Lecture 4 NPTE FF Neuro Basics and Examination Review

Non-Fluent Aphasia

A PT asks a patient how he is doing. The Patient is unable to put together words to respond, but is able to nod and smile while putting thumbs up to demonstrate he is feeling good. Which of the following is the MOST appropriate diagnosis of this finding? A. Wernicke's Aphasia B. Receptive Aphasia C. Non-Fluent Aphasia D. Lesion to CN VII

Wernicke's Aphasia

A PT asks a patient how he is doing. The Patient's response is, "I am frontiwarrior". Which of the following is the MOST appropriate diagnosis of this finding? A. Wernicke's Aphasia B. Broca's Aphasia C. Non Fluent Aphasia D. Lesion to CN VII

Right Side Sensorineural Hearing Loss

A patient reports experiencing sudden onset of mild hearing loss on the Left side. Rinne test was consistent with air conduction greater than bone conduction on Both sides. Weber's test findings show sound was louder in the left ear. Which of the following is MOST appropriate? A. Right Side Sensorineural Hearing Loss B. Left Side Conduction Hearing Loss C. Right Side Conduction Hearing Loss D. Left Side Sensorineural Hearing Loss

Left Side Conduction Hearing Loss

A patient reports experiencing sudden onset of mild hearing loss on the Left side. Rinne test was consistent with bone conduction greater than air conduction on both sides. Weber's test findings show sound was louder in the left ear. Which of the following is MOST appropriate? A. Right Side Sensorineural Hearing Loss B. Left Side Conduction Hearing Loss C. Right Side Conduction Hearing Loss D. Left Side Sensorineural Hearing Loss

Strabismus

Abnormal position of the eye. Lazy eye so the eye rest laterally instead of being centered. Occurs when CN III is affected. A. Presbyopia B. Myopia C. Ptosis D. Strabismus

Brainstem

Area of the brain responsible for Involuntary Responses? A. Frontal Lobe B. Cerebellum C. Brainstem D. Temporal Lobe

Cerebellum

Area of the brain responsible for balance and coordination of movement? A. Frontal Lobe B. Cerebellum C. Parietal Lobe D. Temporal Lobe

True

BEN Brocas Aphasia Expressive Aphasia Non-Fluent Aphasia Is a way to remember the names for Aphasia A. True B. False

True

CANS is used to determine Weber's If Conductive ------ Louder to AFFECTED EAR If Sensorineural ------Louder in Normal ear A. True B. False

True

CEMIPONSMEDU Cerebrum CN 1 and CN 2 Midbrain CN 3 and CN 4 Pons CN 5, CN 6, CN 7, and CN 8 Medulla CN 9, CN 10, CN 11, CN 12 Is a way to remember how many and which cranial nerves are in each location of the brain A. True B. False

B and C

Considering patient has a lesion of the Occulomotor, which of the following statements is MOST appropriate? A. Patient will be unable to look outwards B. Patient will be unable to move eye inwards C. Patient will be unable to look up D. Patient will be unable to look down and in E. B and C

Patient will be unable to look outwards

Considering patient has a lesion of the abducens, which of the following statements is MOST appropriate? A. Patient will be unable to look outwards B. Patient will be unable to move eye inwards C. Patient will be unable to look up D. Patient will be unable to look down and in

Patient will be unable to look down and in

Considering patient has a lesion of the trochlear, which of the following statements is MOST appropriate? A. Patient will be unable to look outwards B. Patient will be unable to move eye inwards C. Patient will be unable to look up D. Patient will be unable to look down and in

Facial Nerve

Considering patient has loss of taste sensation to the anterior tongue, which of the following nerves is MOST likely to cause this presentation? A. Facial Nerve B. Trigeminal Nerve C. Glossopharyngeal Nerve D. Spinal Accessory Nerve

Glossopharyngeal Nerve

Considering patient has loss of touch sensation and taste sensation to the posterior tongue, which of the following nerves is MOST likely to cause this presentation? A. Facial Nerve B. Trigeminal Nerve C. Glossopharyngeal Nerve D. Spinal Accessory Nerve

Trigeminal Nerve

Considering patient has loss of touch sensation to the anterior tongue, which of the following nerves is MOST likely to cause this presentation? A. Facial Nerve B. Trigeminal Nerve C. Glossopharyngeal Nerve D. Spinal Accessory Nerve

Ptosis

Drooping of the eyelids. Occurs when CN III is affected. A. Presbyopia B. Myopia C. Ptosis D. Strabismus

Presbyopia

Farsightedness. Far objects appear clearly but close ones appear fuzzy and harder to focus. CN II Is affected with this disorder. A. Presbyopia B. Myopia C. Ptosis D. Strabismus

Normal or Sensorineural Loss. Further Testing Determined with Weber's

For Rinne's Test, if Air Conduction is more than Bone Conduction, this is considered: A. Sensorineural Loss B. Conduction Loss C. Normal D. Normal or Sensorineural Loss. Further Testing Determined with Weber's

Conduction Loss

For Rinne's Test, if Bone Conduction is more than Air Conduction, this is considered: A. Sensorineural Loss B. Conduction Loss C. Normal D. Undetermined

Conductive Hearing Loss

Hearing impairment caused by interference with sound or vibratory energy in the external canal, middle ear, or ossicles. Related to the "Outer Ear" canal anatomically (think such as headphones) A. CN IV Dysfunction B. Sensorineural Hearing Loss C. CN II Dysfunction D. Conductive Hearing Loss

Sensorineural Hearing Loss

Hearing loss caused by damage to the cochlea's receptor cells or to the auditory nerves; also called nerve deafness. Related to the inner ear and more physiological changes with nerve signals. Deep inner ear structures. A. CN IV Dysfunction B. Sensorineural Hearing Loss C. CN II Dysfunction D. Conductive Hearing Loss

Medial Strabismus

If the Abducens nerve is affected, it will cause what eye complication? A. Presbyopia B. Myopia C. Ptosis D. Medial Strabismus

L Hypoglossal Nerve

If the tongue is off to the L side, what nerve is affected? A. R Vagus Nerve B. L Vagus Nerve C. L Hypoglossal Nerve D. R Hypoglossal Nerve

R Hypoglossal Nerve

If the tongue is off to the R side, what nerve is affected? A. R Vagus Nerve B. L Vagus Nerve C. L Hypoglossal Nerve D. R Hypoglossal Nerve

R Vagus Nerve

If the uvula is off to the L side, what nerve is affected? A. R Vagus Nerve B. L Vagus Nerve C. L Hypoglossal Nerve D. R Hypoglossal Nerve

L Vagus Nerve

If the uvula is off to the R side, what nerve is affected? A. R Vagus Nerve B. L Vagus Nerve C. L Hypoglossal Nerve D. R Hypoglossal Nerve

Occipital Lobe

Lobe responsible for visual perception such as color, form and motion. A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

Frontal Lobe

Lobe that is considered "on top of everything" within the cerebrum. Houses Broca's Area which is responsible for the ability to speak. Also is responsible for planning, programming, movement, Emotion, Behavioral Control and Personality. Controls Olfaction. A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

Temporal Lobe

Lobe that is responsible for hearing, language comprehension, and houses Wernicke's Area. Plays a key role in communication, memory, visual perception, language, and processing emotions. This lobe sits above the ears. A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

Parietal Lobe

Lobe that is responsible for perception and sensation. Involved in sensory processing, sensory integration, spatial awareness, and body awareness and perception. A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

CN IX

Mixed Nerve. Functions to add sensory affect to gag reflex (sensory) and adds sensation to posterior tongue for touch and taste. Also has swallowing component for motor component. A. CN XI B. CN XII C. CN IX D. CN X

CN X

Mixed Nerve. Functions to add sensory effect to gag reflex (motor) and supplies organs (rest and digest, heart rate, and breathing) Also moves uvula. A. CN XI B. CN XII C. CN IX D. CN X

CN VII

Mixed nerve. Involved with MOVEMENT of the face, muscles of facial expression, TASTE sensation to anterior 2/3rds of tongue, and involved in eyes closing/raise eye brows) A. CN V B. CN VII C. CN X D. CN XII

CN V

Mixed nerve. Involved with SENSATION to the face, sensation to anterior 2/3rds of tongue, and involved in mastication/chewing. A. CN V B. CN VII C. CN X D. CN XII

Cranial Nerve III

Motor Nerve. Nerve that is responsible for upward, downward, and medial gaze of eye ball. Also active in pupillary light reflex and constricts pupils from light. Also opens eye lids. A. Cranial Nerve III B. Cranial Nerve VII C. Cranial Nerve II D. Cranial Nerve IX

CN IV

Motor Nerve. Responsible for looking down and in. "Look at nose". A. CN II B. CN IV C. CN VI D. CN XII

CN VI

Motor Nerve. Responsible for looking laterally. "Look at ear" A. CN II B. CN IV C. CN VI D. CN XII

CN XII

Motor Nerve. Responsible for moving the tongue and protrusion. If injured, will deviate toward lesion. A. CN XI B. CN XII C. CN IX D. CN X

Myopia

Nearsightedness. Close objects appear clearly but far ones appear distant. CN II Is affected with this disorder. A. Presbyopia B. Myopia C. Peripheral Vision D. Corneal Reflex

True

Oh Oh Oh To Touch And Feel Very Good Vagina Ah Heaven Olfactory, Optic, Oculomotor, Trochlar, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory, Hypoglossal Is a way to remember the cranial nerves A. True B. False

Cranial Nerve I

Olfactory Nerve that affects sense of smell. Affected with anosmia which means the inability to smell. Lesion to the frontal lobe can affect this CN. A. Cranial Nerve I B. Cranial Nerve II C. Cranial Nerve XII D. Cranial Nerve X

Right Optic Nerve is Affected

On shining light in the patient's right eye none of the pupils constrict, however on shining the light in the patient's left eye both pupils constrict. Which of the following is MOST appropriate about this finding? A. Left Optic Nerve is Affected B. Right Oculomotor Nerve is Affected C. Right Optic Nerve is Affected D. Left Oculomotor Nerve is affected

Receptive Aphasia

Patient has jumbled words. History of temporal lobe damage. When you speak to him, he does not understand but responds in created words and nonsensical sentences. What is his MOST LIKELY diagnosis? A. Broca's Aphasia B. Receptive Aphasia C. Expressive Aphasia D. Non-Fluent Aphasia

Broca's Aphasia

Patient has slow, hesitant speech. He struggles with production of words and word expression. When you speak to him, he understands but can't find the words to respond. What is his MOST LIKELY diagnosis? A. Broca's Aphasia B. Wernicke's Aphasia C. Global Aphasia D. CN VII Lesion

Expressive Aphasia

Patient has slow, hesitant speech. History of frontal lobe damage. When you speak to him, he understands but can't find the words to respond. What is his MOST LIKELY diagnosis? A. Wernicke's Aphasia B. Receptive Aphasia C. Expressive Aphasia D. Fluent Aphasia

Wernicke's Aphasia

Patient has speaks with "word salad", stating nonsensical things and creating words. Overall, he seems to be able to fluently speak, but does not understand when you speak to him with basic words. What is his MOST likely diagnosis? A. Broca's Aphasia B. Wernicke's Aphasia C. Global Aphasia D. CN VII Lesion

CN XI

Patient has weakness of the trapezius and sternocleidomastoid. Which nerve is affected? A. CN XI B. CN XII C. CN IX D. CN X

Right Sided Sensorineural Hearing Loss

Rinne test showed AC>BC. Weber's showed Left side was louder than the Right. What is the diagnosis? A. Normal Hearing B. Left Sided Sensorineural Hearing Loss C. Right Sided Sensorineural Hearing Loss D. Right Sided Conduction Hearing Loss

Left Sided Sensorineural Hearing Loss

Rinne test showed AC>BC. Weber's showed Right side was louder than the Left. What is the diagnosis? A. Normal Hearing B. Left Sided Sensorineural Hearing Loss C. Right Sided Sensorineural Hearing Loss D. Right Sided Conduction Hearing Loss

Normal Hearing

Rinne test showed AC>BC. Weber's showed equal on both sides. What is the diagnosis? A. Normal Hearing B. Left Sided Sensorineural Hearing Loss C. Right Sided Sensorineural Hearing Loss D. Right Sided Conduction Hearing Loss

Right Sided Conduction Hearing Loss

Rinne test showed BC>AC. Weber's showed Right side was louder than the Left. What is the diagnosis? A. Normal Hearing B. Left Sided Sensorineural Hearing Loss C. Right Sided Sensorineural Hearing Loss D. Right Sided Conduction Hearing Loss

Cranial Nerve II

Sensory Nerve. Responsible for vision such as color acuity, peripheral vision, pupillary light reflex. If affected, can deal with blindness, myopia, and presbyopia. Assess by testing visual field. A. Cranial Nerve III B. Cranial Nerve VII C. Cranial Nerve II D. Cranial Nerve IX

CN VIII

Sensory nerve. Responsible for balance and hearing. Also acts to AMPLIFY sound whenever sound is too low. A. CN V B. CN VIII C. CN X D. CN XII

True

Some say money matters but my brother says big brains matters most Is a way to remember sensory motor or both nerves A. True B. False

Cranial Nerve XI

Spinal Accessory Nerve. Responsible for innervating the trapezius and the sternocleidomastoid. Tested through MMT such as resisted shruge. A. Cranial Nerve I B. Cranial Nerve II C. Cranial Nerve XII D. Cranial Nerve XI

True

T/F? All nerves have a afferent branch and efferent branch, with the afferent branch being sensory to stimulus and the efferent branch being a reflexive response. A. True B. False

True

T/F? With the cranial nerve reflex, if you shine a light in the LEFT eye, the LEFT CN II receives the information. Once this occurs, BOTH the RIGHT AND LEFT eye will constrict as both CN III in BOTH eyes respond to stimulus. A. True B. False

False

T/F? With the cranial nerve reflex, if you shine a light in the RIGHT eye, the RIGHT CN II receives the information. Once this occurs, only the LEFT eye will constrict as CN III responds to the light A. True B. False

True

T/F? "Lick your lesions" Helps determine what side tongue will go to A. True B. False

True

T/F? The Cerebrum is divided into 2 hemispheres, Right and Left, which is further divided into 4 lobes, (Frontal, Temporal, Occipital, and Parietal) A. True B. False

True

T/F? With the Pupillary light reflex, if one eye doesn't constrict that eyes CN III is affected (ie R eye doesnt contract R CN III affected). For CN II to be affected, both eyes have to not constrict as the information isn't being sent to CN III in either eye. A. True B. False

The Brain Stem

The Cranial Nerves, Mid Brain, Pons, and Medulla are considered apart of : A. The Peripheral Nervous System B. The Central Nervous System C. The Brain Stem D. The Cerebellum

Left

The DOMINANT hemisphere is typically referring to the : A. Right B. Left C. Parietal Lobe D. Frontal Lobe

The Peripheral Nervous System

The Free Nerve Endings are considered apart of : A. The Peripheral Nervous System B. The Central Nervous System C. The Brain Stem D. The Cerebellum

The Central Nervous System

The brain and spinal cord are considered apart of : A. The Peripheral Nervous System B. The Central Nervous System C. The Brain Stem D. The Cerebellum

12

There are how many pairs of CN? A. 11 B. 12 C. 10 D. 24

Left Brain Hemisphere

Typically, Aphasia is seen with damage to where? A. Left Brain Hemisphere B. Right Brain Hemisphere C. Occipital Lobe D. Parietal Lobe

Parietal Lobe

What lobe can lead to unilateral neglect if effected? A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

Frontal Lobe

What lobe contains Broca's Area? A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

Temporal Lobe

What lobe contains Wernicke's Area? A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

Frontal Lobe

What lobe is responsible for olfaction? A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

Rinne's Test

What test is completed first in diagnosing hear loss to determine the type of hearing loss. Completed with tuning fork where it is hit and then placed on bone behind hear to see how long they hear it. It is then placed in front of the ear and compared. (Air Conduction which is in front of the ear compared to Bone Conduction which is behind ear) A. Rinne's Test B. Weber's Test C. Snellen Chart D. Dix-Hallpike Test

Weber's Test

What test is completed on the second step of diagnosing hearing loss and is related to the SIDE that is involved (L, R, or both). The tuning fork is hit and placed on top of the head equidistant Patient is asked to compare what ear the tuning fork sounds LOUDER. Sensorineural loss will be louder in normal ear, Conduction los will be louder in affected ear A. Rinne's Test B. Weber's Test C. Snellen Chart D. Dix-Hallpike Test

Cranial Nerve V and VII

What two nerves are associated with the Corneal Reflex? A. Cranial Nerve I and II B. Cranial Nerve III and IV C. Cranial Nerve II and III D. Cranial Nerve V and VII

Cranial Nerve II and III

What two nerves are associated with the Pupillary Light Reflex? A. Cranial Nerve I and II B. Cranial Nerve III and IV C. Cranial Nerve II and III D. Cranial Nerve V and VII

Cranial Nerve V and VII

What two nerves are involed in DAMPENING sounds when they are two loud as to not harm the ear complex? A. Cranial Nerve I and II B. Cranial Nerve III and IV C. Cranial Nerve II and III D. Cranial Nerve V and VII

Cranial Nerve IX and X

Which nerves are responsible for the Gag Reflex? A. Cranial Nerve IX and X B. Cranial Nerve III and IV C. Cranial Nerve II and III D. Cranial Nerve V and VII

Right Brain Hemisphere, Parietal Lobe

With perceptual disorders such as L sided neglect (unilateral neglect only acknowledge one side of face) or topographical disorientation, what part of the brain is MOST typically affected? A. Right Brain Hemisphere, Parietal Lobe B. Right Brain Hemisphere, Occipital Lobe C. Left Brain Hemisphere, Frontal Lobe D. Left Brain Hemisphere, Parietal Lobe