Neuro Exam 1 USAHS Questions with complete solutions Graded A+

Neuro Exam 1 USAHS Questions with complete solutions Graded A+ Apraxia inability to make a motor plan, as a result of brain damage. Ataxia lack of muscle coordination Aphasia impairment of language, usually caused by left hemisphere damage either to Broca's area (impairing speaking) or to Wernicke's area (impairing understanding). 1 olfactory Making client smell something pleasant front of brain 2 optic thalamus - test visual acuity (Snellen chart, or # of fingers) front of brain 3 Oculomotor thalamus - looking up, in and left to right midbrain 4 Trochlear midbrain - cross eyes into nose 5. Trigeminal pons - - Dull vs light sensation in: Opthalmic (forehead) Maxillary (Cheek)Mandibular (Jawline) - Have the patient open and close mouth (feel around temporomandibular joint) 6 Abducens pons- looking laterally (left and right) 7 Facial controls most facial expressions secretion of tears & saliva taste pons - Test facial symmetry - Taste on anterior 2/3 of tongue - smile - wrinkle forehead 8 Vestibulocochlear hearing and equilibrium pons (acoustic) - Whisper test - Rinne Test - Weber Test 9 Glossopharyngeal medulla - Gag reflex- Taste on posterior 1/3 of the tongue - not gagging is a sign of lesion 10 Vagus medulla - - Say "aah" - Talk to see if uvula deviates to one side 11 Spinal Accessory controls trapezius & sternocleidomastoid controls swallowing movements spinal cord - shoulder shrug against resistance medulla 12 Hypoglossal medulla - stick tongue straight out - will deviate if there is a lesion Somatosensory pathways - Posterior column pathways: Proprioception, vibration, fine touch Primary afferent sensory information is coming in from the dorsal roots then travels to the ipsilateral white matter columns and ascends all the way to dorsal column nuclei in the medulla then it will synapse onto a second sensory neuron that crosses over to the other side of the medulla and that axon will continue to ascend now on the contralateral synapse on the thalamus will then project up to the primary somatosensory cortex. Somatosensory pathways- Anterolateral pathways: Pain and Temperature Sensory information comes in through dorsal root ganglia to the spinal cord and crosses over to the other side of the spinal cord, and go up to the thalamus and then go to the primary sensory cortex thalamus (relay station). Main motor pathways - Corticospinal tract Begins mainly in the primary motor cortex (4), where neuron cell bodies project via axons down through the cerebral white matter and brain stem to reach the spinal cord. In the medulla. The majority of fibers in the tract (85%) cross over to control movement of the opposite side of the body (Pyramidal decussation) occurs at the junction between the medulla and spinal cord. Lesions occurring above the pyramidal decussation produce contralateral weakness with respect to the lesion, while lesions below the pyramidal decussation will produce ipsilateral weakness. Upper motor neurons: project from the cortex down to the spinal cord and form synapses onto lower motor neurons Lower motor neurons: Located in the anterior horns of the central gray matter of the spinal cord or in the brainstem motor nuclei. The axons project out of the CNS via the anterior spinal roots or via the cranial nerves to finally reach muscle cells in the periphery. Frontal lobe higher executive functioning, motor function, personality Brodmann's Areas Broca's Area: 44, 45 Primary Motor Cortex (precentral gyrus): 4 Broca's Area = expression of speech Deficit = expressive aphasia (unable to express self) Parietal Lobe A region of the cerebral cortex whose functions include processing information about touch. Brodmann's Area Primary Somatosensory Area (postcentral gyrus): 3, 12 Sensory Association Area (proprioception): 5, 7, 39, 40 (interprets sensory info "soft," "dull," "sharp") Deficits = Gerstman's Syndrome Apraxia (unable to plan the motor task) → motor planning Forebrain The largest and most complicated region of the brain, including the thalamus, hypothalamus, limbic system, and cerebrum. Midbrain A small part of the brain above the pons that integrates sensory information and relays it upward. The tectum, cerebal peduncles and tegmentum Hindbrain medulla, pons, cerebellum, reticular formation Germinal stage the 2-week period of prenatal development that begins at conception (Epidymal) (inner)-lines central canal and ventricles (cells create cilia) Mantle layer gray matter Marginal layer white matter Glutamate A major excitatory neurotransmitter; involved in memory Modulation of synaptic plasticity Activation of second messenger systems GABA (gamma-aminobutyric acid) a major inhibitory neurotransmitter Regulates communication between brain cells Acetylcholine A neurotransmitter that enables learning and memory and also triggers muscle contraction athetic functions Neuromodulation Norepinephrine A neurotransmitter involved in arousal, as well as in learning and mood regulation Sympathetic function Neuromodulation Dopamine A neurotransmitter associated with movement, attention and learning and the brain's pleasure and reward system. Nueromodulation Serotonin Affects mood, hunger, sleep, and arousal Mood stabilizer and neuromodulation Histamine A chemical that is responsible for the symptoms of an allergy exitatory neuromodulaton Glycine Converts glucose to energy and help create muscle tissue Inhibitory neurotransmission Peptide short chain of amino acids - proteins Neuromodulation What structures make up the diencephalon? thalamus, hypothalamus, epithalamus What structures make up gray matter? cerebral hemispheres the gray matter cortex is outside, on the inside of the brainstem and spinal cord Thalamus, Basal ganglia, Cortex, cranial nerve nuclei Limbic system Limbic system neural system located below the cerebral hemispheres; associated with emotions and drives Regulations of emotions, memory, appetitive drives, autonomic and neuroendocrine control. Neuro exams include: -hand strength, limb strength -ability to follow commands -ability to move eyes in equal and uniform fashion -deep pain stimulus response -symmetrical and coordinated movement -clear, speech. -Mental status: orientation, memory, language -Cranial nerves: vision, hearing sense, muscles of facial expression -Motor exam: palpating fasciculations, functional testing for fine finger movements -Reflexes: plantar response, deep tendon reflexes -Coordination and gait: Romberg test, gait patterns -Sensory exam: test for primary sensation, graphesthesia T1 images are good for what? Susceptibility artifact from biopsy clips or calcifications and hyperintence hemorrhagic cysts and ductal fluid The outer is gray and the inner is white T2 Images (MRI) The sequence weighting highlights differences in the T2 relaxation time of tissues. The outer is white and the inner is gray Different planes of imaging Horizantal (axial): Transverse images represent "slices" of the body Coronal: Images taken perpendicular to the sagittal plane which separate the front from the back. (frontal view) Sagittal: images taken perpendicular to the axial plane which separate the left and right sides (lateral view) Angiogram The radiographic visualization of blood vessels after the injection of radiopaque substance. To see lesions such as atherosclerotic plaques, aneurysms, arteriovenous malformations neural plasticity Ability of the brain to change their experience, both structurally and chemically It is change within the organization and number of connection among neurons Unmasking of silent synapses Synapses that have not been used or have been damaged are suddenly stimulated Neuronal injury -Interrupted axonal projections from areas injured -Denervation (loss of nerve supply) of neurons innervation by the injured neurons Principles of Neuroplasticity Use it or lose: if we don't push specific brain functions we can lose it Use it and improve it: retrain a specific function to improve it Specificity: the type of training on our brain dictates the nature of plasticity Repetition matters: sufficient repetition affects functions Intensity matters: train in an intense matter for the plastic changes Time matters: different forms of plasticity are going to occur at different times Salience matters: the training experience has to be important to induce high plasticity Age matters: plasticity occurs more readily in a younger brain Transference: the training experience can enhance the asset of other similar skills Interference: plasticity response to one experience may affect other behaviors