Neuroanatomy Flashcards
1
Q
3 ascending tracts?
A
- lat spinothalamic
- ant spinothalamic
- dorsal column medial lemniscus
2
Q
_____ spinothalamic = tests pain, hot/cold of extremities
A
lat
3
Q
Receptors in lat spinothalamic tract ?
A
free nerve endings
4
Q
Lat spinothalamic: sharp pain = __ ____ fibers, slow/dull are type __ fibers
A
A delta; C
5
Q
Lat spinothalamic = ascends in lateral white column on SC, crosses w/in __ - __ segments
A
1-2
6
Q
Lat spinothalamic: if HALF the cord has a lesion, ______ loss at the level and ______ loss below the lesion
A
IPSI; CONTRA
7
Q
______ spinothalamic tract = crude touch and pressure
A
anterior
8
Q
Receptors in anterior spinothalamic tract?
A
- Merckels discs
- Ruffini corpuscles
- free nerve endings
9
Q
Nerve types in anterior spinothalamic tract?
A
- A delta
2. A beta
10
Q
Ant spinco thalamic ascends in ____ white column and crosses w/in __ - __ segments
A
anterior; 1-2
11
Q
Where does the anterior spinothalamic tract finish?
A
parietal lobe
12
Q
Ant spinothalamic: if HALF the cord has a lesion, ______ loss at level and _____ loss below the lesion
A
IPSI; CONTRA
13
Q
DCML = __ ___ discrimination
A
2 point
14
Q
_______ = fine touch, stereognosis, and vibration
A
DCML
15
Q
Receptors in DCML?
A
- pacinian corpuscle
- Merckel’s disc
- Meissners
16
Q
Type of nerve fiber in DCML?
A
a beta
17
Q
DCML: fibers cross in ____ ____
A
brain stem
18
Q
DCML: lesion below medulla = _____ loss; lesions above medulla= _____ loss
A
ipsi; contra
19
Q
2 descending tracts?
A
- lateral corticospinal
2. anterior corticospinal
20
Q
_____ _____ = primary motor tract
A
lat corticospinal; anterior corticospinal
21
Q
Lat corticospinal: 90% of fibers cross in ______ (part of ______)
A
pyramids; brainstem
22
Q
Lat corticospinal: synapse in ___ horn in grey matter of SC; goes out on an ___ motor neuron; terminates at the neuromuscular junction
A
ant; alpha
23
Q
Lat corticospinal: lesions ABOVE level of medulla = loss of voluntary movement _______ to the lesion
A
CONTRA
24
Q
_____ corticospinal = 10% that cross at level of innervation
A
anterior
25
Ant corticospinal = target _____ motor neurons; start in _____ lobe
lower; frontal
26
Ant corticospinal tracts travel in ______ white column
ventral
27
Ant corticospinal: if lesions i on one side of cord = loss of 10 % voluntary movement _______ to the lesion
CONTRA
28
If internal carotid artery if affected, collateral supply is possible though which two arteries?
1. anterior cerebral artery
| 2. middle cerebral artery
29
_____ _____ = main supply for ant, post and middle cerebral arteries
internal carotid
30
6 deficits if internal carotid artery is compromised?
1. contralateral hemiplegia and hemi-sensory disturbance
2. global aphasia
3. mentally slow
4. contralateral homonymous hemianopia
5. partial Horner's syndrome
6. gaze palsy
31
If anterior cerebral artery is compromised what deficits do we see (3)?
1. weakness and sensory loss of contra limbs
2. self care problems
3. emotionally labile
32
If middle cerebral artery is compromised what deficits do we see (7) ?
1. contra hemiplegia. hemi sensory loss, hemianopia
2. contralateral neglect
3. aphasia if on dominant side
4. apraxia
5. impaired hearing
6. difficulty dressing
7. may also produce motor speech dysfunction
33
Two _______ arteries join to form the basilar artery
vertebral
34
Largest branch of vertebral artery?
PICA
35
Post cerebral artery supplies ______ lobes
occipital
36
8 deficits if PCA is compromised?
1. vision problems
2. CN III palsy
3. contralateral hemiplegia,
4. chorea
5. hemiballism
6. semi-sensory impairment
7. contralateral homonymous hemianopia
8. difficulty w/ naming and colours
37
Superior cerebellar artery supplies ______
cerebellum
38
3 deficits if superior cerebellar artery is compromised ?
1. limb ataxia
2. Horners syndrome
3. contralateral sensory loss
39
3 arteries that supply cerebellum?
1. ant inf cerebellar artery
2. PICA
3. superior cerebellar artery
40
5 deficits if ant inf cerebellar artery is compromised ?
1. ispilateral limb ataxia
2. ipsilateral Horners
3. contralateral sensory loss of limbs and trunk
4. facial weakness
5. paralysis of lateral gaze
41
Damage to ______ = deficits such as dysarthria, ispilateral limb ataxia, veritgo, nystagmus, ipsilateral horners, sensory loss of face, pharyngeal and laryngeal paralysis, and contralateral sensory loss of trunk
PICA
42
Brocas area = in the ____ _____ lobe
left frontal
43
Wernickes = in ____ ______ lobe
left temporal
44
Where is the olfactory area located?
both temporal lobes
45
Left CVA = most muscles on ___ side of body affected.
right
46
4 areas of deficits seen with left CVA?
1. aphasia
2. numerical and scientific skills
3. spoken and written language
4. sign language
47
6 deficits seen with R CVA?
1. musical and artistic awareness
2. spatial and pattern perception
3. recognition faces
4. emotional content of language
5. discriminating smells
6. HEMINEGLECT
48
Damage to _____ areas with right CVA = difficulty discriminating smells
Broadmanns
49
Cranial nerves?
1. olfactory
2. optic
3. oculomotor
4. trochlear
5. trigeminal
6. abducens
7. facial
8. vestibular
9. glossopharygeal
10. vagus
11. accessory
12. hypoglossal
50
Testing olfactory nerve?
introduce non-irritating smells to one nostril at a time
51
Damage to olfactory nerve?
anosmia
52
Optic nerve responsible for _____
vision
53
Testing optic nerve?
1. Snellen chart
| 2. peripheral vision testing
54
Damage to optic nerve can cause what 2 things ?
1. blindness
| 2. homonymous hemianopsia
55
_______ nerve = pupillary reflexes
oculomotor
56
5 muscles supplied by occulomotor nerve?
1. inferior oblique
2. medial rectus
3. superior rectus
4. inferior rectus
5. levator palpebrae
57
Autonomic branch of oculomotor nerve supplies _____ _____ and ______ muscles
sphincter pupillae; ciliary
58
How to test oculomotor nerve?
1. pupil Ax: size, shape and equality
2. pupillary light reflex
3. H test
59
Damage to oculomotor nerve?
1. loss of pupillary constricion
| 2. Horners syndrome
60
5 S/S of Horners syndrome ?
1. ptosis
2. mitosis (pupil construction)
3. decreased sweating of face
4. redness / conjunctiva of eye
5. unequal pupils
61
Trochlear motor innervation = _____ ____ muscle
superior oblique
62
How to test trochlear nerve?
1. test with CN III
| 2. smooth pursuits
63
Damage to trochlear nerve - eye cannot look down when ______
adducted
64
3 branches of trigeminal nerve and respective sensory innervation?
1. ophthalmic
2. maxillary
3. mandibular
65
4 tests for trigeminal nerve?
1. pain and light touch of face
2. open and close jaw against resistance
3. corneal reflex
4. jaw jerk reflex
66
Abducens motor branch to ____ _____ muscle
lateral rectus (abducts eye)
67
How to test abducens nerve?
observe eye position
68
Damage to abducens?
eye pulled inward, cannot look out
69
Facial sensory branch = taste from ______ 2/3 of tongue
anterior
70
Motor branch of facial nerve = muscles of facial ______
expression
71
Autonomic branch of facial nerve = ______ control of lacrimal, nasal mucosal, submandibular and sublingual glands
parasympathetic
72
How to test facial nerve?
motor function of facial muscles -
1) raise eyebrows
2) frown
3) smile
4) close eyes tightly
5) puff cheeks
73
Damage to facial nerve?
1. bell's palsy
2. UMN lesion
3. LMN lesion
74
Facial nerve ____ lesion = damage to ______ LOWER half of face
CONTRa
75
Facial nerve _____ lesion = damage to _______ side of face
ISPILATERAL
76
Sensory branch of vestibulocochlear nerve: hearing (_______ branch); linear and angular acceleration acceptation or head position (_______ branch) in space to maintain balance and stability
cochlear; vestibular
77
How to test vestibulocochlear nerve?
1. balance
2. gaze instability w/ head rotations
3. auditory acuity
78
What does Weber's test examine?
auditory acuity
79
Damage to vestibulocochlear nerve can cause what 6 things ?
1. vertigo
2. disequilibrium
3. nystagmus
4. deafness
5. tinnitus
6. hearing loss
80
Glossopharyngeal sensory division = touch and taste from _______ 1/3 of tongue; visceral sensory from _______ bodies
poster; carotid
81
Motor branch of glossopharyngeal nerve = ______ muscle, aids in ______ (voice quality)
pharyngeal; phonation
82
Autonomic branch of glossopharyngeal nerve = increase secretion from _______ salivary gland
parotid
83
How to test glossopharyngeal nerve?
1. listen to voice quality
2. difficulty swallowing
3. observe soft palate while patient says "ah"
4. gag reflex
84
Damage to glossopharyngeal nerve could lead to what 3 things ?
1. dysphonia
2. dysphagia
3. absent gag reflex
85
Sensory branch of vagus nerve = ______ sensation
visceral
86
Sensory branch of vagus nerve detects visceral sensation EXCEPT pain (T/F)
TRUE
87
Motor branch of vagus nerve = _______ and _______ muscles, and muscles are back of tongue, elevates the ____ palate, controls position of uvula, gag reflex
pharyngeal; laryngeal; soft
88
Autonomic branch of vagus nerve = smooth muscle/ glands of which 5 organs?
1. heart
2. lungs
3. larynx
4. trachea
5. most abdominal organs!
89
Test vagus nerve same as you would with CN ___
IX
90
Accessory motor branch = to ____ and ____
trapezius; SCM
91
How to test accessory nerve?
examine muscle bulk, MMT and associated muscles
92
Damage to accessory nerve can lead to what 4 things?
1. atrophy
2. fasciculations
3. inability to shrug ipsilateral shoulder
4. inability to turn head to contralateral side
93
Hypoglossal nerve motor branch = intrinsic and extrinsic muscles of _____
tongue
94
How to test hypoglossal nerve?
protrude tongue and observe for deviations
95
Damage to hypoglossal nerve can lead to what 2 things ?
1. dysarthria
| 2. deviation of tongue to weak side
96
2 outcome measures for motor control / strength?
1. MMT
| 2. Fugl-Meyer
97
2 outcome measures for cognition and perception?
1. MMSE
| 2. MOCA
98
Test for tone and spasticity in adults? in Peds?
1. modified ashworth
| 2. modified Tardieu
99
2 outcome measures for sensation?
1. sensation body diagram
| 2. Nottingham sensory assessment
100
4 outcome measures for gait?
1. TUG
2. 10m walk
3. 6MWT
4. dynamic gait index
5. functional gait assessment
101
5 outcome measures for balance?
1. BERG
2. Fullerton balance assessment
3. Best / mini best
4. functional reach test
5. community balance and mobility scale
102
4 outcome measures for UE ?
1. DASH
2. action research arm test
3. UE performance test for elderly
4. wolf motor function test
103
_____ _____ _____ = test quadrants w/ other eye closed; pt looking at you, then superior, inferior, medial, and lateral
visual field testing
104
Pupillary light reflex: should see _______ of both pupils, direct and indirect (aka the ______ reflex)
constriction; consensual
105
_______ = bring finger slowly towards patients nose and look for convergence and pupillary constriction
accommodation
106
Accommodation tests which 4 cranial nerves?
1. optic
2. oculomotor
3. trochlear
4. abducens
107
______ = look for dropping of eyes; tests oculomotor nerve
ptosis
108
Eye movements tests which 3 cranial nerves ?
1. oculomotor
2. trochlear
3. abducens
109
Smooth pursuits = range of __ degrees side to side and up and down, look for ______
30; nystagmus
110
Saccades = have finger __ degrees to one side of nose; have pt look rapidly side to side and up and down, look for _____
15; overshooting
111
Light touch tests?
DCML
112
Sharp and dull tests?
lat spinothalamic
113
Hot/cold tests?
lat spinothalamic
114
Complete hot/cold testing __ - __ times and record it as one of what 4 options ?
3-5; intact, reduced, absent, hyperesthesia
115
If light touch is intact, do you need to go and further test sharp / dull?
No
116
Vibratory sense tests ______
DCML
117
Vibratory sense: have a ___Hz tuning fork, start distally and move proximally, hold to specific area of skin for __ minutes
128; 2
118
Vibratory sense can be recorded as one of what 3 things?
1. intact
2. absent
3. impaired
119
Joint position sense tests which pathway?
DCML
120
Joint position sense: start _____ and work _____ until you get normal, up/down
distal; proximal
121
Record joint position sense as one of what 3 things ?
1. intact
2. absent
3. impaired
122
2 point discrimination tests which pathway?
DCML
123
For 2 point discrimination, start with points __ mm apart
5
124
Normal mm distance for 2 point discrimination in fingers, palms and trunk?
1. fingers = 2-5 mm
2. palm = 8-12 mm
3. extremity and trunk = 20-30mm
125
How to perform stereognosis test, and what 3 ways you can record it?
1. pick three objects, test one hand at a time
| 2. can be intact, impaired or absent
126
_________ = assessing all systems and higher level planning, draw numbers or letters on palm (can be intact, absent of impaired)
graphesia
127
____ _____ = ask if you are touching them on both sides r one, can be intact, absent or present
double stimulation
128
Is sitting balance usually impaired with vestibular issues?
NO
129
6 contraindications for stretching ???
1. bony block
2. recent #
3. acute inflammatory process
4. sharp or acute joint pain
5. hematoma or tissue trauma
6. contracture or soft tissue is providing stability to area or function (tenodesis grip)
130
2 indications for PNF?
1. increase ROM and strength in multi-joint muscles
| 2. Ax abnormal movement patterns
131
UE and LE D1 PNF pattern?
1. shoulder ER --> IR w/ elbow extension (think upper cut)
| 2. hip IR --> ER (kicking a ball)
132
UE and LE D2 PNF pattern?
1. shoulder ER --> IR (reach pick and apple and put it in bag)
2. hip IR --> ER (fire hydrant)
133
CI's for PNF?
same as any for resistant exercises
134
Precautions for PNF? (4)
1. avoid quick stretch on hypertonic mm
2. gentle stretch and care on hypotonic mms
3. care not to promote invariant movement patterns
4. watch for substitution
135
Flexor synergy for UE?
flexion of elbow, ER and ABD of shoulder, flex of wrist
136
Flexor synergy of LE?
hip flex, knee flex, DF an INV of foot
137
Extensor synergy for UE ?
shoulder adducts and IR, elbow extension/pronation, wrist extends
138
Extensor synergy for LE?
hip extends and IR, knee extends, ankle PF and inverts
139
Muscle _____ = resistance force in response to lengthening, a continuum
resistance
140
Muscle tone can occur from neural and non-neural factors (T/F)
TRUE
141
Type of non-neural muscle tone? (7)
1. muscle length
2. thixotrophy
3. CT and muscle fiber changes
4. immobilization
5. weakness
6. abnormal postures
7. abnormal movement patterns
142
Types of neural muscle tone?
1. increased input to alpha motor neuron (emotion, fear, pain, infection, full bladder)
2. loss of functioning motor units
3. altered motor unit firing rate
4. loss of orderly recruitment
5. impaire motor unit synchronisation
143
______ = velocity dependent increase in passive stretch
SPASTICITY
144
______ = velocity INDependent to passive stretch ; usually seen with a TBI
rigidity
145
____ lesions = hypotonia / hyporeflexia
LMN
146
___ lesions = hypotonia or hyperreflexia OR hypertonia and hypereflexia
UMN
147
Modified ashworth scale = __ - ___ scale
0-5
148
How to test modified ash worth scale?
ask them to do AROM, feel muscle, then PROM, then PROM w/ quick stretch
149
3 examples of exaggerated proprioceptive reflexes ?
1. clonus
2. tendon jerk
3. pendulum test
150
2 examples of exaggerated cutaneous reflexes ?
1. touch to palmar and plantar surfaces
| 2. babinski reflex
151
______ = failure of muscle coordination and irregularity of muscle action due to cerebellar lesion
ataxia
152
How to test UE coordination for cerebellar lesion?
1. finger to nose
2. dysdiadochokinesia
3. finger opposition
153
How to test LE coordination for cerebella lesion?
1. toe tapping
| 2. heel on shin
154
Balace test for cerebellar lesions?
Rhomberg (to differentiate from somatosensory deficit)
155
3 postural strategies?
1. hip
2. ankle
3. stepping
156
5 functional measures of postural strategies?
1. BERG
2. fullerton
3. ABC
4. community balance and mobility scale
5. functional reach test
157
When working on functional mobility, you should always monitor what 4 things?
1. vitals
2. dizzines
3. lightheadedness
4. change of status or disease symptoms
158
Someone walking > ___ m/s = community ambulator
.8
159
___m/s = average walking speed for community ambulators
1.3
160
For reach and grasp, what 3 systems must work together?
1. postural control
2. transport
3. manipulation
161
Reach and grasp: ______ movements are preprogrammed and don't require sensory feedback, _____ does
ballistic; manipulation
162
Grasp requires which 3 movements?
1. radial deviation
2. wrist extension
3. thumb opposition
163
Seating Ax in SCI is done is sitting and lying (T/F)
TRUE
