NeuroExam/Dx/PathoPhys Dz Flashcards
Neuroanatomic localization to alterations in a patient sensorium is usually caused by alternation in which region?
A) Ascending reticular activating system
B) Cerebellum
C) Forebrain
D) Cranial nerve VIII
A) Ascending reticular activating system
What is pleurothotonus? A) Multiple sites of flaccid paralysis B) Multiple sites of rigid extension C) Deviation of the head and neck to one side D) Seen with decerebellate rigidity
C) Deviation of the head and neck to one side
What is the difference between decerebellate rigidity and decerebrate rigidity?
A) Decerebrate causes flexion of hips.
B) Decerebrate generally doesn’t cause change in mentation.
C) Decerebellate rigidity involves flexion of the hips.
D) Decerebellate always affects mentation
C) Decerebellate rigidity involves flexion of the hips.
Which of the following is false regarding reflexes?
a. A normal reflex requires an intact afferent (sensory) and efferent (motor) arm
b. The afferent and efferent arms tend not to enter and exit the spinal cord at the same segments
c. The afferent arm is composed of sensory receptors, sensory nerve, dorsal nerve root, and spinal cord segment
d. Sensory receptors include the muscle spindle or Golgi tendon organ
b. The afferent and efferent arms tend not to enter and exit the spinal cord at the same segments
Which of the following reflexes is not matched with the appropriate nerve segments
a. Patellar reflex – l4-l6
b. Biceps – C6-C8
c. Triceps – C7-T2
d. Withdrawal – C1-C5
d. Withdrawal – C1-C5 (C6-T2)
Patellar: femoral
Biceps: w/ musculocutaneous
Triceps: Radial n.
L6-S1 is sciatic
The menace is a learned response that may not be present until which age? 6-8 weeks 8-10 weeks 10-12 weeks 12-14 weeks
10-12 weeks
The menace response requires all these aspects of the brain to function except which? Cerebellum Medial geniculate nucleus. Occipital lobe of the cerebrum Optic nerve
Medial geniculate nucleus. (Should be lateral gen nucleus)
Describe what it means to have a negative direct but positive indirect PLR verse a negative direct and negative indirect PLR? Where are the lesions?
if the nonresponsive pupil is the result of an ocular, retinal, or optic nerve lesion, it will constrict when the light is directed into the contralateral eye (e.g., positive indirect pupillary light reflex).
If the nonresponsive eye remains dilated with light directed into the unaffected eye, a lesion involving the parasympathetic oculomotor nerve nucleus of CN III should be suspected.
Which of the following autonomous zones will have sensation if the sciatic nerve is damaged?
- Dorsal surface
- Plantar surface
- Medial surface
- Lateral surfac
Medial surface (saphaneous is a br of femoral nerve that projects to L4-L6 spinal cord segments)
Lateral surface - not an autonomous zone
Provide the localization for the following clinical signs: Normal mentation, reduced tone in the thoracic limbs, normal to exaggerated tone in pelvic limbs, hypalgesia in thoracic limbs, unilateral horner syndrome.
- C1-C5
- C6-T2
- T3-L3
- Mid to caudal brainstem
C6-T2 (T1-T3 specifically with the Horner’s syndrome)
Provide the localization for the following clinical signs: depressed mental state, vestibular ataxia, facial paresis, increased tone in all four limbs,
- Prosencephalon
- C1-C5
- Mid to caudal brainstem
- Cerebellum
- Mid to caudal brainstem (Pontine lesion)
True/false: Spinal shock is disruption of ascending inhibitory axons of border cells in the dorsolateral border of the ventral grey matter L1-L4.
False
Correct answer is schiff-sherrington
T/F Dysmetria or a disturbance in rate, range and force of movement is seen with general ataxia
False: Cerebellar ataxia
T/F reticulospinal and rubrospinal tracts function in gait generation
True
T/F Abnormal postural reactions detect a lesion functionally ipsilateral to the level of the medulla oblongata
False: midbrain
anatomic crossover at medulla oblongata
