Name the neurological disorder characterized by the loss of the ability to execute or carry out skilled movements and gestures, despite having the desire and the physical ability to perform them?

1. A

   Anhedonia

2. B

   Apraxia

3. C

   Apathy

4. D

   Amnesia

Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021

Explanation

• Apraxia is defined as the inability to perform learned, purposeful movements on command.
• This deficit occurs despite the patient having the physical strength, coordination, sensation, and comprehension needed to perform the task.
• It is fundamentally a disorder of motor planning and sequencing, not a deficit in the motor or sensory systems themselves.
• A classic example is a patient who cannot mime the action of brushing their teeth when asked, but can perform the action automatically as part of their daily routine.

Why Other Options Were Wrong

• Option A: Anhedonia is a disorder of mood and emotion, not motor planning. It refers to the inability to experience pleasure.
• Option C: Apathy is a state of indifference or lack of motivation. While a person with apathy might not perform a task, it is due to a lack of will or interest, not an inability to formulate the motor plan.
• Option D: Amnesia is a deficit in memory. It involves the inability to recall information or past events and does not directly affect the execution of learned motor skills.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Neurological deficits affecting motor planning and execution as background academic context rather than a clinical decision trigger.
• Nurses are in a key position to identify apraxia during routine care and activities of daily living (ADLs), such as dressing, eating, or personal hygiene.
• A simple bedside assessment for apraxia involves asking the patient to pantomime a common action, like 'Show me how you would comb your hair' or 'Pretend you are using a key to unlock a door'.
• Identifying apraxia is crucial for patient safety and planning care. A patient with apraxia may struggle to use a call bell, operate a bed control, or feed themselves, increasing the risk of falls and other complications. Collaboration with occupational therapy is essential.

How to Approach the Question

• First, analyze the question stem to identify the core concept. The key phrase is 'loss of the ability to execute or carry out skilled movements and gestures,' which is qualified by 'despite having the desire and the physical ability to perform them.'
• This contrast indicates the problem is not with the muscles (physical ability) or motivation (desire), but with the brain's 'know-how' to perform the action.
• Next, evaluate each option based on its medical definition.
• Anhedonia (loss of pleasure), Apathy (lack of motivation), and Amnesia (memory loss) are related to emotion, motivation, and cognition, respectively. They do not fit the description of a motor planning deficit.
• Apraxia specifically means the inability to perform a planned, skilled movement when the physical capacity is intact.
• Therefore, by matching the definition to the clinical picture described in the stem, Apraxia is the only correct choice.

Concept Tested & Keywords

• Concept Tested: Neurological deficits affecting motor planning and execution.
• Stem keywords: neurological disorder, loss of ability, skilled movements, gestures, desire, physical ability
• Lead-in keywords: Name the

Question ID

QGA38kpwB5X05iWJqy2zA7

Copy ID

Reference Book

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2927-2929

E6 Medicine Harrison 22e Part 1 p. 244-246