Define the term proximal myopathy. What actions would the patient have difficulty with? Which diseases is this associated with?

• deep tendon reflexes (DTRs) may be diminished/absent in hypokalemic paralysis.

symmetrical weakness of proximal upper and/or lower limbs

. There is a broad range of underlying causes including drugs, alcohol, thyroid disease, osteomalacia, idiopathic inflammatory myopathies (IIM), hereditary myopathies, malignancy, infections and sarcoidosis

Define the following

Upper motor neurone Lower motor neurone

The lower motor neuron is responsible for transmitting the signal from the upper motor neuron to the effector muscle to perform a movement

Upper motor neurons are first-order neurons which are responsible for carrying the electrical impulses that initiate from the cerebral cortex and modulate movement they travel to the dorsal horn of lower motor neurons and synapse with them to initiate the last leg of movement

UMN = BRAIN/CEREBRAL CORTEX. LMN = SPINAL CORD - MUSCLE INNERVATIONS

List the signs associated with an Upper motor neurone lesion and a Lower motor neurone lesion

upper motor neurone lesions are associated with over exaggerated movements of the reflex arc as their normal function is to supress over use of the reflex arc and so when they become damaged this inhibition does not work properly. clinical signs include clonus which is involuntary twitching of the limbs usually the ankle. another sign is babinskis sign, when running a finger from the top of the toes to the bottom of the feet the toes should curl inwards, if they flex this is a sign of an UMN lesion, this sign is only normal in infants. the other thing it can cause is Spasticity which is a condition in which there is an abnormal increase in muscle tone

LMN lesions - may show abnormalities such as decreased/absent reflexes, weakness, Atrophy of muscles and fasiculations. this is due to the fact that when the nerve is cut, its branches are cut off and so this results in the muscle that they once supplied no longer being inervated and so reflexes from the muscle cannot happen, atrophy (muscle wasting will occur) and fasiculations occur due to discharge from the now dormant skeletal muscle present in the space. (fasiculations are visible fast-spontaneous muscle contractions)