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Questions and Answers
What is the primary role of upper motor neurons in movement control?
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?
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?
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?
What consequence arises from damage to the premotor cortex?
Which of the following statements best describes the impact of stroke on motor control?
Which of the following statements best describes the impact of stroke on motor control?
What is one identified recovery mechanism after a stroke?
What is one identified recovery mechanism after a stroke?
What is a primary aim of rehabilitation programs following a stroke?
What is a primary aim of rehabilitation programs following a stroke?
How does the dorsal reticular formation respond to cortical damage?
How does the dorsal reticular formation respond to cortical damage?
Which symptom is characterized by exaggerated reflexes due to disinhibition of spinal reflexes?
Which symptom is characterized by exaggerated reflexes due to disinhibition of spinal reflexes?
What is the primary difference between spasticity and rigidity?
What is the primary difference between spasticity and rigidity?
Which symptom is associated with a sudden release of resistance to movement, commonly found in corticospinal spasticity?
Which symptom is associated with a sudden release of resistance to movement, commonly found in corticospinal spasticity?
What is indicated by the positive Babinski sign?
What is indicated by the positive Babinski sign?
What clinical sign indicates a reversal of the cutaneous flexor reflex commonly seen in upper motor neuron lesions?
What clinical sign indicates a reversal of the cutaneous flexor reflex commonly seen in upper motor neuron lesions?
What is the primary cause of contracture in individuals with upper motor neuron dysfunction?
What is the primary cause of contracture in individuals with upper motor neuron dysfunction?
At what age do infants typically transition from the extensor response to the flexor response?
At what age do infants typically transition from the extensor response to the flexor response?
Which of the following is NOT a characteristic of upper motor neuron (UMN) lesions?
Which of the following is NOT a characteristic of upper motor neuron (UMN) lesions?
Which of the following symptoms indicates a loss of voluntary control often associated with upper motor neuron damage?
Which of the following symptoms indicates a loss of voluntary control often associated with upper motor neuron damage?
Which symptom is characterized by brisk, repeated, rhythmic muscle contractions and relaxations?
Which symptom is characterized by brisk, repeated, rhythmic muscle contractions and relaxations?
What happens to tendon reflexes in patients with lower motor neuron (LMN) damage?
What happens to tendon reflexes in patients with lower motor neuron (LMN) damage?
Which type of contraction is characterized by irregular rhythm and variable amplitude occurring rapidly?
Which type of contraction is characterized by irregular rhythm and variable amplitude occurring rapidly?
What phenomenon describes the muscle twitching associated with lower motor neuron dysfunction?
What phenomenon describes the muscle twitching associated with lower motor neuron dysfunction?
Which statement about the Babinski sign is true in infants compared to adults?
Which statement about the Babinski sign is true in infants compared to adults?
In terms of muscle wasting, how do upper and lower motor neuron injuries differ?
In terms of muscle wasting, how do upper and lower motor neuron injuries differ?
What type of reflex is typically associated with upper motor neuron lesions?
What type of reflex is typically associated with upper motor neuron lesions?
What common mechanism leads to cerebral hemorrhage?
What common mechanism leads to cerebral hemorrhage?
Which structure is least likely to be affected by basal ganglia lesions?
Which structure is least likely to be affected by basal ganglia lesions?
What is a potential long-term risk associated with subarachnoid hemorrhage (SAH)?
What is a potential long-term risk associated with subarachnoid hemorrhage (SAH)?
What neurological symptom progression might occur with a growing hematoma?
What neurological symptom progression might occur with a growing hematoma?
In what condition is ataxia commonly observed?
In what condition is ataxia commonly observed?
Which of the following is NOT a characteristic of apraxia?
Which of the following is NOT a characteristic of apraxia?
What defines aphasia in neurological terms?
What defines aphasia in neurological terms?
What effect can the resolution of cerebral edema have after a hemorrhagic stroke?
What effect can the resolution of cerebral edema have after a hemorrhagic stroke?
What is a typical consequence of a stroke in the anterior cerebral artery?
What is a typical consequence of a stroke in the anterior cerebral artery?
Which area of the brain is affected by neglect following a lesion?
Which area of the brain is affected by neglect following a lesion?
What is a significant risk associated with acute basilar artery occlusion?
What is a significant risk associated with acute basilar artery occlusion?
What symptom is commonly associated with posterior cerebral artery stroke?
What symptom is commonly associated with posterior cerebral artery stroke?
Which of the following can result in 'locked-in' syndrome?
Which of the following can result in 'locked-in' syndrome?
What type of dysfunction is mostly seen with damage to the posterior cerebral artery?
What type of dysfunction is mostly seen with damage to the posterior cerebral artery?
What does anosmia refer to in the context of anterior cerebral artery strokes?
What does anosmia refer to in the context of anterior cerebral artery strokes?
Which of the following is NOT typically a consequence of a posterior cerebral artery stroke?
Which of the following is NOT typically a consequence of a posterior cerebral artery stroke?
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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.
Definitions of Related Terms
- 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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