Exam (elaborations)
NU 673 FINAL EXAM
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Exam of 40 pages for the course NU 673 at NU 673 (NU 673 FINAL EXAM)
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NU 673 FINAL EXAM WITH ANSWERSThis consists of aggregations of neuro- nal cell bodies. It rims the surfaces of the
cerebral hemispheres, forming the cerebral cortex
A. Gray matter
B. White matter - ANSWER A. Gray matter
- Deep in the brain lie additional clusters of gray matter (Fig. 17-2). These include the
basal ganglia, which affect movement, and the thalamus and the hypothala- mus
structures in the diencephalon. The thalamus processes sensory impulses and
relays them to the cerebral cortex. The hypothalamus maintains homeostasis
(Bickley)
- and regulates temperature, heart rate, and blood pressure. The hypothalamus
affects the endocrine system and governs emotional behaviors such as anger and
sexual drive. Hormones secreted in the hypothalamus act directly on the pitu- itary
gland. (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th
Edition. Wolters Kluwer Health, 20160620. VitalBook file.
This consists of neuronal axons that are coated with myelin. The myelin sheaths,
which create the white color, allow nerve impulses to travel more rapidly.
A. Gray matter
B. White matter - ANSWER B. White matter
- The internal capsule is a white-matter structure where myelinated fibers converge
from all parts of the cerebral cortex and descend into the brainstem. The brainstem,
which connects the upper part of the brain with the spinal cord, has three sec- tions:
the midbrain, the pons, and the medulla. (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th
Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Consciousness relies on the interaction between intact cerebral hemispheres and a
structure in the diencephalon and upper brainstem
A. Reticular activating system
B. Cerebellum - ANSWER A. Reticular activating system
- Consciousness relies on the interaction between intact cerebral hemispheres and a
structure in the diencephalon and upper brainstem, the reticular activating (arousal)
system.
- The cerebellum, which lies at the base of the brain, coordinates all movement and
helps maintain the body upright in space. (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th
Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Determine how many segements of the ff
A. Cervical
B. Thoracic
C. Lumbar
,D. Sacral - ANSWER A. Cervical C1-C8
B. Thoracic T1-T12
C. Lumbar L1-L5
D. Sacral S1-S5
This regulates muscle movements and response to the sensations of touch and pain
A. Somatic
B. Autonomic - ANSWER A. Somatic
- The peripheral nervous system (PNS) consists of both CNs and periph- eral nerves
that project to the heart, visceral organs, skin, and limbs. It controls the somatic
nervous system, which regulates muscle move- ments and response to the
sensations of touch and pain, and the autonomic nervous system that connects to
internal organs and gener- ates autonomic reflex responses. The autonomic nervous
system consists of the sympathetic nervous system, which "mobilizes organs and
their functions during times of stress and arousal, and the para- sympathetic nervous
system, which conserves energy and resources during times of rest and relaxation."5
(Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th
Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Determine the pairs of peripheral nerves
A. Cervical
B. Thoracic
C. Lumbar
D. Sacral
E. Coccygeal - ANSWER A. Cervical- 8
B. Thoracic- 12
C. Lumbar- 5
D. Sacral- 5
E. Coccygeal- 1
- The PNS includes spinal and peripheral nerves that carry impulses to and from the
cord. A total of 31 pairs of spinal nerves attach to the spinal cord: 8 cervical, 12
thoracic, 5 lumbar, 5 sacral, and 1 coccygeal. Each nerve has an anterior (ventral)
root containing motor fibers, and a posterior (dorsal) root containing sensory fibers.
The anterior and posterior roots merge to form a short spinal nerve, <5 mm long.
Spinal nerve fibers commingle with similar fibers from other levels in plexuses
outside the cord, from which peripheral nerves emerge. Most peripheral nerves
contain both sensory (afferent) and motor (efferent) fibers. (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th
Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Determine the Cranial Nerve:
Oflactory: sense of smell
A. I
B. Ii
C. III
D. IV
E. V
,F. Vi
G. VII
H. VIIi
I. IX
J. X
K. Xi
L. XII - ANSWER XII Hypoglossal motor tongue
Determine the Cranial Nerve:
Optic: vision
A. II
B. I
C. III
D. IV
E. VI
F. V
G. VIII
H. VII
I. IX
J. XI
K. X
L. XII - ANSWER A. II
This mediate voluntary movement and integrate skilled, complicated, or delicate
movements by stim- ulating selected muscular actions and inhibiting others. They
also carry impulses that inhibit muscle tone, the slight tension maintained by normal
muscle even when it is relaxed. (Bickley)
A. Corticospinal (pyramidal) tract
B. Basal Ganglia
C. Cerebellar system - ANSWER A. Corticospinal (pyramidal) tract
- The corticospinal (pyramidal) tract. The corticospinal tracts mediate voluntary
movement and integrate skilled, complicated, or delicate movements by stim- ulating
selected muscular actions and inhibiting others. They also carry impulses that inhibit
muscle tone, the slight tension maintained by normal muscle even when it is relaxed.
The corticospinal tracts originate in the motor cortex of the brain (Fig. 17-6). Motor
fibers travel down into the lower medulla, where they form an anatomical structure
resembling a pyramid.
- There, most of these fibers cross to the opposite or contralateral side of the
medulla, continue downward, and synapse with anterior horn cells or with
intermediate neurons. Tracts synapsing in the brainstem with motor nuclei of the
CNs are termed corticobulbar.
● The basal ganglia system. This exceedingly complex system includes motor
pathways between the cerebral cortex, basal ganglia, brainstem, and spinal cord. It
helps to maintain muscle tone and to control body movements, espe- cially gross
automatic movements such as walking.
● The cerebellar system. The cerebellum receives both sensory and motor input and
coordinates motor activity, maintains equilibrium, and helps to control posture.
(Bickley)
, Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th
Edition. Wolters Kluwer Health, 20160620. VitalBook file.
When upper motor neuron systems are damaged above their crossover in the
medulla, motor impairment develops on and becomes (STA)
A. Ipsilateral
B. Contralateral
C. Exaggerated reflex
D. Lack of reflex - ANSWER B. Contralateral & C. Exaggerated reflex
- When upper motor neuron systems are dam- aged above their crossover in the
medulla, motor impairment develops on the opposite or contralateral side. In damage
below the crossover, motor impairment occurs on the same or ipsi- lateral side of the
body (Bickley)
- slow- ness or lack of spontaneous and automatic movements termed bradykinesia,
and various involuntary movements. (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th
Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Determine the location of the spinal nerve
A. Ankle
B. Knee
C. Brachioradialis
D. Bicep
E. Tricep reflex - ANSWER
Identify the presentation
A. classically presents as "the worst headache of my life" with instantaneous onset
B. Severe headache and stiff neck
C. Dull headache increased by coughing and sneezing, especially when recurring in
the same location
D. headache is often preceded by an aura or prodrome, and is highly likely if three of
the five "POUND" features are present: Pulsatile or throbbing; One- day duration, or
lasts 4 to 72 hours if untreated; Unilateral; Nausea or vomit- ing; Disabling or
intensity causing inter- ruption of daily activit (Bickley) - ANSWER A. Subarachnoid
hemorrhage
B. Meningitis
C. Brain tumor
D. Migraine
Identify
A. Feeling light-headed, weak in the legs, or about to faint points t o
B. often reflects vestibular dis- ease, usually from peripheral causes in the inner ear
C. ataxia, diplopia, and dysarthria are suspicious for (Bickley) - ANSWER A. pre-
syncope from vasovagal stimulation, orthostatic hypotension, arrhythmia, or side
effects from blood pressure and other medications. (Bickley)
B. Vertigo, Benign positional vertigo, labyrinthitis, or Ménière disease
C. Vertebrobasilar TIA or stroke. Also consider posterior fossa tumor and migraine
with brainstem aura. (Bickley)
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