NCS Neuroanatomy and Pathophysiology Flashcards
true or false: practice following neurological injury results in only neuronal structure changes
false - there are also cellular level changes
you are working in a neuro acute ICU. knowing the anatomy and pathophysiology of a stroke, why is it important to get a stroke patient TPA as soon as possible?
to minimize the damage/disconnection that could result in the penumbra or peri infarct zone
why is hemmorhagic stroke associated with worse prognosis than ischemic
we do not have strategies to improve perfusion or minimize penumbra and it is associated with greater areas of affect
true or false: TMS is only helpful when be used in addition to PT if the TMS excites the affected side
false - there are benefits with exciting the affected hemisphere AND with inhibiting the contralateral hemisphere
a patient arrives to the neuro acute ICU s/p MVA resulting in a TBI. the patient is in a coma. this is likely due to what injury/damage to the brain
a. axonal shear
b. localize pressure
c. metabolic acidotoxicity
d. diffuse axonal injury
d. diffuse axonal injury
a patient arrives to the hospital s/p MVA resulting in a TBI. the patient c/o of photo and phonophobia. this is likely due to what injury/damage to the brain
a. axonal shear
b. localize pressure
c. metabolic acidotoxicity
d. diffuse axonal injury
c. metabolic acidotoxicity
a patient arrives to your OP clinic s/p MVA resulting in a TBI. following a stay in the ICU they are not demonstrating motor deficits but persistent post concussion symptoms. this is likely due to what injury/damage to the brain
a. axonal shear
b. localize pressure
c. metabolic acidotoxicity
d. diffuse axonal injury
a. axonal shear
a patient arrives to your OP clinic s/p MVA resulting in a TBI. following a stay in the ICU they are not demonstrating motor deficits but impaired cognition and STM as well as reduced information processing and slowed reaction time. this is likely due to what injury/damage to the brain
a. axonal shear
b. localize pressure
c. metabolic acidotoxicity
d. diffuse axonal injury
a. axonal shear
what are the mechanism associated with degenerative and demyelinating diseases such as MS, ALzheimers, PD, ALS, or HD
inflammation due to an immune response attacking the myelin, systemic inflammatory effects, metabolic changes and toxic accumulation of proteins
which of the following protein accumulations is associated with PD
a. beta amyloid
b. alpha synuclein
c. SOD1
d. huntingtin
b. alpha synuclein
which of the following protein accumulations is associated with ALS
a. beta amyloid
b. alpha synuclein
c. SOD1
d. huntingtin
c. SOD1
which is the correct order of affects following BI:
a. injury, necrosis, axonal injury, apoptosis, demyelination, microgliosis, neuroregeneration
b. injury, demyelination, axonal injury, apoptosis, microgliosis, necrosis, neuroregeneration
c. injury, demyelination, axonal injury, apoptosis, necrosis, microgliosis, neuroregeneration
a. injury, necrosis, axonal injury, apoptosis, demyelination, microgliosis, neuroregeneration
true or false: demyelination following BI occus at days to weeks from injury
true
true or false: axonal injury following BI occus at days to weeks from injury
false - minutes to days
true or false: necrosis following BI occus at days to weeks from injury
false - minutes to hours
true or false: apoptosis following BI occus at days to weeks from injury
true - typically days
true or false: neurogeneration following BI occus at days to weeks from injury
false - weeks to months
what are the 5 cellular mechanism for neuro recovery
improved cell response
improved synaptic activity
axonal and dendritic sprouting
remyelination
neurogenesis
what cell responses occur during recovery from neurologic injury
long term potentiation or depression where there is an increase or decrease in receptors
you are working in an IRF facility and your newly admitted patient who suffered an SCI begins to show dramatic improvement. why is this occurring?
a. high intensity practice of IRF
b. neural shock resolution
b. neural shock resolution
what is neural shock resolution
when the inflammation and edema in the NS begins to go down and allows signals to be transmitted
what is diaschisis
when there is a lesion to a middle neuron resulting in retrograde and orthograde neuronal changes (pre and post)
what synaptic changes occur during recovery from neurologic injury
synaptic hypereffectiveness where there is increased release of NT into the cleft
denervation supersensitivity where the post synaptic neuron becomes more sensitive to NT
what axonal and dendritic changes occur during recovery from neurologic injury
unmasking (recruitment of silent synapses) where inactive connections become active after injury
homotypic collateral sprouting of the same fiber that was lost
heterotypic collateral sprouting of a different nerve type
what is vicarious function
when the function of the damaged portion of the brain is taken over by an area not previously concerned with that function
what is the different in homotypic and heterotypic collateral sprouting and how does it affect prognosis
homotypic is from the same type of fiber; this process takes a long time of weeks to a year and associated with good prognosis and recovery of function
heterotypic is from a different nerve type and occurs quickly within days and is not associated with good prognosis
you are working in the neuro acute ICU and are seeing a patient s/p TBI. you read in the chart, that they had a seizure yesterday. this is likely due to
a. long term potentiation
b. neural shock resolution
c. denervation supersensitivity
d. heterotypic collateral sprouting
d. heterotypic collateral sprouting
you are working in the neuro acute ICU and are seeing a patient s/p TBI. at the start of the session, the patient require maxAx2 for bed mobility but at the end of the session they only require minA. this is likely due to
a. long term potentiation
b. fast cortical plasticity
c. slow cortical plasticity
d. heterotypic collateral sprouting
b. fast cortical plasticity occurring in minutes
you are working at an IRF and are seeing a patient s/p TBI. at the start of rehab, the patient require maxAx2 for bed mobility but at the end of 2 weeks they only require minA. this is likely due to
a. long term potentiation
b. fast cortical plasticity
c. slow cortical plasticity
d. heterotypic collateral sprouting
c. slow cortical plasticity occurring over days to weeks demonstrating permanent change
what are the respective NT for the sympathetic and parasympathetic nervous systems
NE and ACh
what of the following is a glial cell of the PNS
a. astrocyte
b. ependymal cell
c. microglia
d. satellite cell
d. satellite cell
true or false: glial cells sole purpose is to provide myelin and structure to the PNS and CNS
false - they also recycle NT, maintain extracellular ion balance, release gliotransmitters influencing the release of glutamate, produce CSF, and protect the brain from disease and illness
what is the function of the astrocyte in the CNS?
a. support cells forming the BBB, nutrition, recycle NT, maintain extracellular ion balance, release gliotrasmitters influencing the release of glutamate
b. line the ventricles and produce CSF
c. protect the brain from illness and disease
d. create myelin
a. support cells forming the BBB, nutrition, recycle NT, maintain extracellular ion balance, release gliotrasmitters influencing the release of glutamate
what is the function of the ependymal cell in the CNS?
a. support cells forming the BBB, nutrition, recycle NT, maintain extracellular ion balance, release gliotrasmitters influencing the release of glutamate
b. line the ventricles and produce CSF
c. protect the brain from illness and disease
d. create myelin
b. line ventricles and produce CSF
what is the function of the microglia in the CNS?
a. support cells forming the BBB, nutrition, recycle NT, maintain extracellular ion balance, release gliotrasmitters influencing the release of glutamate
b. line the ventricles and produce CSF
c. protect the brain from illness and disease
d. create myelin
c. protect the brain from illness and disease
true or false: electrical synapses are long junctions which permit current flow from pre to post synaptic neuron
false - electrical synapses rely on gap junctions which are extremely close together
true or false: chemical synapses are small gaps which communicate via NT
false - chemical synapses are larger gaps
what neurotransmitters are in charge of rapid communication between single neurons via excitatory or inhibitory AP
GABA (inhibition) and glutamate (excitation)
what neurotransmitters are associated with neuromodulation or slow communication affecting a group of neurons
DA, 5HT, ACh, histamine
the NT ACh is associated with which brain areas/bodily functions
a. thalamus, pons, medulla, cerebellum
b. pons, smooth muscle, cardiac muscle
c. cortical regions, limbic lobe, amygdala
d. midbrain and pons
e. hypothalamus
a. thalamus, pons, medulla, cerebellum
the NT NE is associated with which brain areas/bodily functions
a. thalamus, pons, medulla, cerebellum
b. pons, smooth muscle, cardiac muscle
c. cortical regions, limbic lobe, amygdala
d. midbrain and pons
e. hypothalamus
b. pons, smooth muscle, cardiac muscle
the NT DA is associated with which brain areas/bodily functions
a. thalamus, pons, medulla, cerebellum
b. pons, smooth muscle, cardiac muscle
c. cortical regions, limbic lobe, amygdala
d. midbrain and pons
e. hypothalamus
cortical regions, limbic lobe, amygdala
the NT 5HT is associated with which brain areas/bodily functions
a. thalamus, pons, medulla, cerebellum
b. pons, smooth muscle, cardiac muscle
c. cortical regions, limbic lobe, amygdala
d. midbrain and pons throughout CNS
e. hypothalamus throughout CNS
d. midbrain and pons throughout CNS
the NT histamine is associated with which brain areas/bodily functions
a. thalamus, pons, medulla, cerebellum
b. pons, smooth muscle, cardiac muscle
c. cortical regions, limbic lobe, amygdala
d. midbrain and pons throughout CNS
e. hypothalamus throughout CNS
e. hypothalamus throughout CNS
which 2 cranial nerves do NOT originate from the brainstem
a. olfactory and optic
b. vestibulocochlear and accessory
c. trigeminal and facial
a. olfactory and optic
accessory comes off the spinal cord but CN 8 comes from the brain stem
true or false: the vermis controls trunk control and proximal limb movement
true
true or false - the cerebellum has a roll in cognitive function such as sequencing inhibition and executive function
true
impaired executive function, visuospatial impairment, behavioral changes, and language impairment are associated with which injury/brain area
a. frontal lobe stroke
b. parietal lobe stroke
c. occipital lobe stroke
d. cerebellar cognitive affective syndrome
d. CCAS cerebellar cognitive affective syndrome
your patient presents with amnesia but their hippocampus and medial temporal lobe is fine. where is the lesion
B/L anteromedial thalamus
huntingtons is associated with injury to which portions of the basal ganglia
a. caudate
b. putamen
c. basal ganglia
d. a and b
d. a and b
true or false - the basal ganglia plays a roll in memory and executive function and behavior
true
what are the four main functions if the limbic system
emotion, memory, olfaction, homeostasis
which of the following is not a function of the limbic system
a. emotion
b. memory
c. olfaction
d. homeostasis
e. none of the above
e. none of the above as they are all functions of the limbic system
true or false: the hypothalamus influences release of hormones from the pituitary gland and influences memory as well as sleep-wake cycles
true
a patient is being treated for anxiety and panic attacks but their medications are not effective and there are no triggers. there are no other motor Reponses. this patient could have
seizures of the amygdala
true or false - temporal lobe is associated with consolidation of declarative memory
true
true or false: the right hemisphere is associated with spatial awareness, complex visual and non language sound understanding, tactile recognition, spatial movement orientation 3D visualization and visual memory
true
true or false: left hemisphere is associated with speech comprehension, reading writing and arithmetic, verbal memory
true
what does the dorsal stream to the occipital lobe detect
motions; the “where”
what does the ventral stream to the occipital lobe detect
the “what” is it that you are seeing
prosopagnosia or the inability to ID faces results from injury to what lobe
a. frontal
b. parietal
c. temporal
d. occipital
d. occipital
autopagnosis or the inability to ID own body parts and anosognosia or the unawareness of illness results from injury to what lobe
a. frontal
b. parietal
c. temporal
d. occipital
b. parietal
balint syndrome or the inability to perceive more than one object at a time is a result of damage to pathways between which two lobes
a. frontal and parietal
b. parietal and temporal
c. temporal and occipital
d. occipital and parietal
d. occipital and parietal
apraxia or the inability to carry out a skill despite absence of motor impairment results from damage to which lobe
parietal
auditory processing is associated with which lobe
temporal
