MICRO
CNS (1).pptx

Passive flexion of the hip and knee or passive

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Passive flexion of the hip and knee or passive extension of the knee may produce a positive Babinski sign in adults. 82
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Crossed extensor response/bilateral Babinski sign: May be encountered in cases with bilateral cerebral or spinal cord disease. Unilateral foot stimulation elicits a bilateral response in such cases. Tonic Babinski reflex: Is characterized by a slow prolonged contraction of the toe extensors. It is encountered in patients with combined frontal lobe lesions and extrapyramidal involvement. 83
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Bilateral Babinski sign is characteristic of - a) Subarachnoid hemorrhage (AIIMS May 13) b) Basal ganglia and thalamic hemorrhage c) Pontine hemorrhage d) Cerebellar hemorrhage. C > A 84
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Bulbar palsy is seen in - (PGI Dec 2000) a) Myesthania gravis b)M.N.D. c) Arsenic poisoning d) Lead poisoning e) Polio 85
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Similar to the corticospinal tract (pyramidal), the motor tract of the cranial nerve can also be divided into upper motor neurons and lower motor neurons. The motor fibres from the cortex to the brain stem nuclei are the  upper motor neurons. The cranial nerves arising from the brain stem nuclei are  the lower motor neurons. 86
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Bulbar palsy:- The dorsal elevated portion of the medulla is called the bulb of the medulla. Four cranial nerve nuclei are situated in the bulb of the medulla i.e. 9, 10, 11, 12. The lower motor neuron paralysis of these nerves is called bulbar paralysis. where as Upper motor neuron paralysis of these nerves is called pseudobulbar paralysis 87
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Clinical feature of Pseudobulbar palsy:- Unilateral supranuclear lesions usually do not cause any neurological deficit because of b/L corticobulbar input. However b/L lesions produce several clinical features (recall the features of U.M.N. lesion of pyramidal tract). Severe dysphagia . Explosive dysarthria. Pathological laughter and crying . Spastic retching. Markedly brisk reflex (exaggerated jaw jerk0) 89
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Bulbar palsy is seen in - (PGI Dec 2000) a) Myesthania gravis b)M.N.D. c) Arsenic poisoning d) Lead poisoning e) Polio A,B,E 92
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SPINAL CORD DISORDERS 93
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MOTOR TRACTS (DESCENDING TRACT) There is only one major motor tract. Corticospinal tract:- The corticospinal tract is arranged somatotopically such that the fibres controlling, the upper extremitry are located medially to the fibres controlling the lower extremity. 94
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SENSORY TRACTS (ASCENDING TRACT) :- There are two important sensory tracts 1. Dorsal column and 2. spinothalamic tract 95
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Spinothalamic tract:- Axons of the spinothalamic tract from sacral and lumbar segments of the body are pushed laterally by axons crossing the midline at successively higher levels.
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  • Winter '16
  • jean grey

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