Question 1

A patient demonstrates considerable velocity-dependent increase in muscle tone (spasticity) of the knee extensors,and in fact passive movement into knee flexion is "difficult".Which of the following grades of the Modified Ashworth Scale would best fit this patient?

A)1
B)2
C)3
D)4

C

Accepted Answer

Grade 3 on the Modified Ashworth Scale indicates "considerable increase in muscle tone, passive movement difficult," which matches the description of the patient's condition.

Question 2

Which of the following muscle groups GENERALLY would be most likely affected with paresis following cerebrovascular accident (CVA)?&#10;A)Scapular retractors&#10;B)Hip flexors&#10;C)Trunk rotators&#10;D)Finger extensors

Accepted Answer

Finger extensors are often affected in a cerebrovascular accident (CVA) due to their location in the upper extremities, which are commonly impacted by stroke-related weakness or paresis.

Question 3

A patient displays great toe extension with or without splaying of toes following noxious stimulation of the dorsolateral aspect of the foot (inferior to the malleolus).This presentation is associated with which of the following signs?

A)Babinski
B)Chaddock
C)Oppenheim
D)Clasped-knife

B

Accepted Answer

The described response is indicative of the Chaddock sign, which involves great toe extension following stimulation of the dorsolateral aspect of the foot.

Question 4

A patient presents to physical therapy with a tremor,during postural activities,that diminishes when the limb is supported proximally.Which of the following tests could be most helpful for assessing whether the tremor is related to cerebellar impairment?

A)Finger-to-nose test
B)Scapula locator method test
C)Electromyography
D)Fatigue Severity Scale

Accepted Answer

The finger-to-nose test is a common neurological examination used to assess coordination and possible cerebellar dysfunction. It involves the patient touching their nose with their finger, then reaching out to touch the examiner's finger, and repeating. This test can reveal intention tremor, a hallmark of cerebellar impairment, which may become more apparent during targeted movements.

Question 5

Foot-tapping,hand-flapping &#34;pancake&#34; (rapid alternation between pronation and supination),repetitive hand-patting,or rapid fist open-close alternation each test for&#8230;&#10;A)Intention tremor&#10;B)Dysmetria&#10;C)Dysdiadochokinesia&#10;D)Dyssynergia

Accepted Answer

Dysdiadochokinesia is the inability to perform rapid, alternating movements due to cerebellar dysfunction. The tests mentioned, such as foot-tapping, hand-flapping, and rapid fist open-close alternation, are used to assess this condition.

Question 6

Lesions of the extrapyramidal system commonly are associated with which of the following manifestations?&#10;A)Preserved automatic movements&#10;B)Contralateral paresis&#10;C)Dystonia&#10;D)Flaccidity

Accepted Answer

Lesions of the extrapyramidal system often result in movement disorders such as dystonia, which is characterized by involuntary muscle contractions that cause repetitive or twisting movements.

Question 7

Which of the following medications can produce side effects that mimic extrapyramidal symptoms?&#10;A)Baclofen&#10;B)Diuretics&#10;C)Antipsychotics&#10;D)Tricyclics

Accepted Answer

Antipsychotics can produce side effects that mimic extrapyramidal symptoms, such as tremors, rigidity, bradykinesia, and dystonia, due to their dopamine-blocking effects in the brain.

Question 8

Which of the following motor deficits are associated with a cerebrovascular accident (CVA) related to the anterior cerebral artery?&#10;A)Contralateral ankle dorsiflexors&#10;B)Ipsilateral knee extensors&#10;C)Contralateral muscles of mastication&#10;D)Ipsilateral shoulder flexors

Accepted Answer

The anterior cerebral artery supplies blood to the medial portion of the frontal and parietal lobes, which includes the primary motor cortex responsible for controlling lower limb movement. A cerebrovascular accident (CVA) affecting this artery can lead to motor deficits in the contralateral (opposite side) lower limb, particularly affecting the ability to dorsiflex the ankle. Choices B, C, and D involve muscles that are not primarily supplied by the anterior cerebral artery or do not correspond with the typical pattern of deficits seen in an anterior cerebral artery stroke.

Question 9

Which of the following is associated with ataxia observed during intentional upper extremity movement?&#10;A)Resting tremor&#10;B)Intentional movement decomposition&#10;C)Myotomal weakness&#10;D)Astasia

Accepted Answer

Intentional movement decomposition is associated with ataxia observed during intentional upper extremity movement, as it refers to the breakdown of smooth and coordinated movements into their component parts, a hallmark of cerebellar ataxia.

Question 10

Which of the following muscle groups would MOST likely be flaccid or have a manual muscle test (MMT) grade &#8804;3/5 with a spinal cord lesion at L4?&#10;A)Ankle dorsiflexors&#10;B)Hip flexors&#10;C)Knee extensors&#10;D)Great toe extensors

Accepted Answer

A spinal cord lesion at L4 would most likely affect the great toe extensors, as these are primarily innervated by the L5 nerve root. The other muscle groups listed are primarily innervated by L4 or higher, so they would be less likely to be flaccid or have an MMT grade ≤3/5.

Question 11

A patient 3 months post-cerebrovascular accident is now able to release their grasp.Which of the following assessments specifically address this function?&#10;A)Fugl-Meyer Assessment&#10;B)Motricity Index&#10;C)Modified Ashworth Scale&#10;D)Modified Tardieu Scale

Accepted Answer

The answer of A patient 3 months post-cerebrovascular accident is...

Deck 6: Examination and Evaluation of Neuromotor Systems