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OT Neuro > NEURO Final > Flashcards

NEURO Final Flashcards

1
Q

Neurons that are deprived of oxygen for a prolonged period:

A

Release glutamate, which causes overexcitation of the surrounding neurons

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2
Q

Excitotoxicity begins with:

A

Persistent binding of glutamate to N-methyl-D-aspartate (NMDA)–type receptors in the postsynaptic cell membrane

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3
Q

Cellular effects of excitotoxicity include:

A
  • Excessive production of lactic acid
  • Destruction of cellular proteins
  • Cellular edema
  • Interference of mitochondria functions
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4
Q

Which types of memory are affected by an injury to the hippocampus?

A

Memory of names and events

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5
Q

In the mature central nervous system (CNS), axonal regeneration is impeded by:

A
  • Glial scar formation
  • Absence of neural growth factor
  • Release of growth inhibiting factors
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6
Q

Constraint-induced movement after a stroke requires:

A

Repetitive, task-specific functional movements of only the affected UE

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7
Q

Learning an individual’s name requires:

A

Long term potentiation (LTP)

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8
Q

In what stage does myelination of axons begin:

A

Fetal stage

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9
Q

In what stage do the endoderm, mesoderm, and ectoderm develop:

A

Pre-embryonic stage

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10
Q

In what stage do organs form:

A

Embryonic stage

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11
Q

Somites are derived from which pre-embryonic cell layer?

A

Mesoderm

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12
Q

Which direction are somites added?

A

Rostral-to-caudal direction

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13
Q

What form of Spina Bifida is the least severe and usually does not result in neural symptoms?

A

Spina bifida occulta

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14
Q

During acute appendicitis, the contribution of the somatosensory nociceptive afferents is:

A

Signaling conscious awareness of pain in the umbilical region

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15
Q

Areas of the central nervous system (CNS) that modulate autonomic control include:

A

Thalamus, hypothalamus, limbic system

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16
Q

Characteristics of the autonomic efferent system

A
  • Innervates blood vessels in skeletal muscle
  • Hormones regulate effector control
  • Usually a two-neuron pathway with a synapse outside the CNS
  • Neurotransmitters are used for signaling
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17
Q

Sympathetic activation does NOT produce:

A

Increased digestive activity

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18
Q

Capacitance vessels include:

A

Skeletal muscle veins and venules

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19
Q

Drugs that block beta-1 (β1) receptors are used to treat:

A

Tachycardia

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20
Q

Where are the cell bodies of sympathetic preganglionic neurons located?

A

Lateral horn of SC T1-L2 level

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21
Q

What is NOT a cause of syncope?

A

Hyperglycemia

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22
Q

Which proteins are NOT involved in the active process of muscle contraction?

A

Titin

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23
Q

What is the purpose of alpha-gamma coactivation?

A

Maintain muscle spindle sensitivity when extrafusal muscle fibers contract

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24
Q

Reciprocal inhibition produces inhibition of the alpha motor neurons to:

A

Antagonist muscle

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25
Q

What major factor limits movement in individuals who have had a stroke?

A
  • Paresis caused by decreased agonist activation
  • Loss of ability to fractionate movement
  • Abnormal timing of muscle activation
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26
Q

If the lower motor neurons to a muscle are destroyed, what signs affect the denervated muscles?

A

Loss of reflexes and atrophy

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27
Q

List the five separate, parallel cortico-basal ganglia-thalamic loops and their functions

A

(1) Motor loop: adjusts the activity of cortical upper motor neurons (corticospinal, corticobrainstem, and corticopontine tracts) and reticulospinal tracts.
(2) Oculomotor loop: makes decisions about eye movements and spatial attention.
(3) Executive loop: goal-directed behavior, including evaluating information for making perceptual decisions, planning, and choosing actions in context.
(4) Behavioral flexibility and control: recognition of social disapproval, self-regulatory control, selecting relevant knowledge from irrelevant, maintaining
attention, and stimulus-response learning.
(5) Limbic: Links limbic, cognitive, and motor systems; identifies value of stimuli; involved in reward-guided behaviors; monitors errors in predictions; concerned with seeking pleasure.

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28
Q

The cortico-basal ganglia-thalamus motor loop contributes to:

A
  • Regulation of muscle force
  • Sequencing of movements
  • Regulation of muscle tone
  • Selection and inhibition of specific motor synergies
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29
Q

Nystagmus, dysequilibrium, truncal ataxia

A

Vestibulocerebellum

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30
Q

Wide-based, staggering gait

A

Spinocerebellum

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31
Q

Dysarthria

A

Vermis

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32
Q

Dysdiadochokinesia, dysmetria, and action tremor, and wide-based, staggering gait

A

Cerebrocerebellum

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33
Q

What is the most functionally important branch of the cervical plexus?

A

Phrenic nerve

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34
Q

Which one of the plexes innervates the posterior thigh and most of the leg and foot?

A

Sacral

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35
Q

What type of lesion would cause: lack of posterolateral sensation in digits four and five of the right hand; intact sensation of all fingertips; paralysis of long extensors for right wrist and finger; paralysis of the right supinator; sensation and motor function intact for remainder of the body

A

Right radial nerve lesion

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36
Q

What type of lesion would cause: Babinski’s sign; paralysis; hyperreflexia; muscle hypertonia; complete loss of all sensation below the level of the umbilicus

A

Complete T10 spinal cord lesion

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37
Q

What type of lesion would cause: Weakness of the quadriceps on the right side; no other motor or sensory loss

A

Right L3 ventral root lesion

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38
Q

What type of lesion would cause: Decreased strength in right deltoid and biceps; decreased sensation in anterolateral right upper arm; sensation and motor function intact for the remainder of the body

A

Right C5 spinal nerve lesion

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39
Q

What type of lesion would cause: Paralysis of the right iliopsoas and all muscles in the right lower limb; loss of discriminative touch and conscious proprioception in the right lower limb; loss of discriminative pain and temperature sensation in the left lower limb and left buttock region

A

Right hemi-lesion of spinal cord, L1 segment

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40
Q

Autonomic dysreflexia is characterized by:

A

Abrupt increase in blood pressure and pounding headache

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41
Q

Complete spinal cord lesions above which level results in long-term ventilator dependence?

A

C4

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42
Q

Loss of descending sympathetic control as a result of complete spinal cord lesions above T6 result in which of the following?

A
  • Orthostatic hypotension
  • Autonomic dysreflexia
  • Poor thermoregulation
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43
Q

The Hallpike maneuver was designed to:

A

Provoke maximal movement of otoconia in the posterior semicircular canals

44
Q

What happens second during excitotoxicity?

A

Stimulation results in an influx of Ca2+ into cell and indirectly facilitates release of Ca2+ stores

45
Q

What is the hippocampus not responsible for?

A

Performing motor acts (procedural memory)

46
Q

Constraint-Induced Movement Therapy

A

Type of task specific functional movements used in individuals with chronic dysfunction resulting from a stroke

47
Q

How would constraint-induced movement therapy be performed?

A
  • Use of unaffected UE is constrained by a sling

- Pt then undergoes intense practice of functional movements with affected UE

48
Q

Long Term Potentiation (LTP)

A

Cellular mechanism for memory that results from synthesis/activation of new proteins and growth of new synaptic connections

49
Q

What rehabilitation mechanism(s) promote beneficial neural plasticity?

A
  • Task specific practice/training (essential for motor learning)
  • Early initiation of rehabilitation (improved recovery)
50
Q

Meningocele (Spina Bifida)

A

Protrusion of the meninges through bony defect

51
Q

Meningomyelocele (Spina Bifida)

A

Most severe

  • Always results in abnormal growth of SC
  • Results in some LE dysfunction (usually bowel/bladder)
52
Q

Cerebral Palsy

A

Movement and postural disorder caused by permanent, non progressive damage to developing brain

53
Q

Spastic CP

A

Damaged neurons adjacent to ventricles

- Results in increased muscle stiffness or hypertonicity

54
Q

Athetoid (Dyskinetic) CP

A

Damage to basal ganglia

- Characterized by writhing/uncoordinated movements

55
Q

Ataxic CP

A

Damage to cerebellum

- Characterized by incoordination, tremors and weakness

56
Q

ADHD

A

Characterized by developmentally inappropriate inattention, impulsivity and motor restlessness

57
Q

Treatment for ADHD

A

Stimulant drugs

58
Q

What do stimulant drugs do for ADHD as a treatment?

A

Increases the availability of dopamine and norepinephrine in synapses which leads to improved function in some

59
Q

Signs and Symptoms of Autism Spectrum Disorders

A
  • 12 mo of age
  • Poor eye contacted
  • Decreased shared attention
  • Decreased communication
  • Decreased social interaction
60
Q

Autistic Disorder

A
  • Limited interests
  • Appear to lack imagination
  • Not interested in interacting with others
61
Q

Asperger’s Disorder

A
  • Speak/have normal or higher intelligence
  • Limited social skills
  • Narrow range of interests
  • Repetitive/frequently obsessive behaviors that interfere with school, work or social life
62
Q

Pervasive Developmental Disorders

A
  • Atypical behaviors similar to autism or Asperger’s disorder, but do not meet all criteria for diagnosis of autism/Asperger’s
63
Q

What neurologic development happens in the embryonic stage (day 15 - end of wk 8)?

A
  • Neural tube formation (day 18 - 26)

- Brain formation (day 28)

64
Q

Growing Into Deficit

A

Nervous system damage occurring early is not evident until damaged system normally becomes functional

65
Q

Developmental Coordination Disorder

A

Classification for children with normal intellect w/o TBI, CP or other neurologic problems

  • Lack motor coordination to perform tasks that most children their age able to perform
  • Usually continues into adulthood
66
Q

What time period is the CNS most susceptible to major malformation?

A

Between day 14 and wk 20

67
Q

What are the effects of alcohol abuse during pregnancy?

A

FAS or alcohol related birth defects

  • Abnormally small head, indistinct philtrum, thin upper lip, short vertical space between open eyelids
  • Cognitive, movement and behavioral problems
  • Impaired intelligence, memory, language, attention, reaction time, visuospatial abilities, decision-making skills, goal-oriented behavior, fine/gross motor skills, social/adaptive functioning
68
Q

Contribution of somatosensory nociceptive afferents during acute appendicitis:

A

Signaling conscious awareness of pain in umbilical region

69
Q

What results from sympathetic activation?

A
  • Increased blood flow to active muscles
  • Increased blood glucose levels
  • Dialation of bronchioles
  • Increased HR
70
Q

What does autonomic regulation of the heart depend on?

A

Parasympathetic fibers of vagus nerve and sympathetic fibers from thoracic level

71
Q

Signs of Horner’s syndrome

A
  • Group of symptoms seen when lesion to descending sympathetic tract, upper thoracic SC, brachial plexus or cervical sympathetic chain affected (sympathetic activity to one side of head decreased)
  • Ipsilateral upper eyelid drooping
  • Constriction of pupil
  • Skin vasodilation
  • Absence of sweating of ipsilateral face/neck
72
Q

Causes of syncope

A
  • Strong emotions

- Prolonged bed rest and then position change

73
Q

Describe the process of muscle contraction

A
  • Binding of Ca2+ with troponin causes tropomyosin to move, exposing active sites on actin for myosin to bind
  • When the head of myosin swivel, the sarcomere actively contracts
74
Q

Signs of UMNL: Spastic

A

More muscle contraction

75
Q

Signs of UMNL: Hypertonic

A

More muscle tone

76
Q

Signs of UMNL: Hyperreflexic

A

More muscle reflexes

77
Q

Signs of UMNL: Disuse Atrophy

A

More disuse of the muscle

78
Q

Signs of UMNL: Babinski Sign

A

Toes point up

79
Q

Signs of LMNL: Flaccid

A

Less muscle contraction

80
Q

Signs of LMNL: Hypotonic

A

Less muscle tone

81
Q

Signs of LMNL: Hypreflexia

A

Less muscle reflexes

82
Q

Signs of LMNL: Denervation Atrophy

A

Less muscle innervation

83
Q

Signs of LMNL: Babinski Sign

A

Toes point down

84
Q

Symptoms of Lesions: Vestibulocerebellum

A

Unsteadiness, truncal ataxia - difficulty maintaining sitting/standing balance
Nystagmus - abnormal eye movement

85
Q

Symptoms of Lesions: Spinocerebellum

A

Intentional tremor - shaking of limb during voluntary movement
Ataxic gait - wide based unsteady, staggering, veering gait
Dysarthria - slurred, poorly articulated speech
Dysdiadochocinesia - inability to rapidly alternate movements
Dysmetria - inability to accurately move an intended distance
Movement decomposition - moving each joint separately during an activity

86
Q

Cerebrocerebellum

A

Finger ataxia - inability to move fingers in coordinated mater
Dysarthria - slurred, poorly articulated speech

87
Q

Goal Directed Behavior Loop (Basil Ganglia)

A
  • Makes perceptual decisions
  • Plans and decides upon actions in context
  • Divergent thinking
88
Q

Social Behavior Loop (Basil Ganglia)

A
  • Recognition of social disapproval
  • Self regulatory control
  • Select relevant information from irrelevant, maintains attention and decision making
89
Q

Emotion Loop (Basil Ganglia)

A
  • Emotions

- Concerned with seeking rewards

90
Q

Signs of akinetic-rigid Parkinson’s

A
  • Akinesia/hypokinesia/bradykinesia
    • Generally, hypokinesia or bradykinesia (not akinesia)
  • Rigidity
  • Postural unsteadiness
  • Resting tremor
  • Freezing during movement (FOG)
    • Often triggered by visual cues
  • Visuaoperceptual impairment
  • Mask like facial expression
  • Non-motor signs: depression, psychosis, Parkinson’s dementia, autonomic dysfunction
  • Difficulty initiating movement
  • Less control of amount of force their muscle produce
  • Prone to falls
  • Postural corrections are slow
  • Cogwheel rigidity
  • Rigidity may be present even during sleep
  • Resting tremor including pin rolling tremor of hands
91
Q

Huntington’s Disease

A

Autosomal dominant hereditary disorder that causes degeneration in many areas of the brain, primarily in stratum and cerebral cortex

  • Characterized by hyperkinesia
  • Chorea: consisting of involuntary, jerky, rapid movements and dementia
92
Q

Cervical Plexus Emerges

A

C1 - C4 // deep to SCM

93
Q

Cervical Plexus Innervates

A
  • Cutaneous sensory information from posterior scalp to clavicle
  • Motor innervation of neck/diaphragm (Phrenic nerve)
94
Q

Brachial Plexus Emerges

A

Anterior rami of C5-T1 between ant/mid scalene muscles, passes deep to clavicle and enter axilla
- Distal axilla, plexus becomes - radial, axilla, ulnar, median, musculotaneous

95
Q

Brachial Plexus Innervates

A

Entire UE

96
Q

Lumbar Plexus Emerges

A

Anterior rami of L1-L4 and forms in psoas muscles

97
Q

Lumbar Plexus Innervates

A

Skin/muscles of anterior/medial thigh

- Cutaneous branch, medial leg/foot

98
Q

Sacral Plexus Emerges

A

Sacrum

99
Q

Sacral Plexus Innervates

A

Posterior thigh and most of leg/foot

100
Q

Characteristics associated with autonomic dysreflexia

A

Abrupt increase in BP and pounding headache

101
Q

Symptoms of vestibular dysfunction

A
  • Pt report dizziness are often describing different experiences
    Vertigo - illusion of movements
    Near syncope - feeling of impending faint
    Dysequilibrium - loss of balance
    Light headedness - inability to concentrate
102
Q

Hallpike Maneuver

A

Designed to provoke maximal movement of otoconia in posterior semicircular canals as diagnostic tests for Benign Paroxysmal Postitional Vertigo (BPPV)
- If elicits nystagmus and vertigo after few seconds of latency indicates otoconia in horizontal semicircular canal

103
Q

Myasthenia Gravis

A

Autoimmune disorder where antibodies destroy nicotinic receptors on muscle cells (CNS)

  • Normal levels of ACh released, but not enough receptors to bind with at neuromuscular joint
  • Slowly progressive
  • Worsens throughout day
104
Q

S/S of Myasthenia Gravis

A

Ptosis, proximal limb weakness, dysarthria, dysphagia

105
Q

Guillian Barre Syndrome

A

Autoimmune disorder that attach Schwann cells which leads to demyelination of peripheral motor/sensory neurons

  • Rapid onset, gradual recover
  • Severe fatigue
106
Q

S/S of Guillian Barre Syndrome

A
  • Decreased sensation
  • Muscle paralysis
  • Distal to proximal symmetric progression

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