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Stroke and Rehabilitation Overview
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Stroke and Rehabilitation Overview

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@ThoughtfulRetinalite

Questions and Answers

What is the primary role of upper motor neurons in movement control?

  • They provide inhibitory control over spinal reflexes.
  • They suppress the excitability of motoneurons.
  • They mediate spinal reflex responses without cortical involvement.
  • They are responsible for initiating voluntary movements. (correct)

    • What happens to spinal reflexes when descending control from the upper motor neurons is diminished?

  • Spinal reflexes are completely suppressed.
  • Reflex activity increases only during voluntary movements.
  • There is an increased inhibitory input to reflex arcs.
  • Exaggerated excitation reaches motor neurons. (correct)

    • Which brain structure acts as the major inhibitory system controlling spinal reflexes?

  • Premotor cortex
  • Ventromedial bulbar reticular formation (correct)
  • Corticospinal tract
  • Dorsal reticulospinal tract

    • What consequence arises from damage to the premotor cortex?

    <p>Inhibition of spinal reflex suppression is removed.</p> Signup and view all the answers

    Which of the following statements best describes the impact of stroke on motor control?

    <p>Common symptoms include exaggerated reflex actions and motor deficits.</p> Signup and view all the answers

    What is one identified recovery mechanism after a stroke?

    <p>Increased intrinsic motoneuron excitability.</p> Signup and view all the answers

    What is a primary aim of rehabilitation programs following a stroke?

    <p>To enhance voluntary movement initiation.</p> Signup and view all the answers

    How does the dorsal reticular formation respond to cortical damage?

    <p>It increases its excitatory output without cortical regulation.</p> Signup and view all the answers

    Which symptom is characterized by exaggerated reflexes due to disinhibition of spinal reflexes?

    <p>Hyperreflexia</p> Signup and view all the answers

    What is the primary difference between spasticity and rigidity?

    <p>Spasticity is velocity-dependent, while rigidity shows consistent resistance throughout the range of motion.</p> Signup and view all the answers

    Which symptom is associated with a sudden release of resistance to movement, commonly found in corticospinal spasticity?

    <p>Clasp-knife phenomenon</p> Signup and view all the answers

    What is indicated by the positive Babinski sign?

    <p>Abnormal fanning of the toes and extension of the big toe</p> Signup and view all the answers

    What clinical sign indicates a reversal of the cutaneous flexor reflex commonly seen in upper motor neuron lesions?

    <p>Babinski sign</p> Signup and view all the answers

    What is the primary cause of contracture in individuals with upper motor neuron dysfunction?

    <p>Prolonged hypertonic spasticity</p> Signup and view all the answers

    At what age do infants typically transition from the extensor response to the flexor response?

    <p>12 to 24 months</p> Signup and view all the answers

    Which of the following is NOT a characteristic of upper motor neuron (UMN) lesions?

    <p>Decreased muscle tone</p> Signup and view all the answers

    Which of the following symptoms indicates a loss of voluntary control often associated with upper motor neuron damage?

    <p>Loss of dexterity</p> Signup and view all the answers

    Which symptom is characterized by brisk, repeated, rhythmic muscle contractions and relaxations?

    <p>Clonus</p> Signup and view all the answers

    What happens to tendon reflexes in patients with lower motor neuron (LMN) damage?

    <p>They become absent or decreased</p> Signup and view all the answers

    Which type of contraction is characterized by irregular rhythm and variable amplitude occurring rapidly?

    <p>Myoclonus</p> Signup and view all the answers

    What phenomenon describes the muscle twitching associated with lower motor neuron dysfunction?

    <p>Fasciculations</p> Signup and view all the answers

    Which statement about the Babinski sign is true in infants compared to adults?

    <p>Infants exhibit an extensor response</p> Signup and view all the answers

    In terms of muscle wasting, how do upper and lower motor neuron injuries differ?

    <p>LMN injury shows disuse atrophy eventually</p> Signup and view all the answers

    What type of reflex is typically associated with upper motor neuron lesions?

    <p>Extensor plantar reflexes</p> Signup and view all the answers

    What common mechanism leads to cerebral hemorrhage?

    <p>Rupture of an aneurysm</p> Signup and view all the answers

    Which structure is least likely to be affected by basal ganglia lesions?

    <p>Cerebellum</p> Signup and view all the answers

    What is a potential long-term risk associated with subarachnoid hemorrhage (SAH)?

    <p>Increased risk of stroke due to vasospasm</p> Signup and view all the answers

    What neurological symptom progression might occur with a growing hematoma?

    <p>Worsening of neurological symptoms</p> Signup and view all the answers

    In what condition is ataxia commonly observed?

    <p>Disorders of the cerebellum</p> Signup and view all the answers

    Which of the following is NOT a characteristic of apraxia?

    <p>Inability to coordinate muscle activity</p> Signup and view all the answers

    What defines aphasia in neurological terms?

    <p>Impairment of language production or comprehension</p> Signup and view all the answers

    What effect can the resolution of cerebral edema have after a hemorrhagic stroke?

    <p>More profound neurological recovery</p> Signup and view all the answers

    What is a typical consequence of a stroke in the anterior cerebral artery?

    <p>Weakness in the contralateral foot and leg</p> Signup and view all the answers

    Which area of the brain is affected by neglect following a lesion?

    <p>Right posterior parietal cortex</p> Signup and view all the answers

    What is a significant risk associated with acute basilar artery occlusion?

    <p>High mortality rate</p> Signup and view all the answers

    What symptom is commonly associated with posterior cerebral artery stroke?

    <p>Visual field loss</p> Signup and view all the answers

    Which of the following can result in 'locked-in' syndrome?

    <p>Basilar artery stroke</p> Signup and view all the answers

    What type of dysfunction is mostly seen with damage to the posterior cerebral artery?

    <p>Visual processing dysfunction</p> Signup and view all the answers

    What does anosmia refer to in the context of anterior cerebral artery strokes?

    <p>Loss of the sense of smell</p> Signup and view all the answers

    Which of the following is NOT typically a consequence of a posterior cerebral artery stroke?

    <p>Sensory loss in the legs</p> Signup and view all the answers

    Study Notes

    Stroke and Rehabilitation Overview

    • Upper Motor Neuron (UMN) syndromes significantly impact movement control, leading to various motor dysfunctions.
    • Common symtoms of stroke include loss of voluntary control, hyperreflexia, spasticity, and decreased dexterity.

    Consequences of Diminished Descending Control

    • UMNs provide excitatory input for voluntary movements; their loss results in increased spinal reflex excitability.
    • Dorsal reticular formation remains active after cortical damage, contributing to exacerbated spinal motion.
    • Spasticity is velocity-dependent, increasing resistance to stretch when muscles are moved quickly.

    Signs and Symptoms of UMN Dysfunction

    • Hyperreflexia: Exaggerated reflex responses due to loss of inhibitory control.
    • Spasticity: Increased muscle tone with exaggerated tendon reflexes; primarily affects antigravity muscles.
    • Clasp-Knife Phenomenon: Sudden release of resistance to passive movement in spastic muscles.
    • Clonus: Rapid rhythmic contractions of a muscle group; can be indicative of UMN lesions.
    • Myoclonus: Irregular, shock-like contractions of muscles.
    • Contracture: Permanent shortening of muscles or joints due to prolonged spasticity.
    • Babinski Sign: Abnormal extension and fanning of toes when the sole is stimulated; indicative of corticospinal damage.

    Mechanisms of Stroke

    • Haemorrhagic Stroke: Caused by the rupture of an aneurysm, typically affecting deep subcortical structures and leading to progressive neurological impairment.
    • Subarachnoid Haemorrhage (SAH): Bleeding into the subarachnoid space causing vasospasms, potentially leading to ischemic deficits similar to those of other strokes.
    • Ataxia: Inability to coordinate voluntary muscle activity, often due to cerebellar disorders.
    • Apraxia: Difficulty executing familiar movements despite intact desire and capability.
    • Aphasia: Language impairment affecting speech production and comprehension.

    Arterial Strokes and Their Consequences

    • Anterior Cerebral Artery Stroke: Affects the frontal and parietal lobes. Symptoms include paralysis or weakness of the contralateral leg, sensory loss, and anosmia.
    • Posterior Cerebral Artery Stroke: Impaired function in the occipital lobe and thalamus. Characterized by visual field loss (hemianopsia) and sensory dysfunction.
    • Basilar Artery Stroke: High mortality rate with symptoms like locked-in syndrome, where patients are aware but cannot move or communicate due to paralysis.

    Rehabilitation Aims

    • Rehabilitation seeks to regain motor functions and adapt to neurological deficits due to strokes or UMN syndromes.
    • Understanding the impact of different strokes aids in targeted recovery strategies and patient management.

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    Description

    This quiz explores the upper motor neuron syndromes and their impact on movement control, focusing on signs and symptoms of dysfunction. Key concepts include hyperreflexia, spasticity, and the clasp-knife phenomenon. It aims to enhance understanding of stroke consequences and rehabilitation strategies.

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