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SPASTICIT Y DRUGS B Y A L A I N A DA R B Y Which of the following is true of upper motor neurons? a. Pyramidal neurons constitute the indirect corticobulbo-spinal tracts b.Extrapyramidal neurons constitute the direct corticospinal tract c. Pyramidal neurons control posture and fine coordinated motion d.Extrapyramidal neurons control balance and coordination Which of the following is true? a. Pyramidal neurons are located in the lateral portion of the posterior horn of the spinal cord b.Extrapyramidal neurons are located in the lateral portion of the posterior horn of the spinal cord c. Pyramidal neurons are located in the lateral portion of the anterior horn of the spinal cord d.Extrapyramidal neurons are located in the lateral portion of the anterior horn of the spinal cord Injury to which of the following would produce weakness and increased stretch reflexes? a. Basal ganglia b.Cerebellum c. Spinal cord d.Non-primary motor cortical areas Which of the following does not receive input directly from the brain stem? a. Cerebellum b.Spinal cord c. Thalamus d.Cerebral cortex Which of the following does not provide input directly to the thalamus? a. Internal globus pallidus b.Cerebral cortex c. Brain stem d.Cerebellum Which of the following is true of spasticity? a. It is characterized by velocity dependent decreases in tonic stretch reflexes b.It includes exaggerated tendon jerks resulting from hypoexcitability of the stretch reflex c. Resistance to stretch increases with increasing speed and varies with joint angle d.It is a component of the lower motor neuron syndrome Which of the following is a positive symptom of spasticity? a. Babinski reflex b.Paresis c. Fatigability d.Fine control Mary is trying to stretch out her arm but can’t because her bicep remains tight. Which form of spasticity would this be considered? a. Spastic dystonia b.Spastic co-contraction c. Extra-segmental co-contraction d.Muscle shortening Bill has developed a spastic foot deformity. Which of the following types of spasticity likely contributed to his deformation? a. Spastic dystonia b.Spastic co-contraction c. Extra-segmental co-contraction d.Muscle shortening Which of the following is caused by immobilization and muscle overactivity? a. Spastic dystonia b.Spastic co-contraction c. Extra-segmental co-contraction d.Muscle shortening Which of the following is not one of the most disabling features in spastic patients? a. Muscle shortening b.Motor weakness c. Muscle atonia d.Spastic co-contration Which of the following tracts is not involved in spasticity? a. Laterorospinal b.Rubrospinal c. Reticulospinal d.Vestibulospinal Which of the following is not an established alteration within the reflex arc? a. Increased ratio torque b.Increased excitability of the alpha motor neuron c. Decreased extensibility d.Decreased pre-synaptic inhibition Which of the following is not a result of spasticity? a. Cardiovascular problems b.Respiratory infections c. Liver toxicity d.Osteoporosis Margret has painful spasticity resulting from a stroke and also has a history of anxiety. Which of the following would be most likely to help her? a. Tizanidine b.Baclofen c. Riluzole d.Dantrolene Sara has stopped taking the medicine for her spasms but is now experiencing seizures and hallucinations. Which medication was she most likely taking? a. Gabapentin b.Baclofen c. Cyproheptadine d.Cannabinoids Which of the following may be taken with any of the other answer options without potentiating sedation? a. Tizanidine b.Diazepam c. Gabapentin d.Baclofen Which of the following is an alpha-2 noradrenergic agonist? a. Tizanidine b.Baclofen c. Gabapentin d.Riluzole Amber is taking amlodipine for her high blood pressure and has spasticity resulting from multiple sclerosis. Which of the following would be best for her to take? a. Baclofen b.Tizanidine c. Diazepam d.Cyproheptadine Which of the following acts only postsynaptically? a. Tizanidien b.Diazepam c. Baclofen d.Riluzole Greg sustained a spinal cord injury playing football but has since recovered. However, he now has spasms as a result. Which of the following would be most appropriate for him to take? a. Baclofen b.Gabapentin c. Riluzole d.Orphenadrine Which of the following is used to treat spasms resulting from stroke, multiple sclerosis, spinal cord injury, and cerebral palsy? a. Gabapentin b.Dantrolene c. Baclofen d.Diazepam Dan is starting physical therapy. Which of the following agents could be useful in these sessions? a. Dantrolene b.Cyproheptadine c. Orphenadrine d.Botulinium toxin Which of the following is used to treat ALS by inhibiting glutamate transmission? a. Riluzole b.Orphenadrine c. Gabapentin d.Dantrolene Which of the following is used off label for spasms but exhibits few side effects? a. Cyproheptadine b.Orphenadrine c. Botulinum toxin d.Cannabinoids