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Which muscle fiber type is involved with spindles? Which is the GTO type?
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Musle types II, III, and IV are of what type?
Sensory Muscle
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Do primary sensory muscle neurons terminate ipsilaterally or contralaterally?
Ipsilaterally
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What type of muscles (where) do medial motoneurons project to?
Axial (shoulder to elbow; thigh to knee) and girdle (trunk) muscles
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What type of muscles (where) do lateral motoneurons project to?
Distal limbs (elbow and knee down) and extremities
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alpha-Motoneurons innervate what type of muscle fibers?
Extrafusal (force generating) muscle fibers
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gamma-Motoneurons innervate what type of muscle fibers?
Intrafusal (non-force generating) muscle fibers within the muscle spindle
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What are the two steps, in general, by which a muscle can increase its force of contraction?
- 1. Recruitment -- smaller motoneurons are recruited first, then larger ones
- 2. Increased frequency of action potentials
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Slow motor units are composed of small motoneurons that innervate "slow" muscle. What color are these, and are they type I or II? Are they susceptible to fatigue?
- Red
- Type I
- Fatigue Resistant
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Fast motor units are composed of large motoneurons that innervate "fast" muscle. What color are these, and are they type I or II? Are they susceptible to fatigue?
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Which spinal nerve has no dorsal root?
C1
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What is an encapsulated structure that senses muscle strength? Where are these generally located in the muscle?
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All Ia muscle fibers innervate spindles. As the spindle gets longer, due to muscle lengthening, what do the Ia fibers do?
Generate more action potentials
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Both Bag1 and Bag2 intrafusal muscle fibers respond to signal length. Which one also responds to velocity?
Bag1
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gamma-Motoneurons innervate lateral to center of Bag1 fibers. When these get excited, they generate a contraction, shortening that area of the spindle. These are located on both sides. So, as the outside of the spindle shortens due to the excitation of these gamma-motoneurons, what happens to the middle?
Lengthens
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In intrafusal motoneurons, where are Ia primary endings located? Where are II secondary endings located? What type of intrafusal muscle fibers (bag1 or bag2s, or both) do each of these innervate?
- Ia primary endings: surround the center region; both -- signal both rate of change in length and magnitude of length
- II secondary endings: are a short distance from the center region; innervated by bag2s, so cannot signal dynamic stretch (velocity)
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Gamma efferents are located away from center and lateral to secondary endings; what type of fibers do they innervate?
Bags
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beta=motoneurons innervate both extrafusal and intrafusal fibers. Which type of bag do they provide innervation for?
Bag1
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gamma-motoneurons alter the sensitivity (or gain) of the spindle by increasing or decreasing the amount of _________ on the center region of the spindle.
Stretch
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In group Ib fibers, sensory information signals muscle _________.
Tension
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GTOs respond to ___________; spindles respond to __________.
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During passive stretch, spindle (Ia) fibers will _________ (excite/inhibit). GTO (Ib) fibers will _________ (excite/inhibit).
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During contraction (with shortening), spindle (Ia) fibers will _________ (excite/inhibit). GTO (Ib) fibers will _________ (excite/inhibit).
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What type of fibers does the stretch (myotatic) reflex activate?
Ias
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What is the only monosynaptic reflex?
The Stretch Reflex
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If a stretch reflex is lost in the biceps, what nerve root is likely involved? What muscles are affected?
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If a stretch reflex is lost in the triceps, what nerve root is likely involved? What muscles are affected?
- C7
- Triceps, Wrist & Finger Extensors
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If a stretch reflex is lost in the knee (knee jerk reflex), what nerve roots are likely involved? What muscles are affected?
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If a stretch reflex is lost in the ankle (ankle jerk reflex), what nerve root is likely involved? What muscles are affected?
- S1
- Gastroc, Plantar flexors
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What is an oscillation in muscle contraction in which the muscle alternatively contracts and relaxes rapidly (3-7 contractions/s)?
Clonus
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What type of reflex is elicited by activity in Ib fibers?
Tendon Reflex
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If the arm is extended and then flexed, what happens to Ia activity in the biceps? Ib activity?
- Ia activity from the biceps will decrease due to muscle shortening
- Ib activity originating in the biceps will increase due to increased force in development on biceps
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If the arm is extended, and then flexed, what happens to Ia activity in the triceps? Ib activity?
- Ia activity originating in the triceps will increase due to muscle lengthening
- Ib activity in the triceps will decease due to it being contracted to start with
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The flexor reflex is elicited by what type of stimulus? What type of fibers are involved in this?
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What type of cell is a unique type of inhibitory interneuron -- a collateral axon of an alpha-motoneuron excites this cell type, which then inhibits the alpha-motoneuron that excited it, and may inhibit all homonymous alpha-motoneurons to the same muscle? What neurotransmitter excites this cell type?
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Which neuromuscular junction disorder is a post-synaptic disorder?
Myasthenia Gravis
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What two antibody types are seen in myasthenia gravis?
- AChR -- antibodies against the alpha subunit of the AChR
- MuSK -- antibodies against muscle specific kinase
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Most congenital myasthenic disorders are of what inheritance pattern? What is the exception?
- AR
- Slow channel syndrome -- mostly AD
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What type of antibodies are seen in Lambert-Eaton Myasthenic Syndrome?
Antibodies against pre-synaptic VGCC (voltage-gated calcium channel)
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What two enzymes are often elevated in myopathies?
Creatinine phosphokinase and Aldolase
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In what neuromuscular syndrome type is myoglobinuria seen?
Myopathies
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What is the inheritance pattern and gene affected in Duchenne MD?
X-linked; dystrophyn
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What is the most common adult form of MD?
Myotonic Dystrophy
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In what type of myopathies are polymyositis, dermatomyositis, and inclusion body myositis seen?
Inflammatory Myopathies
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In what type of myopathy are ragged red fibers seen?
Mitochondrial Myopathies
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What is the treatment for hypokalemic or hyperkalemic periodic paralysis?
Acetazolamide
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What type of peripheral neuropathy involves the lateral femoral cutaneous nerve?
Meralgial paresthetica
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What is the most common inherited neurological disorder? What is the most common inheritance pattern?
- Charcot-Marie-Tooth Disease
- AD
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In what syndrome do you see elevated CSF protein with normal cell count? What is the treatment for this?
- GBS
- IVIg or plasma exchange
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What are the treatment options for Chronic Inflammatory Demyelinating Polyradiculoneuropathy?
- Steroids
- IVIg
- Plasma Exchange
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