NCS Neuroanatomy and Pathophysiology

Question 1

true or false: practice following neurological injury results in only neuronal structure changes

Answer 1

false - there are also cellular level changes

Question 2

you are working in a neuro acute ICU. knowing the anatomy and pathophysiology of a stroke, why is it important to get a stroke patient TPA as soon as possible?

Answer 2

to minimize the damage/disconnection that could result in the penumbra or peri infarct zone

Question 3

why is hemmorhagic stroke associated with worse prognosis than ischemic

Answer 3

we do not have strategies to improve perfusion or minimize penumbra and it is associated with greater areas of affect

Question 4

true or false: TMS is only helpful when be used in addition to PT if the TMS excites the affected side

Answer 4

false - there are benefits with exciting the affected hemisphere AND with inhibiting the contralateral hemisphere

Question 5

a patient arrives to the neuro acute ICU s/p MVA resulting in a TBI. the patient is in a coma. this is likely due to what injury/damage to the brain
a. axonal shear
b. localize pressure
c. metabolic acidotoxicity
d. diffuse axonal injury

Answer 5

d. diffuse axonal injury

Question 6

a patient arrives to the hospital s/p MVA resulting in a TBI. the patient c/o of photo and phonophobia. this is likely due to what injury/damage to the brain
a. axonal shear
b. localize pressure
c. metabolic acidotoxicity
d. diffuse axonal injury

Answer 6

c. metabolic acidotoxicity

Question 7

a patient arrives to your OP clinic s/p MVA resulting in a TBI. following a stay in the ICU they are not demonstrating motor deficits but persistent post concussion symptoms. this is likely due to what injury/damage to the brain
a. axonal shear
b. localize pressure
c. metabolic acidotoxicity
d. diffuse axonal injury

Answer 7

a. axonal shear

Question 8

a patient arrives to your OP clinic s/p MVA resulting in a TBI. following a stay in the ICU they are not demonstrating motor deficits but impaired cognition and STM as well as reduced information processing and slowed reaction time. this is likely due to what injury/damage to the brain
a. axonal shear
b. localize pressure
c. metabolic acidotoxicity
d. diffuse axonal injury

Answer 8

a. axonal shear

Question 9

what are the mechanism associated with degenerative and demyelinating diseases such as MS, ALzheimers, PD, ALS, or HD

Answer 9

inflammation due to an immune response attacking the myelin, systemic inflammatory effects, metabolic changes and toxic accumulation of proteins

Question 10

which of the following protein accumulations is associated with PD
a. beta amyloid
b. alpha synuclein
c. SOD1
d. huntingtin

Answer 10

b. alpha synuclein

Question 11

which of the following protein accumulations is associated with ALS
a. beta amyloid
b. alpha synuclein
c. SOD1
d. huntingtin

Answer 11

c. SOD1

Question 12

which is the correct order of affects following BI:
a. injury, necrosis, axonal injury, apoptosis, demyelination, microgliosis, neuroregeneration
b. injury, demyelination, axonal injury, apoptosis, microgliosis, necrosis, neuroregeneration
c. injury, demyelination, axonal injury, apoptosis, necrosis, microgliosis, neuroregeneration

Answer 12

a. injury, necrosis, axonal injury, apoptosis, demyelination, microgliosis, neuroregeneration

Question 13

true or false: demyelination following BI occus at days to weeks from injury

Answer 13

true

Question 14

true or false: axonal injury following BI occus at days to weeks from injury

Answer 14

false - minutes to days

Question 15

true or false: necrosis following BI occus at days to weeks from injury

Answer 15

false - minutes to hours

Question 16

true or false: apoptosis following BI occus at days to weeks from injury

Answer 16

true - typically days

Question 17

true or false: neurogeneration following BI occus at days to weeks from injury

Answer 17

false - weeks to months

Question 18

what are the 5 cellular mechanism for neuro recovery

Answer 18

improved cell response
improved synaptic activity
axonal and dendritic sprouting
remyelination
neurogenesis

Question 19

what cell responses occur during recovery from neurologic injury

Answer 19

long term potentiation or depression where there is an increase or decrease in receptors

Question 20

you are working in an IRF facility and your newly admitted patient who suffered an SCI begins to show dramatic improvement. why is this occurring?
a. high intensity practice of IRF
b. neural shock resolution

Answer 20

b. neural shock resolution

Question 21

what is neural shock resolution

Answer 21

when the inflammation and edema in the NS begins to go down and allows signals to be transmitted

Question 22

what is diaschisis

Answer 22

when there is a lesion to a middle neuron resulting in retrograde and orthograde neuronal changes (pre and post)

Question 23

what synaptic changes occur during recovery from neurologic injury

Answer 23

synaptic hypereffectiveness where there is increased release of NT into the cleft
denervation supersensitivity where the post synaptic neuron becomes more sensitive to NT

Question 24

what axonal and dendritic changes occur during recovery from neurologic injury

Answer 24

unmasking (recruitment of silent synapses) where inactive connections become active after injury
homotypic collateral sprouting of the same fiber that was lost
heterotypic collateral sprouting of a different nerve type

Question 25

what is vicarious function

Answer 25

when the function of the damaged portion of the brain is taken over by an area not previously concerned with that function

Question 26

what is the different in homotypic and heterotypic collateral sprouting and how does it affect prognosis

Answer 26

homotypic is from the same type of fiber; this process takes a long time of weeks to a year and associated with good prognosis and recovery of function heterotypic is from a different nerve type and occurs quickly within days and is not associated with good prognosis

Question 27

you are working in the neuro acute ICU and are seeing a patient s/p TBI. you read in the chart, that they had a seizure yesterday. this is likely due to a. long term potentiation b. neural shock resolution c. denervation supersensitivity d. heterotypic collateral sprouting

Answer 27

d. heterotypic collateral sprouting

Question 28

you are working in the neuro acute ICU and are seeing a patient s/p TBI. at the start of the session, the patient require maxAx2 for bed mobility but at the end of the session they only require minA. this is likely due to a. long term potentiation b. fast cortical plasticity c. slow cortical plasticity d. heterotypic collateral sprouting

Answer 28

b. fast cortical plasticity occurring in minutes

Question 29

you are working at an IRF and are seeing a patient s/p TBI. at the start of rehab, the patient require maxAx2 for bed mobility but at the end of 2 weeks they only require minA. this is likely due to a. long term potentiation b. fast cortical plasticity c. slow cortical plasticity d. heterotypic collateral sprouting

Answer 29

c. slow cortical plasticity occurring over days to weeks demonstrating permanent change

Question 30

what are the respective NT for the sympathetic and parasympathetic nervous systems

Answer 30

NE and ACh

Question 31

what of the following is a glial cell of the PNS a. astrocyte b. ependymal cell c. microglia d. satellite cell

Answer 31

d. satellite cell

Question 32

true or false: glial cells sole purpose is to provide myelin and structure to the PNS and CNS

Answer 32

false - they also recycle NT, maintain extracellular ion balance, release gliotransmitters influencing the release of glutamate, produce CSF, and protect the brain from disease and illness

Question 33

what is the function of the astrocyte in the CNS? a. support cells forming the BBB, nutrition, recycle NT, maintain extracellular ion balance, release gliotrasmitters influencing the release of glutamate b. line the ventricles and produce CSF c. protect the brain from illness and disease d. create myelin

Answer 33

a. support cells forming the BBB, nutrition, recycle NT, maintain extracellular ion balance, release gliotrasmitters influencing the release of glutamate

Question 34

what is the function of the ependymal cell in the CNS? a. support cells forming the BBB, nutrition, recycle NT, maintain extracellular ion balance, release gliotrasmitters influencing the release of glutamate b. line the ventricles and produce CSF c. protect the brain from illness and disease d. create myelin

Answer 34

b. line ventricles and produce CSF

Question 35

what is the function of the microglia in the CNS? a. support cells forming the BBB, nutrition, recycle NT, maintain extracellular ion balance, release gliotrasmitters influencing the release of glutamate b. line the ventricles and produce CSF c. protect the brain from illness and disease d. create myelin

Answer 35

c. protect the brain from illness and disease

Question 36

true or false: electrical synapses are long junctions which permit current flow from pre to post synaptic neuron

Answer 36

false - electrical synapses rely on gap junctions which are extremely close together

Question 37

true or false: chemical synapses are small gaps which communicate via NT

Answer 37

false - chemical synapses are larger gaps

Question 38

what neurotransmitters are in charge of rapid communication between single neurons via excitatory or inhibitory AP

Answer 38

GABA (inhibition) and glutamate (excitation)

Question 39

what neurotransmitters are associated with neuromodulation or slow communication affecting a group of neurons

Answer 39

DA, 5HT, ACh, histamine

Question 40

the NT ACh is associated with which brain areas/bodily functions a. thalamus, pons, medulla, cerebellum b. pons, smooth muscle, cardiac muscle c. cortical regions, limbic lobe, amygdala d. midbrain and pons e. hypothalamus

Answer 40

a. thalamus, pons, medulla, cerebellum

Question 41

the NT NE is associated with which brain areas/bodily functions a. thalamus, pons, medulla, cerebellum b. pons, smooth muscle, cardiac muscle c. cortical regions, limbic lobe, amygdala d. midbrain and pons e. hypothalamus

Answer 41

b. pons, smooth muscle, cardiac muscle

Question 42

the NT DA is associated with which brain areas/bodily functions a. thalamus, pons, medulla, cerebellum b. pons, smooth muscle, cardiac muscle c. cortical regions, limbic lobe, amygdala d. midbrain and pons e. hypothalamus

Answer 42

cortical regions, limbic lobe, amygdala

Question 43

the NT 5HT is associated with which brain areas/bodily functions a. thalamus, pons, medulla, cerebellum b. pons, smooth muscle, cardiac muscle c. cortical regions, limbic lobe, amygdala d. midbrain and pons throughout CNS e. hypothalamus throughout CNS

Answer 43

d. midbrain and pons throughout CNS

Question 44

the NT histamine is associated with which brain areas/bodily functions a. thalamus, pons, medulla, cerebellum b. pons, smooth muscle, cardiac muscle c. cortical regions, limbic lobe, amygdala d. midbrain and pons throughout CNS e. hypothalamus throughout CNS

Answer 44

e. hypothalamus throughout CNS

Question 45

which 2 cranial nerves do NOT originate from the brainstem a. olfactory and optic b. vestibulocochlear and accessory c. trigeminal and facial

Answer 45

a. olfactory and optic accessory comes off the spinal cord but CN 8 comes from the brain stem

Question 46

true or false: the vermis controls trunk control and proximal limb movement

Answer 46

true

Question 47

true or false - the cerebellum has a roll in cognitive function such as sequencing inhibition and executive function

Answer 47

true

Question 48

impaired executive function, visuospatial impairment, behavioral changes, and language impairment are associated with which injury/brain area a. frontal lobe stroke b. parietal lobe stroke c. occipital lobe stroke d. cerebellar cognitive affective syndrome

Answer 48

d. CCAS cerebellar cognitive affective syndrome

Question 49

your patient presents with amnesia but their hippocampus and medial temporal lobe is fine. where is the lesion

Answer 49

B/L anteromedial thalamus

Question 50

huntingtons is associated with injury to which portions of the basal ganglia a. caudate b. putamen c. basal ganglia d. a and b

Answer 50

d. a and b

Question 51

true or false - the basal ganglia plays a roll in memory and executive function and behavior

Answer 51

true

Question 52

what are the four main functions if the limbic system

Answer 52

emotion, memory, olfaction, homeostasis

Question 53

which of the following is not a function of the limbic system a. emotion b. memory c. olfaction d. homeostasis e. none of the above

Answer 53

e. none of the above as they are all functions of the limbic system

Question 54

true or false: the hypothalamus influences release of hormones from the pituitary gland and influences memory as well as sleep-wake cycles

Answer 54

true

Question 55

a patient is being treated for anxiety and panic attacks but their medications are not effective and there are no triggers. there are no other motor Reponses. this patient could have

Answer 55

seizures of the amygdala

Question 56

true or false - temporal lobe is associated with consolidation of declarative memory

Answer 56

true

Question 57

true or false: the right hemisphere is associated with spatial awareness, complex visual and non language sound understanding, tactile recognition, spatial movement orientation 3D visualization and visual memory

Answer 57

true

Question 58

true or false: left hemisphere is associated with speech comprehension, reading writing and arithmetic, verbal memory

Answer 58

true

Question 59

what does the dorsal stream to the occipital lobe detect

Answer 59

motions; the "where"

Question 60

what does the ventral stream to the occipital lobe detect

Answer 60

the "what" is it that you are seeing

Question 61

prosopagnosia or the inability to ID faces results from injury to what lobe a. frontal b. parietal c. temporal d. occipital

Answer 61

d. occipital

Question 62

autopagnosis or the inability to ID own body parts and anosognosia or the unawareness of illness results from injury to what lobe a. frontal b. parietal c. temporal d. occipital

Answer 62

b. parietal

Question 63

balint syndrome or the inability to perceive more than one object at a time is a result of damage to pathways between which two lobes a. frontal and parietal b. parietal and temporal c. temporal and occipital d. occipital and parietal

Answer 63

d. occipital and parietal

Question 64

apraxia or the inability to carry out a skill despite absence of motor impairment results from damage to which lobe

Answer 64

parietal

Question 65

auditory processing is associated with which lobe

Answer 65

temporal