oth 520/521- all semester questions

what are the 2 functional roles of vestibular system for motor control

gaze stabilization. postural control and adjustment

2: t/f?. smooth control of automatic movement requires the continuous integration of visual, somatosensory, and vestibular info

2: true

_____ non neuronal cell that provides services for neurons

glial cell

an OTR is finishing their initial evaluation with a patient who presented with Parkinson’s Disease and difficulty completing daily routines without assistance. the OT instructs the patient through a BERG balance scale assessment to assess their safety, balance, and fall risk as it relates to ADLs, scored a 34. which of the following is the MOST appropriate to document regarding this patient?

patient demonstrates impaired functional balance, decreased postural stability, and poor protective responses

a client who recently experienced a CVA in the Broca’s area of the brain is most likely to exhibit which impairment

difficulty responding to your OP questions due to inability to verbally express and/or write their answers, despite indicating that they understand what you are asking

you are screening a client for potential OT evaluation who scored a 3 on the Ashworth scale for muscle tone. which of the following performance assessments would be MOST affected by ashworth scale

range of motion assessment

propagation of AP along axon is dependent on

anterograde spread of the electric potential with active generation of new potentials

athetosis

clinical symptom seen in patients with CP. slow wormlike movement patterns combined with spasticity or hypertonicity

akinesia

inability to initiate voluntary motion (seen in end stage parkinson’s disease)

astenia

muscle weakness related to cerebellar pathology

focal dystonia (disorder), region nervous system associated

basal ganglia

hemiparesis (disorder), region nervous system associated

lateral UMN

alcohol induced ataxia (disorder), region nervous system associated

cerebellum

an OT beings working with a new client in the outpatient clinic who presents to them with a diagnosis of MS and referral for assessing ADLs for safety in the home. as the client enters the clinic the OT begins taking notes. Which of the following is the BEST description of the clinical skill the OT is applying

clinical observation

the resting membrane potential is…

typically measured at -70 mV and maintained by active transport of Na+ and K+ and passive diffusion of Na+, K+, and Cl- through the cell membrane

which neurotransmitter is responsible for initiating muscle contraction

ACh

chorea

involuntary, jerky, rapid movement

huntington’s disease

autosomal dominant hereditary disorder that causes degeneration in many areas of the brain, primarily in the striatum and cerebral cortex. characterized by hyperkinesia

feed forward

neural preparation for anticipated movement, based on instruction, experience, and ability to predict movement requirements and/or outcome

ataxia

abnormal voluntary movements that are of normal strength but jerky and inaccurate. umbrella term for uncoordinated movement patterns seen in gait, posture, and extremity function

hyperkinetic

characterized by abnormal involuntary movements. includes dystonic, chorea, and athetotic, and choreoathetotic movements

choreoathetosis

combination of involuntary, jerky, rapid movements and slow, writhing, purposeless movements

feedback

info resulting from a movement; for example when person flexes the elbow, ____ consist of info from sensory receptors in muscles, tendons, and skin

a referral to you with a diagnosis of “spinocerebellar lesion”. you can expect to see which of the following during your evaluation

wide based unsteady gait and inability to rapidly pronate and supinate the arm

patient has been admitted to the hospital after being involved in a house level explosion. they are experiencing dizziness, nausea, and light sensitivity, and vomiting; with help they are able to state their name, DOB, and current location. which of the following would you MOST likely anticipate as the reason for their clinical presentation?

transient post traumatic amnesia

a teenager who is diagnosed with CP has been referred for screening in the outpatient OT clinic. What is primary purpose of screening of screening?

to determine if further OT evaluation if appropriate/warranted

info from R visual field is conveyed to which of the following

left lateral geniculate and left visual cortex

what is the most common symptom of vestibular dysfunction

vertigo

superior colliculius

visual orientation and coordination of head and eye movements

secondary visual cortex

analysis of visual info for colors and motion

lateral geniculate body

thalamic relay of visual info to primary visual cortex

primary visual cortex

discrimination of shape, size, or texture of objects

meniere diease

syndrome consisting of both auditory and vestibular disorders associated with abnormal fluid pressures of inner ear

oscillopsia

loss of visual stabilization

vertigo

illusion of movement

11: t/f? ocular alignment is required to be able to focus on a stable objecy

11: true

12: t/f? romberg test is used to test vestibular branch of CN 8

12: true

13: t/f? optokinetic response includes the presence of nystagmus

13: true

to which part of the visual system pathway would a lesion result in homonymous hemmianopsia

posterior of optic chiasm

fibromyalgia, what type of pain

pain matrix dysfunction

gallbladder pain perceived as originating in the right subscapular region, what type of pain

referred pain

pain caused by a tumor pressing on nociceptors in the spinal cord meninges, what type of pain

nociceptive pain

phantom limb pain, what type of pain

neuropathic pain

what are the 4 distinct domains of the biopsychosocial model of pain

nociception, pain, suffering, and pain behavior

what type of sensation can be described as an unpleasant abnormal sensation, whether evoked or spontaneous

dysesthesia

the type of sensory info we received from the skin, superficial or cutaneous include

psi. vibration. temp. pain

select all the type of proprioceptive info you received from the musculoskeletal system

stretch on muscles tendons or ligaments. position of a joint. deep vibration. static and dynamic sesne

touch and vibration stimulus, what type of receptor

pacinian or meissner

muscle stretch stimulus, what type of receptor

muscle spindle

tendon tension, what type of receptor

golgi tendon organ

tissue damage, temp, course touch, tickle, itch stimulus, what type of receptor

free nerve endings

27: t/f? a receptive field is an area of skin innervated by a single afferent neuron. they tend to be larger distally than proximally

27: false

When testing a patient's vibration sense, you are targeting which somatosensory receptors?

mechanoreceptors

Receptors that are responding the entire time the stimulus is present are called?

tonic receptors

Information is conveyed from spinal cord or brainstem to the thalamus via these pathways`

2nd order neuronal pathway

31: t/f? Both musculoskeletal and cutaneous primary afferents are named according to their axon diameter

31: true

Which of the following is true about receptive fields for cutaneous innervation?

distal receptive fields are smaller and have a greater density of receptors

The area of the skin that is innervated by one dorsal root is known as a?

dermatome

Gamma motor neurons are responsible for 

• modulating the responds to stretch in the intrafusal muscle fiber

• maintaining the sensitivity to stretch in the intrafusal muscle fiber

all of the following are true about GTOs except”

• they respond to changes in tension caused by active muscle contraction

• they are sensitive to very slight changes in tension on a tendon

• they transmit info into the spinal cord by type Ib afferents

• they do not respond to changes in tension caused by passive stretch of muscle

they do not respond to changes in tension caused by passive stretch of the muscle

A person with sensory ataxia may have which of the following findings on examination

• impaired vibration sense

• impaired conscious proprioception

  • positive romberg sign

Which of the following is (are) involved in determining whether the results of a nerve conduction study are normal 

• conduction velocity

• distal latency

• amplitude of evoked potential

Prolonged sitting with the legs crossed can, occasionally, cause sensory loss to occur  resulting in part of the limb feeling as thought it has "fallen asleep". I what order will this loss occur?

1. conscious proprioception and light touch

2. cold

3. fast pain

4. heat

5. slow pain

Which of the following pathways bring sensory information to the brain?

• conscious relay

• divergent

• unconscious relay

Which relay pathway primarily conveys high accuracy, somatotopically arranged information to the cerebral cortex

conscious relay

41: t/f? Nonconscious proprioceptive information is carried to the cerebellum and is involved in postural control

41: true

Which of the following statements is true about the homunculus for the somatosensory cortex?

homunculus was developed by experimentally recording electrical potentials from cells in the somatosensory cortex during stimulation of various parts of the body

The spinoreticular tract originates in the?

spinal cord

Divergent nociceptive pathways provide information that contributes to?

• directing attention to the source of the nociceptive input

• eliciting a protective response

• an autonomic and emotional response to the nociceptive input

Signals in  spinolimbic tract that reach consciousness affect?

• emotion

• personality

• autonomic function

Referred pain…

• perceived as coming from a site distinct from the actual site of origin

• usually referred from visceral tissues to the skin

• results from the convergence of nociceptive info from the skin with nociceptive info from internal organs

Spinal axons conveying a signal for conscious somatosensation from the upper limb ascend in which of the following?

fasciculus cuneatus

Cell bodies of second-order neurons conveying a signal for conscious proprioceptive information from the lower limb are located in which of the following?

fasciculus gracilis

these statements are true about acute pain, select all that apply

• pain resolve after noxious stimulus is removed

• pain resolves after tissue injury heals

• pain detected by nociceptors

50: t/f? Pain itself can be a disease, a neural dysfunction can create to experience of pain in the absence of tissue damage. 

50: true

Chronic primary pain syndromes includes all but

carpal tunnel pain

What type of sensation can be described as a painless abnormal sensation in the absence of nociceptor stimulation?

paresthesia

What type of sensation can be described as an unpleasant abnormal sensation, whether evoked or spontaneous?

dysesthesia

What type of sensation can be described as pain evoked by a stimulus that would not normally cause pain?

allodynia

secondary hyperalgesia

person experiences pain in adjacent areas of where there is nociceptive input. This is result of somatotopic organization of the somatosensory nervous system and convergence of information as it travels in the cortical direction

hyperalgesia

Person experiences an increase in pain in response to a nociceptive stimulus

temporal summation

person perceives increased pain in response to either repeated stimulus or continued presence of a stimulus

spontaneous pain

person experiences burning pain or shooting sensation at a time that there is not a direct nociceptive stimulus

While evaluating a new client, he reports 5/10 pain as you test the sensation of his left hand with monofilaments. In your visit note, you should document this finding as?

allodynia

What syndrome is characterized by severe, spontaneous pain out of proportion to the original injury?

CRPS

which of the following would be classified as chronic primary pain?

complex regional pain syndrome

Which of the following treatments will likely be least effective for your client with fibromyalgia?

opioids

Neuropathic pain can arise from abnormal neural activity in which of the following?

• CNS

• dorsal horn

  • PNS

Which of the following mechanisms produce neuropathic pain?

• ectopic foci

• central sensitization

• ephaptic transmission

  • structural reorganization

What causes the pain in postherpetic neuralgia, diabetic neuropathy, and Guillain-Barré syndrome?

small fiber neuropathy

According to the  Biopsychosocial Model of chronic pain the pain experience is influenced by all but?

age

One of the mechanisms to produce neuropathic pain is ephaptic transmission this is also known as?

cross talk

What is the clinical presentation of a client who sustained a stroke in the left middle cerebral artery?

• UE is more involved than the LE

• aphasia

• apraxia

• compulsive behavior

An 85 year old women status post CVA is experiencing ipsilateral ataxia, dysphasia caused by weak palate muscles, and loss of pain and temperature sensitivity. Which artery or artery system has been affected by the CVA?

cerebellar artery system

what are signs of motor tract lesions

• abnormal reflex

• paresis/paralysis

• myoplasticity

• abnormal muscle tone

The highest percentage of strokes are due to infarcts in the ______, and may result in significant impairment due to the _______ of that artery.

middle cerebral artery…. large distribution area

Movement disorders following a middle cerebral artery (MCA) stroke are due to which of the following? 

• paresis

• decreased fractionation of movement

• myoplasticit

List the flow of cerebrospinal fluid in the correct order, starting with lateral ventricles

1. lateral ventricles

2. interventricular foramen

3. third ventricle

4. cerebral aqueduct

5. fourth ventricle

6. median aperture

7. subarachnoid space

vertebrobasilar artery ischemia is associated with

• diplopia

• ataxia

• weakness

• oropharyngeal dysfunction

acute cerebellar infarction typically produces which of the following

• dizziness

• nausea

• vomiting

• dysarthria

• headache