Randolph Self Test 3

Front 1

Over a period of years, a construction worker begins to have difficulty hammering nails using his right arm and hand. When he walks, he seems to teeter to the right. A neurological exam reveals that muscle strength is 5/5 in both the upper and lower extremities, but the patient exhibits a tremor when attempting to touch his right index finger to the tip of his nose. Cranial nerve testing and the rest of neurological exam are normal. Where might a lesion be located that accounts for all the patient's symptoms?

Back 1

the vermis and corticocerebellum on the right

Front 2

What is the location in the spinal cord of the motor neuron pool controlling proximal muscles?

Back 2

medial region of the anterior/ ventral grey matter in the spinal cord

Front 3

Which of the following disorders is most likely to be seen in a lower motor neuron lesion?

Back 3

Loss of reflexes

Front 4

Your patient is a 65 yo woman with a diagnosis of Parkinson's disease in the past 5 years. Which of the following neurotransmitters is contributing to her resting tumors?

Back 4

Dopamine

Front 5

A 35 y o man traveled in the jungles of South America to explore the effects of infectious diseases in a restricted area of the Amazon. He comes back to the US and the very next day develops a fever and lack of voluntary voluntary movement in his quads. On examination, his sensation is normal, but he shows absent patella reflex and lack of voluntary knee extension. Hamstring, dorsiflexion, plantarflexion 5/5 muscle strength.
Which is most likely the diagnosis in this case?

Back 5

Poliomyelitis

Front 6

Disinhibition of motor thalamus and pedunculopontine nucleus result in ____

Back 6

involuntary jerky, chorea and rapid movements.

Front 7

You are doing an examination on a 17 yo male who was injured in a motor vehicle accident three months ago. The results of the neuro examination show the following: positive babinski sign, hyperreflexia, abnormal cutaneous reflexes. What classification would be accurate in your documentation?

Back 7

upper motor neuron lesion

Front 8

A 55 yo man experienced a very painful headache while at work. Two hours later, he fell as attempting to stand and became unconscious. Two days after the incident he is in the Neurology ICU and you observed the following: Pt is comatose and unresponsive his head is hyperextended, his upper extremities flexed and lower extremities extended. This posture is consistent with which of the following?

Back 8

Decorticate rigidity

Front 9

Match characteristic with condition:
1. sharply decreased muscle bulk (atrophy)
2. abnormal postural control
3. ataxic movement speed and efficiency
4. increase velocity dependent muscle tone

Back 9

1. lower motor neuron lesion
2. Huntington's disease
3. Cerebellum lesion
4. Upper Motor Neuron Lesion

Front 10

Which of the following mechanisms is operating in Huntington Chorea?

Back 10

the basal ganglia does not provide enough inhibition to the motor thalamus and the PPN resulting in excessive activity of the motor areas of the cerebral cortex, combined with excessive output of the PPN which decreases the activity of the medial tracts

Front 11

Match disorder with diagnosis.
1. hypokinesia
2. focal dystonia
3. hyperkinesia

Back 11

1. Parkinson's Disease
2. Torticollis
3. Huntington chorea

Front 12

Give one example of feedback and feedforward mechanism.

Back 12

1. crossed extensor reflex, or reciprocal inhibition
2. anticipated movement, change in postural muscles (cerebellum) via medial pathways