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Written Prep > Neuroanatomy > Flashcards

Neuroanatomy Flashcards

1
Q

3 ascending tracts?

A
  1. lat spinothalamic
  2. ant spinothalamic
  3. dorsal column medial lemniscus
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2
Q

_____ spinothalamic = tests pain, hot/cold of extremities

A

lat

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3
Q

Receptors in lat spinothalamic tract ?

A

free nerve endings

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4
Q

Lat spinothalamic: sharp pain = __ ____ fibers, slow/dull are type __ fibers

A

A delta; C

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5
Q

Lat spinothalamic = ascends in lateral white column on SC, crosses w/in __ - __ segments

A

1-2

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6
Q

Lat spinothalamic: if HALF the cord has a lesion, ______ loss at the level and ______ loss below the lesion

A

IPSI; CONTRA

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7
Q

______ spinothalamic tract = crude touch and pressure

A

anterior

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8
Q

Receptors in anterior spinothalamic tract?

A
  1. Merckels discs
  2. Ruffini corpuscles
  3. free nerve endings
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9
Q

Nerve types in anterior spinothalamic tract?

A
  1. A delta

2. A beta

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10
Q

Ant spinco thalamic ascends in ____ white column and crosses w/in __ - __ segments

A

anterior; 1-2

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11
Q

Where does the anterior spinothalamic tract finish?

A

parietal lobe

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12
Q

Ant spinothalamic: if HALF the cord has a lesion, ______ loss at level and _____ loss below the lesion

A

IPSI; CONTRA

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13
Q

DCML = __ ___ discrimination

A

2 point

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14
Q

_______ = fine touch, stereognosis, and vibration

A

DCML

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15
Q

Receptors in DCML?

A
  1. pacinian corpuscle
  2. Merckel’s disc
  3. Meissners
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16
Q

Type of nerve fiber in DCML?

A

a beta

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17
Q

DCML: fibers cross in ____ ____

A

brain stem

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18
Q

DCML: lesion below medulla = _____ loss; lesions above medulla= _____ loss

A

ipsi; contra

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19
Q

2 descending tracts?

A
  1. lateral corticospinal

2. anterior corticospinal

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20
Q

_____ _____ = primary motor tract

A

lat corticospinal; anterior corticospinal

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21
Q

Lat corticospinal: 90% of fibers cross in ______ (part of ______)

A

pyramids; brainstem

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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

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23
Q

Lat corticospinal: lesions ABOVE level of medulla = loss of voluntary movement _______ to the lesion

A

CONTRA

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24
Q

_____ corticospinal = 10% that cross at level of innervation

A

anterior

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25
Q

Ant corticospinal = target _____ motor neurons; start in _____ lobe

A

lower; frontal

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26
Q

Ant corticospinal tracts travel in ______ white column

A

ventral

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27
Q

Ant corticospinal: if lesions i on one side of cord = loss of 10 % voluntary movement _______ to the lesion

A

CONTRA

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28
Q

If internal carotid artery if affected, collateral supply is possible though which two arteries?

A
  1. anterior cerebral artery

2. middle cerebral artery

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29
Q

_____ _____ = main supply for ant, post and middle cerebral arteries

A

internal carotid

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30
Q

6 deficits if internal carotid artery is compromised?

A
  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
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31
Q

If anterior cerebral artery is compromised what deficits do we see (3)?

A
  1. weakness and sensory loss of contra limbs
  2. self care problems
  3. emotionally labile
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32
Q

If middle cerebral artery is compromised what deficits do we see (7) ?

A
  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
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33
Q

Two _______ arteries join to form the basilar artery

A

vertebral

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34
Q

Largest branch of vertebral artery?

A

PICA

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35
Q

Post cerebral artery supplies ______ lobes

A

occipital

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36
Q

8 deficits if PCA is compromised?

A
  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
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37
Q

Superior cerebellar artery supplies ______

A

cerebellum

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38
Q

3 deficits if superior cerebellar artery is compromised ?

A
  1. limb ataxia
  2. Horners syndrome
  3. contralateral sensory loss
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39
Q

3 arteries that supply cerebellum?

A
  1. ant inf cerebellar artery
  2. PICA
  3. superior cerebellar artery
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40
Q

5 deficits if ant inf cerebellar artery is compromised ?

A
  1. ispilateral limb ataxia
  2. ipsilateral Horners
  3. contralateral sensory loss of limbs and trunk
  4. facial weakness
  5. paralysis of lateral gaze
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41
Q

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

A

PICA

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42
Q

Brocas area = in the ____ _____ lobe

A

left frontal

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43
Q

Wernickes = in ____ ______ lobe

A

left temporal

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44
Q

Where is the olfactory area located?

A

both temporal lobes

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45
Q

Left CVA = most muscles on ___ side of body affected.

A

right

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46
Q

4 areas of deficits seen with left CVA?

A
  1. aphasia
  2. numerical and scientific skills
  3. spoken and written language
  4. sign language
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47
Q

6 deficits seen with R CVA?

A
  1. musical and artistic awareness
  2. spatial and pattern perception
  3. recognition faces
  4. emotional content of language
  5. discriminating smells
  6. HEMINEGLECT
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48
Q

Damage to _____ areas with right CVA = difficulty discriminating smells

A

Broadmanns

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49
Q

Cranial nerves?

A
  1. olfactory
  2. optic
  3. oculomotor
  4. trochlear
  5. trigeminal
  6. abducens
  7. facial
  8. vestibular
  9. glossopharygeal
  10. vagus
  11. accessory
  12. hypoglossal
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50
Q

Testing olfactory nerve?

A

introduce non-irritating smells to one nostril at a time

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51
Q

Damage to olfactory nerve?

A

anosmia

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52
Q

Optic nerve responsible for _____

A

vision

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53
Q

Testing optic nerve?

A
  1. Snellen chart

2. peripheral vision testing

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54
Q

Damage to optic nerve can cause what 2 things ?

A
  1. blindness

2. homonymous hemianopsia

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55
Q

_______ nerve = pupillary reflexes

A

oculomotor

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56
Q

5 muscles supplied by occulomotor nerve?

A
  1. inferior oblique
  2. medial rectus
  3. superior rectus
  4. inferior rectus
  5. levator palpebrae
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57
Q

Autonomic branch of oculomotor nerve supplies _____ _____ and ______ muscles

A

sphincter pupillae; ciliary

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58
Q

How to test oculomotor nerve?

A
  1. pupil Ax: size, shape and equality
  2. pupillary light reflex
  3. H test
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59
Q

Damage to oculomotor nerve?

A
  1. loss of pupillary constricion

2. Horners syndrome

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60
Q

5 S/S of Horners syndrome ?

A
  1. ptosis
  2. mitosis (pupil construction)
  3. decreased sweating of face
  4. redness / conjunctiva of eye
  5. unequal pupils
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61
Q

Trochlear motor innervation = _____ ____ muscle

A

superior oblique

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62
Q

How to test trochlear nerve?

A
  1. test with CN III

2. smooth pursuits

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63
Q

Damage to trochlear nerve - eye cannot look down when ______

A

adducted

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64
Q

3 branches of trigeminal nerve and respective sensory innervation?

A
  1. ophthalmic
  2. maxillary
  3. mandibular
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65
Q

4 tests for trigeminal nerve?

A
  1. pain and light touch of face
  2. open and close jaw against resistance
  3. corneal reflex
  4. jaw jerk reflex
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66
Q

Abducens motor branch to ____ _____ muscle

A

lateral rectus (abducts eye)

67
Q

How to test abducens nerve?

A

observe eye position

68
Q

Damage to abducens?

A

eye pulled inward, cannot look out

69
Q

Facial sensory branch = taste from ______ 2/3 of tongue

A

anterior

70
Q

Motor branch of facial nerve = muscles of facial ______

A

expression

71
Q

Autonomic branch of facial nerve = ______ control of lacrimal, nasal mucosal, submandibular and sublingual glands

A

parasympathetic

72
Q

How to test facial nerve?

A

motor function of facial muscles -

1) raise eyebrows
2) frown
3) smile
4) close eyes tightly
5) puff cheeks

73
Q

Damage to facial nerve?

A
  1. bell’s palsy
  2. UMN lesion
  3. LMN lesion
74
Q

Facial nerve ____ lesion = damage to ______ LOWER half of face

A

CONTRa

75
Q

Facial nerve _____ lesion = damage to _______ side of face

A

ISPILATERAL

76
Q

Sensory branch of vestibulocochlear nerve: hearing (_______ branch); linear and angular acceleration acceptation or head position (_______ branch) in space to maintain balance and stability

A

cochlear; vestibular

77
Q

How to test vestibulocochlear nerve?

A
  1. balance
  2. gaze instability w/ head rotations
  3. auditory acuity
78
Q

What does Weber’s test examine?

A

auditory acuity

79
Q

Damage to vestibulocochlear nerve can cause what 6 things ?

A
  1. vertigo
  2. disequilibrium
  3. nystagmus
  4. deafness
  5. tinnitus
  6. hearing loss
80
Q

Glossopharyngeal sensory division = touch and taste from _______ 1/3 of tongue; visceral sensory from _______ bodies

A

poster; carotid

81
Q

Motor branch of glossopharyngeal nerve = ______ muscle, aids in ______ (voice quality)

A

pharyngeal; phonation

82
Q

Autonomic branch of glossopharyngeal nerve = increase secretion from _______ salivary gland

A

parotid

83
Q

How to test glossopharyngeal nerve?

A
  1. listen to voice quality
  2. difficulty swallowing
  3. observe soft palate while patient says “ah”
  4. gag reflex
84
Q

Damage to glossopharyngeal nerve could lead to what 3 things ?

A
  1. dysphonia
  2. dysphagia
  3. absent gag reflex
85
Q

Sensory branch of vagus nerve = ______ sensation

A

visceral

86
Q

Sensory branch of vagus nerve detects visceral sensation EXCEPT pain (T/F)

A

TRUE

87
Q

Motor branch of vagus nerve = _______ and _______ muscles, and muscles are back of tongue, elevates the ____ palate, controls position of uvula, gag reflex

A

pharyngeal; laryngeal; soft

88
Q

Autonomic branch of vagus nerve = smooth muscle/ glands of which 5 organs?

A
  1. heart
  2. lungs
  3. larynx
  4. trachea
  5. most abdominal organs!
89
Q

Test vagus nerve same as you would with CN ___

A

IX

90
Q

Accessory motor branch = to ____ and ____

A

trapezius; SCM

91
Q

How to test accessory nerve?

A

examine muscle bulk, MMT and associated muscles

92
Q

Damage to accessory nerve can lead to what 4 things?

A
  1. atrophy
  2. fasciculations
  3. inability to shrug ipsilateral shoulder
  4. inability to turn head to contralateral side
93
Q

Hypoglossal nerve motor branch = intrinsic and extrinsic muscles of _____

A

tongue

94
Q

How to test hypoglossal nerve?

A

protrude tongue and observe for deviations

95
Q

Damage to hypoglossal nerve can lead to what 2 things ?

A
  1. dysarthria

2. deviation of tongue to weak side

96
Q

2 outcome measures for motor control / strength?

A
  1. MMT

2. Fugl-Meyer

97
Q

2 outcome measures for cognition and perception?

A
  1. MMSE

2. MOCA

98
Q

Test for tone and spasticity in adults? in Peds?

A
  1. modified ashworth

2. modified Tardieu

99
Q

2 outcome measures for sensation?

A
  1. sensation body diagram

2. Nottingham sensory assessment

100
Q

4 outcome measures for gait?

A
  1. TUG
  2. 10m walk
  3. 6MWT
  4. dynamic gait index
  5. functional gait assessment
101
Q

5 outcome measures for balance?

A
  1. BERG
  2. Fullerton balance assessment
  3. Best / mini best
  4. functional reach test
  5. community balance and mobility scale
102
Q

4 outcome measures for UE ?

A
  1. DASH
  2. action research arm test
  3. UE performance test for elderly
  4. wolf motor function test
103
Q

_____ _____ _____ = test quadrants w/ other eye closed; pt looking at you, then superior, inferior, medial, and lateral

A

visual field testing

104
Q

Pupillary light reflex: should see _______ of both pupils, direct and indirect (aka the ______ reflex)

A

constriction; consensual

105
Q

_______ = bring finger slowly towards patients nose and look for convergence and pupillary constriction

A

accommodation

106
Q

Accommodation tests which 4 cranial nerves?

A
  1. optic
  2. oculomotor
  3. trochlear
  4. abducens
107
Q

______ = look for dropping of eyes; tests oculomotor nerve

A

ptosis

108
Q

Eye movements tests which 3 cranial nerves ?

A
  1. oculomotor
  2. trochlear
  3. abducens
109
Q

Smooth pursuits = range of __ degrees side to side and up and down, look for ______

A

30; nystagmus

110
Q

Saccades = have finger __ degrees to one side of nose; have pt look rapidly side to side and up and down, look for _____

A

15; overshooting

111
Q

Light touch tests?

A

DCML

112
Q

Sharp and dull tests?

A

lat spinothalamic

113
Q

Hot/cold tests?

A

lat spinothalamic

114
Q

Complete hot/cold testing __ - __ times and record it as one of what 4 options ?

A

3-5; intact, reduced, absent, hyperesthesia

115
Q

If light touch is intact, do you need to go and further test sharp / dull?

A

No

116
Q

Vibratory sense tests ______

A

DCML

117
Q

Vibratory sense: have a ___Hz tuning fork, start distally and move proximally, hold to specific area of skin for __ minutes

A

128; 2

118
Q

Vibratory sense can be recorded as one of what 3 things?

A
  1. intact
  2. absent
  3. impaired
119
Q

Joint position sense tests which pathway?

A

DCML

120
Q

Joint position sense: start _____ and work _____ until you get normal, up/down

A

distal; proximal

121
Q

Record joint position sense as one of what 3 things ?

A
  1. intact
  2. absent
  3. impaired
122
Q

2 point discrimination tests which pathway?

A

DCML

123
Q

For 2 point discrimination, start with points __ mm apart

A

5

124
Q

Normal mm distance for 2 point discrimination in fingers, palms and trunk?

A
  1. fingers = 2-5 mm
  2. palm = 8-12 mm
  3. extremity and trunk = 20-30mm
125
Q

How to perform stereognosis test, and what 3 ways you can record it?

A
  1. pick three objects, test one hand at a time

2. can be intact, impaired or absent

126
Q

_________ = assessing all systems and higher level planning, draw numbers or letters on palm (can be intact, absent of impaired)

A

graphesia

127
Q

____ _____ = ask if you are touching them on both sides r one, can be intact, absent or present

A

double stimulation

128
Q

Is sitting balance usually impaired with vestibular issues?

A

NO

129
Q

6 contraindications for stretching ???

A
  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
Q

2 indications for PNF?

A
  1. increase ROM and strength in multi-joint muscles

2. Ax abnormal movement patterns

131
Q

UE and LE D1 PNF pattern?

A
  1. shoulder ER –> IR w/ elbow extension (think upper cut)

2. hip IR –> ER (kicking a ball)

132
Q

UE and LE D2 PNF pattern?

A
  1. shoulder ER –> IR (reach pick and apple and put it in bag)
  2. hip IR –> ER (fire hydrant)
133
Q

CI’s for PNF?

A

same as any for resistant exercises

134
Q

Precautions for PNF? (4)

A
  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
Q

Flexor synergy for UE?

A

flexion of elbow, ER and ABD of shoulder, flex of wrist

136
Q

Flexor synergy of LE?

A

hip flex, knee flex, DF an INV of foot

137
Q

Extensor synergy for UE ?

A

shoulder adducts and IR, elbow extension/pronation, wrist extends

138
Q

Extensor synergy for LE?

A

hip extends and IR, knee extends, ankle PF and inverts

139
Q

Muscle _____ = resistance force in response to lengthening, a continuum

A

resistance

140
Q

Muscle tone can occur from neural and non-neural factors (T/F)

A

TRUE

141
Q

Type of non-neural muscle tone? (7)

A
  1. muscle length
  2. thixotrophy
  3. CT and muscle fiber changes
  4. immobilization
  5. weakness
  6. abnormal postures
  7. abnormal movement patterns
142
Q

Types of neural muscle tone?

A
  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
Q

______ = velocity dependent increase in passive stretch

A

SPASTICITY

144
Q

______ = velocity INDependent to passive stretch ; usually seen with a TBI

A

rigidity

145
Q

____ lesions = hypotonia / hyporeflexia

A

LMN

146
Q

___ lesions = hypotonia or hyperreflexia OR hypertonia and hypereflexia

A

UMN

147
Q

Modified ashworth scale = __ - ___ scale

A

0-5

148
Q

How to test modified ash worth scale?

A

ask them to do AROM, feel muscle, then PROM, then PROM w/ quick stretch

149
Q

3 examples of exaggerated proprioceptive reflexes ?

A
  1. clonus
  2. tendon jerk
  3. pendulum test
150
Q

2 examples of exaggerated cutaneous reflexes ?

A
  1. touch to palmar and plantar surfaces

2. babinski reflex

151
Q

______ = failure of muscle coordination and irregularity of muscle action due to cerebellar lesion

A

ataxia

152
Q

How to test UE coordination for cerebellar lesion?

A
  1. finger to nose
  2. dysdiadochokinesia
  3. finger opposition
153
Q

How to test LE coordination for cerebella lesion?

A
  1. toe tapping

2. heel on shin

154
Q

Balace test for cerebellar lesions?

A

Rhomberg (to differentiate from somatosensory deficit)

155
Q

3 postural strategies?

A
  1. hip
  2. ankle
  3. stepping
156
Q

5 functional measures of postural strategies?

A
  1. BERG
  2. fullerton
  3. ABC
  4. community balance and mobility scale
  5. functional reach test
157
Q

When working on functional mobility, you should always monitor what 4 things?

A
  1. vitals
  2. dizzines
  3. lightheadedness
  4. change of status or disease symptoms
158
Q

Someone walking > ___ m/s = community ambulator

A

.8

159
Q

___m/s = average walking speed for community ambulators

A

1.3

160
Q

For reach and grasp, what 3 systems must work together?

A
  1. postural control
  2. transport
  3. manipulation
161
Q

Reach and grasp: ______ movements are preprogrammed and don’t require sensory feedback, _____ does

A

ballistic; manipulation

162
Q

Grasp requires which 3 movements?

A
  1. radial deviation
  2. wrist extension
  3. thumb opposition
163
Q

Seating Ax in SCI is done is sitting and lying (T/F)

A

TRUE

Written Prep (9 decks)

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