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PT 851 Neuro > BCN Back of book questions Quiz 2 > Flashcards

BCN Back of book questions Quiz 2 Flashcards

1
Q

Why is there high susceptibility for the pyramidal tract to get injured?

A

The pyramidal tract runs without interruption from the cerebral cortex to the caudal end of the spinal cord

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2
Q

What abnormalities come from lesions in the corticospinal tract?

A

Contralateral spastic hemiplegia with exaggerated myotatic reflexes, increased resistance to passive stretch, and extensor plantar response.

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3
Q

What abnormalities come from a lesion in the corticolbulbar tract?

A

Contralateral lower facial muscle paralysis

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4
Q

What abnormalities come from a lesion in the pyramidal tracts from the hypoglossal nerve?

A

Paralysis, atrophy, and deviation of protruded tongue to ipsilateral side

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5
Q

What abnormalities come from a lesion in the abducens nerve?

A

Medial deviation (esotropia) and abductor paralysis of ipsilateral eye

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6
Q

What happens with a lesion in the oculomotor nerve?

A

Ipsilateral ptosis and ophthalmoplegia with eye turned down and out

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7
Q

Upper motor neurons in the primary motor cortex are activated by inputs from the:

A

Premotor cortex
primary somatosensory cortex
secondary somatosensory cortex
thalamic motor nuclei

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8
Q

Self-initiated movement sequences originate in what cortical area before transmission to upper motor neurons in the primary motor cortex?

A

Supplementary motor cortex

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9
Q

Spasticity can be ameliorated by what surgical or pharmacotherapeutic procedures?

A

Cutting dorsal roots or chronic intrathecal administration of baclofen

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10
Q

Monosynaptic cortical motoneuronal synapses are associated with what movements?

A

Rapid movements of fingers

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11
Q

A patient has weakness in his legs and loss of sensation. Examination showed weakness in both legs, brisk lower limb tendon reflexes, and extensor plantar responses bilaterally below the umbilicus. Where is the spinal lesion?

A

T10

Umbilicus is a landmark for spinal segment T10

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12
Q

A small lesion in the anterior part of the right paracentral lobule will result in:

A

Left extensor plantar response (babinski)

anterior paracentral lobule is the primary motor area for contralateral lower limb

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13
Q

Right esotropia and paralysis of abduction in the eye is a result of?

A

Right abducens nerve damage

ipsilateral lateral rectus muscle paralysis

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14
Q

Left side, spastic paralyses of the upper and lower limbs, exaggerated knee jerk reflexes and extensor plantar response shows damage to what?

A

Right pyramidal tract

contralateral spastic hemiplegia

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15
Q

If there is damage to the abducens nerve and pyramidal tract where is the lesion?

A

Caudal Pons

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16
Q

When there is spactic hemiplegia on the contralateral side and ipsilateral damage to a cranial nerve (particularly CN III, VI, and XII) what is the condition?

A

Alternating hemiplegia

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17
Q

At what levels of the brainstem are the vestibular and red nuclei?

A

Vestibular nuclei are at pontomedullary junction

Red Nuclei are at rostal midbrain at level of superior colliculus

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18
Q

The position of the upper limbs in a comatose patient with a decorticate posture is due to?

A

Activity in the red nuclei

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19
Q

An irreparable midbrain lesion resulting in irreversible coma is associated with damage to the?

A

Paramedian midbrain at rostral levels

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20
Q

Which neurons facilitate extrensor movements and inhibit flexor movements in the reticular nuclei?

A

Reticular neurons in reticular nuclei

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21
Q

Which neurons inhibit extensors and facilitate flexors in the reticular nuclei?

A

Medullary reticular neurons

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22
Q

Which part of the vestibular nuclei strongly facilitates extensor muscles in the ipsilateral limbs?

A

Lateral vestibular nucleus

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23
Q

A comatose patient with functional impairment rostral to the brainstem may exhibit what posture?

A

Lower limb extension and upper limb flexion (decorticate)

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24
Q

The spinal ventromedial descending paths strongly influence movements of the?

A

vertebral column (ventromedial go most medial down)

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25
Q

The partial recovery of motor function that often occurs following capsular stroke is dependent upon a number of factors. However, the enduring paralysis that follows this lesion is due to?

A

Some lower motor neurons being soley innervated by corticospinal projections

26
Q

In a patient with bilateral neurosurgical destruction of the anterior funiculi and anterior halves of the lateral funiculi you would observe?

A

Relatively normal motor activity

This is a surgery for intractable pain

27
Q

What are the anatomic and functional subdivisions of the corpus striatum?

A

Caudate Nucleus

Lentiform (Globus pallidus, and Putamen)

28
Q

Medium spiny neurons in the striatum are distinguished functionally by what type of receptor?

A

D1, and D2 receptors

29
Q

What is the chief input to the basal ganglia?

A

Corticostriate projections from neocortex.

Putamen gets projections from motor, premotor and somatosensory cortical areas

30
Q

What characterizes the physiologic effects of activation of the direct pathway on thalamic ventral anterior neurons?

A

The direct pathway is responsible for decreased inhibition, (enables desired movements to occur)

31
Q

Activation of the indirect pathway is responsible for what component of intended movements?

A

Activation of the indirect pathway is responsible for inhibition of thalamic ventral anterior neurons (suppresses undesired movements)

32
Q

Output of the basal ganglia indirectly regulates activity of upper motor neurons in the primary motor cortex chiefly through what connections?

A

Ventral anterior (VA) thalamocortical projections

33
Q

Lead-pipe rigidity is characterized by?

A

Cocontraction of agonist and antagonist muscles

34
Q

What are the cardinal manifestations of the basal ganglia disorders?

A

Disorders of movement and alterations in muscle tone. (tremors, chorea, ballismus)

35
Q

Movement disorders resulting from pathology in the basal ganglia are manifested chiefly by what motor command pathway?

A

Basal ganglia regulate voluntary movements through the pyramidal system

36
Q

What abnormalities result in damage to the substantia nigra?

A

Parkinsons disease

37
Q

What abnormalities will come from damage to the Striatum?

A

Huntington chorea

38
Q

What abnormalities will come from damage to the subthalmic nucleus?

A

Contralateral hemiballisumus

39
Q

A small vascular lesion in the brain on the right side results in hemiballismus. As the result of this stroke, you would expect to observe:

A

Abnormal impulse activity in the ipsilateral pyramid tract

40
Q

Positive signs of basal ganglia disorders include involuntary abnormal movements. The underlying pathophysiological basis for these abnormal involuntary movements may be the result of

A

Decrease impulse activity in pallidothalamic projections

41
Q

Passively moving the forearm of a patient with dopamine depletion in the stratum evokes a series of abnormal ratcheting-type movements regardless of the direction (flexion or extension) of the movement. This ratcheting is characterized as:

A

Cogwheeling

42
Q

In a patient with Huntington disease, the clinical course of presentation of the symptom would not include?

A

Sudden onset

43
Q

Name the cerebellar peduncles, and give the principal components of each.

A

Superior-Output some input (cerebellar output to the thalmus)
Medial-All input (Pontocerebellar)
Inferior-Input some output (comes from medulla)

44
Q

Activation of the olivocerebellar climbing fibers evokes what type of response in Purkinje cells?

A

complex spike

45
Q

What neuron is excitatory in the cerebellar cortex?

A

Granule cells

46
Q

Name the cerebellar nuclei and give their chief excitatory and inhibitory inputs.

A

Festidule
Interpose
Dentate
Inhibitory comes from Purkinge fibers, and excitatory comes from mossy and climbinb fibers

47
Q

Impulse activity in the lateral hemisphere and dentate nucleus precedes, occurs coincident with, or follows a voluntary movement?

A

Precedes (dentate nucleus is involved in planning)

48
Q

Information processing in the anterior lobe cortex chiefly compares what two types of information and pathways?

A

Anterior lobe compares info about an intended movement transmitted by collaterals of corticospinal axons via pontocerebellar projections and info about the movement as it is occuring trasmitted by spinocerebellar projections

49
Q

Can a patient with a midline medulloblastoma perform a normal skilled movement?

A

Trunk stabilizer muscles don’t work, but limbs might have normal function.

50
Q

What abnormalities will result from a lesion of the inferior cerebellar peduncle?

A

Ipsilateral limb ataxia

51
Q

What abnormalities will result from a lesion of the red nucleus?

A

Contralateral posterior lobe syndrome

52
Q

A patient presents with uncoordinated movements of the left lower limb as indicated by the inability to run the left heel smoothly against the right shin. In addition, the patient has a right spastic hemiplegia. This symptomatology would result from a single lesion in the?

A

Left lateral rostral closed medulla

53
Q

The right hand of a patient reaching for a glass of water shakes uncontrollably when nearing the target and spills the water. In addition, the patient’s left eye lid droops significantly and the pupil appears to be directed down and out. Where is the lesion?

A

The rostral midbrain on the left side

54
Q

Ataxia can occur as the result of?

A

Can be from damage to peripheral axons
damage to the dorsal part of the lateral funiculus in the spinal cord
damage to the inferior cerebellar peduncle
damage to the cerebellar anterior lobe

55
Q

During neurological examination, a patient presents a speech pattern characterized by loud, forceful expression of words that may be broken into individual syllables. This condition, defined as explosive speech, reflects damage to?

A

Dentate nuclei bilaterally

56
Q

A 40 year old woman with MS awakens with double vision, seeing tow side-by-side images whenever she looks to the left side. Her examination shows incomplete medial movement of the right eye when gazing to the left. Which structure has been affected?

A

Medial longitudinal fasciculus

57
Q

A small tumor in the pineal gland is detected by neuroimaging in an 80 year old male patient. If this tumor increases in size, the first deficit you would expect to see clinically would be?

A

impaired vertical gaze

58
Q

A small unilateral vascular lesion in the reticular formation adjacent to the abducens nucleus results in paralysis of gaze toward the ipsilateral side. Which of the following structures has been affected?

A

Ipsilateral horizontal gaze center

59
Q

A small contusion injury to the cerebral cortex on the left side damages the frontal eye field. This acute injury will result in:

A

Transient paralysis of lateral gaze to the contralateral side

60
Q

A patient presents with esotropia and horizontal diplopia. These signs are characteristic of:

A

Abducens nerve palsy

PT 851 Neuro (10 decks)

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