Chapter Review Questions

A young man experiences a closed head injury with a contusion of the right frontal lobe from falling over the handlebars of his bicycle; the likely place for a contre coup injury would be: A) right temporal lobe B) left temporal lobe C) right parietal lobe D) left occipital lobe

D) left occipital lobe

in which part of the spinal cord would we expect to find a complete absence of the ventral (anterior) corticospinal tract) A) upper cervical B) cervical enlargement C) thoracic D) lumbosacral enlargement

D) lumbosacral enlargement

chronic degeneration (>1 year post TBI) likely results from which mechanisms? A) anterograde degeneration B) excitotoxicity C) retrograde degeneration D) negative plasticity

D) negative plasiticity

when working to retrain gait after a stroke the BEST choice of assistive device for the individual who continues to need a device during therapy sessions would be: A. parallel bars B. a quad cane or standard cane C. a standard walker D. a wheeled walker with arm trough

D. a wheeled walker with arm trough

which of these processes can NOT contribute to the removal of the neurotransmitter so the synapses can recover to normal? A. Diffusion B. Enzyme degradation C. Reuptake into the presynaptic terminal D. Glial cells scavenging up the breakdown products E. Absorption of the neurotransmitter into the postsynaptic cell

E. Absorption of the neurotransmitter into the postsynaptic cell

An injury at C8 will likely produce the following impairments: A. autonomic dysreflexia B. weak cough C. kyphotic C sitting posture D. weak finger abduction E. all of the above

E. all of the above

a patient in a neurologic clinic has trouble moving the right side of her body, reaches with her right arm in a very limited way and does not seem to use her right hand. She can sit and walk with a cane butt here is also some difficulty in the right leg. She is speaking and her eye movements and facial function seem fairly normal. Where would you expect the lesion in this person's nervous system to be found? A) left cervical spinal cord B) left motor cortex C) left brainstem D) left cerebellum

left motor cortex

an individual with elevated intracranial pressure the head of the bed should be in what position? A. flat B. elevated to 10 degrees C. elevated to 30 degrees D. in 5 degrees of trendelenburg

C. elevated to 30 degrees

which cranial nerve has a long series of nuclei reaching from the midbrain to the medulla?

A. Trigeminal (CN V)

a patient presents with the ability to understand speech but can only produce a few single words. what type of aphasia would present like this? A. conductive aphasia B. expressive aphasia C. global aphasia D. receptive aphasia

B. Expressive aphasia

which of the cortical motor areas is most likely to produce a corticospinal cell that synapses directly on an alpha motoneuron? A) primary motor cortex B) supplementary motor cortex C) premotor cortex D) all are equal in this regard

A) primary motor cortex

At what level in the projections of sensation, would you expect a lesion to create contralateral loss of both pain /temperature and touch? A. Above the lower medulla B. Below the lower medulla

A. Above the lower medulla

which stroke syndrome is likely to produce lower extremity paresis without upper extremity paresis? A. Anterior cerebral artery stroke B. Basilar artery stroke C. Middle cerebral artery stroke D. Posterior cerebral artery stroke

A. Anterior cerebral artery stroke

which part of the basal ganglia is found immediately lateral to the lateral ventricle?

A. Caudate nucleus

which part of the spinal cord has more spinal cord segments than there are actual vertebral bones for that region?

A. Cervical

Your patient is experiencing hyperalgesia on the left side of her face, occurring when her hair touches it. Damage to what cranial nerve, associated with facial sensation would it most likely be associated with?

A. Cranial Nerve V

match the lobe of the cerebral hemisphere with the functions listed: (1) sensations and perception, (2) forming memories, (3) making decisions, or (4) vision A. Frontal lobe B. Parietal lobe C. Occipital lobe D. Temporal lobe

A. Frontal lobe = (3) making decisions B. Parietal lobe = (1) sensations and perception C. Occipital lobe = (4) vision D. Temporal lobe = (2) forming memories

In infants, which symptom is most likely to be noticed at stroke onset? A. absent speech B. hemiparesis C. impaired consciousness D. sensory loss

C. impaired consciousness

which tumor would be correctly classified as a glioma A. astrocytoma B. ependymoma C. meningioma D. pituitary adenoma

A. astrocytoma

a grade 2 diffuse axonal injury typically involves damage to which structure? A. corpus callosum B. corpus callosum and parasagittal projections C. corpus callosum, parasagittal projections, and brainstem white matter D. microstructural damage to the parasagittal white matter

A. corpus callosum

in the client with "locked in" syndrome the key to successful rehabilitation is to: A. establish a means of effective communication B. position the individual in upright to aid in breathing C. provide position changes at least every 2 hours D. provide sensory stimulation to assist in bringing them out of their coma

A. establish a means of effective communication

Assuming other characteristics are equal, the neuron with the fastest conduction velocity would be the one with the.... A. largest diameter axon B. Longest axon C. highest number of voltage-gated sodium channels D. smallest number of inhibitory synapses

A. largest diameter axon

which of the following signs of autonomic dysreflexia are most likely to indicate a serious life-threatening problem: A. pounding headache B. sweating C. piloerection D. facial flushing

A. pounding headache

when working with an individual who has developed "pusher syndrome" post-stroke it is important to: A. set up training to obtain effective weight-bearing on the side they are pushing toward B. set up training to obtain effective weight-bearing on the side that is doing the pushing C. set up the environment so that all visual stimuli are on the paretic side and force the gaze to that side D. set up the environment so that all visual stimuli are on the non-paretic side and force the gaze to that side

A. set up training to obtain effective weight-bearing on the side they are pushing toward

Your patient is experiencing contralateral loss of pain and ipsilateral loss of touch on their right leg; where would a lesion be to produce these symptoms? A. spinal cord B. Upper medulla C. Ventroposterior nucleus of the thalamus D. Sensory cortex

A. spinal cord

which part of the meninges is toughest and thickest?

A. the Dura mater

how do astrocytes react in the presence of injury? A. they absorb glutamate to prevent neuronal death B. they induce excitotoxicity C. they become enlarged and more widely spaced D. they enhance axonal regeneration through the formation of a glial scar

A. they absorb glutamate to prevent neuronal death

for impulsivity which of the following is an appropriate intervention? A. use a written list of steps to be followed for each activity B. encourage task completion without rehearsal C. do not leave the client unsupervised D. provide calendars of daily activities

A. use a written list of steps to be followed for each activity

to improve function that is impaired by deficits in divided attention and executive dysfunction the therapist should progressively challenge which area of cognitive functioning?

A. working memory

which assessment is commonly used to determine the clearance of post-traumatic amnesia? A. Braintree Scale of Neurologic Stages of Recovery from Brain Injury B. Galveston Orientation and Amnesia Test C. JFK Coma Recovery Scale D. Ranchos Los Amigos Cognitive Recovery Scale

B. Galveston Orientation and Amnesia Test

which commonly used sensory test requires no additional equipment to perform? A. Sharp/dull B. Graphesthesia C. Stereognosis D. Two point discrimination

B. Graphesthesia

you have your client in supine with hips extended and the feet turned outward. You are testing active range of motion. which of the following motions is being tested with gravity eliminated in this position. A. ankle dorsiflexion B. Hip abduction C. Hip internal rotation D. Knee extension

B. Hip abduction

the ventromedial systems for motor control serve what general function?

B) control of the postural and proximal limb muscles

complete paralysis during the first week of injury means there will be no motor recovery A) true B) false

B) false

a patient in a neurologic clinic has trouble moving the right side of her body, reaches with her right arm in a very limited way and does not seem to use her right hand. She can sit and walk with a cane butt here is also some difficulty in the right leg. She is speaking and her eye movements and facial function seem fairly normal. what additional motor deficit would you expect to discover upon testing this individual? A) marked weakness in the left hand B) spasticity (difficulty regulating reflexes) in the right arm or leg C) inability to swallow D) ataxia (discoordinated, flailing movements) on the left side

B) spasticity (difficulty regulating reflexes) in the right arm or leg

what is the name of the tissue that secretes cerebrospinal fluid?

B. Choroid plexus

Your client who is s/p CVA is having difficulty rolling from supine to side-lying. In order to work on this activity and improve his motor control and strength for the activity it would be advisable to: A. assist him to roll by placing your hands under his shoulder and hip and push him over into side-lying B. Cross his leg over the other leg in the direction he is rolling, then instruct him to use his arm and head to develop momentum and then roll over by flinging them to the side he is rolling onto. C. Place a pillow between the legs to position them in abduction prior to initiating the rolling D. Raise the foot of the bed and have him fling his arm and head side to side to develop momentum to move into the roll

B. Cross his leg over the other leg in the direction he is rolling, then instruct him to use his arm and head to develop momentum and then roll over by flinging them to the side he is rolling onto.

which of the following correctly describes the activity of cytokines and chemokine, during neuronal injury?

B. Cytokines activate microglia in both an autocrine and paracrine manner

Which cranial nerve carries motor effects to extraocular muscles and autonomic efferents to the muscles of the pupil and lens?

B. Oculomotor nerve (CN III)

Damage to Clarke's nucleus would disrupt what sensory function emanating from the legs?

B. Proprioception

which of these cells would not be found inside the cerebral cortex? A. Astrocytes B. Schwann Cells C. Oligodendrocytes D. Microglia

B. Schwann Cells

Of the components of the anterolateral pathway, which is most associated with the emotional aspects of our pain experience? A. Neospinothalamic tract B. Spinomesencephalic tract C. Spinoreticular tract D. Ventral spinothalamic tract

B. Spinomesencephalic tract (this is wrong answer, in lecture said most comes from spinolimbic tract = how they behave in response)

an oligodendroglioma presents with fairly good differentiation, no infiltration and is slowly growing. this tumor would be staged as: A. stage I B. Stage II C. stage III D. stage IV

B. Stage II

what is different about the axon membrane at the nodes of Ranvier than in the axon where it is wrapped with the substance produced by Schwann cells? A. there is a high degree of membrane resistance B. there is a high concentration of voltage-gated sodium channels C. there is no passive decay of the membrane potential D. Ligand-gated receptors are present to respond to neurotransmitters

B. There is a high concentration of voltage-gated sodium channels

if there were a condition that resulted in the absence of Ruffini receptors, what type of sensation would be disrupted? A. Tension and touch B. Touch and stretch C. Pain and touch D. Tension and pain

B. Touch and stretch

What kind of ion channel must be opened to initiate an action potential at the axon hillock of a projection interneuron?

B. Voltage-gated sodium channel

how is a ganglion different from a nucleus? A. a ganglion has neuronal cell bodies B. a ganglion is outside the CNS C. a ganglion has incoming and outgoing connections D. a ganglion is for sensory neurons

B. a ganglion is outside the CNS

what kind of neural structure can be found in gray matter and in white matter? A. neuronal cell bodies B. axons C. dendrites of neurons D. synapses

B. axons

the cerebellum is physically connected to the rest of the nervous system at the level of the A. cerebrum B. brainstem C. spinal cord D. all of the above

B. brainstem

a patient is receiving PT in the ICU, following a severe TBI, begins to vomit. The therapist should be most concerned about: A. dysautonomia B. elevated intracranial pressure C. Multi-organ failure D. seizure activity

B. elevated intracranial pressure

a patient recovering from TBI is watching a TV show where one of the characters dies; in response the patient begins to cry and continues crying for almost an hour. This is likely a sign of what condition? A. emotional dyscontrol B. emotional lability C. pathologic crying D. pseudobulbar affect

B. emotional lability

which of the following is true regarding repetitive mild TBI? A. motor function is the area most sensitive to this damage B. external provocation is one means for screening for mild TBI C. does not lead to neural changes such as atrophy D. attention and concentration are not impacted

B. external provocation is one means for screening for mild TBI

for the patient receiving radiation treatment for brain tumor, exercise should be avoided until treatment is complete? A. true B. false

B. false

When rehabilitating for function the appropriate progression is to start with the task that is least physically demanding and use the task that A. allows for the most error in movement B. avoids variability until the first form of the task is mastered C. demands the movement pattern you are training D. utilizes the non-paretic extremities to ensure the task is accomplished

C. demands the movement pattern you are training

Functional Electrical Stimulation (FES) can be used during gait to aid in dorsiflexion. which of the following is a true statement regarding functional electrical stimulation? A. at present there is insufficient evidence to support the use of FES B. functional electrical stimulation can slow or stop muscle fiber type conversion C. the stimulation is applied to the dorsiflexors throughout the gait cycle D. the use of functional electrical stimulation impedes neuroplasticity

B. functional electrical stimulation can slow or stop muscle fiber type conversion

Multi-modal sensory stimulation programs should A. present stimuli in random order B. include monitoring of vitals C. sessions can be up to 1 hour long D. use standardized stimuli with no emotional overlay

B. include monitoring of vitals

your patient is experiencing localized spasticity in the thumb abductor; what would be the most likely medical treatment to decrease his spasticity? A. intrathecal baclofen B. injection of botulinum toxin type A C. Oral baclofen D. Oral diazepam

B. injection of botulinum toxin type A

for those with severe TBI which long-term outcome is most likely? A. complete return to work, school, or homemaking activity B. return to supervised work and living environments C. no return to work but able to live independently D. require total care at home and unable to work

B. return to supervised work and living environments

which of the following statements is true about best practice as related to the use of treadmill training with the individual post-stroke? A. is best to used in the chronic stroke population B. should be progressed to over-ground training C. use 50% body weight support D. use velocity set at 1.0 m/s or greater

B. should be progressed to over-ground training

what structure would not contain any corticospinal fibers passing from the cortex to the spinal cord? A. the internal capsule B. the corpus callosum C. the cerebral peduncle D. the medullary pyramid

B. the corpus callosum

what structure is associated with the brain's regulation of hormones in the bloodstream?

B. the hypothalamus

what is the best example of feed-forward control? A) a stretch reflex resisting forward sway when a person is pushed from behind B) Looking at a mouse before reaching for it C) leaning forward before reaching forward D) moving one finger while holding the wrist stable

C) leaning forward before reaching forward

which of the descending systems listed here has bilateral influence? A) rubrospinal B) lateral reticulospinal C) medial reticulospinal D) lateral vestibulospinal

C) medial reticulospinal

which body area has a disproportionately small representation in the primary motor cortex? A) face (mouth) B) arm and hands C) trunk D) legs and feet

C) trunk

What is the name of the force that determines which way ions will flow across the neural cell membrane when a certain ion pore opens?

C. Electrochemical gradient

A stroke disrupting the medial posterior thalamic nucleus would disrupt sensation from which part of the body? A. Arms B. Legs C. Face D. Trunk

C. Face

in learning a new motor skill, what oligodendrocyte changes would be expected?

C. Increased myelination and an increased number of internodal segments

where are the dorsal column nuclei found? A. Midbrain B. Pons C. Medulla D. Spinal cord

C. Medulla

What is the name of the fatty substance that covers axons to improve their ability to conduct action potentials?

C. Myelin

which of the following structures is most prominent on the mesial surface of the cerebral cortex along the midline? A. lateral sulcus B. Central sulcus C. Parietal occipital sulcus D. Insular cortex

C. Parietal occipital sulcus

when a neuron is active, the number of action potentials it makes per second should be proportional to the membrane potential at the trigger zone of the cell. What is the name for this relationship?

C. Rate coding

Amy is 14 weeks s/p a severe head injury; she does not remember anything about her accident. she is currently unable to remember what kind of job she held prior to the accident, anything about her 2 years of marriage to Matt or details of her college years. She is able to remember her therapy schedules and transport herself to each session. within sessions she is able to remember some of the things she learned from the preceding day and verbalize them. What kind of amnesia is Amy demonstrating? A. anterograde B. Post-traumatic C. Retrograde

C. Retrograde

the vermis is considered part of which functional division of the cerebellum?

C. Spinocerebellum

at which Ranchos LOC can you begin to expect explicit learning with carryover? A. IV B. V C. VI D. VII

C. VI

in a person standing, what two directions are roughly equivalent in the cerebral hemisphere? A. anterior-ventral B. inferior-dorsal C. anterior-rostral D. posterior-dorsal

C. anterior-rostral

an individual post-TBI who is in Ranchos LOC Stage IV and agitated has left hemiplegia and is doing repetitive sit to stand transfers in all therapies and with nursing. After a week he remains in Ranchos LOC IV and has improved his transfer from moderate assist to CGA with cueing. this improvement is due to: A. hypertrophy of the quadriceps B. explicit learning C. implicit learning D. improved memory

C. implicit learning

recent research suggests that the best treatment for concussion is: A. absolute rest B. moderate levels of physical and cognitive activity are best C. moderate physical activity with minimal cognitive activity is best D. high-level physical and cognitive activity are recommended

C. moderate physical activity with minimal cognitive activity is best

in hospice the primary focus should be? A. increasing aerobic capacity B. strengthening C. pain management D. walking endurance

C. pain management

loss of the upper left visual fields is likely to occur with damage to which component of the optic projections? A. left temporal optic radiations B. left parietal optic radiations C. right temporal optic radiations D. right parietal optic radiations

C. right temporal optic radiations

while assessing a client who is s/p TBI a therapist asks the client to demonstrate how to safely perform a sit to stand transfer. the client takes a long time to initiate the activity but then performs the activity in a safe and correct manner. when a nurse rushes the client to stand up from the dining room chair after dinner the client is unsafe and requires cueing. based on this description the two transfers look different due to which area of cognitive function? A. loss of memory B. poor judgement C. slow speed of processing D. poor selective attention

C. slow speed of processing

What is the name of the passageway between the third and fourth ventricles?

C. the cerebral aqueduct

a teenage lacrosse player comes off the field after having been hit over the helmet with another player's lacrosse stick. the player says he feels fine and wishes to return to play. he can repeat digits back to you in reverse order and knows where he is and what happened. he is also able to tell you who they played a week ago and the score of the game. Pupils are symmetrical and reactive and finger to nose is normal. he is asked to sprint 40 yards and then to do five pushups. on the third pushup he vomits. which of the following statements is true regarding his screen for mild TBI? A. the screening exam is negative and he can return to play B. the screening exam has a positive finding but it is only with provocation so he can return to play C. the provocation test was positive so he should be held from play

C. the provocation test was positive so he should be held from play

Which structure in the thoracic and abdominal area cavities is the initial target for neurons of the autonomic nervous system?

C. the sympathetic chain ganglion

when training gait which of the following set ups would discourage knee hyperextension? A. stepping over small objects with the paretic extremity B. transferring sit to stand with a soft object under the non-paretic foot C. walking up a slope D. walking while stepping with the non-paretic extremity

C. walking up a slope

which of the deep cerebellar nuclei is principally connected though the thalamus to the cerebral cortex?

D. Dentate

Which is a monosynaptic reflex? A. Ib activation of the heteronymous muscle B. Ib activation of the homonymous muscle C. Ia activation of the heteronymous muscle D. Ia activation of the homonymous muscle

D. Ia activation of the homonymous muscle

for the type of axon noted above (that has fatty substance that covers axons to improve their ability to conduct action potentials) what is the name of the gap not covered by fatty substance?

D. Node of Ranvier

a patient presents with ipsilateral paresis of the facial muscles, ipsilateral sensory loss of the face, contralateral paresis of the trunk and extremities, and contralateral sensory loss in the trunk and extremities. A lesion of which area of the brain would produce these symptoms? A. Cerebellum B. Medulla C. Midbrain D. Pons

D. Pons

Damage to the most medial part of the dorsal column in the cervical spinal cord would disrupt sensation from which spinal nerve roots?

D. Sacral

which part of the basal ganglia is in the midbrain? A. Caudate B. Putamen C. Globus pallidus D. Substantia nigra

D. Substantia nigra

over activity of the pontine reticular formation is responsible for what post-stroke phenomenon? A. Clonus B. Hyperreflexia C. Phasic stretch reflex D. Tonic stretch reflex

D. Tonic stretch reflex

When providing range of motion in the acute care setting which of the following muscle groups should be a focus in the individual post-stroke who is developing typical patterns of hypertonicity through providing range of motion that moves the joint into ________ A. elbow extension B. forearm pronation C. Shoulder adduction D. Wrist extension

D. Wrist extension

deep vein thrombosis is caused by which of the following A. hypertension B. spasticity C. spinal shock D. bed rest

D. bed rest

which symptoms of a brain tumor is only found in young children? A. irritability B. fatigue/sleep disturbance C. seizures D. protruding fontanelles

D. protruding fontanelles

an individual with a spinal injury classified as AIS C will have the following functions below the level of the injury

D. spared motor and sensory function

in dealing with a client who is agitated which of the following is appropriate? A. restrain the individual to prevent self-harm and harm to others B. medication improves time to recovery from agitation and confusion C. be sure to bring at least 3 staff into the room to ensure you can control the individual D. try to figure out what is causing them to agitated and modify the environment and agitation can be decreased

D. try to figure out what is causing them to agitated and modify the environment and agitation can be decreased

the primary cause of excitotoxicity post-CNS injury is:

Glutamate

what happens when a climbing fiber sets off a complex spike in a Purkinje cell?

Synapses of parallel fibers on the Purkinje cell get weaker if they were active

a central cord injury will typically have the following type of dysfunction

severe atrophy of the hands and good motor control of the legs

in the basal ganglia, which pathway includes the subthalamic nucleus?

the indirect pathway