Spinal Cord Injury Quiz

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Questions and Answers

What term describes the impairment or loss of motor function due to damage to the upper motor neurons in the cervical segments of the spinal cord?

Neuropathy

Paraplegia

Spinal shock

Tetraplegia (correct)

Which of the following is a common complication associated with tetraplegia?

Osteoporosis (correct)

Insomnia

Fever

Headaches

What is characterized by a temporary loss of spinal cord function after an injury?

Spinal shock (correct)

Paralysis

Cerebral palsy

Myelitis

What type of paralysis results from damage to the thoracic, lumbar, or sacral segments of the spinal cord?

Paraplegia Signup and view all the answers

Which of the following is NOT a potential management strategy for spinal cord injuries?

Antibiotics Signup and view all the answers

Which structure is responsible for connecting the cerebrum and cerebellum to the spinal cord?

Brainstem Signup and view all the answers

Which part of the motor system is considered the highest level of function?

Motor cortex Signup and view all the answers

What is the primary role of the cerebellum in the motor system?

Fine-tune movement timing and coordination Signup and view all the answers

Where are the cell bodies of motor neurons located?

Within the CNS, specifically in the spinal cord Signup and view all the answers

What is the primary function of the basal ganglia in the motor system?

Facilitate graceful motor movements Signup and view all the answers

Which of the following structures directly relays motor information to the muscles?

Spinal cord Signup and view all the answers

What is the main responsibility of the primary motor cortex?

Control precise, skillful movements Signup and view all the answers

Which component of the motor system helps in the planning and executing of motor movements together with the cerebellum?

Basal ganglia Signup and view all the answers

What is pure sensory neuropathy characterized by?

Tingling without muscle weakness Signup and view all the answers

Which of the following is NOT a risk factor for Carpal Tunnel Syndrome?

Prolonged wrist extension Signup and view all the answers

Which treatment is commonly recommended for managing Carpal Tunnel Syndrome?

NSAIDs and wrist splints Signup and view all the answers

What often causes polyneuropathies?

Systemic disorders leading to demyelination Signup and view all the answers

Which of the following would be correctly associated with the management of carpal tunnel syndrome?

Avoidance of wrist flexion Signup and view all the answers

What is a common initial sign of Myasthenia Gravis related to eye movement?

Ptosis Signup and view all the answers

What test is used for the clinical diagnosis of Myasthenia Gravis?

Tensilon test Signup and view all the answers

Which of the following symptoms occurs due to weakness in pharyngeal muscles in Myasthenia Gravis?

Dysphagia Signup and view all the answers

During which situation might a patient with Myasthenia Gravis experience an asthenic crisis?

Following a surgical procedure Signup and view all the answers

What is one characteristic of mononeuropathies?

Usually caused by local disorders Signup and view all the answers

Which of the following is an example of a polyneuropathy?

Guillain-Barré syndrome Signup and view all the answers

What is a potential complication associated with Myasthenia Gravis during times of stress?

Asthenic crisis Signup and view all the answers

Which of the following statements about peripheral neuropathies is true?

They can cause both numbness and weakness. Signup and view all the answers

What is characterized by sensory or motor deficits that are bilaterally symmetrical?

Diabetes Signup and view all the answers

What condition involves the destruction of the myelin sheath of peripheral nerves?

Guillain-Barré Syndrome Signup and view all the answers

Which of the following is a common early symptom of Guillain-Barré Syndrome?

Pain and tingling in limbs Signup and view all the answers

Which age group is primarily affected by Spinal Muscular Atrophy characterized by severe hypotonia?

Infants aged 6 weeks to 1 year Signup and view all the answers

What is a potential consequence of severe cases of Guillain-Barré Syndrome?

Respiratory muscle involvement leading to death Signup and view all the answers

What is a defining feature of Spinal Muscular Atrophy?

Progressive degeneration of lower motor neuron cell bodies Signup and view all the answers

Which treatment is commonly used for managing Guillain-Barré Syndrome?

IV immunoglobulins and physical therapy Signup and view all the answers

What is primarily affected in infants with Spinal Muscular Atrophy?

Ventral horns of the spinal cord Signup and view all the answers

What is the primary cause of muscle wasting in denervation atrophy?

Damage to lower motor neurons Signup and view all the answers

What characterizes the muscle fibers in muscular dystrophy?

They become enriched with fat and connective tissue Signup and view all the answers

Which type of muscular dystrophy is more prevalent?

Duchenne muscular dystrophy Signup and view all the answers

What is Gower’s maneuver indicative of?

Hip and thigh muscle weakness Signup and view all the answers

Which genetic characteristic is associated with both Duchenne and Becker muscular dystrophy?

X-linked recessive inheritance Signup and view all the answers

What is a significant clinical feature of Myasthenia Gravis?

Decreased functional acetylcholine receptors Signup and view all the answers

What is the primary role of dystrophin in muscle cells?

Maintain structural integrity Signup and view all the answers

What conditions may develop in patients with Duchenne muscular dystrophy by early adolescence?

Scoliosis Signup and view all the answers

Which diagnostic tool is typically used to demonstrate mutations in the dystrophin gene?

Blood sample analysis Signup and view all the answers

Which treatment approach is commonly used to improve muscle regeneration in muscular dystrophy?

Steroids Signup and view all the answers

What is the outcome when acetylcholine receptors are destroyed in Myasthenia Gravis?

Diminished motor response Signup and view all the answers

What can Pseudohypertrophy of muscles lead to in conditions like muscular dystrophy?

Reduced physical activity Signup and view all the answers

What condition is characterized by abnormal curvature of the spine commonly seen in muscular dystrophy?

Scoliosis Signup and view all the answers

What is the effect of prolonged bed rest during hospitalization on muscle health?

Leads to denervation atrophy Signup and view all the answers

Study Notes

Alterations in Motor Function

Definition: The study covers various disorders affecting the motor system, from its organization and control to specific diseases affecting the nervous system and muscles
Overview: The motor system is a functional hierarchy with high levels (motor cortex) for planning movements and lower levels (spinal cord) to execute them; the cerebellum and basal ganglia contribute to coordination, timing, and accuracy.
Motor System Organization: The brain's motor cortex, brainstem, cerebellum, and basal ganglia work together to plan and execute bodily movements, maintain posture, and respond to the environment.

Motor Cortex

Function: Controls precise, skillful, and intentional movements (examples like typing and skillful actions).
Components: Primarily, premotor, and supplementary motor areas found within the frontal lobe.
Role in Movement: Involved in the planning and execution of intended activities.

Cerebellum & Basal Ganglia

Function: The cerebellum refines movements and helps with timing, coordination, and accuracy. The basal ganglia control the initiation, execution, and termination of complex movement sequences in a smooth, graceful manner.
Interactions: Together these structures ensure precise, coordinated movements.

Brainstem

Function: Connects the cerebrum and cerebellum to the spinal cord; relays motor information.

Spinal Cord

Function: Contains motor neurons that send efferent signals (motor commands) to muscles.
Organization: Includes dorsal (sensory) roots and ventral (motor) roots.
Action Potential: Provides pathways for neural signaling.

Descending Pathways

Overview: Upper Motor Neurons (UMNs) project from the brain down to the lower motor neurons, facilitating motor control.
Two Categories:
- Pyramidal Tracts: Responsible for conscious, voluntary control of movements (head, face, and body muscles); these initiate voluntary movements.
- Extrapyramidal Tracts: Control unconscious and automatic movements; these regulate posture and balance.
Function of Pathways: UMNs send signals to LMNs for detailed movement.

Neuromuscular Junctions

Function: LMN axons connect and initiate signals to the muscle fibers.
Motor Unit: A motor neuron and all the muscle fibers it controls.
Endplate Region: The axon terminal of a motor neuron and its receptors where signals are transmitted to contract the muscle.

Spinal Reflexes

Action: Simple, involuntary responses to stimuli, occurring quickly and automatically
Components:
- Sensory receptors: Detect stimuli affecting body functions.
- Sensory neurons: Relay information about stimuli to the spinal cord.
- Integrating center: Interneurons in the spinal cord form a processing station; they interpret and analyze the data from the sensors.
- Motor neurons: Send signals to muscles to initiate the response.
- Effectors (muscles): Carry out the reflex movement.
Types:
- Monosynaptic: Only one synapse; quickly contracts muscle (eg, knee-jerk).
- Polysynaptic: Multiple synapses; involves interneurons (eg, withdrawal reflex).
Roles: Protective mechanisms, maintain posture and balance swiftly.

Upper Motor Neuron Disorders (UMN)

Signs: Spasticity, clonus, hypertonia, and hyperreflexia can occur; babinski sign or fanning of toes occurs.
Common Disorders: Multiple sclerosis, amyotrophic lateral sclerosis (ALS), and spinal cord injuries.
Impact: Damage to UMNs impairs voluntary movement control, causing stiffness and overactive reflexes.

Multiple Sclerosis (MS)

Definition: Autoimmune disorder that damages myelin in the CNS, particularly UMNs, affecting speed and transmission.
Cause: Precise cause is unknown, but likely related to genetic predisposition and environmental factors.
Pathophysiology: Destruction of myelin in the UMNs results in slowing or blocking nerve impulses.
Symptoms: General symptoms (fatigue, dizziness, weakness); more specific symptoms such as brief, shocking sensations and difficulties moving, coordinating, or speaking can also arise.
Complications: Leads to impairments in balance and coordination.

Amyotrophic Lateral Sclerosis (ALS)

Definition: Progressive, neurodegenerative disease affecting the motor neurons (both UMN and LMN) of the brain and spinal cord, that causes muscle wasting and weakness.
Cause: Exact cause is still debated, potentially stemming from multiple genetic or environmental factors (but 90-95% of cases are sporadic and not inherited.
Pathophysiology: Degeneration of motor neurons in the spinal cord and brain; particularly the UMNs, and the degeneration of axons in the corticospinal tracts leads to progressive muscle weakness.
Symptoms: Early symptoms include muscle stiffness, weakness and cramping; later symptoms arise such as slowed or slurred speech and swallowing difficulties (dysphagia).

Spinal Cord Injuries

Types: Tetraplegia/quadriplegia, Paraplegia, spinal shock.
Causes: Trauma (fractures or dislocations of vertebrae), forceful bending or compression of neck.
Symptoms: Vary depending on the segment of the spinal cord injured and can include weakness or paralysis.

Disorders of the Cerebellum & Basal Ganglia

Definition: Disorders or conditions related to the cerebellum or basal ganglia.
Cerebellar Disorders: Cerebellar ataxia and cerebellar tremor.

Cerebellar Ataxia

Definition: Lack of coordination, characterized by wide-based and unsteady gait; and difficulty performing coordinated movements.
Causes: Alcohol abuse and other brain conditions.

Cerebellar Tremor

Definition: Visible tremors that worsen when approaching a target.
Causes: Various conditions, including alcohol overdose.

Basal Ganglia Disorders

Function: Control of slow, sustained movements; initiation, and execution. They are crucial for coordinating smooth movements and stopping skilled movements.
Causes: Infections, genetic mutations, or drug overdose.

Parkinson's Disease

Definition: Progressive disorder of the basal ganglia.
Cause: Degeneration of dopamine-producing neurons in the substantia nigra; the exact cause remains unknown.
Symptoms: Tremors, rigidity, bradykinesia (slowed movement), postural instability.

Lower Motor Neuron Disorders (LMN)

Definition: LMN disorders affect the LMNs impacting muscle control.
Signs: Muscle weakness, paresis, hypotonia, hyporeflexia/areflexia.
Broad Categories: Myopathies (affecting muscle fibers), endplate disorders (neuromuscular junctions), peripheral neuropathies (axons of the LMNs), and ventral horn cell disorders (cell bodies of the LMNs).

Myopathies

Examples: Muscle atrophy, muscular dystrophy.

Endplate Disorders

Example: Myasthenia gravis

Peripheral Neuropathies/PNS

Definition: Conditions that damage nerves outside the brain and spinal cord.
Examples: Carpal tunnel syndrome, Guillain-Barré syndrome.

Carpal Tunnel Syndrome

Definition: Compresses the median nerve within the wrist's carpal tunnel; causing numbness and tingling (especially thumb and index fingers, and part of the ring finger) .
Causes: Repetitive hand movements, inflammation.

Guillain-Barré Syndrome

Definition: Autoimmune disorder that targets the myelin sheath, impacting multiple peripheral nerves.
Symptoms: Progressive weakness that starts in the legs and ascends to the upper body.

Spinal Muscular Atrophy

Definition: Progressive degeneration of LMN cell bodies in the spinal cord; causing muscle weakness and atrophy, starting as a child.
Cause: Genetic mutations, leading to reduced availability of a protein needed for muscle function.
Symptoms: Muscle weakness that becomes more extreme over time, typically beginning as an infant.

Muscle Atrophy

Definition: Reduction in muscle fiber size due to reduced or lack of stimulation
Types: Disuse atrophy (due to lack of exercise), Denervation atrophy (due to loss of nerve stimulation).

Muscular Dystrophy

Definition: Inherited muscle disorders; affecting muscle fibers and leading to progressive weakness and disability.
Types: Duchenne and Becker Muscular Dystrophies.
Cause: Mutations in the dystrophin gene, which encodes a protein essential for maintaining muscle structure.
Symptoms: Gradual muscle weakness; often beginning in childhood, resulting in decreased mobility, and in some cases requiring assisted movement.

Myasthenia Gravis

Definition: Autoimmune neuromuscular junction disorder that impairs neuromuscular transmission; causing weakness and fatigability in skeletal muscles.
Cause: Damage to the acetylcholine receptors on the muscle causes the muscles to not get proper stimulation; Antibodies attack and damage the acetylcholine receptors on muscles.
Symptoms: Muscle weakness; especially in the face, eyes, and throat; muscle weakness often worsens with exertion.

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Description

Test your knowledge on spinal cord injuries, including types of paralysis and common complications. This quiz covers essential concepts related to the impairment of motor functions and management strategies for spinal cord injuries.