CNS Unit 2

Question 1

With an UMN lesion, will the patient have weakness?

Answer 1

Yes

Question 2

With an LMN lesion, will the patient has weakness?

Answer 2

Yes

Question 3

With an UMN lesion, will the patient have atrophy?

Answer 3

No

Question 4

With an LMN lesion, will the patient have atrophy?

Answer 4

Yes

Question 5

With an UMN lesion, will the patient have fasciculations?

Answer 5

No

Question 6

With an LMN lesion, will the patient have fasciculations?

Answer 6

Yes

Question 7

With an UMN lesion, would a patient have increased or decreased reflexes?

Answer 7

Increased

Question 8

With an LMN lesion, would a patient have increased or decreased reflexes?

Answer 8

Decreased

Question 9

With an UMN lesion, would a patient have increased or decreased tone?

Answer 9

Increased

Question 10

With an LMN lesion, would a patient have increased or decreased tone?

Answer 10

Decreased

Question 11

What is Apraxia? What are various ways to test Apraxia?

Answer 11

• Apraxia means inability to follow a motor command, when this inability is not due to a primary motor deficit or a language impairment, its caused by a deficit in higher-order planning or conceptualization of the motor task.
• You can test for Apraxia by asking the pt. to do complex task, using commands such as “pretend to comb your hair”, pt. with apraxia will perform awkward movements that only minimally resemble those requested, despite having intact comprehension and otherwise normal motor exam. This is sometimes called ideomotor apraxia

Question 12

What structures are involved in Alertness/Attention?

Answer 12

Brainstem reticular formation, bilateral thalami or cerebral hemispheres.

• Level of consciousness is severely impaired in damage to the brainstem reticular formation and in bilateral lesions of the thalami or cerebral hemisphere. It may also be mildly impaired in unilateral cortical or thalamic lesion s

Question 13

What are causes of impaired consciousness?

Answer 13

• Common causes are toxic or metabolic factors
• Generalized impaired attention and cooperation are relatively nonspecific abnormalities that can occur in may different focal brain lesions; in diffuse abnormalities such as dementia, delirium, or encephalitis; and in behavior and mood disorders

Question 14

What structures are involved in Memory, what general lobes/areas? Damage to these area can cause what?

Answer 14

Limbic memory structures located in the medial temporal lobes and medial diencephalon

• Damage to these areas causes two characteristic forms of amnesia, which usually co-exist.
  –Anterograde amnesia is difficulty remembering new facts and events occurring after lesion onset
  –Retrograde amnesia is impaired memory of events for a period of time immediately before the lesion onset, with relative sparing of earlier memories

Question 15

What structures are involved in Language? Lesions to what lobes generally affect language?

Answer 15

Lesions usually in the dominant (usually left), frontal lobe (including Broca’s area, the left temporal and parietal lobes, including Wernicke’s area) , subcortical white matter and gray matter structors, including thalamus and caudate nucleus; as well as non-dominate hemisphere

Question 16

What is the difference between Broca’s and Wernicke’s aphasia?

Answer 16

Broca’s: occurs when there is damage to broca’s area (Frontal lobe on left or dominant hemisphere). Pt. have intact auditory comprehension, they have a hard time expressing what they want to say.

Wernicke’s: occurs when there is damage to wernicke’s area (Temporal lobe on left or dominant area). Pt. have auditory comprehension that is impaired, they dont understand whats being said to them.

Question 17

Damage to what area would cause apraxia?

Answer 17

Commonly present in lesions affecting the language areas and adjacent structures of the dominant hemisphere.

Question 18

What lobe/side of the brain deals with spatial awareness? Damage to what lobe/side results in neglect?

Answer 18

Hemineglect is most common in lesions of the right (nondominant) parietal lobe (causing pt. to neglect the left side)
- Left sided neglect can also occasionally be seen in right frontal lesions, in right thalamic or basal ganglia lesions and rarely in lesions of the right midbrain