Neurophysiology

Question 1

Neurophysiology

Answer 1

The functioning of the nervous system

Question 2

Trigeminal Nerve

Answer 2

The trigeminal nerve (the fifth cranial nerve, or simply CN V) is a nerveresponsible for sensation in the face and motor functions such as biting and chewing.

Question 3

Trigeminal Lesions (motor and sensory effects)

Answer 3

Motor:

• Atrophy of the jaw
• Jaw deviates toward side of lesion or weakness
• Open mouth posture
• Weakness or paralysis of the velum
• Hypernasality

Sensory:

•Loss of tactile sensation to anterior two thirds of the tongue

Question 4

Trigeminal Neuralgia

Answer 4

Chronic pain that affects the trigeminal nerve

Question 5

Trrigeminal Neuralgia- Typical type (TN1):

Answer 5

Extreme sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode.

Question 6

Trigeminal Nerualgia- Atypical type (TN2):

Answer 6

Constant aching, burning, stabbing pain of somewhat lower intensity than TN1

Question 7

The facial nerve

Answer 7

The facial nerve is the seventh cranial nerve, or simply cranial nerve VII. It emerges from the brainstem between the pons and the medulla, controls the muscles of facial expression, and functions in the conveyance of tastesensations from the anterior two-thirds of the tongue and oral cavity.

Question 8

Facial Nerve Lesions

Answer 8

• Articulatory functioning
• Paralysis to muscles of facial expression
• Facial paralysis on the side of the lesion
• Bells palsy may result from any compression of the nerve

Answer 9

Bells Palsy

Question 10

The glossopharyngeal nerve

Answer 10

The glossopharyngeal nerve, known as the ninth cranial nerve, is a mixed nerve that carries afferent sensory and efferent motor information. It exits the brainstem out from the sides of the upper medulla, just rostral (closer to the nose) to the vagus nerve.

Question 11

Glossopharyngeal Lesions

Answer 11

• Paralysis of the stylopharngeus muscle
• Loss of general sensation (anesthesia) to posterior one third of the tongue and pharynx
• Reduced or absent gag reflex

Question 12

The vagus nerve

Answer 12

The vagus nerve (/ˈveɪɡəs/ vay-gəs), historically cited as the pneumogastric nerve, is the tenth cranial nerve or CN X, and interfaces with parasympathetic control of theheart and digestive tract. The vagus nerves are paired; however, they are normally referred to in the singular.

Question 13

Vagus Lesions

Answer 13

• Loss of gag reflex
• Hypernasality
• Asymmetrical palatal elevation
• Nasal regurgitation
• Laryngeal stridor
• Vocal fold paralysis

Question 14

Dysphagia

Answer 14

Dysphagia is the medical term for the symptom of difficulty in swallowing. The word is derived from the Greek dys meaning bad or disordered, and the root phag-meaning “eat”.

Not to be confused with Dysphasia

Question 15

The hypoglossal nerve

Answer 15

The hypoglossal nerve is the twelfth cranial nerve XII, and innervates muscles of thetongue. The name hypoglossus springs from the fact that its passage is below thetongue, hypo meaning “under”, and glossus meaning “tongue”, both of which are fromAncient Greek. The nerve is involved in controlling tongue movements required for speech, food manipulation (i.e. formation of bolus), and swallowing.

Question 16

Hypoglossal Lesions

Answer 16

• Profoundly affects articulation and speech intelligibility
• Intrinsic and extrinsic muscles of the tongue
• May have fasiculations

Question 17

Flaccid Paralysis

Answer 17

• Hypotonia and hyporeflexia
• Reduced or absent reflexes
• Low muscle tone

Question 18

Plegia (3 types)

Answer 18

• Para lower portion of body
• Hemi half of the body
• Quad from the neck down or all 4 extremities

Question 19

Speech Disorders (6 types)

Answer 19

• Dysarthria
• Apraxia
• Aphasia
• Myasthenia gravis
• Amyotrophic Lateral Sclerosis
• MS

Question 20

Dysarthria

Answer 20

• Speech disorder arising from paralysis and muscle weakness
• Flaccid – hypotonia and fasiculations
• Spastic – paralysis and hyperflexia and hypertonia
• Ataxic – cerebellum or brainstem, loss of coordination
• Hypokinetic – paucity of movement, Parkinson’s
• Hyperkinetic –extraneous voluntary movements, ballism (uncontrolled flailing)
• Mixed – ALS, combination of many

Question 21

Apraxia

Answer 21

• Inability to perform sequential and isolated motor movements
• Problem with motor programming and planning for speech and non speech production
• Not due to weakness

Question 22

Aphasia

Answer 22

Caused by brain damage

• Non fluent –Broca’s-expressive aphasia
• Fluent – Wernicke’s-receptive

Paraphasias

• Verbal – substitute one word for another two types
• Random and semantic
• Random dog for flower
• Semantic same category i.e. mother for father
• Neologistic- entirely new word that is non meaningful i.e. arbuckel
• Phonetic or literal substitutes one sound for another i.e. mandwhich for sandwich

Question 23

Myasthenia Gravis

Answer 23

• Neuromuscular disease
• Builds antibodies that blocks reception of neurotransmitters
• Extreme fatigue at end of day
• Speech becomes more unintelligible
• Reduced velar functioning is an early sign
• Hypernasal speech

Question 24

ptosis

Answer 24

drooping eyelid

Question 25

ALS

Answer 25

• Demyelinating disease of the brain myelin
• Progressive
• Unknown etiology
• 2-5 years from date of diagnosis to death
• 40-50 years of age

Question 26

Multiple Sclerosis

Answer 26