Physiology & Rehabilitation MCQs

The artery of Adamkiewicz supplies the anterior two-thirds of the spinal cord. Infarction causes anterior cord syndrome, preserving the dorsally located proprioception and vibration pathways.

Brown-Sequard syndrome presents with ipsilateral loss of motor function and proprioception, and contralateral loss of pain and temperature. This occurs because the spinothalamic tract crosses near the cord entry level.

Anterior cord syndrome is due to injury of the anterior elements of the spinal cord, which is usually due to a space-occupying lesion anterior to the cord such as vertebral body fracture fragments, a herniated disk, or a hematoma. The clinical presentation consists of: Complete motor paralysis (loss of anterior corticospinal tract) Loss of pain/temperature sensation (loss of lateral and anterior spinothalamic tracts) Preservation of vibration sensation/proprioception and light touch sensation (preservation of dorsal columns) In less severe cases, some motor function is preserved through the lateral corticospinal pathways. Prognosis is generally poor and in patients with absence of sacral sensation (pin prick/temperature) after 24 hours following injury, recovery is seen in 10% of patients.

Brown-Séquard syndrome results from spinal cord hemisection. It classically presents with ipsilateral loss of motor function, proprioception, and vibratory sense (corticospinal and dorsal columns), and contralateral loss of pain and temperature sensation (spinothalamic tract).

Anterior cord syndrome is characterized by loss of motor function, pain, and temperature sensation below the injury level due to damage to the anterior two-thirds of the spinal cord. Proprioception and vibration remain intact as the dorsal columns are spared.

Brown-Sequard syndrome causes ipsilateral loss of motor function (corticospinal tract) and proprioception/vibration (dorsal columns), and contralateral loss of pain and temperature sensation (spinothalamic tract) which crosses 1-2 levels above the entry site.

Anterior cord syndrome typically results from flexion injuries or anterior spinal artery compromise. It causes motor, pain, and temperature loss below the lesion, with preserved dorsal column function (proprioception and vibration).

Brown-Sequard syndrome (hemisection of the cord) causes ipsilateral loss of motor function and proprioception (corticospinal and dorsal columns) and contralateral loss of pain and temperature sensation (spinothalamic tract).

Anterior cord syndrome spares the dorsal columns, which are supplied independently by the posterior spinal arteries. Therefore, proprioception, vibratory sense, and fine touch remain intact while motor, pain, and temperature functions are lost.

Brown-Sequard syndrome results from a spinal cord hemisection. Patients exhibit ipsilateral loss of motor function and proprioception, combined with a contralateral loss of pain and temperature sensation.

Brown-Sequard syndrome involves hemisection of the spinal cord. It presents with ipsilateral loss of motor function and proprioception (corticospinal tract and dorsal columns cross in the medulla) and contralateral loss of pain/temperature (spinothalamic tract crosses near the entry level).

Anterior spinal artery syndrome causes bilateral loss of motor function, pain, and temperature sensation. The dorsal columns, which mediate proprioception and vibratory sense, are preserved as they are supplied by the posterior spinal arteries.

Brown-Sequard syndrome (hemicord syndrome) results in ipsilateral loss of motor function (corticospinal tract) and proprioception/vibration (dorsal columns). It also causes contralateral loss of pain and temperature sensation (spinothalamic tract).

Brown-Sequard syndrome involves hemicord compression. It presents with ipsilateral loss of motor function and proprioception (right side), and contralateral loss of pain and temperature sensation (left side) due to the crossover of the spinothalamic tracts.

Brown-Sequard syndrome (cord hemisection) causes ipsilateral loss of motor function and proprioception (corticospinal and dorsal columns cross high), and contralateral loss of pain and temperature (spinothalamic tract crosses early).

Brown-Sequard syndrome involves hemisection of the spinal cord. It causes ipsilateral loss of motor function and proprioception (due to damage to the corticospinal tract and dorsal columns) and contralateral loss of pain and temperature (spinothalamic tract).

Anterior cord syndrome involves damage to the anterior two-thirds of the spinal cord, affecting the corticospinal (motor) and spinothalamic (pain/temperature) tracts. The dorsal columns (proprioception/vibration) are spared, but this syndrome has a poor prognosis for functional recovery.

This describes Brown-Séquard syndrome (spinal cord hemisection). It results in ipsilateral loss of motor function and proprioception (corticospinal and dorsal columns) and contralateral loss of pain and temperature sensation (spinothalamic tract).

A closed kinetic chain exercise is one in which the ends of a limb are fixed from free movement by resistance.

Correct Answer: E- Silicosis Explanation Silicosis Silicosis is a fibrotic disease of the lungs caused by inhalation of crystalline silicon dioxide, usually in the form of quartz. Silicosis can affect anyone involved in quarrying, carving, mining, tunnelling, grinding or sand- blasting, if the dust generated contains quartz. Between 50 and 60 cases are diagnosed in the UK each year, generally in people involved in the production of slate or granite, among miners cutting through rock and in fettlers in foundries. Crystalline silica is present in the earth’s crust usually as quartz, although other forms such as crystobalite and tridymite occur occasionally. They are all extremely toxic to macrophages. Quartz seems to be most toxic when freshly fractured, suggesting that its surface properties are important in toxicity. Silicosis presents a spectrum of clinical appearances, depending on the circumstances in which it is contracted. The most severe form is acute silicosis, which can be acquired after very heavy exposure over just a few months, such as during a sand-blasting job without respiratory protection. These patients become intensely breathless and die within months. The X-ray shows appearances resembling pulmonary oedema. Less heavy exposure causes progressively less dramatic symptoms, ranging from a progressive upper lobe fibrosis with slowly increasing exertional dyspnoea over several years (accelerated silicosis) to a condition with radiographic nodular changes similar to coal-worker’s pneumoconiosis (simple nodular silicosis) that is unassociated with any symptoms or physical signs. This last type of silicosis is the most common, and is usually associated with exposure to dust containing 10–30% silica over a prolonged period. Simple nodular silicosis differs from coal-worker’s pneumoconiosis in that the lesions tend to be larger (3–5 mm) and in that it is progressive even after dust exposure ceases. Lesions increase in size and become more profuse. Moreover, extensive simple silicosis can be associated with some restriction of lung volumes. Accelerated silicosis and progressive massive fibrosis cause lung restriction and lead to cor pulmonale and cardiorespiratory failure. Asbestosis Asbestosis is incorrect. Asbestosis can develop following exposure to asbestos fibres. Typical occupations associated with possible exposure include plumbers, electricians, engineers and ship dockyard workers. Asthma Asthma is incorrect. The short history given alludes to an occupation-related cause of breathlessness. The specific mentioning of quartz particles suggests a diagnosis of silicosis. Asthma is not an occupation-related lung disease. Eosinophilic pneumonitis Eosinophilic pneumonitis is incorrect. The short history given alludes to an occupation-related cause of breathlessness. The specific mentioning of quartz particles suggests a diagnosis of silicosis. Eosinophilic pneumonitis is not an occupation-related lung disease. Sarcoidosis Sarcoidosis is incorrect. The short history given alludes to an occupation-related cause of breathlessness. The specific mentioning of quartz particles suggests a diagnosis of silicosis. Sarcoidosis is not an occupation- related lung disease.