbs c. Increased muscle bulk d. Generalized hyperreflexia

a. Muscle weakness that is asymmetrical and progressive

Which type of movement disorder is characterized by slow, writhing movements, and is commonly associated with basal ganglia dysfunction? a. Bradykinesia b. Athetosis c. Hemiballismus d. Dystonia

b. Athetosis

What is the clinical significance of identifying a "stocking-glove" distribution of sensory loss during an examination? a. It points to a specific dermatome involvement b. It is characteristic of upper motor neuron leSions c. It indicates a central nervous system lesion d. It suggests a peripheral neuropathy, often due to diabetes

d. It suggests a peripheral neuropathy, often due to diabetes

A patient reports an inability to feel their feet touch the ground when walking. This symptom is most indicative of a deficit in: a. Temperature discrimination b. Tactile localization c. Pain perception d. Proprioception

d. Proprioception

Which test condition would likely reveal significant deficits in a patient with impaired vestibular function during the CTSIB? a. Condition 1 (firm surface, eyes open) b. Condition 5 (foam surface, eyes closed) c. Condition 6 (foam surface, visual conflict) d. Condition 3 (foam surface, eyes open)

b. Condition 5 (foam surface, eyes closed)

How does a patient’s inability to execute learned voluntary acts on command (but not automatically) help diagnose apraxia? Question 62Answer a. It highlights the impact of emotional disturbances on motor function b. It differentiates apraxia from paralysis c. It rules out cerebellar involvement d. It confirms the presence of sensory deficits

b. It differentiates apraxia from paralysis

Which coordination impairment is most likely to be observed in a patient with basal ganglia pathology? a. Ataxia b. Dysmetria c. Dysdiadochokinesia d. Chorea

d. Chorea

Which sensory modality is least likely to be affected by an isolated lesion in the anterior spinothalamic tract? a. Pressure sensation b. Temperature discrimination c. Fine touch d. Crude touch

c. Fine touch

Which symptom would most likely suggest a diagnosis other than ALS? a. Sensory deficits b. Progressive muscle weakness c. Cognitive decline d. Fasciculations in the arms

a. Sensory deficits

The term "dysmetria" refers to: a.Inability to perform rapid alternating movements b.Loss of muscle tone c.Inability to judge the distance or range of movement d.Rhythmic oscillatory movements

c.Inability to judge the distance or range of movement

Which of the following pathogens is most commonly associated with triggering Guillain-Barré syndrome? a.Campylobacter jejuni’ b.Epstein-Barr virus c.Mycoplasma pneumoniae d.Haemophilus influenzae

a.Campylobacter jejuni’

Guillain-Barré syndrome (GBS) is primarily associated with which of the following characteristics? a.Permanent loss of motor function b.Progressive symmetrical limb weakness c.Asymmetrical sensory loss d.Rapid onset of unilateral limb weakness

b.Progressive symmetrical limb weakness

During a coordination examination, a patient exhibits dysdiadochokinesia when performing the rapid alternating movement (RAM) test. This finding most likely indicates a lesion in which area of the brain? a.Basal ganglia b.Spinal cord c.Cerebellum d.Motor cortex

c.Cerebellum

In patients with impaired somatosensory function, which sensory input is most likely to take on a greater role in maintaining balance? a.Auditory input b.Motor feedback c.Vestibular input d.Visual input

d.Visual input

What is the role of the basal ganglia in motor function? a.Sensory integration b.Control of reflexes c.Facilitation of voluntary movements d.Visual perception

c.Facilitation of voluntary movements

Which condition is characterized by large-amplitude, flailing motions of one side of the body? a.Athetosis b.Chorea c.Dystonia d.Hemiballismus

d.Hemiballismus

During balance assessment, a patient exhibits a delayed postural adjustment when reaching forward. This finding is most indicative of impairment in which type of postural control? a.Proactive (anticipatory) postural control b.Static postural control c.Reactive postural control d.Adaptive postural control

a.Proactive (anticipatory) postural control

A patient demonstrates significant difficulty with fine motor tasks, such as buttoning a shirt. Which assessment tool would be most appropriate to quantify their level of hand function? a.Romberg test b.Purdue Pegboard Test c.Heel-to-shin test d.Minnesota Rate of Manipulation Test

b.Purdue Pegboard Test

A patient undergoing coordination assessment shows signs of truncal ataxia and a wide-based, unsteady gait. Which cerebellar region is most likely affected in this patient? a.Cerebellar hemispheres b.Flocculonodular lobe c.Vermis (midline cerebellum) d.Dentate nucleus

c.Vermis (midline cerebellum)

Which of the following is least likely to be a symptom of Post-Polio Syndrome? a.New bulbar symptoms b.Joint pain c.Hyperreflexia d.Muscle atrophy

c.Hyperreflexia

ost-Polio Syndrome is considered a progressive neuromuscular disorder due to: a.Continuous loss of motor neurons b.Development of new sensory abnormalities c.Recurrent episodes of acute muscle paralysis d.Recurrence of poliovirus infection

a.Continuous loss of motor neurons

The progression of muscle weakness in Post-Polio Syndrome is typically: a. Asymmetrical and focal b.Unilateral and spastic c.Generalized and consistent d.Symmetrical and rapid

a. Asymmetrical and focal

In Guillain-Barré syndrome, albuminocytologic dissociation is typically observed in which diagnostic test? a.Nerve conduction study b.Blood test c.Electromyography (EMG) d.Cerebrospinal fluid analysis

d.Cerebrospinal fluid analysis

Which diagnostic criterion is essential for confirming Post-Polio Syndrome? a.Elevated CSF protein levels b.Presence of new sensory deficits c.History of recent viral infection d.Gradual onset of new weakness and fatigue

d.Gradual onset of new weakness and fatigue

A patient demonstrates an intention tremor during the finger-to-clinician-finger test. Which neurological structure is most likely affected? a.Spinal cord b.Basal ganglia c.Motor cortex d.Cerebellum

d.Cerebellum

A patient recovering from a stroke exhibits significant instability in conditions 5 and 6 of the CTSIB. What does this suggest about the patient's sensory integration? a. Dependence on somatosensory inputs b.Sensory selection problem c.Vestibular dysfunction d.Dependence on visual inputs

c.Vestibular dysfunction

Which of the following muscle activation patterns would be expected during a backward sway when utilizing the hip strategy? a.Abdominals followed by quadriceps b.Paraspinals followed by hamstrings c.Hamstrings followed by gastrocnemius d.Quadriceps followed by tibialis anterior

b.Paraspinals followed by hamstrings

In the context of postural control, which of the following terms describes the maximum distance an individual can lean in any direction without losing balance? a.Center of Gravity (COG) b.Range of Motion (ROM) c.Base of Support (BOS) d.Limits of Stability (LOS)

d.Limits of Stability (LOS)

Which muscle group is primarily activated during forward sway in the ankle strategy? a.Quadriceps b.Abdominals c.Gastrocnemius d.Hamstrings

c.Gastrocnemius

The Romberg test is used to assess which aspect of balance? a.Muscle strength b.Coordination of limb movements c.Static postural control d.Dynamic balance

c.Static postural control

Guillain-Barré syndrome is often triggered by which of the following antecedent events? a.Physical inactivity b.Immune stimulation by infection c.Exposure to cold temperatures d.Trauma

b.Immune stimulation by infection

PRELIMS: Reviewer [2] Flashcards

(95 cards)