Quiz Questions Exam 2 Flashcards by candace gray

In the upper spinal cord, the first two cervical cord segments roughly match the first two cervical vertebral levels.
A) True
B) False

A) True

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In the thoracic spinal cord, the first five thoracic cord segments roughly match first five thoracic vertebral levels.
A) True
B) False

B) False

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Lumbar cord segments are situated at the:
A)   T3 through T8 vertebral segments
B)   T9 through T11 vertebral segments
C)   T12 through L2 vertebral segments
D)   L3 through S2 vertebral segments

B) T9 through T11 vertebral segments

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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:
A)  T11 or T12
B)   L1 or L2
C)   L4 or L5 
D)   S2 or S3

B) L1 or L2

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The lateral horn contains which of the following?
A) Preganglionic parasympathetic cell bodies
B) Preganglionic sympathetic cell bodies
C) Postganglionic parasympathetic cell bodies
D) Postganglionic sympathetic cell bodies

B) Preganglionic sympathetic cell bodies

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Reciprocal activation of a stepping pattern generator (SPG) is thought to be coordinated by signals conveyed in the:
A) DCML.
B) Golgi tendon organs
C) Posterior commissure of spinal cord.
D) Anterior commissure of spinal cord.
E) Ventral horn gamma motor neurons.

B) Golgi tendon organs

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Autonomic dysreflexia is characterized by which one of the following?
A) Abrupt decrease in blood pressure because of sympathetic vasoconstriction
B) Abrupt increase in blood pressure and pounding headache
C) Profuse sweating below the level of the lesion
D) Excessive activation of the parasympathetic nervous system
E) Excessive shivering associated with hyperthermia

B) Abrupt increase in blood pressure and pounding headache

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Loss of descending sympathetic control as a result of complete spinal cord lesions above T6 result in which of the following?
A) Orthostatic hypotension
B) Autonomic dysreflexia
C) Poor thermoregulation
D) Both A and B
E) A, B, and, C

E) A, B, and, C

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Vertebral canal stenosis is associated with which one of the following?
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
D) All of the above
E) None of the above

D) All of the above

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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?
A) Multiple sclerosis
B) Cervical spondylosis
C) Meningomyelocele
D) Syringomyelia
E) Erb’s paralysis

D) Syringomyelia

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Following an SCI, allowing some muscles to tighten/shorten may improve function. For example, in patients with tetraplegia:
A) Allowing tightness to develop in the long finger flexors will allow a tenodesis grip
B) Allowing tightness in the hip flexors to develop will help with sitting balance.
C) Allowing tightness in the ankle plantarflexors to develop will provide stability for transfers.
D) All of the above.

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

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Which of the following injuries result in a lower motor neuron injury? 
 A)  Cauda equina injuries
 B)  Posterior cord syndrome
 C)  Brown–Sequard syndrome
 D)  Incomplete spinal cord injuries

A) Cauda equina injuries

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Following SCI, spinal shock is characterized by:
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
D) All of the above

D) All of the above

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Autonomic dysreflexia is often indicated by all of the following EXCEPT?
A) Severe headache
B) Positive bulbocavernosus reflex (indicating reflexive bowel)
C) Sudden decrease in systolic blood pressure of 20-40 mmHg below baseline
D) Sweating and “goosebumps” above the level of injury
E) “Flushing” of skin due to vasodilation above the level of injury

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

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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?
A) Lie the patient down immediately
B) Check the patient’s catheter and if it is clamped, release it
C) Check for irritating stimuli such as tight clothing or abdominal binder and remove source of irritation
D) Seek medical attention if symptoms do not resolve

A) Lie the patient down immediately

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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: 
A)  Spastic Bladder, Spastic Bowel 
B)  Spastic Bladder, Flaccid Bowel
C)  Flaccid Bladder, Spastic Bowel
D)  Flaccid Bladder, Flaccid Bowel

D) Flaccid Bladder, Flaccid Bowel

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You have just received a referral for a patient with a SCI with a halo device. Halo devices are:
A) Typically used to immobilize cervical fractures; patients with halos are usually on bedrest for 3 to 4 weeks until the fracture begins to heal.
B) Typically used to immobilize thoracic fractures; patients with halos are usually on bedrest for 3 to 4 weeks until the fracture begins to heal.
C) Typically used to immobilize cervical fractures; in general halo devices allow an earlier progression to upright activities and involvement in rehabilitation.
D) Typically used to immobilize thoracic fractures: in general, halo devices allow an earlier progression to upright activities and involvement in rehabilitation

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

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Central cord syndrome is typically characterized by:
A) Loss of pain and temperature with no loss of proprioception; UEs and LEs affected equally.
B) Motor deficits that are more severe than sensory deficits; UE involvement is greater than LE.
C) Sensory deficits that are more severe than motor deficits; LE involvement is greater than UE.
D) Loss of proprioception with no loss of pain and temperature; UE and LE involvement is based on level of lesion.

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

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Which of the following can be used to help prevent postural hypotension when reacclimating to the vertical position?
A)  An abdominal binder
B)  A cervical collar
C)  Elastic stockings
D)  Both A and C

D) Both A and C

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When sitting in their wheelchairs, patients with SCI should do pressure relief for 10 to 15 seconds:
A)   every 10 minutes.
B)   every 20 minutes.
C)   every 1 to 2 hours.
D)   every 3 to 4 hours.

A) every 10 minutes.

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Pressure relief can be performed by:
A)  wheelchair push-ups.
B)   leaning forward or laterally in the wheelchair.
C)   tilting back a tilt-in-space chair.
D)   all of the above

D) all of the above

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When treating a patient with mid- to low-level cervical injuries, a mat program:
A) would include rolling, prone on elbows, and supine on elbows because these are important positions for dressing and transitioning to sitting.
B) would include rolling for dressing and pressure relief but would not include prone and supine on elbows positions because they are not functional.
C) should be initiated as soon as the patient is cleared for activity.
D) both A and C

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

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When doing lateral transfers, a patient with a complete SCI at C6:
A) will use the triceps to actively extend the elbow and lift.
B) will not be able to extend the elbow—transfers will be done with elbow flexion by pulling on a trapeze.
C) 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.
D) should be able to use the wrist extensors to substitute for triceps and extend the elbow if the wrist and hand are fixed.

C) 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.

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A patient with a C7 complete SCI would most likely:
A) require a power wheelchair for mobility.
B) require a lightweight manual wheelchair for mobility.
C) require a power wheelchair for community mobility but use a manual wheelchair for short distances.
D) require a lightweight manual wheelchair for community distances but ambulate for short distances.

B) require a lightweight manual wheelchair for mobility.

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``` 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: A) B, Complete B) A, Incomplete C) E, Normal D) C, Incomplete E) D, Incomplete ```

D) C, Incomplete

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. A) True B) False

A) True

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. A) True B) False

B) False

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. A) True B) False

A) True

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. A) True B) False

A) True

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. A) True B) False

B) False Muscle function grading is out of 5 not 2.

``` Recognition of an unseen object by touch and manipulation occurs in which of the following? A. Cerebellum B. Basal ganglia C. Primary somatosensory cortex D. Secondary sensory area E. Dorsolateral prefrontal association ```

D. Secondary sensory area

``` Categorizing sounds as language, music, or noise occurs in which of the following? A. Superior colliculus B. Secondary auditory cortex C. Secondary visual cortex D. Primary auditory cortex E. Cochlear nuclei ```

B. Secondary auditory cortex

Initiation of movement, orientation, and planning of bimanual or sequential movements are influenced by which of the following? A. Supplementary motor area B. Premotor area C. Broca’s area D. Area analogous to Broca’s area in the nondominant hemisphere E. Primary motor cortex

A. Supplementary motor area

Trunk and girdle muscles are controlled by descending signals from neurons in which of the following? A. Supplementary motor area B. Premotor area C. Broca’s area D. Area analogous to Broca’s area in the nondominant hemisphere E. Primary motor cortex

B. Premotor area

``` The parietotemporal association area is important for which of the following? A. Solving a problem B. Comprehending communication C. Understanding spatial relationships D. A and B E. A, B, and C ```

E. A, B, and C

The areas associated with impulse control, personality, and reactions to surroundings are located in which of the following? A. Precentral and postcentral gyri B. Dorsolateral prefrontal cortex C. Parietotemporal and dorsolateral prefrontal cortices D. Ventral and medial dorsal prefrontal association cortices E. Parietotemporal and cingulate cortices

D. Ventral and medial dorsal prefrontal association cortices

Which of the following structures are involved in the recognition, generation, and perception of emotion? A. Amygdala and mediodorsal thalamic nucleus B. Epithalamus and subthalamus C. Anterior insula and ventral striatum D. A and C E. All of the above

D. A and C

A patient has severe motor learning deficits. These deficits likely involve damage to which of the following areas? A. Motor cortex, cingulate cortex, and thalamus B. Parietal cortex, temporal cortex, and ventral striatum C. Motor cortex, parietal cortex, and ventral striatum D. Parietal cortex, cingulate cortex, and thalamus

C. Motor cortex, parietal cortex, and ventral striatum

Which of the following statements about Wernicke’s area is correct? A. It provides the instructions for speech output. B. It is important for reading and writing. C. It is contralateral to Broca’s area. D. Both A and B are true. E. All of the above are true.

B. It is important for reading and writing.

Dysarthria is caused by a lesion of which of the following? A. Broca’s area, usually in the left hemisphere B. Broca’s area, usually in the right hemisphere C. Wernicke’s area, Broca’s area, and the intervening cortical and subcortical structures D. Lower motor neurons or corticobrainstem neurons E. Neurons connecting Wernicke’s area with Broca’s area

D. Lower motor neurons or corticobrainstem neurons

``` Synonyms for Broca’s aphasia include which of the following? A. Motor aphasia B. Expressive aphasia C. Nonfluent aphasia D. A and B E. A, B, and C ```

E. A, B, and C

Which of the following describes the motor control approach to regaining function subsequent to a stroke? A. Therapist uses hands-on techniques to inhibit excessive muscle tone. B. Client is encouraged to use the nonparetic side to substitute for the paretic side. C. A rigid lower limb brace is provided to allow early ambulation. D. Desired task is practiced in the environment in which the client will be performing the task. E. Sequence of preparatory activities is perfected before the desired task is attempted.

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

``` For which condition might a callosotomy be beneficial? A. Epilepsy B. Parkinson’s disease C. Arthritis D. Dementia ```

A. Epilepsy

``` Which kind of disorder may be caused by a lesion or dysfunction of the caudate head? A. Movement disorders B. Apathy C. A and B D. None of the above ```

B. Apathy

What is motor preseveration? A. Acquisition of a new motor skill through repetition B. Inability of a person to perform a movement or sequence of movements despite intact sensation, normal muscle strength and coordination, and understanding of the task C. Uncontrollable repetition of a movement D. Impairment in the ability to draw and to arrange objects correctly in space

C. Uncontrollable repetition of a movement

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? A. Wernicke’s area B. Hippocampus, Wernicke’s area, or Broca’s area C. Secondary somatosensory cortex D. Premotor or supplementary motor areas

D. Premotor or supplementary motor areas

Which of the following items is an aspect of emotional lability? A. Abrupt mood shifts B. Lack of emotion C. Intentionally ignoring someone else’s emotions D. None of the above

A. Abrupt mood shifts

``` What is Wernicke's aphasia? A. Inability to use language in any form B. Use of unintended words or phrases C. Difficulty in expressing oneself using language D. Impairment of language comprehension ```

D. Impairment of language comprehension

If a patient has lesions in the right parietotemporal cortex, which of the following symptoms are they likely to experience? A. Disorders of language B. Difficulty understanding nonverbal communication C. None of the above D. A and B

B. Difficulty understanding nonverbal communication

``` Vertebrobasilar artery ischemia is associated with: A. Diplopia B. Ataxia C. Weakness D. Oropharyngeal dysfunction E. All of the above ```

E. All of the above

Lacunar infarctions: A. Are due to hemorrhage. B. Typically result in severe residual disability. C. Produce small avascular cavities in the brain. D. Are a form of TIAs. E. Occur most often in the anterior cerebral artery.

C. Produce small avascular cavities in the brain.

``` Partial occlusion of the basilar artery may cause: A. Tetraplegia. B. Loss of sensation. C. Coma. D. Cranial nerve signs. E. All of the above ```

E. All of the above

Acute cerebellar infarction typically produces which of the following? A. Dizziness and/or vertigo with a lack of balance B. Nausea and vomiting, dysarthria, and headache C. Receptive aphasia D. A and B E. A, B, and C

D. A and B

Which of the following stimulate vasoconstriction of the cerebral arteries? A. Low blood pressure B. Low pH levels (acidic) C. Low oxygen (O2) concentrations D. Low carbon dioxide (CO2) concentrations

D. Low carbon dioxide (CO2) concentrations

``` Occlusion of the middle cerebral artery and ischemia of the inferior parietofrontal lobes of the right hemisphere may result in which of the following? A. Impaired nonverbal communication B. Apraxia C. Hemispatial and hemipersonal neglect D. All of the above E. None of the above ```

D. All of the above

``` 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 B. Middle cerebral C. Posterior cerebral D. None of the above ```

A. Anterior cerebral

``` Which of the following generally carries the most promising prognosis for recovery? A. Thrombic infarction B. Lacunar infarction C. Basilar artery occlusion D. Subdural hematoma ```

B. Lacunar infarction

``` Autoregulation of cerebral blood flow occurs via which of the following mechanisms? A. Blood pressure B. Metabolite concentration C. pH level D. A and C only E. All of the above ```

E. All of the above

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: A. sudden confusion, trouble speaking or understanding. B. sudden increase in tone/spasticity on one side of the body. C. sudden loss of hearing out of one ear. D. sudden pain in the face, arm, or leg, especially on one side of the body.

A. sudden confusion, trouble speaking or understanding.

Early recognition of and treatment for ischemic stroke are critical because A. a thrombolytic agent can be given within the first 3 hours to decrease the chance of death and disability. B. physical therapy can be started within 48 hours to decrease the risk of disability. C. patients can be given antispasticity medications, which have been shown to prevent the development of abnormal tone. D. patients can receive early evaluation for surgical correction.

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

``` Your next patient has had right hemispheric damage and left hemiplegia. Which of the following behaviors might you expect to see exhibited by your patient? A. Hesitancy in trying a new task B. Impulsivity C. Difficulty with communication D. Some anxiety and need for reassurance ```

B. Impulsivity

``` 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? A. Stage 2 B. Stage 3 C. Stage 4 D. Stage 5 ```

C. Stage 4

Which of the following are true with regard to homonymous hemianopsia? A. It results in a loss of vision in the contralateral half of each visual field B. It occurs most commonly in patients with anterior cerebral artery strokes. C. It is commonly associated with nystagmus. D. It affects anterior and middle cerebral artery strokes equally.

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

``` 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: A. Brunnstrom stage 2. B. Brunnstrom stage 3. C. Brunnstrom stage 4. D. Brunnstrom stage 5. ```

C. Brunnstrom stage 4.

``` Alterations in tone are common following a stroke. Immediately following a stroke the patient will most commonly present with: A. flaccidity and hyporeflexia. B. rigidity and hyperreflexia. C. spasticity and hyperreflexia. D. athetosis with hyporeflexia ```

A. flaccidity and hyporeflexia.

Patients who exhibit lateropulsion / ipsilateral pushing (pusher syndrome): A. push posteriorly during all transfers and transitions, increasing risk of backward falls. B. push toward their uninvolved side, resulting in decreased use of the hemiplegic side. C. push toward their hemiplegic side, resulting in safety concerns and increased falls. D. push strongly into extension during all transfers, limiting functional independence.

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

``` The technique that is usually NOT appropriate to manage spasticity/decrease tone in patients recovering from stroke is: A. rhythmic rotation. B. deep pressure to the muscle tendon. C. slow rocking. D. muscle tapping. ```

D. muscle tapping.

The four cardinal signs of Parkinson's disease are: A. rigidity, sensory loss, akinesia, micrographia. B. bradykinesia, tremor, festinating gait, paresthesia C. rigidity, festinating gait, incontinence, sensory loss D. bradykinesia, rigidity, tremor, postural instability

D. bradykinesia, rigidity, tremor, postural instability

Two distinct clinical subgroups have been identified in patients with PD. These two groups are those whose dominant symptoms include: A. postural instability/gait disturbances and primary rigidity. B. primary rigidity and cognitive impairments. C. cognitive impairment and tremor. D. tremor and postural instability/gait disturbances.

D. tremor and postural instability/gait disturbances.

``` 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: A. sensory loss. B. blurred vision. C. orthostatic hypotension. D. muscle spasm and cramping. ```

C. orthostatic hypotension.

How does motor information from the basal ganglia reach spinal lower motor neurons? A. Neurons in the basal ganglia that have axonal connections directly to spinal lower motor neurons. B. Neural connections with the cerebellum. C. Output to the thalamus and pedunculopontine nucleus (PPN), which synapse with cortical and brainstem motor neurons that project to the spinal lower motor neurons. D. Direct connections from the striatum to lower motor neurons. E. Neurons from the subthalamic nucleus directly synapse with spinal lower motor neurons.

C. 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 cortico-basal ganglia-thalamus motor loop contributes to: A. Regulation of muscle force- B. Sequencing of movements- C. Regulation of muscle tone D. Selection and inhibition of specific motor synergies E. All of the above

E. All of the above

Dyskinesia is a side effect caused by prolonged use of which one of the following chemical agents for treatment of Parkinson’s disease? A. Acetylcholinesterase B. L-dopa C. Botulinum D. Baclofen E. Gamma-aminobutyric acid (GABA) agonists

B. L-dopa

``` Deep brain stimulation of which structure is safe and effective for reducing tremors in Parkinson’s disease? A. Putamen B. Caudate C. Thalamus D. Substantia nigra E. Red nucleus ```

C. Thalamus

Which of the following is (are) associated with the emergence of focal hand dystonia? A. Excessive repetition or overuse- B. Somatotopic degradation of somatosensory cortex- C. Central impairment of proprioception- D. Both A and B E. A, B, and C

E. A, B, and C

Which one of the following brain structures is part of the basal ganglia motor circuit? A. Primary motor cortex and premotor cortical areas B. Putamen C. Thalamus motor areas D. All of the above

D. All of the above

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

D. All of the above

Which one of the following basal ganglia loops is involved in goal-directed behavior, planning, and choosing actions in context? A. Motor loop B. Executive loop C. Behavioral flexibility and control loop D. Limbic loop

B. Executive loop

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? A. Motor loop B. Executive loop C. Behavioral flexibility and control loop D. Limbic loop

C. Behavioral flexibility and control loop

Which one of the following basal ganglia loops motivates a pediatric patient to participate in therapy for stickers? A. Motor loop B. Executive loop C. Behavioral flexibility and control loop D. Limbic loop

D. Limbic loop

``` Which one of the following are distinctive signs of akinetic-rigid Parkinson’s disease? A. Hypokinesia- B. Freezing during movement- C. Resting tremor- D. All of the above ```

D. All of the above

Postural instability in individuals with akinetic-rigid Parkinson’s disease is caused by which of the following? A. Rigidity of postural flexor and extensor musculature B. Disinhibition of the reticulospinal tracts C. Loss of pedunculopontine cells D. All of the above

D. All of the above

``` Which of the following is a potential treatment option for individuals with Parkinson’s disease? A. L-3,4-dihydroxyphenylalanine (L-DOPA) B. Deep-brain stimulation C. Physical and occupational therapy D. All of the above ```

D. All of the above

``` 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? A. Progressive supranuclear palsy B. Alzheimer disease C. Chronic traumatic encephalopathy D. Huntington’s disease ```

A. Progressive supranuclear palsy

``` MSA is characterized by which one of the following? A. Akinetic-rigid syndrome B. Cerebellar signs C. Autonomic dysfunction D. All of the above ```

D. All of the above

``` Huntington’s disease is characterized by which one of the following? A. Chorea B. Dementia C. Hypokinesia D. Both A and B ```

D. Both A and B

``` Which one of the following is an example of focal dystonia? A. Segawa’s dystonic B. Tourette’s disorder C. Spasmodic torticollis D. None of the above ```

C. Spasmodic torticollis

The return of motor control after treatment of focal dystonia is likely the result of which one of the following? A. Stretching of tight muscles B. Application of heat to relieve spasms C. Improvement in the organization of somatosensory cortex D. None of the above

C. Improvement in the organization of somatosensory cortex

Quiz Questions Exam 2 Flashcards

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