Neuroanatomic Localization

Question 1

What are the 2 components of gait generation?

Answer 1

Motor (initiation and strength) - efferent
Sensory (coordination) - afferent

Question 2

What spinal cord segments are the UMN segments?

Answer 2

C1 - C5
T3 - L3

Question 3

Where in the brain is motor generated?

Answer 3

Cerebrum and brainstem
NOT cerebellum

Question 4

What spinal cord segments are the LMN segements?

Answer 4

C6 - T2
L4 - S3

Question 4

What is the function of UMNs?

Answer 4

Initiate voluntary movement
Maintain tone (posture)

Question 5

What is the function of LMNs?

Answer 5

Direct innervation of effector muscles

Question 6

What is the function of the efferent vs afferent tracts?

Answer 6

Efferent (brain to mm): movement generation
Afferent (mm to brain): coordination

Question 7

What happens when something goes wrong with the motor tracts?

Answer 7

Efferent
Weakness

Question 8

What happens when something goes wrong with the sensory tracts?

Answer 8

Afferent
Ataxia

Question 9

When can you see both weakness and ataxia together?

Answer 9

UMN spinal cord region

Question 10

UMN Gait Deficits

Answer 10

Spastic paresis/paralysis
Increased stride length
Normal/increased reflexes
Normal/increased muscle tone
+/- mild disuse atrophy

Question 11

LMN Gait Deficits

Answer 11

Flaccid paresis/paralysis
Decreased stride length
Decreased/absent reflexes
Decreased/flaccid muscle tone
Severe denervation atrophy

Question 12

UMN = loss of ___________

Answer 12

signal

Question 13

LMN = loss of ____________

Answer 13

power

Question 14

Characteristics of Cerebellar Ataxia

Answer 14

Hypermetria, over-flexion of joints
Intention tremor
Normal to wide-based stance

Question 15

Characteristics of Vestibular Ataxia

Answer 15

Asymmetrical, head tilt
Spontaneous nystagmus
Central = proprioceptive deficits + paralysis
Wide-based stance

Question 16

Characteristics of General Proprioceptive Ataxia

Answer 16

Caudal brainstem and spinal cord
Over-reaching, over-extension of joints
Proprioceptive deficits/paresis (+ knuckling)
Wide or narrow-based stance

Question 17

What do postural reactions tell us?

Answer 17

Not much, just that the nervous system isn’t normal
100% of the nervous system needs to be functioning normally for postural reactions to be normal

Question 18

Which type of damage causes GP ataxia?

Answer 18

UMN segments

Question 19

When are lesions contralateral? Ipsilateral?

Answer 19

Contralateral: rostral to midbrain
Ipsilateral: caudal to midbrain

Question 20

What abnormalities do we see with a forebrain lesion?

Answer 20

Unilateral weakness
Contralateral to the lesion
NO ataxia

Question 21

What abnormalities do we see with a brainstem lesion?

Answer 21

Bilateral or ipsilateral weakness
Ipsilateral = focal
Bilateral = diffuse
Vestibular and/or GP ataxia

Question 22

What abnormalities do we see with a cerebellar lesion?

Answer 22

NO weakness
Cerebellar and/or vestibular ataxia

Question 23

What signs are seen with a C1 - C5 spinal cord lesion?

Answer 23

Question 24

What signs are seen with a C6 - T2 spinal cord lesion?

Answer 24

Question 25

What signs are seen with a T3 - L3 spinal cord lesion?

Answer 25

Question 26

What signs are seen with a L4 - S3 spinal cord lesion?

Answer 26