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NCS Prep > NCS Neuroanatomy and Pathophysiology > Flashcards

NCS Neuroanatomy and Pathophysiology Flashcards

1
Q

true or false: practice following neurological injury results in only neuronal structure changes

A

false - there are also cellular level changes

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2
Q

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?

A

to minimize the damage/disconnection that could result in the penumbra or peri infarct zone

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3
Q

why is hemmorhagic stroke associated with worse prognosis than ischemic

A

we do not have strategies to improve perfusion or minimize penumbra and it is associated with greater areas of affect

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4
Q

true or false: TMS is only helpful when be used in addition to PT if the TMS excites the affected side

A

false - there are benefits with exciting the affected hemisphere AND with inhibiting the contralateral hemisphere

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5
Q

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

A

d. diffuse axonal injury

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6
Q

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

A

c. metabolic acidotoxicity

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7
Q

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

a. axonal shear

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8
Q

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

a. axonal shear

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9
Q

what are the mechanism associated with degenerative and demyelinating diseases such as MS, ALzheimers, PD, ALS, or HD

A

inflammation due to an immune response attacking the myelin, systemic inflammatory effects, metabolic changes and toxic accumulation of proteins

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10
Q

which of the following protein accumulations is associated with PD
a. beta amyloid
b. alpha synuclein
c. SOD1
d. huntingtin

A

b. alpha synuclein

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11
Q

which of the following protein accumulations is associated with ALS
a. beta amyloid
b. alpha synuclein
c. SOD1
d. huntingtin

A

c. SOD1

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12
Q

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

a. injury, necrosis, axonal injury, apoptosis, demyelination, microgliosis, neuroregeneration

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13
Q

true or false: demyelination following BI occus at days to weeks from injury

A

true

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14
Q

true or false: axonal injury following BI occus at days to weeks from injury

A

false - minutes to days

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15
Q

true or false: necrosis following BI occus at days to weeks from injury

A

false - minutes to hours

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16
Q

true or false: apoptosis following BI occus at days to weeks from injury

A

true - typically days

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17
Q

true or false: neurogeneration following BI occus at days to weeks from injury

A

false - weeks to months

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18
Q

what are the 5 cellular mechanism for neuro recovery

A

improved cell response
improved synaptic activity
axonal and dendritic sprouting
remyelination
neurogenesis

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19
Q

what cell responses occur during recovery from neurologic injury

A

long term potentiation or depression where there is an increase or decrease in receptors

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20
Q

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

A

b. neural shock resolution

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21
Q

what is neural shock resolution

A

when the inflammation and edema in the NS begins to go down and allows signals to be transmitted

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22
Q

what is diaschisis

A

when there is a lesion to a middle neuron resulting in retrograde and orthograde neuronal changes (pre and post)

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23
Q

what synaptic changes occur during recovery from neurologic injury

A

synaptic hypereffectiveness where there is increased release of NT into the cleft
denervation supersensitivity where the post synaptic neuron becomes more sensitive to NT

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24
Q

what axonal and dendritic changes occur during recovery from neurologic injury

A

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

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25
Q

what is vicarious function

A

when the function of the damaged portion of the brain is taken over by an area not previously concerned with that function

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26
Q

what is the different in homotypic and heterotypic collateral sprouting and how does it affect prognosis

A

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

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27
Q

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

A

d. heterotypic collateral sprouting

28
Q

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

A

b. fast cortical plasticity occurring in minutes

29
Q

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

A

c. slow cortical plasticity occurring over days to weeks demonstrating permanent change

30
Q

what are the respective NT for the sympathetic and parasympathetic nervous systems

A

NE and ACh

31
Q

what of the following is a glial cell of the PNS
a. astrocyte
b. ependymal cell
c. microglia
d. satellite cell

A

d. satellite cell

32
Q

true or false: glial cells sole purpose is to provide myelin and structure to the PNS and CNS

A

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

33
Q

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

a. support cells forming the BBB, nutrition, recycle NT, maintain extracellular ion balance, release gliotrasmitters influencing the release of glutamate

34
Q

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

A

b. line ventricles and produce CSF

35
Q

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

A

c. protect the brain from illness and disease

36
Q

true or false: electrical synapses are long junctions which permit current flow from pre to post synaptic neuron

A

false - electrical synapses rely on gap junctions which are extremely close together

37
Q

true or false: chemical synapses are small gaps which communicate via NT

A

false - chemical synapses are larger gaps

38
Q

what neurotransmitters are in charge of rapid communication between single neurons via excitatory or inhibitory AP

A

GABA (inhibition) and glutamate (excitation)

39
Q

what neurotransmitters are associated with neuromodulation or slow communication affecting a group of neurons

A

DA, 5HT, ACh, histamine

40
Q

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

a. thalamus, pons, medulla, cerebellum

41
Q

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

A

b. pons, smooth muscle, cardiac muscle

42
Q

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

A

cortical regions, limbic lobe, amygdala

43
Q

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

A

d. midbrain and pons throughout CNS

44
Q

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

A

e. hypothalamus throughout CNS

45
Q

which 2 cranial nerves do NOT originate from the brainstem
a. olfactory and optic
b. vestibulocochlear and accessory
c. trigeminal and facial

A

a. olfactory and optic
accessory comes off the spinal cord but CN 8 comes from the brain stem

46
Q

true or false: the vermis controls trunk control and proximal limb movement

A

true

47
Q

true or false - the cerebellum has a roll in cognitive function such as sequencing inhibition and executive function

A

true

48
Q

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

A

d. CCAS cerebellar cognitive affective syndrome

49
Q

your patient presents with amnesia but their hippocampus and medial temporal lobe is fine. where is the lesion

A

B/L anteromedial thalamus

50
Q

huntingtons is associated with injury to which portions of the basal ganglia
a. caudate
b. putamen
c. basal ganglia
d. a and b

A

d. a and b

51
Q

true or false - the basal ganglia plays a roll in memory and executive function and behavior

A

true

52
Q

what are the four main functions if the limbic system

A

emotion, memory, olfaction, homeostasis

53
Q

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

A

e. none of the above as they are all functions of the limbic system

54
Q

true or false: the hypothalamus influences release of hormones from the pituitary gland and influences memory as well as sleep-wake cycles

A

true

55
Q

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

A

seizures of the amygdala

56
Q

true or false - temporal lobe is associated with consolidation of declarative memory

A

true

57
Q

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

A

true

58
Q

true or false: left hemisphere is associated with speech comprehension, reading writing and arithmetic, verbal memory

A

true

59
Q

what does the dorsal stream to the occipital lobe detect

A

motions; the “where”

60
Q

what does the ventral stream to the occipital lobe detect

A

the “what” is it that you are seeing

61
Q

prosopagnosia or the inability to ID faces results from injury to what lobe
a. frontal
b. parietal
c. temporal
d. occipital

A

d. occipital

62
Q

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

A

b. parietal

63
Q

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

A

d. occipital and parietal

64
Q

apraxia or the inability to carry out a skill despite absence of motor impairment results from damage to which lobe

A

parietal

65
Q

auditory processing is associated with which lobe

A

temporal

NCS Prep (26 decks)

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