Review questions for Exam 1

Question 1

The pt presents with tongue atrophy & fasiculations. Upon tongue protrusion, the tongue deviates to the right. Your best estimation is that it is a: ________________ (UMN or LMN) lesion and that the lesion is on which side (left or right).

Answer 1

LMN lesion on the right

Question 2

The pt presents with spasciticy. Upon tongue protrusion, the tongue deviates to the right. Is the lesion UMN or LMN lesion? The lesion is on which side?

Answer 2

UMN lesion on the left

Question 3

The jaw hangs open at rest with little strength to resist closing. Describe lesion.

Answer 3

Bilateral V. Don’t know if it is UMN or LMN with this info

Question 4

The jaw deviates to the right side. With this information can you tell which is the side of weakness? Which is the side of lesion?

Answer 4

Yes – the side of weakness is the right side. But you can’t tell which is the side of lesion because you don’t know if it is UMN or LMN.

Question 5

There is a single UMN lesion on the right side that affects the Vth nerve. Will there be a significant effect on speech?

Answer 5

Jaw will deviate or be weaker on the left side. The effect on speech will be minimal.

Question 6

Are UMNs part of the CNS?

Answer 6

Yes

Question 7

Are LMNs part of the Final Common Pathway?

Answer 7

Yes

Question 8

Do LMNs originate in the cortex?

Answer 8

NO, they originate in brainstem and spinal cord.

Question 9

Do UMNs (including both DAP and IAP) terminate at the synapses either in the brain stem or spinal cord?

Answer 9

Yes

Question 10

A pt presents with a “flutter” in the cheeck area. What cranial nerve is implicated?

Answer 10

Facial Nerve (VII)

Question 11

In assessing AMRs, which sound/syllable will most likely be affected with VIIth nerve damage?

Answer 11

Puh

Question 12

With bilateral VIIth nerve lesions pts may have difficulty saying bilabials, what is the likely substitution?

Answer 12

lingual phonemes

Question 13

Which nerve innervates the stylopharyngeus muscles? What does this muscle do?

Answer 13

Glossopharyngeal NerveIXth, elevates pharynx for speech & swallowing

Question 14

Pt complains of pain going down back of throat. Which cranial nerve is implicated?

Answer 14

Glossopharyngeal nerve (IX)

Question 15

Pt presents with hypernasality. Which cranial nerve is implicated?

Answer 15

Primarily pharyngeal branch of Xth.

Question 16

Which intrinsic laryngeal muscle is the primary pitch changer? Which nerve innervates it?

Answer 16

Cricothyroid, Superior laryngeal branch of Xth.

Question 17

Which will have a more significant effect – a lesion on the recurrent laryngeal nerve or a lesion above the pharyngeal nerve?

Answer 17

Lesion on the recurrent laryngeal nerve.

Question 18

An axon that originates from a motor neuron on the part of the motor cortex that controls the jaw will descend through the corticobulbar tract to synapse with which cranial nerve?

Answer 18

Vth Trigeminal Nerve

Question 19

Which subsystems can dysarthria effect?

Answer 19

All systems.

• Articulation
• resonance
• prosody
• respiration
• phonation

Question 20

At which anatomic level (supratentorial, etc.) do cranial nerves III – XII originate?

Answer 20

Posterior fossae

Question 21

Which cells form myelin in CNS?

Answer 21

Oligdendroglia cells

Question 22

Name the structures that make up the basal ganglia?

Answer 22

a. Globus Pallidus
b. Striatum
i. Putamen
ii. Caudate Nucleus
c. Lentiform nucleus – composed of globus pallidus & putamen.

Question 23

5. Define Focal:

Answer 23

found in single area.

Question 24

Define multifocal:

Answer 24

found in more than one area.

Question 25

Define diffuse:

Answer 25

involve bilateral symmetric parts of nervous system, such as dementia, where there is generalized cerebral atrophy

Question 26

Define Upper Motor Neuron

Answer 26

- cell bodies in motor cortex and their descending axonal processes that synapse on cranial and spinal neurons. - Originate in cerebral cortex (upper brain levels)

Question 27

Define Lower Motor Neuron

Answer 27

motor nuclei through which central nervous system sends impulses to muscles (and glands) -Originate in brainstem or spinal cord

Question 28

Describe the innervation to the Trigeminal Nerve

Answer 28

BIlateral innervation Provides sensory information about face, jaw, lip and tongue Provides motor functions to jaw, muscles of mastication, tensor veli palatini, tensor tympani, mylohyoid (extrinsic laryngeal muscle involved in moving larynx)

Question 29

What are the lobes of the cerebellum?

Answer 29

anterior posterior flocculondular

Question 30

What is the midportion of the cerebellum called?

Answer 30

vermis

Question 31

The cortex is the ______ of the cerebrum.

Answer 31

outer layer (bark)

Question 32

Ridges in the cerebrum is ______.

Answer 32

gyri

Question 33

The valleys in the cerebrum are called _____.

Answer 33

sulci

Question 34

Bells palsy is a unilateral or bilateral lesion.

Answer 34

unilateral

Question 35

linguals usually substitute for what sounds?

Answer 35

bilabials

Question 36

If patient complains of pain going back of throat the CN affected is....

Answer 36

glossopharyngeal

Question 37

What are the speech tasks used to assess glossopharyngeal nerve

Answer 37

IX glossopharyngeal nerve cannot be assessed with speech tasks

Question 38

what is the function of the palatoglossus?

Answer 38

pull down the soft palate and raise the back of the tongue

Question 39

you want soft palate lower for ______ sounds

Answer 39

nasal

Question 40

why would you have dyplophonia

Answer 40

vocal folds vibrating at two different vibrations because one is paralyzed

Question 41

unilateral lesion of the pharyngeal branch would look like what in terms of soft palate symptoms

Answer 41

palate would be hanging low on one side

Question 42

Bilateral recurrent laryngeal nerve can cause what not voice related

Answer 42

stridor

Question 43

One function of CN XI (Accessory)

Answer 43

head and neck, and assist in elevating velum

Question 44

Unilateral lesion to hypoglossal nerve

Answer 44

deviates to weak side

Question 45

Another word for multiple cranial nerve damage?

Answer 45

bulbar palsy

Question 46

List of Duffys of characteristics that associate with flaccid dysarthria

Answer 46

``` hypernasality isolated articulatory impression nasal emission atrophy fasiculations ```