Question Bank Flashcards
Name the 5 lobes of the brain
- Frontal
- Parietal
- Occipital
- Temporal
- Limbic (hidden under the above lobes)
T/F: All the lobes of the brain are located on the periphery.
False: some lobes delve into the midline of the brain
What is the corpus callosum made up of and what is it’s function?
Made of: White fibers - axons
Function: “Bridge” between the two hemispheres of the brain
What is the name, location, and function of the “6th lobe” of the brain?
Name: Insular Lobe
Location: Between temporal and parietal lobes
Function: Emotional tone and regulation
The _____ ________ and the ___________ _______ are parts of the ______ mater, but of which function to __________ the brain.
Falx, cerebri, tentorium, cerebelli, dura, support
T/F: Gray matter is comprised of myelinated axons.
False:
The prompt describes white matter
Gray matter = cell bodies and unmyelinated axonal ends
Why does white matter appear to be white?
Due to myelination of nerve axons
Which cerebral artery supplies the lateral portion of the brain, frontal lobe, temporal lobe, parietal lobe, mouth, face, and UE?
Middle Cerebral Artery (MCA)
Which cerebral artery supplies the medial portion of the brain, frontal lobe, parietal lobe, and LE?
Anterior Cerebral Artery
Central cord lesions are common with what MOI?
Hyperextension (esp. in the eldery)
Other MOI include compression/diving and tumors
Who is more likely to have a SCI?
Men — 80% of all SCI
What is the average age for SCI?
42 yo
How is the level of SCI determined?
By the last intact mm group and dermatome
NOT BY LEVEL OF SPINAL FX
T/F: The ASIA level for a SCI is always the same bilaterally
False: you can have a level of injury for each side of your body
T/F: When determining the ASIA level you always take the lowest number/least function.
True
T/F: Many paraplegics are determined by their motor rather than sensory level.
False, flip it
As PTs we typically look at the ________ level before the _________ level EXCEPT in locations where only __________ options are available.
motor, sensory, sensory
What is the difference between and ASIA A and ASIA B?
Sacral sparing
A = sacral levels not spared
B = sacral levels spared
T/F: A Dr of Neurology and a Dr of Physiatry and Rehabilitation grade SCI the same.
False:
Neurologist: SCI at level of first spinal segment that shows abnormal neurolgical loss
PMandR: SCI at level of lowest normal sensation/motor function
What is the primary cause of autonomic dysreflexia?
Bladder distention
Who is at higher risk for autonomic dysreflexia?
Those with SCI at T6 or higher
T/F: Autonomic dysreflexia is not a medical emergency.
False: Is a medical emergency due to the larger rise in BP
When is DVT most likely to occur in SCI?
2 wks after injury
More likely acute during the flaccidity phase
T/F: There is a relationship between the incidence of DVT and the level of injury.
False
How would you identify heterotrophic ossifications in a patient with a SCI?
They would have a sudden limitation in ROM
What is the most common site for heterotrophic ossification?
The hip joint
Why are those with SCIs at risk for bone fractures?
Due to lack of mobility/WB their bones demineralize to some degree
What is thought to cause spasticity?
Aberrant processing of incoming sensory information by the SC
T/F: All CN are a part of the PNS.
False:
While the majority are part of the PNS and surrounded by Schwann cells
CN I & II are within the skull and surrounded by oligodendrocytes and thus technically part of the CNS
When is a CN classified as a LMN?
If it has any kind of motor component (pure motor or mixed)
Describe how disorders of the brainstem can present
Can have a mix of
- ipsilatera/contralateral signs
- UMN/LMN signs
The 4 D’s
- Dysphagia (difficulty swallowing)
- Dysarthria (difficulty speaking)
- Diplopia (double vision)
- Dysmetria (difficulty coordinating motor movement
T/F: Alternating hemiplegia must effect CN III, CN VI, AND CN XII.
False, the lesion does not damage all 3 in alternating hemiplegia
Describe the Effects of the pictured Alternating Hemiplegia
CN III: LMN sx, L sided ptosis, L eye lateral at rest, Can’t move eye up, down, medial
Rubrospinal/Corticospinal Pathway: Contralateral UMN sx
Describe the Effects of the pictured Alternating Hemiplegia
CN VI: LMN sx, L eye medial at rest, Can’t ABD eye
Corticospinal Pathway: Contralteral UMN sx
Describe the Effects of the pictured Alternating Hemiplegia
CN XII: LMN sx, Difficulty swallowing, slurred speech, tongue deviates left
Corticospinal Pathway: Contralateral UMN sx
Chemorecptors in the medulla respond to?
hydrogen ions and carbon dioxide
Chemoreceptors in the carotid bodies and aortic bodes respond to?
Oxygen
Chemoreceptors in the hypothalamus respond to?
Blood glucose and electrolyte levels
T/F: The limbic system has limited to connections to a few primary structures.
False: highly connected to many structures
What structures is the thalamus comprised of?
Cell bodies and synaptic connections
How much blood does the every 100g of brain tissue require every minute?
50 mL
What amount of blood for every 100g of brain tissue puts the brain cells
- in peril
- kills neurons
- 25 mL
- 8 mL
T/F: The basilar artery is a paired artery.
False, only one basilar artery
T/F: The Circle of Willis is not a common site of aneruism
False, is a common site
A 65 years old man suffering from lack of coordination in speech and disturbance of articulation was referred to a neurologist by his primary physician. The neurologist diagnosed the patient to be suffering from Wallenberg’s syndrome and sent him for angiography. Which of the following arteries is most likely occluded in this patient?
A. Anterior Cerebral Artery
B. Posterior Inferior Cerebellar Artery(PICA)
C. Anterior Spinal Artery
D. Posterior Cerebral Artery
E. Anterior Inferior Cerebellar Artery (AlCA)
B. Posterior Inferior Cerebellar Artery(PICA)
You are caring for a patient who has suffered a stroke and has issues comprehending spoken language. Branches of which artery are the most likely to have been compromised?
A. Anterior cerebral artery
B. Middle cerebral artery
C. Posterior spinal artery
D. Anterior spinal artery
E. Posterior cerebral artery
B. Middle cerebral artery
A 71 year old man suffering from loss of motor control and sensation in her left leg was examined by the neurologist. Subsequent angiographic procedures performed on the patient revealed that one of the arteries supplying the brain was 80% occluded. Which of the following artery most likely was occluded in this patient?
A. Right anterior cerebral artery
B. Posterior communicating artery
C. Right anterior inferior cerebellar artery
D. Left anterior cerebral artery
E. Posterior cerebral artery
A. Right anterior cerebral artery
The anterior cerebral artery and the middle cerebral artery arise from which artery?
A. The internal carotid artery
B. Labyrinthine artery
C. Basilar artery
D. The vertebral artery
A. The internal cartoid artery
A neurologic examination of a 55 year old woman indicated that she had weaknesses and loss of discriminative touch and vibratory sense on the left side of her body. When she attempted to protrude her tongue, it deviated to the right. The blood supply of which one of the following arteries may be occluded in this patient?
A. Posterior Cerebral Artery
B. Anterior Spinal Artery
C. Anterior Cerebral Artery
D. Posterior Inferior Cerebellar Artery(PICA)
E. Anterior Inferior Cerebellar Artery (AlCA)
B. Anterior Spinal Artery
If a lesion occurs in the middle cerebral artery, which of the following deficits are MOST LIKELY to occur?
A. Dysarthria, Dysphagia, Locked-In Syndrome
B. Contralateral Hemiplegia and sensation loss of the leg, Cognitive and Emotional Changes
C. Dyslexia, Memory Impairments, Hemianopsia, Cortical Blindness
D. Contralateral hemiplegia and somatosensory loss in the UE, speech problems
D. Contralateral hemiplegia and somatosensory loss in the UE, speech problems
If a lesion occurs in the posterior cerebral artery, which of the following deficits are MOST LIKELY to occur?
A. Contralateral hemiplegia and somatosensory loss in the UE, speech problems
B. Contralateral Hemiplegia, loss of memory, Apraxia, Aphasia
C. Dysarthria, Dysphagia, Locked-In Syndrome
D. Hemianopsia, Cortical Blindness, Weber’s syndrome
D. Hemianopsia, Cortical Blindness, Weber’s syndrome
Which of the following statement is not true?
A. Circle of Willis consist of anterior communicating, anterior cerebral, posterior communicating, and posterior cerebral arteries
B. Hydrocephalus is a condition in which the primary characteristic is excessive accumulation of CSF in the brain.
C. The venous sinuses drain cerebral spinal fluid, deoxygenated blood from the brain and veins in the scalp
D. The Cerebral aqueduct is a narrow channel running from the 2nd ventricle to the 3rd ventricle.
D. The Cerebral aqueduct is a narrow channel running from the 2nd ventricle to the 3rd ventricle.
Which of the following statements regarding to Circle of Willis is correct?
A. It is the primary source of blood supply for pons and medulla
B. It includes two vertebral arteries
C. It surrounds the optic chiasm and pituitary
D. The superior cerebral artery arises from this circle of arteries
E. It is the site where most of the cerebral spinal fluid is formed
C. It surrounds the optic chiasm and pituitary
The MCA supplies which of the following areas of the brain?
A. Orbital and medial branches of frontal lobe
B. Lateral motor strip, lateral sensory strip. Temporal, frontal, parietal lobes. Broca’s and Wernicke’s areas
C. Cerebellum, diencephalon, spinal cord, occipital, temporal lobes, medial cortex, limbic structures
D. Occipital lobe and some inferior parts of temporal, the midbrain, the thalamus
B. Lateral motor strip, lateral sensory strip. Temporal, frontal, parietal lobes. Broca’s and Wernicke’s areas
What type of hemorrhage is the most dangerous?
Subdural - blood (and pathogens it carries) touching brain
What percent of stroke occur in the MCA?
70%
T/F: The size of the lesion is direclty related to the impact on function.
False: The size doesn’t translate to impact - smaller more central lesions can be worse that larger lesions on the outer edge of the cortex
Why does a lesion of the superior cerebellar artery cause Horner’s Syndrome?
Due to the influence of PNS drive to the eye
What percent of strokes are caused by cerebral venous thrombosis?
~1%
T/F: The dura mater and venous sinuses open the CNS to infection.
True
The blood from the brain gets back to the heart via what vein?
Jugular veins
Where is the choroid plexus located?
Choroid plexuses are present in each ventricle, however, most is located in the 2 lateral ventricles
