Neuromuscular & nervous system

Question 0

Agnosia

Answer 0

Loss of ability to recognize common objects, people, or sounds.

Question 1

Apraxia

Answer 1

Inability to execute learned purposeful movements

Question 2

Alexia

Answer 2

Inability to understand written words

Question 3

Agraphia

Answer 3

Inability to communicate through writing

Question 4

Anasognosia

Answer 4

Unaware of the existence of his disability

Question 5

Basal ganglia
Structure
Function
Associated disorders

Answer 5

Caudate, putamen, globus pallidus, substantia nigra, subthalamic nuclei

Voluntary mvmnt, regulation of autonomic mvmnt, posture, mucle tone, control of motor responses

PD
Huntington's
Tourette's
ADD
OCD
Many addictions

Question 6

Amydala

Answer 6

Emotional and social processing
Fear and pleasure responses
Arousal
Processing of memory and forming emotional memory

Question 7

Frontal lobe lesion deficits

Answer 7

Range from: paralysis and apraxia to loss of executive fxn and goal directed behaviors.
Modifications to therapy may include response to perseveration, apraxia, and impaired executive fxn.
Apathy or may be uninhibited, distractible, and lack judgement.

Question 8

Parietal lobe lesion deficits

Answer 8

Abnormal sensory awareness, perception, and interpretation. Abnormal mvmnt patterns.
Dominant hemisphere (left): agraphia, alexia, agnosia
Non-Dominant hemisphere (right): dressing apraxia, constructnal apraxia, anosognosia
Contralateral sensory deficits
Impaired language comprehension
Impaired taste

Question 9

Temporal lesion deficits

Modifications to therapy

Answer 9

Affect short and long term memory. Learning deficits.
Wernicke’s area: inability to comprehend spoken language.

PT to provide a more kinesthetic approach, relying on demonstration.
New learning is available, but pt.s are usually unable to recall steps surrounding new skill.

Question 10

Occipital lobe lesion deficits

Therapy modifications

Answer 10

Various visual deficits
Ability to receive, but not perceive visual info

Avoid use of diagrams, written materials, reading
Environmental modifications secondary to visual deficits, field cuts, and potential for visual agnosia.

Question 11

Thalamus (Diencephalon)
Fxn
Damage to it.

Answer 11

Coordinates sensory info that goes to the cerebral cortex. It receives info from all sensory pathways except the olfactory tract. Then relays the info to the appropriate association cortex.

Damage can produce thalamic pain syndrome where their is spontaneous pain on the contralateral side of the body to the thalamus.

Question 12

Hypothalamus (diencephalon)
Fxn
Damage

Answer 12

Receives and integrates info from the ANS, assists in regulating hormones. Hunger, thirst, sexual behavior, sleeping, regulates body temp, adrenal and pituitary glands.

Deficits depend on location of lesion: obesity, sexual disinterest, poor temp control, diabetes.

Question 13

Subthalamus (diencephalon)

Answer 13

Regulates mvmnts produced by the skeletal muscles.

Question 14

Epithalamus (diencephalon)

Answer 14

Pineal gland: secretes melatonin, circadian rhythms, emotions.

Question 15

Midbrain fxn and key areas

Answer 15

Mesencephalon
Reflex center for visual, auditory, and tactile responses

Tectum: superor and inferior colliculi
Tegmentum: cerebral acqueduct, periaquaductal grey, reticular formation, substantia nigra, red nucleus

Question 16

Hindbrain (rhombencephalon) consists of:

Damage

Answer 16

Cerebellum (metencephalon): balance, posture, perform rapid alternating mvmnts. Consists of two hemispheres

Damage to one of side results in ipsilateral impairment to the body.
Ie. ataxia, nystagmus, tremor, hypermetria, poor coordination, deficits in postural reflexes, balance, equilibrium.

Pons (metencephalon): assists with regulation of respiratory rate, orientation of head in relation to visual and auditory stimuli.
Cranial nerves 5-8 originate from pons.

Medulla (myelencephalon): regulates ANS activity, resp rate, heart rate. Reflex centers for vomiting, coughing, sneezing.
Damage to motor tracts crossing the medulla produces contralateral impairments. Also relays somatic sensorybinfo from internal organs and controls arousal and sleep.
Cranial nerves 9-12 originate from medulla.

Question 17

Brainstem consists of:
Fxn
Damage

Answer 17

Midbrain, pons, medulla

Primitive fxns essential for survival: resp rate, heart rate, the reticular activating system.

Damage: brain death

The majority of cranial nerves originate here.

Question 18

Blood supply to the brain by the ACA (anterior cerebral artery) and expected possible impairment based on extent of vascular involvment

Answer 18

Contralateral LE motor and sensory involvement
B/B control loss
Loss of behavioral control
Significant mental changes
Anterior frontal lobe
Medial surface of frontal and parietal lobes

Neglect
Aphasia
Apraxia and agraphia
Perseveration ( uncontrollable repetition of word phrase or gesture)
Akinetic mutism with significant bilateral involvement (conscious unresponsiveness)

Question 19

Blood supply to the brain by the MCA (middle cerebral artery) and expected possible impairment based on extent of vascular involvment

Answer 19

Most of outer cerebrum, basal ganglia, post and anterior internal capsule, putamen, pallidum, lentiform nucleus.

Most common site of CVA. 
Wernicke aphasia in dominant hemisphere
Homonymous hemianopsia
Apraxia
Flat affect with R hemisphere damage
Contralateral weakness and sensory loss of face and upper extremity with lesser involvement in the LE
Impaired spatial relations
Anosognosia in dominant hemisphere
Impaired body schema

Question 20

Blood supply to the brain by the PCA (posterior cerebral artery) and expected possible impairment based on extent of vascular involvement

Answer 20

Portion of midbrain
Subthalamic nucleus
Basal nucleus
Thalamus
Inferior temporal lobe
Occipital and occipitoparietal cortices

Contralateral pain and temp sensory loss
Contralateral hemiplegia, mild hemiparesis
Ataxia, athetosis or choreiform mvmnt
Thalamic pain syndrome: abnorm sensation of pain, temp, touch, and proprioception.
Anomia
Prosopragnosia…inability to recognize faces… With occipital infarct
Hemiballismus…flailing, ballistic uncontrolled mvmnt
Visual agnosia
Homonymous hemianopsia
Memory impairment
Alexia, dyslexia
Cortical blindness from bilateral impairment

Question 21

Blood supply to the brain by the vertebral- basilar and expected possible impairment based on extent of vascular involvement

Answer 21

Cerebellum
Medulla
Pons
Midbrain and thalamus

Severe impairment: locked in syndrome or coma
Wallenberg syndrome secondary to lateral medullary artery infarct: ipsilateral fascial pain, ipsilat ataxia, vertigo, contrlat pain and temp impairment.

Question 22

Meningitis

Answer 22

Inflammation of the meninges of brain and SC.
Fatal in hours
Sxs:
Fever, HA, vomiting
C/o stiff painful neck, nuchal rigidity
Pain in lumbar area and posterior thigh
Brudzinski’s sign: flxn of neck facilitates flxn of hips and knees
Kernig’s sign: pain with hip flxn combined with knee ext.
Sensitivity to light

Lumbar puncture is gold stndrd for dx
Tx: antibiotic, antimicrobial, steroid drugs

Question 23

Subarachnoid space

Answer 23

Area between the arachnoid and pia mater

Contains CSF and circulatory system for the brain.

Question 24

Hydrocephalus
Associative conditions and causative factors
Signs of hydroceph or blocked shunt

Answer 24

An excess of CSF in the brain

Spina bifida, choroid plexus neoplasm, CP, tumor, meningitis or encephalocele.

Sxs:
Enlarged head or bulging fontanelles in infants
HA
Change in vision
Large veins noted on scalp
Behavioral changes
Seizures
Alteration in appetite, vomiting
Sun setting sign or downward deviation of the eyes
Incontinence

Requires immediate medical intervention to alleviate the fluid in the brain! Or coma/death

Question 25

Syringomyelia

Answer 25

An excess of CSF in the spinal cord