Neuro clinical questions: 1-3

MS. Mendoza was diagnosed with a tumor in her right optic tract. her occupational therapist has detected a contralateral homonymous hemianopia causing A. a right visual field cut B. A left visual field cut C. Complete blindness D. Tunnel vision

B. Left visual field cut

After a stroke, Ms. Rodriguez displays aphasia, a language disorder in which she has difficulty speaking and interpreting others' words. Language disorders such as aphasia commonly occur in which hemisphere? A. Left B. Right

A. Left (left plays a huge role in human language. People with aphasia (language disfunction) sustained left hemisphere damage)

Ms. Henderson has been diagnosed with a lumbar disc rupture at L4, causing impingement of the lumbosacral plexus. As a result, she has been experiencing severe pain in her back that radiates down her legs. This type of pain is called A. Sciatic pain or sciatica B. Brachial plexus pain C. Referred plexus D. Angia

A. Sciatic pain or sciatica

In the above question, Mr. Staniloposis's therapist administers the Romberg test to assess his balance. Shes asks Mr. Stanilopolis to stand with his eyes closed, feet together, and shoulders flexed to 90 degrees (held in front of the body). Mr. S beings to sway and loses his balance. When using the Romberg test and removing visual cues, a patients postural stability is based on: A. Vestibular and proprioceptive information B. Reticular formation and cerebellar information C. parasympathetic and sympathetic nervous system information D. Basal ganglia information

A. Vestibular and proprioceptive information

After her stroke, Ms. Jenkins has developed hypersensitivity to sensation on the contralateral side of the lesion. The hypersensitivity progressed into burning, agonizing pain that causes Ms. Jenkins nausea and sleep disruption. This syndrome is called __________ and can result from ___________. 1. central post-stroke pain 2. central hypersensitivity syndrome 3. vascular insufficiency to the thalamus and nearby CNS structures 4. vascular insufficiency to the sensory spinal cord tracts A. 1,3 B. 1,4 C. 2,3 D. 2,4

A. 1,3

If Ms. Vaccarino, in the above question could not hear despite intact outer, middle, and inner ear structures, her therapist might suspect pathology in the ____________. This is referred to as a ________ hearing. 1. Primary auditory area 2. Auditory association areas 3. sensorineural 4. Conductive A. 1,3 B. 1,4 C. 2,3 D. 2,4

A. 1,3

Mr. Murakami presents with drooping of his right face, right eyelid ptosis, inability to completely close his right eyelid, and mouth deviation to the right. Additionally, he reports that he has become hypersensitive to noise in his right ear. This condition is called ___________ and results from damage to cranial nerve____________. A. Bells palsy; CN 7 Facial nerve B. Trigeminal neuralgia; CN 5 trigeminal nerve C. Bells Palsy; CN 5 trigeminal nerve D. Trigeminal neuralgia; CN 8 vestinulocochlear nerve

A. Bells palsy; CN facial nerve

Alice has been experiencing decreased proprioception; she has difficulty understanding the location of her limbs in space and in relation to each other. She walks with great clumsiness or motor incoordination and ataxia. Magnetic resonance imagining has most likely detected a tumor in which neurological structure? A. Cerebellum B. Hypothalamus C. Cerebral Peduncles D. Parietal lobe

A. Cerebellum (uses sensomotor system that oversees proprioception) .... unconscious awareness of the body position in space. Coordination, precision control of movement and balance.

A newborn infant has increased expansion with accompanying cranial suture separation and neural tissue compression. This condition is called _________________ and can result from ______________. A. Congenital hydrocephalus; foramina blockage, excessive production of CSF, choroid plexus tumors B. normal pressure hydrocephalus; reduced absorption CSF by arachnoid villae C. Congenital hydrocephalus; reabsorption of CSF by the arachnoid villae. D. Normal-pressure hydrocephalus, foramina blockage

A. Congenital hydrocephalus; foramina blockage, excessive production of CSF, choroid plexus tumors

After his brain injury, Jack has difficulty regulating his temperature, has experienced acne due to hormonal imbalances, and is unable to assume a normal sleep-wake cycle. Which neurological structure can primarily thought to be responsible for these functions. A. Hypothalamus B. Thalamus C. Cerebellum D. Brainstem

A. Hypothalamus (ANS, temperature, hunger/thirst, emotion)

After his stroke, Mr. Donatelli has difficulty expressing meaningful verbal communications to others and has hemiparesis and hemiparesthesia of his right side. His stroke likely occurred in which cerebral hemisphere? A. Left B. Right

A. Left

When playing a high school football, Tyler sustained a peripheral nerve injury at the brachial plexus when he was hit by another player. As a result, he experienced a nerve root avulsion or severe tear. This injury is accompanied by numbness and weakness in Tyler's right arm and hand. This type of injury is considered: A. a lower motor neuron B. an upper motor neuron injury

A. a lower motor neuron

Mr. Greenspan was diagnosed with a severe degenerative neurological disorder affecting both the central and peripheral nervous system. Upper and lower motor neurons denervate, resulting in muscle atrophy, spasticity ( of upper motor neurons) and flaccidity ( of lower motor neurons). Advanced stages of disease, a wider spread of muscle weakness in the throat, neck, head and shoulders occur. Death commonly follows denervation of the respiratory muscles. This disease is known as: A. amyotrophic lateral sclerosis B. Multiple sclerosis C. Myasthenia graivs D. Muscular dystrophy

A. amyotrophic lateral sclerosis

After 5 years of taking a cholinergic drug to reduce the symptoms of schizophrenia, Frank has developed tardive dyskinesia, a condition causing muscular spasms and involuntary motor movements such as lip smacking, tongue protrusion, head snapping, and jerking of the arms and legs. This disorder results from: A. an increased effect of acetylcholine (ACh) at the neuromuscular junction due to long term cholinergic drug use B. Blockage of acetylcholine at the neuromuscular junction causing neurotransmitter fatigue and resulting in skeletal paralysis C. anoxia, lack of oxygen, at the neuromuscular junction resulting in failed synaptic transmission and muscles weakness D. denervation of the ACh receptors causing muscle atrophy and weakness

A. an increased effect of acetylcholine (ACh) at the neuromuscular junction due to long term cholinergic drug use

Mr. Choi has been diagnosed with a tumor in his right secondary somatosensory area. As a result, he has difficulty identifying objects with his left hand ( with vision occluded). The umbrella term for the disorder is called A. Tactile agnosia B. Primary sensation

A. tactile agnosia

Jose lost consciousness after a TBI and has not regained it in 2 months status post-injury. He is able to open his eyes and appears to display regular sleep-wake cycles, but does not have any cognitive function or awareness. Jose's cough, gag, and swallowing reflexes all remain in tact. This state of altered conscioussness is called _______ and is caused by severe damage to the ________. 1. Brain death 2. Persistent vegetative state 3. Cortex 4. Brainstem A. 1,3 B. 2,3 C. 1,4 D. 2,4

B. 2,3

Mr. Wilson has been diagnosed with normal pressure hydrocephalus. This form of hydrocephalus is caused by _______ and can result in _______. 1. blockage of the foramen of Luschka 2. impaired reabsorption of the CSF without foramina blockage 3. fontanel bulging and increased cranial expansion 4. dementia, incontinence, and gait abnormalities A. 1,3 B. 2,4 C. 1,4 D. 2,3

B. 2,4

James has been in a persistent vegetative state for 5 days after an auto vehicle accident. Although an electroencephalogram indicated no cortical activity. James' vegetative functions (eg, temperature, heart rate, respiration, blood pressure, and gag and cough reflexes) continue to be maintained. The neurological system is responsible for the control of vegetative functions is the A. Vestibular system B. ANS C. PNS D. SNS

B. ANS

Josh, a 7-year-old in elementary school, has difficulty interpreting others' emotions through their facial expressions, verbal tone, and body language. HE also has difficulty generating age-appropriate feelings of empathy for his classmates. Josh has been given a diagnosis of autism spectrum disorder by his pediatrician. Researchers have targeted which one of the below neurological structures as dysfunctional in ASD. A. Medial longitudinal fissure B. Amygdala C. Pyramidal decussation D. Anterior median fissure

B. Amygdala ( it is significantly smaller in some people with ASD or decreased dendrites. Damaged amygdala may contribute to difficulty interpreting social cues.

Mr. Cho had a spinal cord injury that occurred at T6 1 year ago. He has spasticity in all muscle groups before Mr.Cho's spinal cord injury is considered: A. lower motor neuron B. An upper motor neuron injury

B. An upper motor neuron injury

Loss of smell is clinically termed: A. anomia B. Anosmia C. Agnosia D. aphasia

B. Anosmia

For example, when small objects are placed in Mr. Choi's left hand (with vision occluded), he cannot interpret them. This is called: A. two-point discrimination B. agraphesthesia C. astereognosis D. topographical disorientation

B. Astereognosis

After a gunshot wound to the head, Jose has been in a vegetative state. Although he shows no response to verbal commands, his cough and gag reflex, swallowing reflex and pupillary response all remain intact. Which neurological structure is responsible for these relfexive functions? A. Thalamus B. Brainstem C. Frontal Lobe D. Basal ganglia

B. Brain stem (controls vegetative function, respiration, cough and gage reflux, pupillary response)

MS. Maniadakis is being tested for the presence of abnormal nystagmus. which of the following is not used to assess nystagmus? A. caloric testing B. electroencephalography C. optokinetic testing D. videonystagmography

B. Electroencephalography

Ms. Chaudhari has a neurological disorder caused by demyelination of neurons in the CNS. The disease process is characterized by periods of exacerbation and remission over many years. Sensory systems include numbness parethesias, and causalgia. Motor systems include abnormal gait, bladder and sexual dysfunction, vertigo, and fatigue. This disease is know as A. Amyotrophic lateral sclerosis B. Multiple sclerosis C. Myasthenia gravis D. Muscular dystrophy

B. Multiple sclerosis

Mr. Morrissey had a stroke to his brainstem, which damaged the structure responsible for states of wakefulness. As a result, he lies in a stuporous, unarousable state. The structure likely damaged was the: A. reticular inhibiting system B. reticular activating system

B. Reticular activating system

Joshua has been admitted to the emergency room after a severe auto vehicle accident in which he was a passenger. He is diagnosed with increased intracranial pressure and neural tissue compression resulting from hemorrhage into the subdural space. Traumatic brain injuries often involve: A. Blockage of the foramen of Magendie, resulting in hydrocephalus B. Rupture of the middle meningeal artery, resulting in hemorrhage

B. Rupture of the middle meningeal artery, resulting in hemorrhage

after a viral infection of the upper respiratory tract, MS. Schumacher began to experience vertigo, nausea, balance problems, and nystagmus. her physician diagnosed ______, which is caused by damage to the _____. A. trigeminal neuralgia; CN 5 trigeminal nerve B. vestibular neuritis; CN 8 vestibulocochlear nerve C. Vestibular neuritis; CN 10 vagus nerve D. Bells palsy: CN 7 facial nerve

B. Vestibular neuritis; CN 8 vestibulocochlear nerve

Howard presents with weakness rotating his head to the right, weakness flexing his head laterally and forward, weakness elevating his left shoulder, and weakness flexing his left arm about 90 degrees. His physician suspects involvement of which cranial nerve? A. CN 12 hypoglossal nerve B. CN 11 accessory nerve C. CN 10 vagus nerve D. CN 9 glossopharyngeal nerve

B. accessory nerve

Mrs. malinowksi had a tumor located in V4. She is able to accurately see and interpret objects when they are still. However, she is unable to interpret objects in motion (such as moving cars on the street). This is referred to as A. achromatopsia B. akinetopsia C. abarognosia

B. akinetopsia

Mary has lateral strabismus (or external deviation) in her left eye accompanied by eyelid ptosis (drooping) , and binocular nystagmus. her therapist suspects the involvement of which cranial nerve? A. Optic nerve (CN 2) B. oculomotor nerve (CN 3) C. Trochlear nerve ( CN 4) D. Abducens nerve ( CN 6)

B. oculomotor nerve

After his motorcycle accident 1 year ago, Jims personality and behavior have changed significantly. He He now has severe short term memory problems and is disorganized, foul-mouthed, and impulsive. Jim can neither foresee the consequences of his actions nor does he possess insight into his behaviors. Damage of which cerebral lobe would largely be responsible for those problems? A. Occipital B. Temporal C. Frontal D.Parietal

C (Frontal works with cognition)

After sustaining a traumatic brain injury, Jayden lost his sense of smell and taste. Loss of these 2 senses likely resulted from damage to which cranial nerves? 1. olfactory nerve (CN 1) 2. Facial nerve ( CN 7) 3. Glossopharyngeal nerve ( CN 9) 4. Vagus nerve ( CN 10) 5. Hypoglossal nerve (CN 12) A. 1,2 B. 1,2,3 C. 1,2,3,4 D. 1,2,3,4,5

C. 1,2,3,4

Although men typically possess larger amygdala volumes than do women ( because of their overall larger body size), women have been found to possess greater numbers to dendritic connections between the amygdala and cortex. Some researchers have suggested that such connections allow women to be better modulators of anger than men. This emotional modulation skill may allow women to be better at which of the below skills. 1. use of symbolic signals to de-escalate potentially threatening situations 2. recognition of subtle expressions of emotions in other humans 3. response to potential threats with overt displays of physical aggression 4. attachment of words to emotions during communication A. 1,2 B. 2,3 C. 1,2,4 D. ALl the above

C. 1,2,4

Jose's friend Alejandro, who was in the car accident with Jose, also sustained a TBI. Alejandro is in a state of sleep-like (eyes closed) unarousability. All cognitive function has been lost as well as a cough, gag, and swallowing reflexes. Alejandro's heartbeat continues from ANS regulation; however, Alejandro has been hooked up to life support because of a severe respiratory infection. This type of coma is called _____________ and results fro severe brain damage to the 1. brain death 2. persistent vegetative state 3. cortex 4. brainstem A. 1,3 B. 2,3 C. 1,4 D. 2,4

C. 1,4

Mrs.Novak had a left cerebral hemisphere stroke located in the inferior gyrus of the premotor area. She can understand language that is spoken to her, but when she tries to respond, she cannot form meaningful sentences. This type of aphasia is called 1. broca aphasia 2. wernicke aphasia 3. receptive aphasia 4. expressive aphasia A. 1,3 B. 2,3 C. 1,4 D. 2,4

C. 1,4

Ms. Vaccarino has intact auditory anatomy of the outer, middle, and inner ear. However, she cannot accurately interpret sounds. For example, when she heard a door close in the clinic setting, she asked if someone fell. This condition likely results from __________________ and is called _______________ 1. a lesion to the primary auditory area (A1) 2. a lesion to the auditory association areas 3. auditory agnosia 4. auditory hemianopia A. 1,3 B. 1,4 C. 2,3 D. 2,4

C. 2,3

MR. weinholtz has seen his physician for an upper respiratory infection. he becomes dizzy upon standing and lists to his right side when attempting to walk. which special sense receptors may have been affected 1. Visual receptors (rods and cones of the retina) 2. Auditory receptors (hair cells of cochlea) 3. Equilibrium receptors ( semicircular canals, utricles, and saccules of the inner ear) 4. Cutaneous receptors 5.Proprioceptors 6. Visceral receptors A. 1,4 B. 2,5 C. 3,5 D. 3,6

C. 3,5

Mr. Jones has been diagnosed with Parkinson's disease and displays the festinating gait, intention tremors, and masked face associated with this disease. Which neurological structure is believed to be responsible for these symptoms and is often the target of drug and surgical treatment? A.Hippocampus B. Brainstem C. Basal Ganglia D. Thalamus

C. Basal Ganglia (When dopamine neurons degenerate automated movements controlled by basal ganglia, they're inhibited)

Mrs. Greenly has been diagnosed with Parkinson's disease. Her physician explains to the family that, while several pharmaceutical options are available, none are highly effective because such drugs cannot reach the brain. The neurological structure by which potentially toxic molecules are prevented from reaching the brain is called the: A. Dura mater B. Cerebral aqueduct C. Blood-brain barrier D. Arachnoid villae

C. Blood Brain barrier

emilia is experiencing tongue deviation to the right, atrophy and paralysis of the tongue and dysphagia secondary to impaired tongue musculature. her therapist immediately suspects impairment to which cranial nerve? A. CN 9 Glossopharyngeal B. CN 11 accessory nerve C. CN 12 hypoglossal nerve D. CN 7 Facial nerve

C. CN 12 hypoglossal nerve

ms. chen is seeing her occupational therapist because she is experiencing loss of sensation to her head, face, and inner oral cavity on her left side. her jaw is deviating to the left side and she is having difficulty chewing on that side. her therapist suspects involvement of which cranial nerve ? A. Facial nerve (CN 7) B. Abducens nerve ( CN 6) C. Trigeminal nerve ( CN 5) D. glossopharyngeal nerve (CN 9)

C. Trigeminal nerve (CN 5)

Mr.Stanilopolis recently fell. He told his therapist that he fell because he was not wearing his glasses. However, his daughter reports to the therapist that her father commonly walks with a broad-based gait, uses furniture in the home to help him stabilize his balance while walking, and frequently loses his balance in dim light and unlevel surfaces. The daughter also states that her father commonly complains of dizziness (vertigo), ear ringing (tinnitus) and decreased hearing. Upon examination, the therapist finds an abnormal presence of nystagmus. She suspects impairment of which neurological system? A. visual system B. proprioceptive system C. vestibular system D. autonomic nervous system

C. Vestibular system

Anna's infant was born with a congenital disorder in which the neural tube did not completely fuse and the spinal cord has not united. The meninges and CSF protrude through the vertebral column and a visible cyst is present on the infants back filled with CSF and neural tissue. This disorder is called: A. Arnold Chiari malformation B. Menigomyeolcele C. Menigocele

C. meningocele

Ms. Lee was diagnosed iwth chronic autoimmune disorder affecting the neuromuscular junction of voluntary muscles. In this disease, acetylcholine receptor antibodies destory acetylcholine receptors at the neuromuscular junction, resulting in severe muscular weakness and fatigue. The disease first affects the eye and head musculature and then progresses to the limbs and respiratory muscles. This disease is known as : A. amyotrophic lateral sclerosis B. Multiple Sclerosis C. myasthenia gravis D. Muscular dystrophy

C. myasthenia gravis

Emile is walking home from work late at night. The street he is walking on is dimly lit and silent. Emile believes that he can hear someone waling behind him in the distance. He is carrying a large sum of money that he must deposit in the bank tomorrow. As he hears the footsteps growing closer. Emiles heart rate accelerates. The hunger that he felt has dissipated, as a blood flow has shifted from his gastrointestinal tract to his skeletal muscles and brain. Emiles blood pressure has increased, and he feels alert and anxious. Which neurological system has become dominant and is responsible for these physiological changes A. vestibular system B. PNS C. SNS D. Enteric nervous system

C. sympathetic nervous system

After a drug overdose that damaged her ventral pons. Lin lost all voluntary muscle control, including the ability to speak. The muscles controlling her eyeball movements are the only muscles over which she still retains control. Lin lies in a hospital bed and is conscious but cannot communicate. This state is called A. brain death B. persistent vegetative state C. Coma D. Locked-in-syndrome

D

Research has shown that when women sustain stroke in the left hemisphere language centers, the resultant aphasia tends to be less severe than that experienced by men and tends to resolves more quickly. The reasons accounting for this sex-based difference include which of the below? 1. Female cortical language centers appear to have higher volumes of dendritic connections than do male cortical language centers 2. women tend to more commonly use both hemispheres in language production than do men (who use the left side language centers more commonly) 3. The cortical language centers have been shown to mature approximately 6 years earlier in girls than boys A. 1,2 B. 1,3 C. 2,3 D. 1,2,3

D. 1,2,3

Mr. Amadi was rushed to the hospital after experiencing pain in his left jaw that radiated down his left arm. This type of pain is called ____________ and occurs as a result of ____________. 1. Neurogenic pain 2. Referred pain 3. Stimulation of the spinal nerve that innervates both specific dermatome level and visceral organ 4. Stimulation of adjacent A.1,3 B. 2,4 C. 1,4 D. 2,3

D. 2,3

Mr. Takahashi was diagnosed with tunnel vision, in which the temporal fields in both eyes have been lost. this condition results from: A. a lesion to the right optic tract B. A lesion to the left optic tract C. A lesion to the lateral regions of the optic chiasm D. A lesion to the central region of the optic chiasm

D. A lesion to the central region of the optic chiasm

From the time Francis was a young child, he displayed tics and uncontrollable movements (eg, tongue protrusion and neck snapping). Although these dyskinesias have improved somewhat as he has aged, they still remain to a moderate extend as an adult. Which neurological structure is believed to be responsible for this movement disorder? A. Occipital lobe B. Brain Stem C. Hippocampus D. Basal Ganglia

D. Basal Ganglia

After a head injury from a fall, Mrs. Mazziotta has lost both the gag and swallowing reflexes. She is also experiencing dysphonia (hoarse voice), dysphagia (difficulty swallowing), and dysarthria (difficulty speaking clearly). These symptoms likely result from damage to which 2 cranial nerves? A. CN 11 accessory nerve, CN 12 hypoglossal nerve B. CN 9 glossopharyngeal nerve, CN 12 hypoglossal nerve C. CN 10 vagus nerve, CN 8 vestibulocochelar nerve D. CN 9 glossopharyngeal nerve, CN 10 vagus nerve

D. CN 9 glossopharyngel nerve, CN 10 vagus nerve

Which cranial nerves are being assessed when a therapist tests extraocular eye movements? A. optic nerve (CN 2), oculomotor nerve (CN 3), trochlear nerve (CN 4) B. optic nerve (CN 2), oculomotor nerve (CN 3), abducens nerve (CN 6) C. oculomotor nerve (CN 3), trochlear nerve (CN 4), trigeminal nerve (CN 6) D. oculomotor nerve (CN 3), trochlear nerve (CN 4), abducens nerve (CN 6)

D. D. oculomotor nerve (CN 3), trochlear nerve (CN 4), abducens nerve (CN 6)

When Mrs. Anderson walked into the hospital to visit her newly born grandson, the scents and odors of the hospital setting reminded her of the time when, 5 years ago, her husband was a hospital patient after experiencing cardiac arrest. In which two structures are primarily repsonsible for long-term memory storage of emotionally laden events associated with a distinct odor? A. Hippocampus and optic chiasm B. Reticular formation and optic chiasm C. Reticular formation and olfactory bulb and tract D. Hippocampus and olfactory bulb and tract

D. Hippocampus and olfactory bulb and tract ( Limbic system structures directly thru hippocampus. Deals with specific odors and long term memory)

ricardo is in first grade and has difficulty with attention and concentration he becomes easily distracted by noise in the hallway or by movement and sound from his classmates. when distracted, ricardo cannot refocus on his schoolwork and instead rises from his chair and walks around the classroom. which neurological system plays a role in screening sensory information so that the cortex can attend to the most salient information while filtering extraneous information from the environment A. Vestibular system B. enteric nervous system C. limbic system D. reticular formation

D. Reticular formation

After his spinal cord injury, Andrew has no sensation above his nipple line. It is likely that his injury occurred at which level of the spinal cord? A. C4-C2 B. S1-L4 C. S5-S1 D.T3-T5

D. T3-T5

Ann and amanda are in a car traveling to school. Amanda is a passenger in the front seat while Ann drives. Amanda is using this commuting time to catch up on reading for her classes. Fifteen minutes into the drive, Amanda begins to sweat and feel nauseated. She first attributes he discomfort to lack for breakfast. Amanda continues to read but feels increasingly dizzy, faint, and nauseous. She tells Ann, who recognizes amanda's conditions as motion sickness and advises her to stop reading and instead watch the oncoming traffic. Ann recognizes that motion sickness is often caused by: A. an incongruence between proprioceptive and vestibular system signals each cortex B.incongruent signals traveling to the cortex from the reticular activating and inhibiting systems C. parasympathetic nervous system dominance (over sympathetic nervous system activity) D. an incongruence between visual and motion signals reaching the vestibular system

D. an incongruence between visual and motion signals reaching the vestibular system

Five days after a stroke Mr. Peters cannot move his right arm and leg and lists to the right when seated in his wheelchair. In which hemisphere did Mr.Peters experience a stroke? A.Left B.Right

Left hemisphere ( think about opposite sides)