Lecture 1

Question 1

3 elements of consciousness

Answer 1

Arousal
alertness
awareness

Question 2

structures required for level of consciousness

Answer 2

Reticular activating system= reticular formation, nucleus, tegmentum (midbrain), intralaminar nucleus of thalamus and dorsal thalamus

cerebral hemisphere

Question 3

Orientation

Answer 3

to: person, place, time

Question 4

Language

Answer 4

• expression
• comprehension
• repitition
• naming

Question 5

Structures required for language

Answer 5

• expression = Brocas area
• comprehension = Wernicke’s area
• repetition= Acute fasciculus
• Naming = verbs/functor: frontal lobe; nouns = temporal-parietal lobe

Question 6

structures for attn and concentration

Answer 6

• cognitive ideas = frontal-subcortical network

- visual-spatial attn = Non-dominant parietal lobe

Question 7

Structures for memory

Answer 7

• encoding and consolidation of memory = hippocampus

- retrieval of memory = frontal-subcortical system

Question 8

structures for semantic knowledge

Answer 8

temporal and parietal lobe

Question 9

CN localization in brain

Answer 9

Midbrain = CN II, III, IV
Pons = CN V, VI, VII, 1/2 of VIII
Medulla = 1/2 of VIII, IX, X, XI, XII

Question 10

CN III paralysis

Answer 10

cannot abduct or look up/down

also have ptosis of eyelid

Question 11

CNIV paralysis

Answer 11

exotropia to R

Question 12

CN VI paralysis

Answer 12

esotropia and no abduction

horizontal homonymous diplopia

Question 13

CN VII paralysis : LMN vs UMN

Answer 13

LMN: ipsilateral facial paralysis with impaired forehead wrinkling
UMN: lower half of face is paralyzed, eye closure and forehead wrinkling preserved

Question 14

Unilateral paralysis of CN IX and X

Answer 14

deviation of uvula to side of lesion

Question 15

CN XIII paralysis

Answer 15

tongue deviation to side of lesion

Question 16

hypotonia

Answer 16

decreased muscle tone

seen in LMN lesions, spinal shock and cerebellar lesions

Question 17

hypertonia

Answer 17

increased, spasticity or rigidity

-seen in pyramidal lesions (spasticity); bilateral frontal lobe lesions (paratonia); extrapyramidal lesions (rigidity)

Question 18

Upper Extremity muscle strength

Answer 18

• shoulder abduction = C5, C6
• Elbow flxn = C5, C6
• elbow extn = C5. C6 (radial nerve)
• finger spreading = C8, TI (ulnar nerve)
• thumb opposition = C8, TI (median nerve)

Question 19

Lower extremity muscle strength

Answer 19

• hip flexion = L1, L2
• knee flexion = L5, S1, S2
• knee extn = L2, L3, L4
• Foot dorsiflexion = L4, L5
• Foot plantar flexion = S1, S2

Question 20

DTR: Upper extremities

Answer 20

Biceps: C5, C6
Triceps: C7
Brachioradials: C6

Question 21

DTR: Lower extremities

Answer 21

Patella: L4
Achilles: S1

Question 22

Babinski reflex

Answer 22

(+) sign = dorsiflexion of big toe

Upper motor neuron lesion

Question 23

Cerebeller sensory signs

Answer 23

dysmetria, dysdiodochokinesis, Romberg (coordination)

Gait and stance