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32 Cards in this Set

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Define LMN.
Neurons which directly innervate skeletal muscle
What are the types of LMN's and where do they go innervation?
Alpha --> Extrafusal muscle

Gamma --> Intrafusal muscle
What is the NT for LMN's.
ACh (nicotinic receptors)
The axial muscles are innervated from where?
Medial nucleus of the anterior horn
The limb muscles are innervated from where?
Lateral nucleus of the anterior horn.

C5-T1, L1-S4

Flexor innervating center is more POSTERIOR than Extensor innervating center.
The Diaphragm is innervated from where?
Phrenic nucleus (C3, C4, C5)
The trapezius and sternocleidomastoid are innervated from where?
Spinal Accessory Nucleus

C1-C6
Reciprocal innervation is done by what type of neurons? Describe the NTs involved.
Internuerons

Glutamate - Excitatory
Glycine - Inhibitory
Define recurrent inhibition.
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
Triceps DTR
- Spinal Cord
- Nerve
C7
Radial
Patellar DTR
- Spinal Cord
- Nerve
L4
Femoral
Achilles DTR
- Spinal Cord
- Nerve
S1
Tibial
Jaw Jerk DTR
- Spinal Cord
- Nerve
No spinal cord
Trigeminal-Mandibular division
Biceps DTR
- Spinal Cord
- Nerve
C5
Musculocutaneous
Brachioradialis
- Spinal Cord
- Nerve
C6
Radial
Question
Answer
Question
Answer
What are the signs and symptoms of LMN lesions in general? x5
1. FLACCID PARALYSIS / PARESIS
2. Muscular Atonia / Hypotonia
3. Areflexia / Hyporeflexia
4. Muscular Fasciculations / Fibrillations
5. Muscular Atrophy
What is the correlation between LMN lesions and the observed deficit?
Same side

Same level
How do you test for fibrillations?
Electromyographic testing
What causes ALS?
Demyelinated anterior roots
What are the symptoms of familial neuropathy?
Atrophy of thenar & hypothenar eminence.
What are the possible sites for LMN lesions?
1. Myoneural junction
2. Anterior horn
3. Ventral root
4. Spinal nerve
Atrophy of left infraspinatus and deltoid muscles would result following what event?
Protrusion of C5
A LEFT tibial nerve lesion would indicate what symptoms? What level is this lesion at?
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
A LEFT median nerve lesion would indicate what symptoms? What level is this lesion at?
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
A LEFT Spinal Accessory nerve damage would indicate what symptoms? What level is this lesion at?
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.
A LEFT Hypoglossal nerve lesion would indicate what symptoms? What is the level of lesion at?
Mid Medulla

1. Flaccid paralysis/atrophy of left tongue

2. Dysarthria (inarticulate speech)

3. Deviation of tongue towards left on protrusion
A LEFT Vagus nerve lesion would indicate what symptoms? What is the level of lesion at?
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
A LEFT facial nerve damage would indicate what symptoms? What is the level of lesion at?
Caudal Pons

1. Flaccid paralysis/atrophy of facial expression muscles

2. Bell's Palsy

3. Corneal reflex impaired
Describe the symptoms associated with Bell's Palsy.
1. Hyperacusis

2. Widening of Palpebral Fissure

3. Drooping of face

4. Corneal reflex impaired
A LEFT Trigeminal nerve lesion would indicate what symptoms? What is the level of lesion at?
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?