M2-C2-L25 --> Lower Motor Neurons

Front 1

Define LMN.

Back 1

Neurons which directly innervate skeletal muscle

Front 2

What are the types of LMN's and where do they go innervation?

Back 2

Alpha --> Extrafusal muscle

Gamma --> Intrafusal muscle

Front 3

What is the NT for LMN's.

Back 3

ACh (nicotinic receptors)

Front 4

The axial muscles are innervated from where?

Back 4

Medial nucleus of the anterior horn

Front 5

The limb muscles are innervated from where?

Back 5

Lateral nucleus of the anterior horn.

C5-T1, L1-S4

Flexor innervating center is more POSTERIOR than Extensor innervating center.

Front 6

The Diaphragm is innervated from where?

Back 6

Phrenic nucleus (C3, C4, C5)

Front 7

The trapezius and sternocleidomastoid are innervated from where?

Back 7

Spinal Accessory Nucleus

C1-C6

Front 8

Reciprocal innervation is done by what type of neurons? Describe the NTs involved.

Back 8

Internuerons

Glutamate - Excitatory
Glycine - Inhibitory

Front 9

Define recurrent inhibition.

Back 9

Where LMN have recurrent axon collaterals which synapse on inhibitory (glycinergic) interneurons (Renshaw cells), which will inhibit the SAME LMN as well as other lower motor neurons

Front 10

Triceps DTR
- Spinal Cord
- Nerve

Back 10

C7
Radial

Front 11

Patellar DTR
- Spinal Cord
- Nerve

Back 11

L4
Femoral

Front 12

Achilles DTR
- Spinal Cord
- Nerve

Back 12

S1
Tibial

Front 13

Jaw Jerk DTR
- Spinal Cord
- Nerve

Back 13

No spinal cord
Trigeminal-Mandibular division

Front 14

Biceps DTR
- Spinal Cord
- Nerve

Back 14

C5
Musculocutaneous

Front 15

Brachioradialis
- Spinal Cord
- Nerve

Back 15

C6
Radial

Front 16

Question

Back 16

Answer

Front 17

Question

Back 17

Answer

Front 18

What are the signs and symptoms of LMN lesions in general? x5

Back 18

1. FLACCID PARALYSIS / PARESIS
2. Muscular Atonia / Hypotonia
3. Areflexia / Hyporeflexia
4. Muscular Fasciculations / Fibrillations
5. Muscular Atrophy

Front 19

What is the correlation between LMN lesions and the observed deficit?

Back 19

Same side

Same level

Front 20

How do you test for fibrillations?

Back 20

Electromyographic testing

Front 21

What causes ALS?

Back 21

Demyelinated anterior roots

Front 22

What are the symptoms of familial neuropathy?

Back 22

Atrophy of thenar & hypothenar eminence.

Front 23

What are the possible sites for LMN lesions?

Back 23

1. Myoneural junction
2. Anterior horn
3. Ventral root
4. Spinal nerve

Front 24

Atrophy of left infraspinatus and deltoid muscles would result following what event?

Back 24

Protrusion of C5

Front 25

A LEFT tibial nerve lesion would indicate what symptoms? What level is this lesion at?

Back 25

Sacral level

1. Plantar flexion impaired
2. Shortening of extensor tendons
3. Dorsiflexion of foot
4. Flaccid paralysis/atrophy of soleus and gastrocnemius
5. Contracture and joint distortion
6. Arthritic changes and pain

Front 26

A LEFT median nerve lesion would indicate what symptoms? What level is this lesion at?

Back 26

Cervical level

1. Flaccid paralysis/atrophy of thenar emminence, wrist, and finger extensors (1-3)

2. Wrist and finger flexion impaired.

3. Extension of wrist and digits 1-3; papal sign

Front 27

A LEFT Spinal Accessory nerve damage would indicate what symptoms? What level is this lesion at?

Back 27

Rostal cord to Caudal medulla

1. Flaccid/atrophy of sternocleidomastoid and trapezius

2. Impaired ability to raise left shoulder.

3. Impaired ability to turn head contralaterally.

Front 28

A LEFT Hypoglossal nerve lesion would indicate what symptoms? What is the level of lesion at?

Back 28

Mid Medulla

1. Flaccid paralysis/atrophy of left tongue

2. Dysarthria (inarticulate speech)

3. Deviation of tongue towards left on protrusion

Front 29

A LEFT Vagus nerve lesion would indicate what symptoms? What is the level of lesion at?

Back 29

Mid Medulla

1. Flaccid paralysis/atrophy of pharynx, larynx, and palate on left side

2. Dyphonia (Voice weak and hoarse)

3. Dysphagia (Swallowing impaired)

4. Deviation of uvula toward RIGHT side

5. Gag reflex impaired

Front 30

A LEFT facial nerve damage would indicate what symptoms? What is the level of lesion at?

Back 30

Caudal Pons

1. Flaccid paralysis/atrophy of facial expression muscles

2. Bell's Palsy

3. Corneal reflex impaired

Front 31

Describe the symptoms associated with Bell's Palsy.

Back 31

1. Hyperacusis

2. Widening of Palpebral Fissure

3. Drooping of face

4. Corneal reflex impaired

Front 32

A LEFT Trigeminal nerve lesion would indicate what symptoms? What is the level of lesion at?

Back 32

Mid Pons

Flaccid paralysis / atrophy of mastication muscles + MATT

Chewing impaired

Deviation of Jaw to left side

Jaw Jaw jerk impaired

Maybe corneal reflex impaired?