Chapter 18 Workbook Questions Flashcards
What would be the effects of a Posterior limb of the internal capsule lesion?
Contralateral deficits of voluntary movement and conscious somatosensation
What would be the effects of a Primary auditory cortex lesion?
Loss of conscious localization of sounds
What would be the effects of a Secondary somatosensory area lesion?
Astereognosis
What would be the effects of a Primary visual cortex lesion?
Homonymous hemianopsia
What would be the effects of a Caudate nucleus lesion?
Apathy, with loss of initiative, spontaneous thought, and/or emotional responses
What would be the effects of a Secondary visual cortex lesion?
Visual agnosia
Cannot pick up a pen when asked to do so but is able to pick up a pen automatically when wanting to write. What is the name of the disorder described?
Apraxia
Cannot individually move the fingers on one hand. What is the name of the disorder described?
Fractionation deficit
Cannot plan; completely lacks initiative. What is the name of the disorder described?
Executive function deficits
Repeatedly picks up an object, although intending to set it down. What is the name of the disorder described?
Motor perseveration
Cannot speak or write fluently but can understand speech and gestures. Has no difficulty with chewing or swallowing. What is the name of the disorder described?
Broca’s aphasia
Speaks with difficulty; the speech is harsh and robotic. Language production and comprehension, including the ability to read and write, are intact. What is the name of the disorder described?
Spastic dysarthria
Why are the worst deficits seen distally in people with severe lesions of the primary motor cortex?
The most severe functional losses occur in the hands, feet, and facial muscles after injury to the primary motor cortex, because fine motor control is exclusively provided by the contralateral primary motor cortex.
Why do people with orbitofrontal lesions exhibit poor judgment, despite intact intellectual abilities?
After lesions to the orbitofrontal cortex, people may exhibit poor judgment associated with impulsive behavior and a poor awareness of the sense of risk.
Can people with declarative memory deficits learn new motor skills? Why or why not?
Yes, people with declarative memory deficits can learn new motor skills because different areas within the central nervous system (CNS) process motor and declarative memories.
The inability to understand written or spoken language, including inability to read and write and produce meaningful language, despite the ability to produce fluent speech sounds: A. Broca’s aphasia B. Conduction aphasia C. Global aphasia D. Wernicke’s aphasia E. Dysarthria
D: In Wernicke’s aphasia, language comprehension (symbolic communication) is impaired. Those with Wernicke’s aphasia easily produce spoken sounds, but the output is meaningless.
Dysarthria is caused by a lesion of which of the following? A. Broca’s area, usually in the left hemisphere B. Broca’s area, usually in the right hemisphere C. Wernicke’s area, Broca’s area, and the intervening cortical and subcortical structures D. Lower motor neurons or corticobrainstem neurons E. Neurons connecting Wernicke’s area with Broca’s area
D: Damage to lower motor neurons (cranial nerves IX, X, and/or XII) causes paresis of speech muscles, producing flaccid dysarthria. Damage to corticobrainstem neurons that synapse with LMNs to speech muscles causes spastic dysarthria.
Synonyms for Broca’s aphasia include which of the following? A. Motor aphasia B. Expressive aphasia C. Nonfluent aphasia D. A and B E. A, B, and C
E: Broca’s aphasia is the difficulty of expressing oneself using language. People with Broca’s aphasia may not produce any language output, or they may be able to generate habitual phrases, such as “Hello. How are you?” or make brief meaningful statements and may be able to produce emotional speech (e.g., obscenities, curses) when upset. People with Broca’s aphasia are usually aware of their language difficulties and are frustrated by their inability to produce normal language. Writing is usually as impaired as speaking. The ability to understand the spoken language and to read is spared. Motor, expressive, and nonfluent aphasia are synonymous with Broca’s aphasia.
Which of the following best defines anosognosia? A. Severe hemiparesis B. Hemilateral personal neglect C. Denial of functional deficits in the paretic limb D. Visual spatial neglect E. Constructional apraxia
C: Anosognosia is the denial of functional deficits in a paretic limb.
If a person speaks in a monotone, is unable to communicate effectively nonverbally, and lacks emotional gestures and facial expressions, the lesion is located in which of the following? A. Broca’s area in the dominant hemisphere B. Area corresponding to Broca’s in the nondominant hemisphere C. Wernicke’s area in the dominant hemisphere D. Area corresponding to Wernicke’s area in the nondominant hemisphere E. Lower motor neurons or corticobrainstem neurons
B: Damage to the right cortex in the area corresponding to Broca’s area may cause the person to speak in a monotone, to be unable to communicate effectively nonverbally, and to lack emotional facial expressions and gestures. These consequences are sometimes referred to as flat affect.
Which of the following may occur with damage to the area corresponding to Wernicke’s area? A. Inability to understand nonverbal communication B. Personal neglect C. Spatial neglect D. A and B E. A, B, and C
E: If the area corresponding to Wernicke’s is damaged on the right side, then the person has difficulty understanding nonverbal communication. The area corresponding to Wernicke’s area is also important for body image and for understanding the relationship between self and the environment. Damage to the area corresponding to Wernicke’s area may cause neglect.
Which of the following characterize spatial neglect? A. Navigation apraxia B. Dressing apraxia C. Visual agnosia D. A and B E. A, B, and C
D: Spatial neglect is characterized by a unilateral lack of understanding of spatial relationships, resulting in a deranged internal representation of space. People with neglect may have only one sign (e.g., lack of awareness of people or objects on their left) or any combination of signs.
Be able to match the following term to its description Visual agnosia
Inability to recognize the shape, orientation, or size of objects combined with intact ability to use visual information to plan movements
Be able to match the following term to its description Optic ataxia
Inability to orient the hand to objects when reaching, despite being able to describe and identify the objects based on visual information
Be able to match the following term to its description Attention deficit disorder
Difficulty in sustaining attention, with onset during childhood
Be able to match the following term to its description Epilepsy
Sudden episodes of involuntary movements, disruption of autonomic regulation, illusions, and/or hallucinations
Be able to match the following term to its description Dementia
Disorientation with impaired memory, judgment, and intellect
Be able to match the following term to its description Lateropulsion
Powerful leaning toward the hemiparetic side when sitting or standing
Which of the following typically occur after traumatic head injury? A. Impulsiveness and inappropriate behaviors B. Difficulty in directing attention C. Decreased executive functions D. A and B E. A, B, and C
E: People with traumatic brain injury show poor judgment, decreased executive functions, memory deficits, slow information processing, attentional disorders, and poor divergent thinking. The inability to use new information effectively results in concrete thinking, an inability to apply rules appropriately, and trouble distinguishing relevant from irrelevant information.
Consequences of violent shaking of an infant may include which of the following? A. Cerebral edema B. Cerebral hemorrhage C. Development of motor abnormalities as the infant matures D. Emergence of cognitive deficits as the infant matures E. All of the above
E: The trauma from shaking is due to the impact of the brain repeatedly striking the skull. Soon after the incident, cerebral edema may increase the infant’s head circumference and cause bulging of the anterior fontanelle. Brain scans show hemorrhage and edema. Survivors may exhibit motor signs similar to those of developmental delay or cerebral palsy and have a pattern of cognitive deficits similar to that seen in adults with traumatic brain injury.
Which of the following describes the motor control approach to regaining function subsequent to a stroke? A. Therapist uses hands-on techniques to inhibit excessive muscle tone. B. Client is encouraged to use the nonparetic side to substitute for the paretic side. C. A rigid lower limb brace is provided to allow early ambulation. D. Desired task is practiced in the environment in which the client will be performing the task. E. Sequence of preparatory activities is perfected before the desired task is attempted.
D: Motor control approaches emphasize task specificity; that is, practicing the desired task in a specific context. If the goal is independent walking, then walking is practiced, rather than preparatory activities. Examples of preparatory activities include standing balance or lateral weight transfers in standing. Using the motor control approach, the client might walk an obstacle course with the therapist guarding for loss of balance.
Be able to match the following disorder with the most likely location of the lesion Inability to name objects, despite intact automatic social speech
Wernicke’s area
Be able to match the following disorder with the most likely location of the lesion Inability to button a shirt, despite an intact sensation, motor control, and understanding of the task
Premotor or supplementary motor areas
Be able to match the following disorder with the most likely location of the lesion Inability to answer the question “Where are we now?”
Hippocampus or Wernicke’s area
Be able to match the following disorder with the most likely location of the lesion Inability to identify an object by touch and manipulation, despite having an intact awareness of discriminative touch
Secondary somatosensory cortex
Shade the areas that, when damaged, produce the following: A. Loss of tactile localization and conscious proprioception B. Loss of localization of sound C. Homonymous hemianopsia D. Change in awareness of head position
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Label the areas that, when damaged, produce the following: A. Astereognosis B. Visual agnosia C. Auditory agnosia
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Label the areas that, when damaged, produce the following: A. Paresis, loss of fine motor control, spastic dysarthria B. Apraxia C. Apraxia and perseveration D. Broca’s aphasia in the dominant hemisphere or deficits in producing nonverbal communication in the nondominant hemisphere
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Label the areas that, when damaged, produce the following: A. Loss of executive functions and divergent thinking B. Disturbances of personality and emotions C. Wernicke’s aphasia in the dominant hemisphere or neglect if in the nondominant hemisphere
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What is the difference between a somatoform disorder and malingering?
In somatoform disorders, no external gain can be identified. In contrast, when a person is malingering, an external gain can be identified.
