Neuro

Question 1

Frontal lobe lesions would result in what deficits?

Answer 1

Aphasia: Broca’s
Controls plan, programming, movements
Emotions, behavior control, personality
Olfaction

Question 2

Temporal lobe lesions would result in what deficits?

Answer 2

Aphasia: Wernicke’s
Hearing
Language comprehension

Question 3

Parietal lobe would result in what deficits?

Answer 3

Perceptual disorders: unilateral neglect
Sensory loss

Question 4

Occipital lobe would result in what deficits?

Answer 4

Visual loss

Question 5

Where do the cranial nerves approximately come out of?

Answer 5

CN 1 and 2 from cerebrum
CN 3 and 4 from midbrain
CN 5, 6, 7, 8 from pons
CN 9, 10, 11, and 12 from medulla

Question 6

What CNs are involved with the pupillary light reflex?

Answer 6

CN 2 (afferent)
CN 3 (efferent)

Question 7

Myopia vs presbyopia

Answer 7

Myopia: short-sighted
Presbyopia: far-sighted

Question 8

What is a normal pupillary response if you shine light into the R eye?

Answer 8

Both pupils should constrict. The R CN 2 takes in the light, sends a message to R and L CN 3 to constrict both pupils.

Question 9

What is affected if you shine light into the R eye and only the R eye pupil constricts?

Answer 9

L CN 3 is affected

Question 10

What is affected if you shine light into the R eye and only the L eye pupil constricts?

Answer 10

R CN 3 is affected

Question 11

What is affected if you shine light into the R eye and both eyes stay dilated?

Answer 11

R CN 2

Question 12

What is strabismus?

Answer 12

Resting position of the eye

Question 13

What is ptosis?

Answer 13

Drooping of the eyelid

Question 14

Which CN provides sensation for the face?

Answer 14

CN 5

Question 15

Which CN innervates majority of the facial muscles besides muscles of mastication and opening of the eye?

Answer 15

CN 7 innervates facial muscles
CN 5 innervates muscles of mastication
CN 3 innervates the muscles that lift the eye lid

Question 16

What CN are involved with the corneal reflex?

Answer 16

CN 5 afferent
CN 7 efferent

Question 17

What CN provides taste to the anterior 2/3rd of the tongue? What CN provides sensation to the anterior 2/3rd of the tongue? What CN provides sensation for the posterior 1/3 of the tongue? What CN provides taste for the posterior 1/3rd of the tongue?

Answer 17

Taste for anterior 2/3rd: CN 7
Sensation for anterior 2/3rd: CN 5
Taste and sensation for posterior 1/3rd: CN 9

Question 18

What CN helps to dampen sound vs which one amplifies it?

Answer 18

CN 5 and 7 dampen the sound
CN 8 amplify the sound

Question 19

What is the difference between conductive vs sensorineural hearing loss?

Answer 19

Conductive hearing loss involves the outer and middle ear structures.
Sensorineural hearing has to do with the inner ear (more commonly what is thought of with older people and hearing loss).

Question 20

What are the steps for determining if someone has conductive vs sensorineural hearing loss?

Answer 20

Step 1 is to perform Rinne’s test. This will tell you what type the person has.
Step 2 is to perform Weber’s test. This will tell you what side is affected.

Question 21

What is a normal response for the Rinne’s test?

Answer 21

Air conduction > bone conduction

Question 22

What is the response for the Rinne’s test if someone has sensorineural hearing loss?

Answer 22

Air conduction > bone conduction

Question 23

What is the response for the Rinne’s test if someone has conductive hearing loss?

Answer 23

Bone conduction > air conduction

Question 24

What is the difference in responses for the Weber’s test if someone has sensorineural hearing loss vs conductive hearing loss?

Answer 24

If conductive hearing loss, the patient should report that the sound is amplified on the affected side. If sensorineural hearing loss, the patient should report that the sound is amplified on the unaffected side.

Question 25

What CN are involved with the gag reflex?

Answer 25

CN 9 afferent CN 10 efferent

Question 26

What CN is involved with the resting position of the uvula? Which CN (L or R) would be affected if the uvula was pulled to the L when viewing it?

Answer 26

CN 10 It would be the R side affected

Question 27

What CN (number and side) is affected if the tongue deviates to the R when the patient protrudes their tongue?

Answer 27

R CN 12

Question 28

What are the cardinal symptoms of Parkinson's Disease?

Answer 28

Tremor (resting) Rigidity Akinesia Postural instability

Question 29

Are males or females more typically affected for Parkinson's Disease?

Answer 29

Males

Question 30

What is used to classify Parkinson's Disease?

Answer 30

Hoehn and Yahr

Question 31

What stage of Hoehn and Yahr will someone have bilateral involvement but no balance deficits?

Answer 31

2

Question 32

What stage of Hoehn and Yahr will someone require and assistive device for standing and walking?

Answer 32

4

Question 33

What stage of Hoehn and Yahr will someone have bilateral involvement with balance deficits, but can live independently and walk?

Answer 33

3

Question 34

What stage of Hoehn and Yahr will someone be confined to a bed or wheelchair?

Answer 34

5

Question 35

Besides the cardinal signs of Parkinson's Disease, what other s/s may be present?

Answer 35

Loss of smell Constipation Sleep disorders Orthostatic hypotension Restrictive lung disease Difficulty with dual tasking

Question 36

What is something that can be added or adjusted to a patients shoe if they have a festinating gait?

Answer 36

Add a toe wedge or declined heel to move COM posterior

Question 37

What exercises do we want to address posture in someone with Parkinson's Disease?

Answer 37

Rotation exercise and crossing midline Can also have them go into prone to help with thoracic kyphosis

Question 38

What medication is taken by patients with Parkinson's Disease? What is the On/Off phenomenon? When do you want the patient to take their medication in regard to treatment with you?

Answer 38

Levodopa/Carbidopa During the On-stage of the medication, the patient experiences dyskinesia. During the Off-stage of the medication (when it no longer works), the patient experiences dystonia. You want the patient to take their medication one hour before treatment with you.

Question 39

What is a dietary concern we want to be aware of in regard to patients who take Levodopa/Carbidopa?

Answer 39

High protein diet can block medication effectiveness

Question 40

What are the typical s/s of a patient with Multiple Sclerosis?

Answer 40

Lhermitte's Sign Uhthoff's phenomenon Charcot's triad Cranial nerve 2

Question 41

What is Charcot's triad?

Answer 41

Scanning speech, intention tremor, nystagmus

Question 42

How will a patient with MS react to the pupillary light reflex? What is it called?

Answer 42

A patient will respond with pupil dilation rather than constriction which is called Marcus Gunn Pupil

Question 43

What is the most common type of MS?

Answer 43

Relapsing remitting

Question 44

What MS type starts off as relapsing remitting and then goes into primary progressive?

Answer 44

Secondary progressive

Question 45

What type of neurons die with ALS?

Answer 45

Motor neurons

Question 46

Will sensation be affected with MS?

Answer 46

Yes, glove and stocking distribution

Question 47

Will sensation be affected with ALS?

Answer 47

No it will not be affected

Question 48

What are we concerned for a patients neck with ALS? What can we recommend for the patient?

Answer 48

They have weak cervical extensors, placing them in increased in neck flexion. We can recommend a soft neck collar.

Question 49

Which type of orthosis do we not want to recommend for patients with ALS who are looking to ambulate?

Answer 49

HKAFO because it requires a lot of energy

Question 50

Guillain-Barre Syndrome is typically precipitated by what?

Answer 50

An infection

Question 51

Does Guillain-Barre affect proximal to distal or distal to proximal?

Answer 51

Distal to proximal

Question 52

How will a patient with Guillain-Barre present when testing reflexes?

Answer 52

Decreased or absent

Question 53

What is one major concern we have for patients after Guillain-Barre?

Answer 53

Respiratory depression

Question 54

How long does recovery take for a patient with Guillain-Barre?

Answer 54

6-12 months

Question 55

What type of imaging would you want to use for seeing an acute brain hemorrhage?

Answer 55

CT scan

Question 56

What type of imaging would you want to use for seeing vascular occlusion or an infarct within a few hours post-stroke?

Answer 56

MRI

Question 57

What type of strokes are CT scans not helpful in observing?

Answer 57

Ischemic/small lesions because they are better at visualizing larger cortical lesions

Question 58

Within how many days post-stroke will an infarction show up on a CT scan?

Answer 58

3-5 days post-stroke

Question 59

If you wanted to detect cerebral edema shortly post-stroke, would you want to use a CT scan or MRI?

Answer 59

MRI because it allows visualization 30 minutes post-stoke and CT scan is within 3 days post-stroke

Question 60

Where is a Lumbar Puncture typically performed?

Answer 60

Spinal needle is inserted BELOW the level of L1-L2

Question 61

Are ischemic or hemorrhagic strokes more common?

Answer 61

Ischemic

Question 62

What are the risk factors for a CVA?

Answer 62

Atherosclerosis HTN Diabetes, metabolic disorder TIA Cardiac disease

Question 63

Irreversible anoxic damage to the brain begins after how long?

Answer 63

4-6 minutes!!

Question 64

Stages of Recovery Post-Stroke

Answer 64

1. Flaccidity 2. Increase in spasticity, hyperreflexia, synnergies emerge. 3. Voluntary movements but only within synergy; spasticity peaks. 4. Voluntary control in isolated joint movements due to decreased spasticity and synergy. 5. Increased voluntary control out of synergy. 6. Coordination and control of movements are almost normal.

Question 65

Difference in behaviors between a right vs left hemisphere stroke.

Answer 65

Left: slow, cautious, anxious. They understand their impairments and that frustrates them. Right: impulsive, quick, and indifferent. They have poor judgement and overestimate their abilities.

Question 66

Which outcome measure has the best evidence and ability to assess a post-stroke patient who has impaired sitting balance?

Answer 66

TIS

Question 67

Which stroke outcome measure is a self-report that evaluates biopsychosocial health and participation after stroke?

Answer 67

Stroke Impact Scale

Question 68

Which side hemispheric stroke will benefit more greatly from gestures with communication?

Answer 68

Left rather than the right because it may confuse a patient with a right hemispheric stroke due to visuospatial deficits

Question 69

What should you think about when trying to remember what UE spasticity looks like in a patient post-stroke?

Answer 69

The chicken dance

Question 70

What should you think about when trying to remember what LE spasticity looks like in a patient post-stroke?

Answer 70

Ballerina

Question 71

Difference between spasticity vs synergy post-stroke.

Answer 71

Spasticity occurs at rest vs synergy occurs with movement

Question 72

Autonomic dysreflexia occurs above what spinal level?

Answer 72

T6

Question 73

What do you not want to do with a patient who has heterotopic ossification?

Answer 73

Aggressive stretching

Question 74

What muscles do we need to keep tight for a patient with a SCI?

Answer 74

Finger flexors Lumbar extensors Hamstrings only 100-110

Question 75

Which level is MOST associated with gaining independence in many of the areas of living/activities?

Answer 75

C6

Question 76

What kind of control can someone with a C1-C3 SCI use for their WC?

Answer 76

Mouth control

Question 77

What kind of control can someone with a C4 SCI use for their WC?

Answer 77

Chin control

Question 78

What kind of control can someone with a C5 SCI use for their WC?

Answer 78

Joystick

Question 79

Which is the most caudal level that a SCI patient can drive a van with adaptive controls?

Answer 79

C5

Question 80

Transfers with a slide board require what to happen at the wrist?

Answer 80

Finger flexion or wrist in neutral

Question 81

Which SCI level requires assistance for a manual cough technique?

Answer 81

C5

Question 82

Which is the most cranial level for a SCI patient to use a manual WC with friction hand rims for community mobility?

Answer 82

C7

Question 83

Which is the most cranial level for a SCI patient to be an independent home ambulator?

Answer 83

T12-L3

Question 84

How often should a patient with a reflexive or flaccid bladder use an IC?

Answer 84

Every 3-6 hours

Question 85

Should a reflexive or flaccid bowel use suppositories and digital stimulation?

Answer 85

Reflexive

Question 86

Should a reflexive or flaccid bowel use manual evacuation techniques and the Valsalva maneuver to empty?

Answer 86

Flaccid

Question 87

Down-beating nystagmus or direction-changing gaze evoked nystagmus =

Answer 87

CNS dysfunction which is a red flag

Question 88

Do you want to increase duration or intensity first for a patient who fatigues easily?

Answer 88

Duration

Question 89

Generalized seizure is also known as what?

Answer 89

Grand mal

Question 90

Absence seizure is also known as what?

Answer 90

Petit mal

Question 91

What seizure involves posture being maintained, person repetitively blinks or has other small movements, and happens several times/day?

Answer 91

Absence

Question 92

Which seizure is involved with a loss of urine?

Answer 92

Generalized or grand mal

Question 93

What is status epilepticus?

Answer 93

Prolonged seizure or series of seizures (> 30 minutes) with no relief in between episodes. MEDICAL EMERGENCY!

Question 94

Partial or focal seizure can be classified as what two seizures?

Answer 94

Complex partial Temporal lobe seizure

Question 95

What electrolyte imbalance can increase the risk of seizures?

Answer 95

Hyponatremia, hypernatremia, hypoglycemia, hypomagnesmia