NEURO - UMN vs LMN Lesions

Which term is most consistent with bladder dysfunction resulting from an S4 spinal cord injury? a. flaccid b. reflexive c. absent d. asymptomatic

A Bladder dysfunction can be subcategorized into flaccid or reflexive categories. Flaccid or lower motor neuron bladders result from an injury of the spinal cord below the S2 spinal level. Reflexive or upper motor neuron bladders result from an injury above T12.

Which diagnosis is considered both an upper and lower motor neuron disease?

ALS Amyotrophic lateral sclerosis causes progressive degeneration of both upper and lower motor neurons. Multiple sclerosis is an upper motor neuron disease, whereas spinal muscular atrophy and Duchenne muscular dystrophy are lower motor neuron diseases.

an inherited UMN disease which affects nerve cells in the brain

HD

T or F: a LMN lesion affects nerves or their axons at or below the level of the brainstem

TRUE

identify two symptoms of an UMN lesion - hypertonicity - flaccidity - fasciculations - abnormal reflexes - muscle atrophy

hypertonicity abnormal reflexes

identify 2 symptoms of a LMN lesion: - hypotonicity - fasciculations - rigidity - hyperreflexia

hypotonicity fasciculations

which of the following is not characterized as an UMN disease? - muscular dystrophy - CP - hydrocephalus - MS

muscular dystrophy

Characteristics of UMN Lesion

Atrophy Hyperreflexive Hypertonic Drift + Babinski

Characteristics of LMN Lesion

Atrophy Weakness Hyporeflexive Hypotonic Fasciculations

Which of the following symptoms is commonly linked to an upper motor neuron disease? a. severe muscular atrophy b. hyperactive reflexes c. fasciculations d. hypotonic

B Upper motor neuron diseases typically display hyperactive reflexes, hypertonic tone, and mild atrophy from disuse. Examples of upper motor neuron diseases include multiple sclerosis, Huntington's chorea, and cerebral palsy.

Which of the following would be a clinical presentation of an upper motor neuron syndrome? a. paresthesia b. fasciculations c. Babinski's sign d. muscle atrophy

C Babinski's sign is indicative of an upper motor neuron lesion. This finding is often associated with damage to the corticospinal (pyramidal) tracts. The remaining options are more characteristic of a lower motor neuron lesion.

Which potential cause would be least likely to be associated with abnormal "floppy" tone in an infant? a. neuromuscular disorder b. the infant is weak c. damage to descending motor pathways d. premature birth at 28 weeks

C Damage to descending motor pathways, or upper motor neuron pathways, results in hypertonia. Abnormal "floppy" tone is more characteristic of hypotonia.

What are some examples of a UMN lesion

CP hydrocephalus ALS (both UMN and LMN) CVA birth injuries MS HD TBI Brain tumors

What is an UMN lesion

Characterized by a lesion found in descending motor tracts within the cerebral motor cortex, internal capsule, brainstem, or spinal cord Damaged tracts are in the lateral white column of the spinal cord

What is a LMN lesion

Characterized by a lesion that affects nerves or their axons at or below the level of the brainstem, usually within the "final column pathway." Ventral gray column of the spinal cord may also be affected

Which of the following is characteristic of a lower motor neuron disease? a. rigidity b. spasticity c. muscle hypertrophy d. fasciculations

D A lower motor neuron disease is characterized by a lesion that affects nerves or their axons at or below the level of the brainstem. Symptoms include flaccidity or weakness of the involved muscles, decreased tone, fasciculations, muscle atrophy, and decreased or absent reflexes.

Which deep tendon reflex grade would be most anticipated in a child diagnosed with cerebral palsy? a. 0 b. 1+ c. 2+ d. 3+

D Deep tendon reflexes elicit a muscle contraction when the muscle's tendon is stimulated. The most commonly used reflex grading system ranges from 0 = no response to 4+ = very brisk/hyperactive response. An upper motor neuron disease such as cerebral palsy would most likely result in reflex grades of 3+ or 4+.

Which pathology is considered to be a lower motor neuron disease? a. bulbar palsy b. MS c. CP d. post-polip

D Post-polio syndrome is a lower motor neuron disorder that refers to new neuromuscular symptoms that occur decades after recovery from an acute paralytic episode of polio. The primary symptom is a decline in the strength of muscles that had previously been affected by polio. Other symptoms include myalgia, joint pain, muscle atrophy, excessive fatigue with activity, and diminished endurance.

Which symptoms would be most consistent with a lesion in the ventral grey column of the spinal cord? a. hyperactive reflexes and hypertonia b. hypoactive reflexes and hypertonia c. hyperactive reflexes and hypotonia d. hypoactive reflexes and hypotonia

D The ventral grey column of the spinal cord contains cell bodies of lower motor neurons. Lesions of lower motor neurons often produce characteristic symptoms including diminished or absent reflexes and low tone.

T or F: poliomyelitis is an example of a UMN lesion

FALSE LMN

T or F: UMN diseases are caused by damaged tracts in the gray matter of the spinal cord

FALSE white matter

T or F: ALS is a disease that affects only LMNs

FASLE UMN and LMN

identify 2 conditions that are characterized as LMN diseases - birth injuries - brain tumors - Guillain-Barre syndrome - CTS - TBI

Guillain-Barre CTS

Muscle weakness, hypotonicity, and muscle fasciculations are all characteristics of:

LMN lesion A lower motor neuron disease is characterized by a lesion that affects nerves or their axons at or below the level of the brainstem. The ventral gray column of the spinal cord may also be affected. Symptoms include flaccidity or weakness of the involved muscles, decreased tone, fasciculations, muscle atrophy, and decreased or absent reflexes.

What are some examples of a LMN lesion

poliomyelitis (anterior horn cell) ALS (both UMN and LMN) Guillain-Barre Syndrome (affects peripheral nerves) Tumors involving the spinal cord trauma Progressive muscular atrophy infection Bell's palsy CTS muscular dystrophy spinal muscular atrophy (anterior horn cell)

a LMN disease that causes muscle wasting

progressive muscular atrophy

an UMN disease that effects voluntary movement of the facial muscles

pseudobulbar palsy