Neuro Online Final Practice

Which of the following situations are triggers for Herpes Zoster? (choose all that apply) Group of answer choices

Stress

Immunosuppressants

Exposure to the virus

Presence of malignancy

Acute/Chronic illness

Stress

Immunosuppressants

Presence of malignancy

Acute/Chronic illness

A patient presents with a macular and vesicular rash that follows along the path of the facial nerve to the vestibulocochlear nerve causing hearing loss and vertigo is likely suffering from: Group of answer choices

Ramsey Hunt Syndrome type ll

Herpes simplex

HPV

CMV

EBV

Ramsey Hunt Syndrome type ll

Herpes Zoster is uncommon in patients under 50 years of age. Group of answer

choices

a. True

b. False

a. True

Cauda equina syndrome is defined by a constellation of symptoms that result

from terminal spinal nerve root compression in the lumbosacral region. It is a true medical emergency. Group of answer choices

a. True

b. False

a. True

The symptoms associated with T4 Syndrome often awaken the patient or are

present upon rising. Group of answer choices a. True

b. False

a. True

What are the two most common pathophysiological cause of cauda equina

syndrome? Group of answer choices

Space occupying lesion in the central canal

Spinal stenosis

Disc herniation

Epidural abscess

Trauma

Disc herniation

Trauma

A patient presents with a complaint of low back pain and bilateral lower extremity symptoms consisting of generalized pain and heaviness feelings which were

usually preceded by tingling in the feet. The symptoms were greater in the left leg and were intermittant. Both legs become stiff in the morning and felt tired and heavy in the afternoon and at the end of the day. Activities that aggravates his symptoms include bending forward, sitting for more than half an hour, sleeping, getting up from sitting position. Walking and shaking legs eases his symptoms once exacerbated. Sometimes massage with oil also relieved his symptoms. On observation Mr. A was found to have good standing posture but with a reduced lumbar lordosis. When he was asked to sit, he adopted a slumped position. On palpation left leg was found cold. The range of right side flexion and right rotation was normal and painless. Left rotation, left side flex

LBP

Bilateral lower extremity pain

Bilateral lower extremity weakness

Morning stiffness

Which of the following conditions needs to be considered with a patient that is suffering from T4 Syndrome: (choose all that apply) Group of answer choices

T10 Syndrome

Carpal Tunnel Syndrome

Thoracic outlet Syndrome

Ulnar Neuropathy

Carpal Tunnel Syndrome

Thoracic outlet Syndrome

In evaluating cauda equina syndrome, the imaging modality of choice to evaluate neurologic compression is: Group of answer choices

Diagnostic ultrasound

Plain films

CT

MRI

MRI

Which of the following areas of the body are commonly involved with Herpes Zoster? Group of answer choices

a. Cervical b. Lumbar c. Thoracic d. Hands e. Toes

a. Cervical b. Lumbar c. Thoracic

It is believed that zoster occurs due to the failure of the immune defense system to control the latent replication of the virus. Group of answer choices

a. True

b. False

True

All of the following are key features in a patient suffering from cauda equina

syndrome except: Group of answer choices

Bilateral leg pain

Saddle anesthesia

Bowel dysfunction

Bladder dysfunction

Normal sensorimotor changes

Normal sensorimotor changes

All of the following are symptoms associated with an acoustic neuroma except:

Group of answer choices

High frequency sensorineural hearing loss

Mild tinnitus

Aural pressure

Unsteadiness may be present

No tinnitus

No tinnitus

Lambert Eaton Myasthenis Syndrome (LEMS) is often associated with cancer.

The symptoms of LEMS may be present before the diagnosis of cancer has been established. What type of cancer is associated with this condition? Group of answer choices

a. Lung b. Bowel c. Gastric d. Pancreatic e. Bone

a. Lung

The differential diagnosis in a patient suffering from Meniere's disease should include: (choose all that apply) Group of answer choices

a. Post head trauma b. Migraine

c. Benign paroxysmal positional vertigo

Acoustic neuroma

Partial seizure

a. Post head trauma b. Migraine

c. Benign paroxysmal positional vertigo

Acoustic neuroma

Partial seizure

Which of the following NMJ conditions is ameliorates fatigue with activity. Group of answer choices

Myasthenia Gravis

Lambert Eaton

Neuromyotonia

Isaac's syndrome

Lambert Eaton

Patient's with myasthenia gravis are known to have weakness with the following muscles_________/________ resulting in symptoms of __________ and __________ of the upper eyelid. Group of answer choices

EOM's

Levator palpebra

Diplopia

Ptosis

Myopia

EOM's

Levator palpebra

Diplopia

Ptosis

Guillain-Barre Syndrome (GBS) is considered an acute onset peripheral polyneuropathy and represents the most common cause of generalized flaccid paralysis. Group of answer choices

a. True

b. False

a. True

All of the following symptoms are associated with Vestibular Meniere's Disease

except: Group of answer choices

Hearing loss

Nausea

Vomiting

Tinnitus

Aural fullness

Hearing loss

Myasthenia gravis is an autoimmune disease characterized by a post junctional

NMJ pathology with a decrease in the number of acetylcholine receptors (AChR).

Group of answer choices

a. True

b. False

a. True

Patients affected with myasthenia gravis below 40 years of age are mostly

female. Group of answer choices

True

False

True →Sex and age appear to influence the occurrence of myasthenia gravis.

Below 40 years of age, female : male ratio is about 3 : 1.

Acoustic neuroma is a usually slow growing benign tumor of the vestibulo-cochlear nerve sheath. Group of answer choices

a. True

b. False

a. True

The association between influenza vaccine and GBS emerged in the United

States in 1976 when 32% of Ohio's population was vaccinated against influenza A, and neurologists noted that GBS was more prevalent in people who received the vaccine. In a rigorous study, which assessed the relationship between influenza A vaccination and the development of GBS in adults, it concluded that there is one case of the disease for every 100,000 doses administered.

a. True

b. False

a. True

Which tumor, from the list below, is the most common infratentorial tumor,

accounting for 80% of cerebellopontine angle tumors? Group of answer choices

Vestibular Schwannoma

Cholesteatoma

Glioblastoma

Neuroblastoma

Vestibular Schwannoma

What are the three causes of ischemic stroke? Group of answer choices

a. Embolic/Thrombotic/MI b. Embolic/Thrombotic/Lacunar c. MI/Lacunar/Embolic d. Embolic/Thrombotic/Watershed

d. Embolic/Thrombotic/Watershed

A 55 y/o male presents to the office with a 2 hour history of altered mental status. He was unresponsive on the sofa while watching Lord of the Rings. On physical exam, you note a 4/5 motor strength of the right lower extremity, and 0/5 motor strength of the left lower extremity and 5/5 motor strength in both upper extremities. He has intact sensation to all facial muscles and is able to puff his cheeks, swallow and smile. His gag reflex is intact and there is no uvula or tongue deviation. Which of the following is the type of stroke experienced by this patient? Group of answer choices

RightACA

LeftACA

Right MCA

LeftMCA

RightLateralMedullaryStroke

RightACA

If a Stroke is suspected, the pneumonic FAST relates: Group of answer choices

Facedrooping,Armgood,speechdifficulty,timetocall911

Facedrooping,armweakness,speechdifficulty,timetocall911

Face drooping, Alignment good, Subluxations, Time

Facedrooping,Atlas,Subluxation,Tremors

Facedrooping,armweakness,speechdifficulty,timetocall911

Patients that suffer an acute stroke of the ACA with motor deficits characteristically involves: Group of answer choices

Involvesthelowerextremitycontralaterallytotheinfarctsite

Involvesthelowerextremityipsilateraltotheinfarctside.

Involves the upper extremity contralateral to the infarct side.

Involvestheupperextremityipsilateraltotheinfarctsite.

Involvesthelowerextremitycontralaterallytotheinfarctsite

Atherosclerosis is a primary cause of ischemic stroke. Group of answer choices a. True

b. False

True

Motor disorders related to the ACA infarction include all of the following except:

Group of answer choices

Hypometria

Bradykinesia

Motor neglect

Hypermetria

Lossofreciprocalcoordination

Hypermetria

The GOLD standard for determining a hemorrhagic vs. ischemic stroke within the first 3 hours of the patient exhibiting symptoms is: Group of answer choices

a. ContrastCT b. MRI c. Non Contrast CT d. MRIwithContrast

Non Contrast CT

Posterior cerebral artery (PCA) occlusions affect vision and thought. Group of answer choices

a. True

b. False

True

Brain tissue dies when cerebral blood flow(CBF)

True

Although the definitive distinction of ischemic stroke and hemorrhagic stroke

require neuroimaging: a meta-analysis found that the following clinical findings increase the probability of hemorrhagic stroke except: Group of answer choices

a. Coma b. Seizures c. Neck stiffness d. Diastolicbloodpressure

d. Diastolicbloodpressure

All of the following are considered known risk factors of cardiovascular disease frequently found in stroke patients except: Group of answer choices

a. Hypotension b. Hypercholesterolemia c. Diabetes d. Smoking

a. Hypotension

Heubner's artery and medial striate artery infarcts are associated with: Group of answer choices

Ipsilateralfaceandarmweakness

Involvesarmweakness

Contralateral face and arm weakness

Contralaterallegweakness

Contralateral face and arm weakness

The condition, cervical myelopathy, begins with the deterioration of the IVD, which results in a reactive hyperostosis of the vertebra bodies. Group of answer choices

a. True

b. False

a. True

Lateral cervical myelopathy is characterized by: (choose all that apply) Group

of answer choices

a. Radicularpain b. Unilateralneurologicdeficits c. Ischemia d. Painlessweakness

a. Radicularpain b. Unilateralneurologicdeficits

A 38 y/o male was examined by a neurologist because of a complaint of severe burning pain over the left shoulder and upper part of the left arm that had started 3 weeks previously. The pain was accentuated by moving his neck and by coughing. After a full clinical examination followed by an MRI, a diagnosis of prolapse of the intervertebral disc between C5 and C6 vertebrae was made. There was no evidence of muscle weakness.

40.The following anatomical facts concerning this case are correct except: Group of answer choices

a. TheposteriorrootoftheC6nervewascompressedbytheprolapseddisc. b. WhenanIVDprolapses,thenucleuspulposusmovesanteriorly.

c. The common site for a disc to press on a nerve root is in the IVF.

Inthecervicalregionthespinalnervesemergeabovethevertebraeofthe

same number.

Inthecervicalregionthereareeightcervicalnervesbutonlyseven

cervical vertebrae.

b. WhenanIVDprolapses,thenucleuspulposusmovesanteriorly.

The vigilant doctor should evaluate the patient suspected of cervical

spondylophytic myelopathy for long tract signs including abnormal plantar response and the presence of Hoffman's reflex in the hands. Group of answer choices

a. True

b. False

a. True

All of the following are types of cervical myelopathy except: Group of answer

choices

LateralCervicalMyelopathy

MedialCervicalMyelopathy

Combination of both lateral and medial

VascularCervicalMyelopathy

AnteriorPosteriorCervicalMyelopathy

AnteriorPosteriorCervicalMyelopathy

Medial cervical myelopathy, is characterized by long tract symptoms and frequently spares the upper limbs as these nerve fibers are usually located further from the midline. Group of answer choices

a. True

b. False

a. True

Acute Cauda Equina Syndrome is a Medical Emergency that requires timely

diagnosis and treatment to reverse or stop the worsening of neurological damage to the spinal nerve roots (the nerves in the low back). Group of answer choices

a. True

b. False

a. True

Compression of an L4/L5 disc usually produces a ______ radiculopathy. Group

of answer choices

a. L4 b. L5 c. S1 d. L3

L5

Which of the following orthopedic test(s) are compression evaluations for the cervical spine? Group of answer choices

a. Valsalva

SotoHall

Maximum cervical

Jackson's

ModifiedSpurling

Maximum cervical

Jackson's

ModifiedSpurling

The patient is a 35 y/o female who presents with lower back pain and left leg pain into the top of the foot and big toe which began suddenly when she bent over to pick up a heavy box. She reports, the pain is worse with sitting which impacts her ability to work a full shift as a receptionist. The patient also reports pain is slightly better when she is standing but her leg feels the best when she is walking. However, she reports her leg sometimes feels weak like it might "give out" which is making her hesitant to walk and exercise. She would like to return to working full time without pain.

Posture: Flexed and antalgic to the left. ROM L-spine: Decreased forward bending, backward bending and left lateral bending to 50% of normal. ( Her pain increased when bending forward and left lateral bending) Orhtopedic: Positive SLR on the left at 40 degrees. Neurologic: DTR's diminished left L5 reflex: Muscle weakness with dors

Antalgicposture

ROMdecreasedinthelumbarspine

Positive L SLR

Diminishedneurologicreflexandmuscleweakness

The vast majority of radiculopathy cases resolve with conservative management. In cases where symptoms fail to resolve, which of the following modalities will aid in making a diagnosis? (choose all that apply) Group of answer choices

a. MRI b. CT c. EMG d. NCV(NerveConduction) e. Plainfilmradiography

a. MRI b. CT c. EMG d. NCV(NerveConduction)

A 31-year-old male recreation center worker presented complaining of left sided low back, gluteal and leg pain that traveled down to his posterior calf for the

previous 3-4 months after playing sports at his workplace. He rated the pain as a 3/10 on the visual analogue scale (VAS) and 7-8/10 at its worst (where 0 was no pain and 10 was the worst pain ever experienced). He recalled that when the pain started a few months prior that it had left him "bedridden", but that his mobility had improved since. He stated that the low back pain "came and went" and was constantly "stiff". He identified the left sided leg pain as constantly "dull" and occasionally "sharp". The aggravating factors included prolonged sitting at work (after 20-30 minutes) and slouching. The relieving factors included stretching, walking and getting up from sitting. He reported taking no medications or supplements. He was a non-smoker, who walked regu

Left sided postero-lateral disc herniation with radiculopathy of the left

L5/S1 nerve root

The neurological examination of a patient with lumbosacral pain radiating into the leg may have hyper or hypo-esthesia/algesia in the dermatome of the affected nerve root. Group of answer choices

a. True

b. False

a. True

In evaluating low back pain patients, the clinician needs to be aware of signs of

cauda equina syndrome. What are the signs of cauda equina syndrome? (choose all that apply) Group of answer choices

Saddleparesthesia

Sexualdysfunction

Back & leg pain/weakness

Bowel/bladderdysfunction

Neurologicdeficits

Saddleparesthesia

Sexualdysfunction

Back & leg pain/weakness

Bowel/bladderdysfunction

Neurologicdeficits

The most common causes of lumbar radiculopathies are: (choose all that apply) Group of answer choices

a. HNP b. Lateralrecessstenosis c. IVF stenosis d. Trauma e. Tumor

a. HNP b. Lateralrecessstenosis c. IVF stenosis

All of the following are considered "Red Flags" in evaluating a patient with a cervical or lumbar radiculopathy except: Group of answer choices

Thoracicpain

Fever/unexplainedweightloss

Bowel/Bladder dysfunction

Gaitataxia

Nosignificantmedicalcomorbidities

Nosignificantmedicalcomorbidities

Patients with a lumbosacral radiculopathy need to be screened for red flags. What are the red flags? (choose all that apply) Group of answer choices

Weightloss

Fever

Saddle paresthesia

Priorhistoryofcancer

Goodappetite

Weightloss

Fever

Saddle paresthesia

Priorhistoryofcancer

The patient is a 35 y/o female who presents with lower back pain and left leg pain into the top of the foot and big toe which began suddenly when she bent over to pick up a heavy box. She reports, the pain is worse with sitting which impacts

her ability to work a full shift as a receptionist. The patient also reports pain is slightly better when she is standing but her leg feels the best when she is walking. However, she reports her leg sometimes feels weak like it might "give out" which is making her hesitant to walk and exercise. She would like to return to working full time without pain.

Posture: Flexed and antalgic to the left. ROM L-spine: Decreased forward bending, backward bending and left lateral bending to 50% of normal. ( Her pain increased when bending forward and left lateral bending) Orhtopedic: Positive SLR on the left at 40 degrees. Neurologic: DTR's diminished left L5 reflex: Muscle weakness with dors

Lowbackpain

Leftlegpaintothetopoftheleftfootandbigtoe

Painwithsitting

The criteria for making a diagnosis of an HNP, all of the following symptoms and test(s) need to be applied to the patient. What are the criteria? (choose all that apply) Group of answer choices

LegpainisthedominantsymptomwhencomparedtoLBP

Paresthesiaislocalizedtoadermatome

Positive SLR (50%decreased)/ positive WLR

Positivebowstring

Motorweakness/alteredsensation

LegpainisthedominantsymptomwhencomparedtoLBP

Paresthesiaislocalizedtoadermatome

Positive SLR (50%decreased)/ positive WLR

Positivebowstring

Motorweakness/alteredsensation

The location of paresthesia is often a more accurate representation of the spinal

nerve involved. Group of answer choices a. True

b. False

a. True

A 31-year-old male recreation center worker presented complaining of left sided

low back, gluteal and leg pain that traveled down to his posterior calf for the previous 3-4 months after playing sports at his workplace. He rated the pain as a 3/10 on the visual analogue scale (VAS) and 7-8/10 at its worst (where 0 was no pain and 10 was the worst pain ever experienced). He recalled that when the pain started a few months prior that it had left him "bedridden", but that his mobility had improved since. He stated that the low back pain "came and went" and was constantly "stiff". He identified the left sided leg pain as constantly "dull"

and occasionally "sharp". The aggravating factors included prolonged sitting at work (after 20-30 minutes) and slouching. The relieving factors included stretching, walking and getting up from sitting. He reported taking no medications or supplements. He was a non-smoker, who walked regu

Leftsidedlowbackpain(chronic)

Painwithsitting/slouching

The differential diagnosis for lumbosacral radiculopathy should include (but is not limited to) the following: Group of answer choices

Degenerativeconditionsofthespine

Trauma

Space occupying lesion (tumor)

HNP

Degenerativeconditionsofthespine

Trauma

Space occupying lesion (tumor)

HNP

Neuropathy is a general term meaning nerve disorder. Group of answer choices a. True

b. False

a. True

The neurological examination of a patient with lumbosacral pain radiating into the

leg may have decreased DTR's and muscle weakness corresponding to the involved nerve roots. Group of answer choices

a. True

b. False

a. True

The patient is a 35 y/o female who presents with lower back pain and left leg pain

into the top of the foot and big toe which began suddenly when she bent over to pick up a heavy box. She reports, the pain is worse with sitting which impacts her ability to work a full shift as a receptionist. The patient also reports pain is slightly better when she is standing but her leg feels the best when she is walking. However, she reports her leg sometimes feels weak like it might "give out" which is making her hesitant to walk and exercise. She would like to return to working full time without pain.

Posture: Flexed and antalgic to the left. ROM L-spine: Decreased forward bending, backward bending and left lateral bending to 50% of normal. ( Her pain increased when bending forward and left lateral bending) Orhtopedic: Positive SLR on the left at 40 degrees. Neurologic: DTR's diminished left L5 reflex: Muscle weakness with dors

L5HNPwithradiculopathy

All back pain patients need to be screened for cauda equina syndrome. Group of answer choices

a. True

b. False

a. True

All of the following are causes of meralgia paresthetica except: Group of answer

choices

Spasmsofthepiriformis

Obesity

Strong gluteals

Weakgluteals

Sittingonawallet

Strong gluteals

What is the second most common Peripheral Nerve Entrapment of the upper extremity? Group of answer choices

Carpaltunnelsyndrome

Pronatorteressyndrome

Guyon canal syndrome

Tarsaltunnelsyndrome

Cubitaltunnelsyndrome

Cubitaltunnelsyndrome

The ulnar n. tunnel divides into three zones. Which of the following ulnar n. zones has a lesion that demonstrates mixed sensory and motor loss. Group of answer choices

Zone1

Zone2

Zone 3

Noanswertextprovided.

Zone1

In patient's suffering from ulnar n. entrapment at Guyon's canal may have exacerbations with riding a bike or manual labor that repetitively compress the ulnar side of the wrist. Group of answer choices

a. True

b. False

a. True

What are the two common sites for entrapment of the ulnar nerve? Group of

answer choices

Cubitaltunnel

Ulnartunnel

Pronator teres

Spiralgroove

Cubitaltunnel

Ulnartunnel

The clinical features of Pronator Teres Syndrome include: (choose all that apply) Group of answer choices

Acheintheforearm

Handclumsiness

Numbness in median n distribution

Nightpain

+Phalen's/Tinel's

Acheintheforearm

Handclumsiness

Numbness in median n distribution

Saturday night palsy is entrapment of the radial n. in the spiral groove of the humerus. Group of answer choices

a. True b. False

a. True

In evaluating Cubital tunnel vs. Guyon tunnel; Cubital tunnel notes sensory complaints ventral and dorsal with motor extrinsic hand muscle weakness and Guyon tunnel notes sensory complaints ventral only with motor intrinsic hand muscle weakness. Group of answer choices

a. True

b. False

a. True

Median nerve compression or entrapment neuropathies include: Supinator

Syndrome(choose all that apply) Group of answer choices

Pronatorsyndrome

Supinatorsyndrome

Anterior interosseous syndrome

Carpaltunnelsyndrome

Guyoncanalsyndrome

Pronatorsyndrome

Anterior interosseous syndrome

Carpaltunnelsyndrome

Which of the following conditions are related to entrapment neuropathies of the

Radial n.? (choose all that apply) Group of answer choices

Posteriorinterosseousnervesyndrome

Radialtunnelsyndrome

Whartenberg's syndrome

Guyoncanalsyndrome

Posteriorinterosseousnervesyndrome

Radialtunnelsyndrome

Whartenberg's syndrome

Which of the following are complications that may arise in a patient suffering

with herpes zoster? (choose all that apply) Group of answer choices a. Bacterialinfection b. Post-herpeticneuralgia c. Scarring

d. Nervepalsy

e. Encephalitis

a. Bacterialinfection b. Post-herpeticneuralgia c. Scarring

d. Nervepalsy

e. Encephalitis

The symptoms associated with T4 Syndrome often awaken the patient or are

present upon rising. Group of answer choices a. True

b. False

a. True

A patient presents with a macular and vesicular rash that follows along the path

of the facial nerve to the vestibulocochlear nerve causing hearing loss and vertigo is likely suffering from:Group of answer choices

a. RamseyHuntSyndrometypell b. Herpessimplex c. HPV d. CMV

a. RamseyHuntSyndrometypell

Herpes Zoster is uncommon in patients under 50 years of age. Group of answer

choices

a. True

b. False

a. True

It is believed that zoster occurs due to the failure of the immune defense system

to control the latent replication of the virus. Group of answer choices a. True

b. False

a. True

Cauda equina syndrome is defined by a constellation of symptoms that result

from terminal spinal nerve root compression in the lumbosacral region. It is a true medical emergency. Group of answer choices

a. True

b. False

a. True

A patient presents with a complaint of low back pain and bilateral lower extremity

symptoms consisting of generalized pain and heaviness feelings which were usually preceded by tingling in the feet. The symptoms were greater in the left leg and were intermittant. Both legs become stiff in the morning and felt tired and heavy in the afternoon and at the end of the day. Activities that aggravates his symptoms include bending forward, sitting for more than half an hour, sleeping, getting up from sitting position. Walking and shaking legs eases his symptoms once exacerbated. Sometimes massage with oil also relieved his symptoms. On observation Mr. A was found to have good standing posture but with a reduced lumbar lordosis. When he was asked to sit, he adopted a slumped position. On palpation left leg was found cold. The range of right side flexion and right rotation was normal and painless. Left rotation, left side flex

LBP

Bilaterallowerextremitypain

Bilateral lower extremity weakness

Morningstiffness

A patient presents with a complaint of low back pain and bilateral lower extremity symptoms consisting of generalized pain and heaviness feelings which were usually preceded by tingling in the feet. The symptoms were greater in the left leg and were intermittant. Both legs become stiff in the morning and felt tired and heavy in the afternoon and at the end of the day. Activities that aggravates his symptoms include bending forward, sitting for more than half an hour, sleeping, getting up from sitting position. Walking and shaking legs eases his symptoms once exacerbated. Sometimes massage with oil also relieved his symptoms. On observation Mr. A was found to have good standing posture but with a reduced lumbar lordosis. When he was asked to sit, he adopted a slumped position. On palpation left leg was found cold. The range of right side flexion and right rotation was normal and painless. Left rotation, left side flex

a. LowerCrossSyndrome b. T10Syndrome

A patient presents with upper to mid thoracic discomfort and stiffness, associated with pain, tingling and numbness of one or both upper extremities, headache and a glove-like paresthesia in the hands. This patient is likely suffering from: Group of answer choices

a. Abdominalmigraine b. Migraineheadache c. T4 Syndrome d. T10Syndrome

c. T4 Syndrome

All of the following are key features in a patient suffering from cauda equina syndrome except: Group of answer choices

Bilaterallegpain

Saddleanesthesia

Bowel dysfunction

Bladderdysfunction

Normalsensorimotorchanges

Normalsensorimotorchanges