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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
Note 
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