reviwe exam pt 2

According to the lecture by Dr. Gritsenko, the role of the stretch reflex is to help resist external perturbation in the limb as part of the motor program. This is tied to feedback gain which:

a. b. Gives the difference between sensory signal and motor response

Is "set" by the muscle spindle sensitivity

c. Adjusts for the difference between expected and actual results of sensory feedback

from m o v e m e n t

d. All o f the above

d

Feedback loops:

a. May be negative or positive force

b. Do not help sustain movement without descending control

c. Are important for movement patterns, like locomotion, but not for balance and standing

d. All of the above

d

The descending pathways from the brainstem tend to impact net effect on the alpha motor

neuron largely in t e r m s of:

a. Skilled m o v e m e n t s of the hand

b. Postural control and postural set

c. Motor learning

d. Coordination

b

The pathways in the attached drawing are:

a. Reticulospinal

b. Vestibulospinal

c. Rubrospinal

d. Tectospinal

a

The pathways identified in question 38 are:

a. All ipsilateral

b. All bilateral

c. Related to level of arousal

d. Both capable of acting without input from the cerebral cortex

c

The pathway indicated in 38A is:

a. Facilitatory to flexors

b. Facilitatory to extensors

c. Neither of the above

d. Requires a cortical connection to act

b

The pathway indicated in 38B:

a. b. C. Causes a release of postural tone in extension, as for reaching

Is facilitatory to postural extension

Requires cortical connections to act

d. A and c

d

Tectospinal pathways:

a. Are crossed

b. Largely terminate in the cervical spinal cord

c. Relate to visual control of the upper limb

d. All of the above

d

Vestibulospinal pathways exhibit the MOST control over:

a. Skilled reaching movements, as of the hand

b. Locomotor reciprocation

c. Balance, as postural sway

d. None of the above

c

Which of the following is NOT true of the rubrospinal pathway:

a. Biased towards flexor muscles

b. Is ipsilateral

c. Originates in the red nucleus

d. Ends o n alpha motor neurons

b

In a classic decerebrate lesion, there is extremely high tone in extensor muscles ("like a pillar"); this is because:

a. Lateral vestibulospinal pathway still able to influence net effect

b. Pathways from cortex and red nucleus cut off from lower motor neuron

c. Only reticulospinal pathway active influences net effect on extensors

d. All of the above

d

In a human who has a brain injury and presents to the ED, if the notes in the Glasgow Coma Scale say "postures in a decerebrate way to pain", the clinical conclusion is:

a. This is likely a sever e brain injury

b. Severity of injury unknown...could be mild

c. All four limbs have high extensor tone

d. All of the above

d

In the scenario mentioned above (question #46), you might also not be surprised if the

individual also displayed coma and loss of papillary light reflex. Anatomically, this is because of:

a. Pressure o n the brainstem

b. Loss of corticospinal input

c. Lower m o t o r n e u r o n lesion

d. None of the above

a

From the primary motor cortex (M1), movements are:

a. Programmed in detail with each specific muscle identified

b. Groups of muscles are targeted with force or position programming

C. | Muscle selection is NOT detailing force or position

d. None of the above

b

In the article by Gritsenko about descending corticospinal control, passive interactional torques:

a. Arise from muscle action at one joint causing passive rotational forces, or torques, at

other joints

b. Do not need to be taken into account during execution of goal-directed movement

because they disappear in volitional movement

c. Are definitely controlled by afferent input to the CPG

d. None of the above

a

In the article discussed above, which of the following methods were used to study the research

question:

a. TMS (Transcranial Magnetic Stimulation)

b. MEP (Motor Evoked Potentials)

c. EMG (Electromyography)

d. All of the above

d

In the article, one conclusion reached from the study is:

a. Descending motor commands in the corticospinal pathway compensate for interaction

torques

b. Interaction torques are not programmed in the descending motor command

c. Compensation for interactive torques is predictive because corticospinal excitability

occurs before the onset of movement.

d. A and c

d

After a stroke,

a. The person usually has significant deficit of contralateral face

b. There is limited facial involvement, because corticobulbar fibers are contralateral

c. There is limited facial involvement, because corticobulbar fibers are bilateral

d. None of the above

c

In normal motor control, areas active BEFORE M1 (Primary Motor cortex) include

a. Basal Ganglia

b. Cerebellum

c. Premotor and Supplementary Motor Areas

d. All of the above

d

Systemic treatment of spasticity (such as oral medication) have limited usefulness because

a. Spasticity is a complex phenomenon

b. People with spasticity have overactivation AND underactivation problems

c.There are often undesirable side effects such as drowsiness

d. All of the above

d

Which of the following statements about treatment of spastic muscles with BoTox is NOT true?

a. The effects are local and transient

b. c. d. Occupational & Physical therapy are not an important part of the treatment program

BoTox gives a chance to re-calibrate the patterns of muscle activation

BoTox is administration of botulism toxin in very diluted amounts

b

Which of the following statements about the basal ganglia is NOT true?

a. Have many direct descending inputs to lower motor neuron

b. Tend to produce bizarre disturbances of posture and movement when damaged

C. Are very important in generation of the motor program

d. Form borders to the descending fibers of the internal capsule

a

Nigrostriatal fibers are commonly damaged in:

a. CVA

b. MS

C. PD

d. Trauma

c

Which movement disorder is NOT commonly associated with striatal damage?

a. Ataxia

b. Athetosis

c. Chorea

d. Dystonia

a

The motor loop of basal ganglia circuitry is:

a. Associated with scaling of movement, maintenance of patterns such as handwriting

b. Directly associated with brainstem reticular formation

C. Between sensory-motor cortex, putamen, GP, VA of thalamus and cortex

d. A and c

d

When someone shows signs and symptoms of Parkinson's disease, you might want to treat them with:

a. Large scale (aka BIG) movements

b. Small controlled practice of discrete movements

c. Lots of rest and energy conservation

d. Not enough information to answer the question

a

Individuals who have cerebellar lesions show all of the following EXCEPT:

a. Ataxia

b. Dysdiadochokinesia

c. Babinski reflex

d. Dysmetria

e. Hypotonia

c

Which of the following fibers travel over the middle cerebellar peduncle?

a. Fibers from the pons, driven by corticopontine connections

b. The important vestibulocerebellar connections

c. Cerebellar efferents to lower m o t o r neuron

d. All of the above

a

The vestibular system and cerebellum are inter-connected by:

a. Abundant fiber input via the juxtarestiform body

b. Clinical signs and symptoms which overlap

c. Anatomic proximity in the posterior fossa/fourth ventricle region

d. All o f the above

d

Cerebellar circuitry is characterized by all of the following EXCEPT:

a. Capacity for "on-off" switching

b. Ability to compare actual and expected sensory consequences

c. Purkinje cells which facilitate the deep cerebellar nuclei

d. Inter-neurons which are inhibitory and can serve as "off" switches

c

The cerebellum plays an important role in:

a. Motor learning

b. Smooth targeting movements

c. B a l a n c e

d. All of the above

a or b