Neurological Conditions Quizzes (Exam 2)

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Quiz 5

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Acute cerebellar infarction typically produces which of the following?

A and B A. Dizziness and/or vertigo with a lack of balance B. Nausea and vomiting, dysarthria, and headache

Which of the following structures are involved in the recognition, generation, and perception of emotion?

A and C A. Amygdala and mediodorsal thalamic nucleus C. Anterior insula and ventral striatum

Synonyms for Broca's aphasia include which of the following?

A, B, and C A. Motor aphasia B. Expressive aphasia C. Nonfluent aphasia

A patient has recently suffered a cerebrovascular accident and demonstrates left-sided hemiplegia with the leg more severely affected than the arm. The most likely location of this patient's infarction is which one of the following arteries?

A. Anterior cerebral

Autonomic dysreflexia is characterized by which one of the following?

Abrupt increase in blood pressure and pounding headache

Which of the following items is an aspect of emotional lability?

Abrupt mood shifts

The cortico-basal ganglia-thalamus motor loop contributes to:

All of the above

Following an SCI, allowing some muscles to tighten/shorten may improve function. For example, in patients with tetraplegia:

Allowing tightness to develop in the long finger flexors will allow a tenodesis grip

Which kind of disorder may be caused by a lesion or dysfunction of the caudate head?

Apathy

Which one of the following basal ganglia loops is involved in recognizing it is socially inappropriate to burp out loud in the middle of lecture?

Behavioral flexibility and control loop

Which of the following can be used to help prevent postural hypotension when reacclimating to the vertical position?

Both A and C A) An abdominal binder C) Elastic stockings

A patient recovering from stroke is beginning to demonstrate movement out of an obligatory synergy pattern. Based on this you would classify the patient as:

Brunnstrom stage 4.

According to the American Spinal Injury Association (ASIA) Impairment Scale, "motor function preserved below the neurological level, and the majority of key muscles (more than ½) below the neurological level have a muscle grade less than 3" is classified as:

C, Incomplete

Lacunar infarctions:

C. Produce small avascular cavities in the brain.

Which one of the following is an example of focal dystonia?

C. Spasmodic torticollis

Which of the following injuries result in a lower motor neuron injury?

Cauda equina injuries

Following SCI, spinal shock is characterized by:

D) All of the above A) Absence of all reflex activity below the level of lesion B) Loss of motor function below the level of lesion C) Loss of sensation below the level of lesion

Vertebral canal stenosis is associated with which one of the following?

D) All of the above A) Narrowing of the vertebral canal caused by bone growth or tissue hypertrophy B) Compression of neural and vascular structures of the spinal cord C) Radiating pain with numbness and loss of proprioception

Pressure relief can be performed by:

D) all of the above. A) wheelchair push-ups. B) leaning forward or laterally in the wheelchair. C) tilting back a tilt-in-space chair.

Occlusion of the middle cerebral artery and ischemia of the inferior parietofrontal lobes of the right hemisphere may result in which of the following?

D. All of the above A. Impaired nonverbal communication B. Apraxia C. Hemispatial and hemipersonal neglect

Which one of the following brain structures is part of the basal ganglia motor circuit?

D. All of the above A. Primary motor cortex and premotor cortical areas B. Putamen C. Thalamus

Postural instability in individuals with akinetic-rigid Parkinson's disease is caused by which of the following?

D. All of the above A. Rigidity of postural flexor and extensor musculature239 B. Disinhibition of the reticulospinal tracts C. Loss of pedunculopontine cells

MSA is characterized by which one of the following?

D. All of the above A. Akinetic-rigid syndrome B. Cerebellar signs C. Autonomic dysfunction

The basal ganglia are important for influencing motor movements but is also involved in other types of behavior. Which of the following additional loops involves the basal ganglia?

D. All of the above A. Oculomotor loop B. Executive loop C. Behavioral flexibility and control loop

Huntington's disease is characterized by which one of the following?

D. Both A and B A. Chorea B. Dementia

Which of the following stimulate vasoconstriction of the cerebral arteries?

D. Low carbon dioxide (CO2) concentrations

Regarding "CASE STUDY 3 Spinal Cord Injury: Locomotor Training," based on the ASIA examination data presented in Figure Box CS3.1, what is the patient's impairment classification?

D: Incomplete: Motor function is preserved below the neurological level, and at least half of key muscles below the neurological level have a muscle grade greater than or equal to 3.

Which of the following is a potential treatment option for individuals with Parkinson's disease?

D:All of the above A. L-3,4-dihydroxyphenylalanine (L-DOPA) B. Deep-brain stimulation C. Physical and occupational therapy

Which one of the following are distinctive signs of akinetic-rigid Parkinson's disease?

D:All of the above A. Hypokinesia B. Freezing during movement C. Resting tremor

Which of the following describes the motor control approach to regaining function subsequent to a stroke?

Desired task is practiced in the environment in which the client will be performing the task.

If a patient has lesions in the right parietotemporal cortex, which of the following symptoms are they likely to experience?

Difficulty understanding nonverbal communication

Loss of descending sympathetic control as a result of complete spinal cord lesions above T6 result in which of the following?

E)A, B, and, C A) Orthostatic hypotension B) Autonomic dysreflexia C) Poor thermoregulation

The parietotemporal association area is important for which of the following?

E. A, B, and C A. Solving a problem B. Comprehending communication C. Understanding spatial relationships

Autoregulation of cerebral blood flow occurs via which of the following mechanisms?

E. All of the above A. Blood pressure B. Metabolite concentration C. pH level D. A and C only

Vertebrobasilar artery ischemia is associated with:

E. All of the above A. Diplopia B. Ataxia C. Weakness D. Oropharyngeal dysfunction

Partial occlusion of the basilar artery may cause:

E. All of the above A. Tetraplegia. B. Loss of sensation. C. Coma. D. Cranial nerve signs.

Which of the following is (are) associated with the emergence of focal hand dystonia?

E: A, B, and C A. Excessive repetition or overuse B. Somatotopic degradation of somatosensory cortex C. Central impairment of proprioception

The functions of the dorsolateral prefrontal association cortex include which of the following?

E: All of the above A. Deciding on a goal B. Planning how to accomplish the goal C. Solving a problem D. A and B

For which condition might a callosotomy be beneficial?

Epilepsy

Which one of the following basal ganglia loops is involved in goal-directed behavior, planning, and choosing actions in context?

Executive loop

In the thoracic spinal cord, the first five thoracic cord segments roughly match first five thoracic vertebral levels.

False

On the ASIA, the motor level is the most caudal segment where the key muscle is a grade of 2 and the next most rostral key muscle tests as a 3.

False

T/F: Proprioception tested by laterally grasping the bony prominences of the extremity to reduce effects of sensory input from other ascending tracts of cord at all major joints of both UE & LE (shoulder, elbow, wrist, fingers, hips, knees, ankles, and toes) is a requirement on the ASIA.

False

Characteristics of urinary and bowel dysfunction whose prognosis for bowel control includes loss of spinal defecation reflex activity and LMN innervation and whose response to medications is less effective and nonresponsive to digital stimulation with manual removal of stool from rectum may being required, while whose prognosis for bladder control is intermittent catheterization secondary to inability to establish reflux voiding, describes a:

Flaccid Bladder, Flaccid Bowel

Reciprocal activation of a stepping pattern generator (SPG) is thought to be coordinated by signals conveyed in the:

Golgi tendon organs (GTOs).

What is Wernicke's aphasia?

Impairment of language comprehension

The return of motor control after treatment of focal dystonia is likely the result of which one of the following?

Improvement in the organization of somatosensory cortex

Your next patient has had right hemispheric and left hemiplegia damage. Which of the following behaviors might you expect to see exhibited by your patient?

Impulsivity

Regarding "CASE STUDY 3 Spinal Cord Injury: Locomotor Training," based on the ASIA examination data presented in Figure CS3.4, what is the patient's neurological level?

Incomplete SCI R L Sensory T4 T4 Motor T1 T1

Which of the following statements about Wernicke's area is correct?

It is important for reading and writing.

Which of the following are true with regard to homonymous hemianopsia?

It results in a loss of vision in the contralateral half of each visual field.

Dyskinesia is a side effect caused by prolonged use of which one of the following chemical agents for treatment of Parkinson's disease?

L-dopa

Usually only the cauda equina, which is less sensitive than the cord, is present and not the spinal cord itself, caudal to (below) what vertebral levels:

L1 or L2

Which of the following generally carries the most promising prognosis for recovery?

Lacunar infarction

Your SCI patient is complaining of symptoms which may be indicative of autonomic dysreflexia. In this case all of the following would be appropriate responses EXCEPT?

Lie the patient down immediately

Which one of the following basal ganglia loops motivates a pediatric patient to participate in therapy for stickers?

Limbic loop

Dysarthria is caused by a lesion of which of the following?

Lower motor neurons or corticobrainstem neurons

A patient has severe motor learning deficits. These deficits likely involve damage to which of the following areas?

Motor cortex, parietal cortex, and ventral striatum

Central cord syndrome is typically characterized by:

Motor deficits that are more severe than sensory deficits; UE involvement is greater than LE.

How does motor information from the basal ganglia reach spinal lower motor neurons?

Output to the thalamus and pedunculopontine nucleus (PPN), which synapse with cortical and brainstem motor neurons that project to the spinal lower motor neurons.

The lateral horn contains which of the following?

Preganglionic sympathetic cell bodies

Trunk and girdle muscles are controlled by descending signals from neurons in which of the following?

Premotor area

If a patient is unable to button a shirt despite intact sensation, motor control, and understanding of the task, where is the most likely location of a lesion?

Premotor or supplementary motor areas

Parkinson-plus syndromes are the collective name for primary neurodegenerative diseases that cause signs similar to Parkinson's disease and include which one of the following diseases?

Progressive supranuclear palsy

Categorizing sounds as language, music, or noise occurs in which of the following?

Secondary auditory cortex

Recognition of an unseen object by touch and manipulation occurs in which of the following?

Secondary sensory area

Where is pain processed?

Secondary sensory cortex

Which of the following characteristics have been associated with less successful rehabilitation outcomes in patients recovering from stroke?

Severe neglect, impaired cognition, severe motor impairments, advanced age

You are working with your CVA patient and note that she is now able to make some voluntary movement out of synergy pattern. You will document that she is currently in which Brunnstrom recovery stage?

Stage 4

Autonomic dysreflexia is often indicated by all of the following EXCEPT?

Sudden decrease in systolic blood pressure of 20-40 mmHg below baseline

Initiation of movement, orientation, and planning of bimanual or sequential movements are influenced by which of the following?

Supplementary motor area

Loss of pain and temperature sensation in a capelike distribution over the shoulders, lower limb paresis, hyperreflexia, and loss of bowel and bladder function are characteristic of which of the following?

Syringomyelia

Lumbar cord segments are situated at the:

T9 through T11 vertebral segments

Deep brain stimulation of which structure is safe and effective for reducing tremors in Parkinson's disease?

Thalamus

Regarding "CASE STUDY 3 Spinal Cord Injury: Locomotor Training," based on the American Spinal Injury Association (ASIA) examination data presented in Figure CS3.4, what is the patient's lower extremity (LE) motor score?

The patient's LE motor score is 16/50.

On the ASIA for SCIs, because the particular spinothalamic tract conveys both pain and temperature, it is not necessary to repeat using hot and cold stimuli after assessing between sharp and dull sensations.

True

T/F In the upper spinal cord, the first two cervical cord segments roughly match the first two cervical vertebral levels.

True

T/F: Sensory level on the ASIA is the most caudal consecutive neurological segment of normal (2) sharp/dull and light touch. This level may differ between right and left and may differ from the motor level.

True

T/F:Because each spinal segment innervates more than one muscle, the motor level is determined by testing key muscles along the myotomal distribution. Motor testing on the ASIA should occur in a rostral to caudal direction, starting with the head/neck and proceeding downward.

True

You have just received a referral for a patient with a SCI with a halo device. Halo devices are:

Typically used to immobilize cervical fractures; in general halo devices allow an earlier progression to upright activities and involvement in rehabilitation.

What is motor perseveration?

Uncontrollable repetition of a movement

The areas associated with impulse control, personality, and reactions to surroundings are located in which of the following?

Ventral and medial dorsal prefrontal association cortices

Early recognition of and treatment for ischemic stroke are critical because

a thrombolytic agent can be given within the first 3 hours to decrease the chance of death and disability.

The four cardinal signs of Parkinson's disease are:

bradykinesia, rigidity, tremor, postural instability

When sitting in their wheelchairs, patients with SCI should do pressure relief for 10 to 15 seconds:

every 10 minutes.

Alterations in tone are common following a stroke. Immediately following a stroke the patient will most commonly present with:

flaccidity and hyporeflexia.

The technique that is usually NOT appropriate to manage spasticity/decrease tone in patients recovering from stroke is:

muscle tapping.

L-dopa is the mainstay of symptomatic treatment for PD. One of its adverse side effects that physical therapists must be aware of when treating patients taking this drug is:

orthostatic hypotension.

Patients who exhibit lateropulsion / ipsilateral pushing (pusher syndrome):

push toward their hemiplegic side, resulting in safety concerns and increased falls.

A patient with a C7 complete SCI would most likely:

require a lightweight manual wheelchair for mobility.

When doing lateral transfers, a patient with a complete SCI at C6:

should be able to use the deltoid and pectoralis muscles to adduct the humerus and extend the elbow if the wrist and hand are fixed.

A therapist is teaching a community education class on the prevention and treatment of stroke. The participants are asked to identify the early warning signs of stroke or "brain attack." In addition to sudden numbness or weakness of the face, arm, or leg, especially on one side of the body, these early warning signs include:

sudden confusion, trouble speaking or understanding.

Two distinct clinical subgroups have been identified in patients with PD. These two groups are those whose dominant symptoms include:

tremor and postural instability/gait disturbances.

When treating a patient with mid- to low-level cervical injuries, a mat program:

would include rolling, prone on elbows, and supine on elbows because these are important positions for dressing and transitioning to sitting.