NPTE-PT Neuromuscular and Nervous Systems 3 — Questions and Answers
Question 1: A patient demonstrates an inability to oppose the thumb and has wasting of the thenar eminence. Which nerve is most likely compressed?
- Ulnar nerve at the wrist
- Median nerve at the wrist (Correct answer)
- Radial nerve at the elbow
- Anterior interosseous nerve
Correct answer: Median nerve at the wrist
Carpal tunnel syndrome involves median nerve compression at the wrist, causing thenar wasting and loss of thumb opposition due to opponens pollicis weakness.
Question 2: Which area of the brain is primarily responsible for the learning and coordination of skilled, sequential movements?
- Basal ganglia
- Cerebellum (Correct answer)
- Thalamus
- Prefrontal cortex
Correct answer: Cerebellum
The cerebellum coordinates the timing, sequencing, and precision of skilled voluntary movements and is critical for motor learning.
Question 3: A patient presents with a positive Romberg test. What does this finding indicate?
- Cerebellar dysfunction
- Vestibular dysfunction only
- Proprioceptive deficit with visual compensation (Correct answer)
- Upper motor neuron lesion
Correct answer: Proprioceptive deficit with visual compensation
A positive Romberg test indicates that the patient can maintain balance with eyes open (using vision) but loses balance with eyes closed, suggesting proprioceptive or dorsal column impairment.
Question 4: Which type of motor neuron disease is characterized by both upper and lower motor neuron signs occurring simultaneously?
- Multiple sclerosis
- Amyotrophic lateral sclerosis (Correct answer)
- Guillain-Barré syndrome
- Poliomyelitis
Correct answer: Amyotrophic lateral sclerosis
ALS (amyotrophic lateral sclerosis) is characterized by simultaneous degeneration of both upper motor neurons (corticospinal tract) and lower motor neurons (anterior horn cells).
Question 5: A therapist observes fasciculations and muscle atrophy in a patient's right quadriceps. These findings are most consistent with a lesion of which structure?
- Upper motor neuron
- Lower motor neuron (Correct answer)
- Corticospinal tract
- Sensory cortex
Correct answer: Lower motor neuron
Fasciculations and muscle atrophy are classic lower motor neuron signs resulting from denervation of the muscle.
Question 6: A patient with Parkinson's disease demonstrates difficulty initiating movements. This symptom is referred to as:
- Ataxia
- Akinesia (Correct answer)
- Dysmetria
- Dyskinesia
Correct answer: Akinesia
Akinesia refers to difficulty or absence of voluntary movement initiation, a hallmark motor symptom of Parkinson's disease due to dopamine depletion in the basal ganglia.
Question 7: The Tinel's sign at the medial elbow (cubital tunnel) tests for entrapment of which nerve?
- Median nerve
- Radial nerve
- Ulnar nerve (Correct answer)
- Musculocutaneous nerve
Correct answer: Ulnar nerve
Tinel's sign at the cubital tunnel (medial elbow) reproduces paresthesias in the ulnar nerve distribution when the nerve is tapped at the site of entrapment.
NPTE-PT Neuromuscular and Nervous Systems 3
A patient demonstrates an inability to oppose the thumb and has wasting of the thenar eminence.
Which nerve is most likely compressed?