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PTRS 852 - Neuro PT 1 Final > Question Bank > Flashcards

Question Bank Flashcards

1
Q

T/F: Somatotopic organization exists only in M1

A

False: is throughout the cortex, basal ganglia, cerebellum, and SC

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2
Q

Where is the majority of the corticospinal pathways located?

A

M1 - Primary Motor Cortex

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3
Q

What are the 4 Motor Areas in the Cortex associated with Voluntary Movements?

A
  1. M1 - Primary Motor Cortex (joint movement)
  2. Premotor Cortex (ventral and dorsal)
  3. Supplementary Motor Area (SMA)
  4. Cingulate Motor Area (we don’t know much about it)
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4
Q

What is the Broadmann’s Area for the Frontal Cortex?

A

46

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5
Q

T/F: The PMA receives input from M1

A

True

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6
Q

In ability to coordination hand movement would be caused by a deficit in what area?

A

SMA

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7
Q

Why do we see syngery in those with M1 damage?

A

Because tracts originating in the brain stem are still intact

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8
Q

What is a potential major alternative route for mediation of voluntary movement?

A

Reticulospinal

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9
Q

What type of reflex does not involve interneurons?

A

Stretch reflexes

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10
Q

Modulation by substantia nigra is lost in what disease?

A

Parkinson’s Disease

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11
Q

T/F: The basal ganglia can output can only facilitate movement

A

False, can also inhibit movement

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12
Q

When do clinical sx become apparent in PD?

A

When 85-90% of dompamine is lost from the substantia nigra

Putamen affected first (motor sx.) followed by the caudate (cognitive sx.)

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13
Q

Dystonia can be distributed in 1 of 3 ways:

A

focal, segmental, or generalized

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14
Q

Basal Ganglia Loop: Input to puamen if ___________ _________, to caudate if ______________ ____________.

A

motor, activity, cognitive, component

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15
Q

What is the incidence of PD?

A

Higher in men

1 in 3 over the age of 85

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16
Q

What is the etiology of PD?

A

A combination of genetic and environmental (pesticides/insecticides) factors

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17
Q

Which PD sx is most disabling?

A

Bradykinesia

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18
Q

What is the fall risk in those with PD?

A

At 9x greater risk of fall compared with age matched normal individuals

> 2/3 wil. fall

More than 10% fall >1x/wk

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19
Q

Dementia occurs in what proportion of those with PD?

A

1/3

includes loss of executive functions (thinking, judgement) and memory impairments

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20
Q

Pharmological Management for PD:

  • In early stages
  • reduces oxidative stress on neurons
  • delays the use of L-dopa
A

Seligiline

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21
Q

Pharmological Management for PD:

  • Antiviral medicaiton
  • Facilitates release of catecholamines (dopamine)
  • Demonstrates modest improvement w/tremor, rigidity, bradykinesia
  • Often used in conjunction w/L-dopa
A

Amantadine

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22
Q

Describe how L-dopa works as a pharmacological tx for PD

A

Is a precursor of dopamine that can cross the blood brain barrier, is converted to dompamine once across the barrier

Reduces bradykinesisa and rigidity

Less effective in reducing tremor and postrual instability

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23
Q

Pharmological Management for PD: Often given with L-dopa to prevent it from converting to dopamine before corssing the blood brain barrier

A

Carbidopa

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24
Q

List the 3 dopamine agonists

A

Bromocriptine and pergolide

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25
Q

List the surgical options for PD

A
  • Thalamotomy: destructive lesion w/in thalamus (reduce tremor)
  • Pallidotomy: destructive lesion w/in basal ganglia (reduce tremor/dyskinesia)
  • Deep brain stimulation
  • Neural transplantation
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26
Q

What is the ratio of fibers in to out of the cerebellum and what does this tell us about it’s function:

A

40 in: 1 out

Function: does a lot of data collection/processing; sensory and adjustment

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27
Q

T/F: The cerebelllum talks directly to motor neurons.

A

False: must go through deep nuclei

Additionally: perkinje fibers don’t tlk to motor neurons, also go through deep nuclei

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28
Q

Purkinje cell output to cerebellar nuclei is _____________.

A

Inhibitory

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29
Q

_________ ___________ not limited to motor events but also involves subjective timing and speed judgements

A

Timing function

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30
Q

T/F: The cerebellum is a storage site fo motor memories

A

False: not likely, can still perform previoulsy learned tasks with dentate nuclei lesion

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31
Q

What % of people are L hemisphere dominant?

A

94%

32
Q

What is the cause of prosopagnosia?

A

bilateral damage to inferior visual secondary sensory area

33
Q

KL is a 72 yo male who was transferred to rehabilitation after sustaining a CVA on the left side. He c/o weakness of his R limbs and of being unable to button his clothing or tie his shoes. R hand movements are clumsy. On the R side of his body, KL is unable to localize tactile stimuli or distinguish between passive flexion and extension of his joints.

Where is the lesion?

A

L primary motor and somatosensory cortices (best answer)

Might also be localized to L somatosensory cortex; being unable to button clothing or tie shoes could be do to loss of sense of touch and proprioception; weakness in R limbs would be less likely a sign of localized lesion in L S1, but because ~20% of corticospinal fibers start in S1, it’s possible

34
Q

Critchley (1953) reported a patient who seemed normal but put a tea bag in the teapot, set the pot on the stove, and poured cold water into a cup. She lit a match, put the match to the gas burner, blew out the match, and turned on the gas.

Where is the lesion?

What is this disorder?

A

Lesion

  • Premotor area (do to issue with sequencing these motor actions)
  • Could also be impaired dorsolateral prefrontal cortex with resultant impaired executive functioning

Disorder

  • apraxia
35
Q

VM, a 72 yo female, was admitted to the hospital with R hemisensory loss, hemiplegia, and communication problems. She greeted visitors with a halting, effortful, and garbled “Hello, how you?” She was able to easily follow simple verbal or written commands.

Where is the lesion?

What is this communication disorder?

Which artery involved?

A

Lesion: L hemisphere affecting motor, sensory, and Broca’s

Disorder: Broca’s aphasia

Artery: MCA

36
Q

T/F: All aging is pathological.

A

False

37
Q

T/F: Age related disease of the brain are a direct result of our increasing life span.

A

True: We had to overcome other life span limiting disease i.e. infection, heart disease, before we lived long enough that brain health became the limiting factor to life span

38
Q

T/F: Older adults are unable to learn.

A

False: able, will take more practice

39
Q

T/F: Older adults have difficulty learning complex new skills.

A

True: will be slower to learn and will develop new skill to a lesser degrees – will take more practice/time to increase skill

40
Q

T/F: Cognitive delcine is absolute in aging.

A

False: keeping mind and body active is critial to maintaining cognitive performance

41
Q

What type of exercise is best to support and improve executive cognitive control?

A

Aerobic

42
Q

T/F: Exercise benefits reaction time and alters brain activity.

A

True: with exercise there is a decrease in reaction time as well as brain activation

43
Q

T/F: Functional decline is a part of AD

A

True.

44
Q

Describe the functional declines related to AD

A
  • Cognitive decline: executive function, sense of self, coordination
  • Physical decline: lean mass and bone loss, sedentary,
45
Q

Describe the physical function changes with AD

A

Gait: slower, variable stride length, wider BOS

Falls: worse balance, greater sway, poor mobility, poor safety awareness

Apraxia

Paratonia

46
Q

What are a PT’s best tools to fight aging?

A

Exercise and Practice

47
Q

What % of those who survive a stroke will have a second stroke?

A

10-20%

48
Q

What is the rate of the following stroke recovery categories?

Almost complete recovery

Minor impairment

Mod-Sev impairment

Requires nursing home

A

almost complete = 10%

minor = 25%

mod-sev = 40%

nursing home = 10%

49
Q

What is the leading cause of disability and the 3rd leading cause of death?

A

Stroke

50
Q

Distruption of what artery presents with lack of function in the face, hand, and arm?

A

MCA

51
Q

Distruption of what artery presents with lack of function in the legs?

A

ACA

52
Q

A CVA to which artery is most common?

A

MCA

53
Q

What type of CVA presents as “wake, rise, fall”

A

Thrombotic CVA

54
Q

Where does an embolic CVA typically lodge itself?

A

In medium sized vessels, i.e. MCA, vertebral, basilar branches

55
Q

What is the effect of immediate impact with a emoblic CVA?

A

No collateral blood flow

Then sx vary if the clot moves

56
Q

What is the window the TPA?

A

3 hours

57
Q

What is prourokinase and it’s window of effectiveness?

A

It’s a microcatheter inserted by a neurosurgeon to remove the clot

6 hours

58
Q

With what type of CVA might you want high BP and why?

A

With an ischemic CVA, High BP may be useful to reperfuse the ischemic tissue

59
Q

When would you decrease BP in a pt. s/p CVA?

A

If their SBP > 220 or DBP > 120

If they’re on TPA

High BP can result in damage to other organ systems

60
Q

What is normal ICP?

A

12-15 mmHg

61
Q

Who is at the highest risk for TBI?

A

Males from 14-24 yo (take more risks)

62
Q

How does cryotherapy work?

A

It decreaes the body temp to slow metabolism to protect tissue from damage and resulting death

63
Q

What type of dx procedures can be used on the brain?

A

MRI or CT to assess structures

EEG to assess function

EMG to assess peripheral nerve

64
Q

What facility requires 3 hours of PT/OT/SLP per day?

A

Rehabilitation hospital

65
Q

What things can be used for spasticity management?

A

Botox (lasts 3-4 months)

Baclofen

Nerve blocks

Serial Casting

66
Q

What type of brain matter has a greater capacity for recovery?

A

Gray matter

67
Q

For what amount of time s/p TBI is spontaneous functional recovery possible?

A

3-6 months

This spontaneous recovery can be facilitated by PT

68
Q

T/F: Consistency is key when learning to communicate in an altered manner

A

True

69
Q

Who is ALS most common in?

A

Men (1.5x more than women), 40-60 yo

70
Q

What percent of those experience cognitive changes? dementa?

A

up to 50%; 15%

71
Q

What is the survival rate for ALS?

A

5 year survival = 20%

10 year survival = 10%

72
Q

What is the average survival from time of ALS dx?

A

3-5 yrs

73
Q

An multi-disciplinary team approach an increase the survival of ALS by how many months?

A

7.5 mo

74
Q

What FVC % indicates respiratory failure and LE < 6 mo w/o invasive ventilation?

A

30%

75
Q

What can be said about the progression of ALS and pain?

A

Pain is directly proportional to disease course

70% report pain at some point

PTRS 852 - Neuro PT 1 Final (13 decks)

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