Neuroscience Remediation

The PNS consists of

The autonomic system and parasympathetic system

The larger the receptor field, the \________ it is

less sensitive

Interoceptors play a role in the PNS by

being sensitive to stimuli within the body

Muscle spindles \_______ while Golgi tendon organs \_______

encode velocity of muscle stretch; sense tension and exertion

"visual" is an example of a receptor classification by:

sensory system

A lesion of the right fasciculus gracilis at T10 produces what impairment?

absence of light touch, vibration, proprioception in the right leg and right trunk

Where does the second order neuron synapse in the DCML tract?

VPL

If you were to feel pain the middle third of the face what division of the trigeminal nerve is affected?

Maxillary division

What pathways associate emotions with pain?

spinolimbic

If I lost discriminative touch in my left hallux, which nucleus is being impaired?

Nucleus gracilis

The spinal nucleus relays what kind of information?

Impulses of pain and temperature

Which branch of the trigeminal nerve provides sensory innervation to the forehead, scalp, and upper eyelid?

Ophthalmic nerve

The motor fibers of the trigeminal nerve originate from which part of the brain?

Pons

Damage to the trigeminal nerve can result in a condition known as \_______, characterized by severe facial pain.

Trigeminal neuralgia

The trigeminal nerve is involved in the blink reflex. Which cranial nerve works in conjunction with the trigeminal nerve to carry out this reflex?

Facial nerve (VII)

Per the Laurie Lundy-Ekman text, what is the most important tract?

lateral corticospinal

Pyramidal decussation occurs primarily at

lower medulla

True or false: cancer can cause nociceptive chronic pain

True

A lesion to corticobrainstem tract before it reaches the facial nucleus would result in

contralateral impairments

You are examining a patient who has a tumor involving the cavernous sinus. Performing a preliminary eye exam, you suspect the right abducens nerve has been damaged. Which direction would you have the patient turn his right eye to confirm the deficit?

outward

During initial intake, you, as the provider, observe that the patient is exhibiting ptosis of the right eye. What muscle must be paralyzed or damaged?

Superior tarsal (smooth muscle portion of levator palpebrae)

If a patient states that they are taking a sympathetic blocking agent what can you notice in their eyes?

Ptosis and constricted pupil

Select the correct option that illustrates horizontal voluntary saccade pathway

Cortical areas ⇒ superior colliculus ⇒ PPRF ⇒ Abducens N ⇒ MLF ⇒ Oculomotor N

Your patient is a 78 year old female presenting with the following symptoms:
- limb ataxia
- gait ataxia
- difficulty with shin to knee functional tests
Which functional division of the cerebellum has been impacted

spinocerebellum

Your patient is unable to coordinate movements to do rapid, alternating hand movements. What is this dysfunction called and where did the lesion occur?

Dysdiadochokinesia; cerebrocerebellum

Your patient continually makes errors in motor tasks and doesn't appear to be making progress in error correction or motor learning. Which cellular component is impacted in this?

Climbing fibers

Your patient comes in complaining of falls with movement and when you test them, they are unable to maintain their gaze. You believe their deficit to be within the cerebellum. Which lobe of the cerebellum is impacted?

Vestibulocerebellum

Your patient is an 89 year old female presenting post-stroke with deficits in sensation and proprioception in bilateral lower extremities. Which cerebellar pathway has been impacted by the stroke?

anterior spinocerebellar

Which part of the cerebral cortex is important for emotions, speech, planning, and motor function?

frontal lobe

If a person suffered damage to the right side of the parietal lobe, which of the following is a likely consequence?

The person would lose motor and sensory awareness on the left side of their body

What are the primary functions of gyrus and sulci?

all of the above

Wernicke's aphasia occurs in the \_____ and affects\_______

temporal lobe; language comprehension

Commissural neurons primarily

connect between areas in the contralateral hemisphere (cross via corpus callosum, and anterior commissure)

acute pain

pain that lasts less than 1 month

chronic pain

pain that lasts longer than 1 month; persistent

red flag

underlying condition; requires immediate referral/consultation
tumor, fracture, infection, DVT

yellow flag

psychosocial and occupational factors that increase chronic pain risk
anxiety, behavior, compensation, depression, emotion, family, work

fear avoidance

can cause low intensity sensation of pain to become unbearable
more prevalent in chronic pain patients
avoid activities and increase disability

scanning exam

identify major problem area
eliminate confusing information
narrow down problem area
rule out referred pain

joint play

passive translatory gliding and distraction mobility characteristic of diarthrodial joints

loose pack

position where joint capsule and ligaments are most relaxed allowing for greatest amount of play

closed pack

position where joint capsule and ligaments are maximally taut allowing little to no joint play

Manipulation (Grade 5 Mobilization)

small amp, high velocity thrust at point of movement restriction/resistance

Chronic plantar heel pain

pain at origin of plantar fascia
start up pain
pain decreases with activity
may have antalgic gait
sharp, localized pain under anteromedial aspect of calcaneus

Tarsal tunnel syndrome

tibial nerve entrapment in flexor retinaculum
burning, tingling, numbness
pain in medial malleolus/heel region
foot eversion/ankle DF test

Sever disease

Metarsalgia

met head pain and met joint pain
pain at surrounding soft tissues
- RA
-hallux valgus/bunion
-decreased gastroc flexibility
difficulty with terminal stance of walking bc pain in loading forefoot
decreased 1st MTP joint extension with hallux valgus or hallux limitus

The PNS consists of

A and B

The larger the receptor field, the \________ it is

less sensitive

Interoceptors play a role in the PNS by

being sensitive to stimuli within the body

Muscle spindles \_______ while Golgi tendon organs \_______

encode velocity of muscle stretch; sense tension and exertion

"visual" is an example of a receptor classification by:

sensory system

A lesion of the right fasciculus gracilis at T10 produces what impairment?

absence of light touch, vibration, proprioception in the right leg and right trunk

Where does the second order neuron synapse in the DCML tract?

VPL

If you were to feel pain the middle third of the face what division of the trigeminal nerve is affected?

Maxillary division

What pathways associate emotions with pain?

spinolimbic

If I lost discriminative touch in my left hallux, which nucleus is being impaired?

Nucleus gracilis

The spinal nucleus relays what kind of information?

Impulses of pain and temperature

Which branch of the trigeminal nerve provides sensory innervation to the forehead, scalp, and upper eyelid?

Ophthalmic nerve

The motor fibers of the trigeminal nerve originate from which part of the brain?

Pons

Damage to the trigeminal nerve can result in a condition known as \_______, characterized by severe facial pain.

Trigeminal neuralgia

The trigeminal nerve is involved in the blink reflex. Which cranial nerve works in conjunction with the trigeminal nerve to carry out this reflex?

Facial nerve (VII)

Per the Laurie Lundy-Ekman text, what is the most important tract?

lateral corticospinal

Pyramidal decussation occurs primarily at

lower medulla

True or false: cancer can cause nociceptive chronic pain

True

A lesion to corticobrainstem tract before it reaches the facial nucleus would result in

contralateral impairments

You are examining a patient who has a tumor involving the cavernous sinus. Performing a preliminary eye exam, you suspect the right abducens nerve has been damaged. Which direction would you have the patient turn his right eye to confirm the deficit?

outward

During initial intake, you, as the provider, observe that the patient is exhibiting ptosis of the right eye. What muscle must be paralyzed or damaged?

Superior tarsal (smooth muscle portion of levator palpebrae)

If a patient states that they are taking a sympathetic blocking agent what can you notice in their eyes?

Ptosis and constricted pupil

Select the correct option that illustrates horizontal voluntary saccade pathway

Cortical areas ⇒ superior colliculus ⇒ PPRF ⇒ Abducens N ⇒ MLF ⇒ Oculomotor N

Your patient is a 78 year old female presenting with the following symptoms:
- limb ataxia
- gait ataxia
- difficulty with shin to knee functional tests
Which functional division of the cerebellum has been impacted

spinocerebellum

Your patient is unable to coordinate movements to do rapid, alternating hand movements. What is this dysfunction called and where did the lesion occur?

Dysdiadochokinesia; cerebrocerebellum

Your patient continually makes errors in motor tasks and doesn't appear to be making progress in error correction or motor learning. Which cellular component is impacted in this?

Climbing fibers

Your patient comes in complaining of falls with movement and when you test them, they are unable to maintain their gaze. You believe their deficit to be within the cerebellum. Which lobe of the cerebellum is impacted?

Vestibulocerebellum

Your patient is an 89 year old female presenting post-stroke with deficits in sensation and proprioception in bilateral lower extremities. Which cerebellar pathway has been impacted by the stroke?

anterior spinocerebellar

Which part of the cerebral cortex is important for emotions, speech, planning, and motor function?

frontal lobe

If a person suffered damage to the right side of the parietal lobe, which of the following is a likely consequence?

The person would lose motor and sensory awareness on the left side of their body

What are the primary functions of gyrus and sulci?

all of the above

Wernicke's aphasia occurs in the \_____ and affects\_______

temporal lobe; language comprehension

Commissural neurons primarily

connect between areas in the contralateral hemisphere (cross via corpus callosum, and anterior commissure)

Where is the medulla located?

Brainstem

Which cranial nerve is associated with the medulla?

Hypoglossal

In an UMN lesion, if the tongue deviates to the right side, what side is the lesion on?

Left side

Where does the medulla divide?

Both open and closed medulla

Which of the following is a symptom of glossopharyngeal medial medullary syndrome?

Loss of discriminative/light touch and proprioception contralaterally

If someone has a LMN lesion causing ipsilateral muscle loss of facial expression, what type is it?

Bell's palsy

If someone presents with an UMN lesion that causes contralateral and lower face muscle loss, what type is it?

Central facial palsy/paralysis

If a patient presents with a facial palsy and hyperacusis due to stapedius muscle in the middle ear, which cranial nerve is affected?

CN VII (Facial N.) lesion

If a patient presents with ipsilateral facial weakness, decreased understanding of words, and nystagmus, what does this patient present with?

Acoustic neuroma

If a patient presents with hyperacusis but no CN V or CN VII deficit then it is a what?

CN VIII (Vestibulocochlear N.) lesion